Campylobacter spp. Prevalence and Levels in Raw Milk: A Systematic Review and Meta-Analysis

Microbiological Analysis Conducted on Raw Milk Collected During Official Sampling in Liguria (North-West Italy) over a Ten-Year Period (2014-2023)

Milk has been consumed by humans for thousands of years for its nutritional properties. In recent years, raw milk demand has increased, valued for its authenticity and connection to local traditions. In Italy, the sale of raw milk is allowed exclusively through direct sale from the producing farm to the final consumer, either at the producing farm itself or through vending machines. However, the consumption of raw milk is not without risks. Among these, microbiological ones are relevant. These can lead to severe symptoms, particularly in vulnerable populations. For this reason, although consumers are advised to boil raw milk before consumption, producing farms in Italy are required to meet the microbiological criteria outlined in the Provision of 25 January 2007. In this retrospective study, the results of the analyses performed on 355 raw milk samples collected in Liguria between 2014 and 2023 for the detection of Campylobacter spp., Salmonella spp., Listeria monocytogenes, Staphylococcus aureus, and Escherichia coli O157 were analysed to better characterise the associated risk for consumers. The samples were collected during official controls by the local veterinary health services at vending machines of seven producing farms. Overall, six samples tested positive for C. jejuni, while only one sample tested positive for Salmonella enterica subsp. enterica, Serovar Veneziana. Listeria monocytogenes, S. aureus, and E. coli O157 were never responsible for non-compliances. Interestingly, three of the six samples positive for C. jejuni derived from the same producer. In farms where positive samples were detected, certain structural and/or operational non-compliances were identified. It can be concluded that, although the scenario in question does not present any cause for concern, it is nevertheless essential to implement a series of preventive measures in order to guarantee the safety of raw milk. These measures include the implementation of biosecurity practices, the maintenance of strict hygiene protocols during milking, and the adherence to the cold chain distribution protocol until the final stage of distribution.

Evaluation of methods for detection of Campylobacter in raw milk: A multi-country study

Raw milk is considered a high-risk source of Campylobacter due to faecal contamination from healthy cattle and farm environments, thus linking raw milk consumption to global outbreaks. Detection of Campylobacter in raw milk poses challenges due to low contamination levels and antibacterial properties of the milk. Culture-based protocols for Campylobacter detection in milk vary, mainly with regard to pH adjustment and the choice of enrichment broth. This European collaborative study was organised by the EU Reference Laboratory (EURL) for Campylobacter together with eight EU National Reference Laboratories (NRL) for Campylobacter with the purpose to evaluate methods for culture-based detection of Campylobacter in raw cow's milk. The study was divided into two parts, an interlaboratory part and an intralaboratory part, both organised around the same two protocols. The aim of protocol 1 was to evaluate the impact of pH adjustment and storage of the milk on the culturability of Campylobacter over time. Aliquots of the spiked milk were adjusted either to pH 7.0 or pH 7.6 or left unadjusted. The milk was stored up to 48 h at refrigerated temperature and Campylobacter was quantified according to ISO 10272-2 on day 0, 1 and 2. The aim of protocol 2 was to evaluate which enrichment broth, Bolton broth (BB) or Preston broth (PB), showed highest sensitivity in detection of Campylobacter. The spiked milk was enriched in BB and PB as described in ISO 10272-1:2017 or ISO 10272-1:2017/Amd1.2023. In the interlaboratory part, each milk batch was collected locally by each participating NRL/EURL and inoculated with the same Campylobacter strain. In the follow-up intralaboratory part, the EURL-Campylobacter repeated the tests in protocol 1 and 2 but used different Campylobacter strains and strains subjected to thermal stress prior to inoculation. The results show that pH adjustment of raw milk has a negligible impact on culture-based detection of Campylobacter, regardless of strain and level of environmental stress. The composition of milk and properties of the inoculated strain influence culture-based detection of Campylobacter over storage time, and strains subjected to additional stress prior to inoculation in milk are reduced in culturability much faster than the same strains prepared under normal conditions. Finally, the study showed that PB without Campylobacter growth supplement is less effective than BB in detecting Campylobacter in raw milk.

Persistence of microbiological hazards in food and feed production and processing environments

Listeria monocytogenes (in the meat, fish and seafood, dairy and fruit and vegetable sectors), Salmonella enterica (in the feed, meat, egg and low moisture food sectors) and Cronobacter sakazakii (in the low moisture food sector) were identified as the bacterial food safety hazards most relevant to public health that are associated with persistence in the food and feed processing environment (FFPE). There is a wide range of subtypes of these hazards involved in persistence in the FFPE. While some specific subtypes are more commonly reported as persistent, it is currently not possible to identify universal markers (i.e. genetic determinants) for this trait. Common risk factors for persistence in the FFPE are inadequate zoning and hygiene barriers; lack of hygienic design of equipment and machines; and inadequate cleaning and disinfection. A well-designed environmental sampling and testing programme is the most effective strategy to identify contamination sources and detect potentially persistent hazards. The establishment of hygienic barriers and measures within the food safety management system, during implementation of hazard analysis and critical control points, is key to prevent and/or control bacterial persistence in the FFPE. Once persistence is suspected in a plant, a 'seek-and-destroy' approach is frequently recommended, including intensified monitoring, the introduction of control measures and the continuation of the intensified monitoring. Successful actions triggered by persistence of L. monocytogenes are described, as well as interventions with direct bactericidal activity. These interventions could be efficient if properly validated, correctly applied and verified under industrial conditions. Perspectives are provided for performing a risk assessment for relevant combinations of hazard and food sector to assess the relative public health risk that can be associated with persistence, based on bottom-up and top-down approaches. Knowledge gaps related to bacterial food safety hazards associated with persistence in the FFPE and priorities for future research are provided.

Zoonotic risks of pathogens from dairy cattle and their milk-borne transmission

Dairy products are major sources of high-quality protein and bioavailable nutrients and dairy production contributes to local, regional and national-level economies. Consumption of raw milk and raw milk products does, however, carry a zoonotic risk, as does direct contact with cattle by farm husbandry staff and other employees. This review will mainly focus on the latter, and deal with it from the standpoint of a well-developed dairy industry, using the example of the Netherlands. With regard to dairy cattle, the main bacterial pathogens are Salmonella spp., Listeria monocytogenes and Leptospira hardjo as well as Brucella abortus and Chlamydia abortus. The main viral pathogens associated with dairy are Rift Valley fever virus, rabies virus, cowpox virus and vaccinia virus. The main parasitological infections are Echinococcus granulosis, Cryptosporidium parvum and Giardia duodenalis, however, the last mentioned have mainly swimming pools as sources of human infection. Finally ectoparasites such as lice and mites and Trichophyton verrucosum may affect employees. Some pathogens may cause health problems due to contamination. Bacterial pathogens of importance that may contaminate milk are Campylolobacter jejuni, Escherichia coli, Mycobacterium avium subsp. paratuberculosis, Leptospira hardjo and Salmonella typhimurium. Excretion of zoonotic viruses in milk is negligible in the Netherlands, and the endoparasite, Toxocara vitulorum is mainly found in suckling and fattening calves, whilst the risk in dairy cattle is limited. Excretion of transmissible spongiform encephalopathies (TSEs) or mycoses in milk are not expected and are, therefore, not of importance here.Being aware of the risks and working according to hygiene standards can substantially limit zoonotic risks for employees. Additionally, diseased employees are advised to limit their contact with cattle and to indicate that they work with cattle when consulting a physician. To prevent zoonotic risks through excretion of pathogens in milk, standard hygiene measures are necessary. Further, using only pasteurised milk for consumption and/or processing of milk can considerably limit the risks. If these measures are not possible, well-constructed monitoring can be followed. Monitoring programmes already exist for pathogens such as for Salmonella spp., Leptospira hardjo and Mycobacterium avium subsp. paratuberculosis. For others, like Campylobacter jejuni and E. coli, programmes are not available yet as far as we know.

Susceptibility of Campylobacter jejuni to Stressors in Agrifood Systems and Induction of a Viable-but-Nonculturable State

Many bacteria can become viable but nonculturable (VBNC) in response to stressors commonly identified in agrifood systems. Campylobacter is able to enter the VBNC state to evade unfavorable environmental conditions, but how food processing can induce Campylobacter jejuni to enter this state and the potential role of foods in inducing the VBNC state in C. jejuni remains largely unknown. In this study, the culturability and viability of C. jejuni cells were investigated under chlorine treatment (25 ppm), aerobic stress (atmospheric condition), and low-temperature (4°C) conditions that mimicked food processing. In addition, the behaviors of C. jejuni cells in ultrahigh-temperature (UHT) and pasteurized milk were also monitored during refrigerated storage. The numbers of viable and culturable C. jejuni cells in both the pure bacterial culture and food matrices were separately determined by propidium monoazide (PMA)-quantitative PCR (qPCR) and plating assay. The C. jejuni cells lost their culturability but partially retained their viability (1% to 10%) once mixed with chlorine. In comparison, ~10% of C. jejuni cells were induced to enter the VBNC state after 24 h and 20 days under aerobic and low-temperature conditions, respectively. The viability of the C. jejuni cells remained stable during the induction process in UHT (>10%) and pasteurized (>10%) milk. The number of culturable C. jejuni cells decreased quickly in pasteurized milk, but culturable cells could still be detected in the end (day 21). In contrast, the number of culturable C. jejuni cells slowly decreased, and they became undetectable after >42 days in UHT milk. The C. jejuni cells responded differently to various stress conditions and survived in high numbers in the VBNC state in agrifood systems. IMPORTANCE The VBNC state of pathogens can pose risks to food safety and public health because the pathogens cannot be detected using conventional microbiological culture-based methods but can resuscitate under favorable conditions to develop virulence. As a leading cause of human gastroenteritis worldwide, C. jejuni can enter the VBNC state to survive in the environment and food-processing chain with high prevalence. In this study, the effect of food-processing conditions and food products on the development of VBNC state in C. jejuni was investigated, providing a better understanding of the interaction between C. jejuni and the agroecosystem. The knowledge elicited from this study can aid in developing novel intervention strategies to reduce the food safety risks associated with this microbe.

Longitudinal Study for the Detection and Quantification of Campylobacter spp. in Dairy Cows during Milking and in the Dairy Farm Environment

Campylobacteriosis outbreaks have repeatedly been associated with the consumption of raw milk. This study aimed to explore the variation in the prevalence and concentration of Campylobacter spp. in cows' milk and feces, the farm environment and on the teat skin over an entire year at a small German dairy farm. Bi-weekly samples were collected from the environment (boot socks), teats, raw milk, milk filters, milking clusters and feces collected from the recta of dairy cows. Samples were analyzed for Campylobacter spp., E. coli, the total aerobic plate count and for Pseudomonas spp. The prevalence of Campylobacter spp. was found to be the highest in feces (77.1%), completely absent in milking equipment and low in raw milk (0.4%). The mean concentration of Campylobacter spp. was 2.43 log₁₀ colony-forming units (CFU)/g in feces and 1.26 log₁₀ CFU/teat swab. Only a single milk filter at the end of the milk pipeline and one individual cow's raw milk sample were positive on the same day, with a concentration of 2.74 log₁₀ CFU/filter and 2.37 log₁₀ CFU/mL for the raw milk. On the same day, nine teat swab samples tested positive for Campylobacter spp. This study highlights the persistence of Campylobacter spp. for at least one year in the intestine of individual cows and within the general farm environment and demonstrates that fecal cross-contamination of the teats can occur even when the contamination of raw milk is a rare event.

Milk-borne diseases through the lens of one health

Reviewing “zoonotic diseases” classically brings to mind human infections contracted in close association with animals, where outdoor occupations and afforested lands usually play a key role in the epidemiological triad. However, there is a very common, yet overlooked route of infection where humans may not come in direct contact with animals or implicated environments. Milk-borne diseases are a unique set of infections affecting all age groups and occupational categories of humans, causing 4% of all the foodborne diseases in the world. The infection reservoir may lie with milch animals and associated enzootic cycles, and the infectious agent is freely secreted into the animal’s milk. Commercial pooling and processing of milk create unique environmental challenges, where lapses in quality control could introduce infective agents during downstream processing and distribution. The infectious agent is finally brought to the doorstep of both rural and urban households through such animal products. The domestic hygiene of the household finally determines human infections. One health approach can target preventive measures like immunization in animals, pasteurization and stringent quality control during the commercial processing of milk, and finally, hygienic practices at the level of the consumer, to reduce the burden of milk-borne diseases. This review hopes to draw the attention of policymakers to this unique route of infection, because it can be easily regulated with cost-effective interventions, to ensure the safety of this precious food product, permeating the life and livelihood of humans from all walks of life.

Prevalence of Listeria monocytogenes, Salmonella spp., Shiga toxin-producing Escherichia coli, and Campylobacter spp. in raw milk in the United States between 2000 and 2019: A systematic review and meta-analysis

Raw (unpasteurized) milk is available for sale and direct human consumption within some states in the United States (US); it cannot be sold or distributed in interstate commerce. Raw milk may contain pathogenic microorganisms that, when consumed, may cause illness and sometimes may result in death. No comprehensive review for prevalence and levels of the major bacterial pathogens in raw milk in the US exists. The objective of the present research was to systematically review the scientific literature published from 2000 to 2019 to estimate the prevalence and levels of Listeria monocytogenes, Salmonella spp., Shiga toxin-producing Escherichia coli (STEC), and Campylobacter spp. in raw milk in the US. Peer-reviewed studies were retrieved systematically from PubMed®, Embase®, and Web of Science^TM. The unique complete nonduplicate references were uploaded into the Health Assessment Work Collaborative (HAWC). Based on the selection criteria, twenty studies were included in the systematic review and meta-analysis. Comprehensive Meta-Analysis (CMA) was used for statistical analyses, specifically, random effects meta-analyses were used to synthesize raw bulk tank milk (BTM) and milk filters (MF) data. Data from studies using culture and non-culture-based detection methods were included. Forest plots generated in CMA (Biostat, Englewood, NJ) were used to visualize the results. The average prevalence (event rate) of L. monocytogenes, Salmonella spp., STEC, and Campylobacter spp. in raw BTM in the US was estimated at 4.3% (95% confidence intervals [CIs], 2.8-6.5%), 3.6% (95% CIs, 2.0-6.2%), 4.3% (95% CIs, 2.4-7.4%), and 6.0% (95% CIs, 3.2-10.9%), respectively. Estimated prevalence was generally larger in MF than in BTM. There was not enough data to perform a meta-analysis for the prevalence or levels of pathogens in raw milk from retail establishments or other milk categories.

The Missing Pieces: The Role of Secretion Systems in Campylobacter jejuni Virulence

Campylobacter jejuni is likely the most common bacterial cause of gastroenteritis worldwide, responsible for millions of cases of inflammatory diarrhea characterized by severe abdominal cramps and blood in the stool. Further, C. jejuni infections are associated with post-infection sequelae in developed countries and malnutrition and growth-stunting in low- and middle-income countries. Despite the increasing prevalence of the disease, campylobacteriosis, and the recognition that this pathogen is a serious health threat, our understanding of C. jejuni pathogenesis remains incomplete. In this review, we focus on the Campylobacter secretion systems proposed to contribute to host-cell interactions and survival in the host. Moreover, we have applied a genomics approach to defining the structural and mechanistic features of C. jejuni type III, IV, and VI secretion systems. Special attention is focused on the flagellar type III secretion system and the prediction of putative effectors, given that the proteins exported via this system are essential for host cell invasion and the inflammatory response. We conclude that C. jejuni does not possess a type IV secretion system and relies on the type III and type VI secretion systems to establish a niche and potentiate disease.

Prevalence and antimicrobial resistance profiles of Campylobacter species in South Africa: a "One Health" approach using systematic review and meta-analysis

OBJECTIVES

This study investigated the prevalence and antibiotic resistance (AR) profiles of Campylobacter spp. isolated from animals, humans, and the environment in South Africa based on available published data.

METHODS

Original articles published from January 1, 1990 to January 1, 2021 were searched from PubMed, ScienceDirect, Google Scholar, Africa Index Medicus, Scopus, and African Journal Online databases. Data were analyzed with Comprehensive Meta-Analysis (version 3.0).

RESULTS

After screening, articles on animals (n = 25), humans (n = 7), environment (n = 3), animals/environment (n = 2), and a (n = 1) study on animals, humans, and the environment were included in this review. The pooled prevalence estimates (PPEs) were 28.8%, 16.4%, and 28.4% in animals, humans, and the environment, respectively. The Campylobacter jejuni and Campylobacter coli species were commonly isolated from humans, animals, and the environment in South Africa. The AR profiles were screened from 2032 Campylobacter spp., with the highest PPE of AR observed against clindamycin (76.9%) and clarithromycin (76.5%). Campylobacter isolates tested with the disk diffusion assay and minimum inhibitory concentration methods recorded an overall AR prevalence of 35.3% and 37.1%, respectively, whereas multidrug resistance PPE was 35.3%.

CONCLUSION

Regular surveillance of Campylobacter spp. prevalence and its antimicrobial resistance strains is recommended, as well as the formulation of a "One Health" approach for better management and control of Campylobacter spp. infection in South Africa.

Current methodologies and future direction of Campylobacter isolation and detection from food matrices, clinical samples, and the agricultural environment

Campylobacter spp. are the leading cause of bacterial foodborne infections in both developed and developing countries. The food commodities primarily attributed to campylobacteriosis include raw milk, poultry, seafood, and fresh produce. Furthermore, insects, animal/bird fecal material, and agricultural water have been shown to be the sources of Campylobacter contamination in these commodities. Both established and emerging species of Campylobacter have been recovered from food and environmental sources. Therefore, optimal detection and isolation of Campylobacter spp., including the emerging species, is critical for improved surveillance, prevention, and traceback of Campylobacter outbreaks. This review focuses on the existing variability in Campylobacter enrichment and isolation procedures used by researchers and regulatory agencies worldwide, for various matrices. Additionally, the challenges associated with developing and validating new culture, molecular, and immunological methods for rapid and sensitive Campylobacter detection are discussed.

Disease outbreaks linked to pasteurized and unpasteurized dairy products in Canada and the United States: a systematic review

OBJECTIVE

Pasteurization kills harmful microorganisms found in milk. While consumption of unpasteurized milk and its products is discouraged due to increased risk of infections, some individuals prefer unpasteurized dairy products. Our objective was to estimate the burden of illness from outbreaks arising from consumption of unpasteurized and pasteurized dairy products in Canada and the United States.

METHODS

We conducted a systematic review of dairy-associated outbreaks in Canada and the USA from 2007 onward. We searched MEDLINE, Embase, Cochrane Library, TRIP Database for guidelines, and North American government agency websites up to October 2020. We included outbreak reports where the pathogenic microbe was confirmed in both the patient and the dairy product through laboratory testing.

SYNTHESIS

Thirty-two disease outbreaks were linked to dairy consumption. Twenty outbreaks involving unpasteurized products resulted in 449 confirmed cases of illness, 124 hospitalizations, and five deaths. Twelve outbreaks involving pasteurized products resulted in 174 confirmed cases of illness, 134 hospitalizations, 17 deaths, and seven fetal losses. Listeria accounted for 10 out of 12 outbreaks from pasteurized products from 2007 through 2020.

CONCLUSION

Public warnings about the risk of unpasteurized dairy consumption need to continue and pregnant women and immunocompromised hosts need to be made aware of foods at high risk of contamination with Listeria.

Social Sustainability in Construction Projects—A Systematic Review of Assessment Indicators and Taxonomy

Despite its importance and appeal, the social dimension of sustainability in construction projects is less explored and lacks a comprehensive and standardized framework. This diminishes the holistic view of sustainability. The existing customized frameworks make the selection of factors challenging across different contexts. Eventually, the practitioners have to pick and choose the factors. This reduces the reliability of social sustainability assessments and makes them a procedural challenge. To fill this gap, the current review synthesizes a framework of social sustainability for construction projects. For this purpose, a systematic review of the literature published until 2021 is performed. The indicators are extracted from the selected 22 papers and their content is analyzed to check for similarities. The final set of 76 factors is synthesized into an assessment framework through a thematic analysis based on a bottom-up approach. The framework is organized into 7 enablers or themes, 27 indicators, and 76 sub-indicators. The enablers of social sustainability are stakeholder, safety and health, human resource development, project, industry, community, and government. The framework provides a comprehensive and precise view of social sustainability which can be leveraged to ensure better planning and sustainable development of construction projects.

S. M. Montenegro MC, Rodríguez-Díaz JM. Contaminants in the cow's milk we consume? Pasteurization and other technologies in the elimination of contaminants

Cow's milk is currently the most consumed product worldwide. However, due to various direct and indirect contamination sources, different chemical and microbiological contaminants have been found in cow's milk. This review details the main contaminants found in cow's milk, referring to the sources of contamination and their impact on human health. A comparative approach highlights the poor efficacy and effects of the pasteurization process with other methods used in the treatment of cow's milk. Despite pasteurization and related techniques being the most widely applied to date, they have not demonstrated efficacy in eliminating contaminants. New technologies have appeared as alternative treatments to pasteurization. However, in addition to causing physicochemical changes in the raw material, their efficacy is not total in eliminating chemical contaminants, suggesting the need for new research to find a solution that contributes to improving food safety.

Prevalence and antimicrobial profiling of Campylobacter spp. isolated from meats, animal, and human feces in Northern of Morocco

The present work was carried out to understand the occurrence and antimicrobial susceptibility of Campylobacter spp., in various samples in Northern of Morocco. For this purpose, a random sampling was undertaken from butcher shops, traditional markets, and slaughterhouse. First, the research of Campylobacter was performed according to the Moroccan standard NM ISO: 10272-1 (2008). Second, the isolates were identified by biochemical tests and real time PCR. After the biochemical and molecular identification of suspected colonies, a disk diffusion method was executed to determine the sensitivity of Campylobacter spp. against 18 antibiotics. The results showed a moderate prevalence of Campylobacter species (130/466) recovered mainly on the Campylobacter blood base agar, where C. coli (108/130) were more prevalent comparable to C. jejuni (22/130) in poultry and cattle meat, raw milk, cloacal and surface swabs, and stool of patient suffering from diarrhea. The findings supported also the sensitivity of multiplex qPCR to detect Campylobacter strains compared to Moroccan standard NM ISO: 10272-1 (2008). Among our isolates, C. jejuni were the most susceptible strain toward colistin, florfenicol, gentamicin, streptomycin, and erythromycin. Nonetheless, the presence of multidrug Campylobacter resistant strains was highly observed in C. jejuni isolated, particularly, from broiler chickens toward the antibiotic classes of cephalosporin, penicillin, monobactam, quinolone, fluoroquinolone, sulfamide, as well as tetracycline. This may be due to common use of these drugs in veterinary medicine and farms as growth factor, which limits the usefulness of these molecules. Hence, the study highlights the importance of resistance profile monitoring of these pathogens in Northern of Morocco, in order to develop appropriate control measures and to reduce the emergence of multidrug-resistant strains.

The Data Behind Risk Analysis of Campylobacter Jejuni and Campylobacter Coli Infections

Campylobacter jejuni and Campylobacter coli are major causes of food-borne enteritis in humans. Poultry meat is known to be responsible for a large proportion of cases of human campylobacteriosis. However, other food-borne, environmental and animal sources are frequently associated with the disease in humans as well. Human campylobacteriosis causes gastroenteritis that in most cases is self-limiting. Nevertheless, the burden of the disease is relatively large compared with other food-borne diseases, which is mostly due to rare but long-lasting symptoms related to immunological sequelae. In order to pave the way to improved surveillance and control of human campylobacteriosis, we review here the data that is typically used for risk analysis to quantify the risk and disease burden, identify specific surveillance strategies and assist in choosing the most effective control strategies. Such data are mostly collected from the literature, and their nature is discussed here, for each of the three processes that are essential for a complete risk analysis procedure: risk assessment, risk management and risk communication. Of these, the first, risk assessment, is most dependent on data, and this process is subdivided into the steps of hazard identification, hazard characterization, exposure assessment and risk characterization. For each of these steps of risk assessment, information from published material that is typically collected will be summarized here. In addition, surveillance data are highly valuable for risk assessments. Different surveillance systems are employed in different countries, which can make international comparison of data challenging. Risk analysis typically results in targeted control strategies, and these again differ between countries. The applied control strategies are as yet not sufficient to eradicate human campylobacteriosis. The surveillance tools of Campylobacter in humans and exposure sources in place in different countries are briefly reviewed to better understand the Campylobacter dynamics and guide control strategies. Finally, the available control measures on different risk factors and exposure sources are presented.

Evaluation of culture-based and molecular detection methods for Campylobacter in New Zealand raw cows' milk

AIMS

This study evaluated the performance of a commercial molecular detection method (mericon Campylobacter triple kit real-time/quantitative (q)PCR) and a selective plating medium (R&F Campylobacter jejuni/Campylobacter coli Chromogenic Plating Medium (CCPM)) against a culture-based reference method (ISO 10272-1:2017 detection procedure B) for the detection of Campylobacter from raw milk enrichment broths.

METHODS AND RESULTS

New Zealand raw cows' milk and Ultra-High Temperature-processed milk samples were inoculated with 50, 125 and 500 colony forming units of C. jejuni and C. coli cocktail per analytical unit. Samples were tested for Campylobacter after 0, 24- and 48 h refrigeration. ISO 10272-1:2017 proved to be a sensitive detection method (77/80 positive samples); detection only failed for some milk samples tested 48 h postinoculation. CCPM was as effective as Cefoperazone Charcoal Deoxycholate Agar for selective plating of Campylobacter raw milk enrichments (78/80 positive samples). However, the qPCR detected Campylobacter in only 42/80 samples and qPCR reaction inhibition was observed.

CONCLUSIONS

The ISO 10272-1:2017 method was a more sensitive method for Campylobacter detection from raw milk than the mericon Campylobacter triple kit qPCR, and CCPM was a useful complementary medium to mCCDA where one of these media is required by the standard.

SIGNIFICANCE AND IMPACT OF THE STUDY

In regions where testing is required or recommended, optimized methods for Campylobacter detection from raw milk will reduce risk to the raw milk consumer. Although molecular methods are generally touted as a rapid alternative to culture, issues with inhibition due to matrix components mean that culture-based methods might provide the most sensitive option for Campylobacter detection in raw milk. Findings also emphasize the importance of minimizing the time between milk collection and testing for Campylobacter.

Zoonotic risks of pathogens from sheep and their milk borne transmission

Sheep were domesticated around 9000 BC in the Middle East, and since then milk from sheep gradually became very popular, not only for drinking but also for making cheeses and other dairy products. Nowadays, these dairy products are also important for people with an allergy to cow milk, and these products are an essential part of the local daily diet in regions of the world that are not suitable for cows and goats. Consumption of raw milk and raw milk products has a zoonotic risk, and with regard to sheep, the main pathogens associated with such dairy products are: Brucella melitensis, Campylobacter spp., Listeria spp., Salmonella spp., Shiga-toxin producing Escherichia coli, Staphylococcus aureus, tick borne encephalitis virus, and Toxoplasma gondii. Especially, young children, elderly people, pregnant women and immunocompromised (YOPI) persons, and those suffering from disease should be aware of the risk of consuming raw milk and raw milk products. This latter risk can be reduced by proper flock health management, prevention of contamination during milking, adequate milk processing, transport, and refrigerated storage. Only processes equaling pasteurization sufficiently reduce zoonotic risks from milk and milk products, but proper cooling is essential and recontamination must be prevented. Therefore, strict hygiene practices throughout the production process and supply chain especially for raw milk and raw dairy products, should be applied. Small scale production systems pose a greater risk compared to industrialized production systems because of a less protocolized and controlled production process. This manuscript describes zoonotic risks of pathogens from sheep and their milk borne transmission. Additionally, routes of contamination, possibilities for multiplication, and prevention measures thereof are described. We summarize some major human outbreaks caused by consumption of sheep milk and products made thereof, and finally discuss their implications.

Occurrence, Virulence and Antimicrobial Resistance-Associated Markers in Campylobacter Species Isolated from Retail Fresh Milk and Water Samples in Two District Municipalities in the Eastern Cape Province, South Africa

Campylobacter species are among the major bacteria implicated in human gastrointestinal infections and are majorly found in faeces of domestic animals, sewage discharges and agricultural runoff. These pathogens have been implicated in diseases outbreaks through consumption of contaminated milk and water in some parts of the globe and reports on this is very scanty in the Eastern Cape Province. Hence, this study evaluated the occurrence as well as virulence and antimicrobial-associated makers of Campylobacter species recovered from milk and water samples. A total of 56 water samples and 72 raw milk samples were collected and the samples were processed for enrichment in Bolton broth and incubated for 48 h in 10% CO2 at 42 °C under microaerobic condition. Thereafter, the enriched cultures were further processed and purified. After which, presumptive Campylobacter colonies were isolated and later confirmed by PCR using specific primers for the detection of the genus Campylobacter, target species and virulence associated genes. Antimicrobial resistance profiles of the isolates were determined by disk diffusion method against a panel of 12 antibiotics and relevant genotypic resistance genes were assessed by PCR assay. A total of 438 presumptive Campylobacter isolates were obtained; from which, 162 were identified as belonging to the genus Campylobacter of which 36.92% were obtained from water samples and 37.11% from milk samples. The 162 confirmed isolates were further delineated into four species, of which, 7.41%, 27.16% and 8.64% were identified as C. fetus, C. jejuni and C. coli respectively. Among the virulence genes screened for, the iam (32.88%) was most prevalent, followed by flgR (26.87%) gene and cdtB and cadF (5.71% each) genes. Of the 12 antibiotics tested, the highest phenotypic resistance displayed by Campylobacter isolates was against clindamycin (95.68%), while the lowest was observed against imipenem (21.47%). Other high phenotypic resistance displayed by the isolates were against erythromycin (95.06%), followed by ceftriaxone (93.21%), doxycycline (87.65%), azithromycin and ampicillin (87.04% each), tetracycline (83.33%), chloramphenicol (78.27%), ciprofloxacin (77.78%), levofloxacin (59.88%) and gentamicin (56.17%). Relevant resistance genes were assessed in the isolates that showed high phenotypic resistance, and the highest resistance gene harbored by the isolates was catII (95%) gene while VIM, KPC, Ges, bla-OXA-48-like, tetC, tetD, tetK, IMI and catI genes were not detected. The occurrence of this pathogen and the detection of virulence and antimicrobial resistance-associated genes in Campylobacter isolates recovered from milk/water samples position them a risk to human health.

Complementary Use of Cultivation and High-Throughput Amplicon Sequencing Reveals High Biodiversity Within Raw Milk Microbiota

Raw milk microbiota are complex communities with a significant impact on the hygienic, sensory and technological quality of milk products. However, there is a lack of knowledge on factors determining their composition. In the present study, four bulk tank milk samples of two farms at two different time points were analyzed in detail for their microbiota using cultivation and 16S rRNA amplicon sequencing. Diversity in samples from the first time point was assessed via cultivation of 500 aerobic mesophilic bacterial isolates in each sample. A high biodiversity of 70 and 110 species per sample was determined, of which 25–28% corresponded to yet unknown taxa. The isolates were dominated by Gram-positive members of the genera Staphylococcus, Corynebacterium, Streptococcus, or Janibacter, whilst Chryseobacterium and Acinetobacter were most abundant among the Gram-negative taxa. At the second time point, samples of the same farms were analyzed via both cultivation (1,500 individual colonies each) and high-throughput 16S rRNA gene amplicon sequencing. The latter revealed a threefold higher biodiversity at the genus level, as anaerobic or fastidious species were also detected. However, cultivation identified genera not captured by sequencing, indicating that both approaches are complementary. Using amplicon sequencing, the relative abundance of a few genera was distorted, which seems to be an artifact of sample preparation. Therefore, attention needs to be paid to the library preparation procedure with special emphasis on cell lysis and PCR.

Salmonella spp. and Escherichia coli O157:H7 prevalence and levels on lettuce: A systematic review and meta-analysis

Lettuce (Lactuca sativa), one of the most consumed leafy vegetables in the world, is frequently implicated with foodborne disease (FBD) outbreaks, with Salmonella spp. and Escherichia coli O157:H7 being the most common bacteria to cause this illness. Estimates of prevalence and levels of these pathogens on lettuce are scarce in developed or in developing countries, which hinders risk assessment attempts. In here, we present a systematic review and meta-analysis of reported prevalence and levels of Salmonella spp. and E. coli O157:H7 on lettuce using the worldwide available data. Literature was reviewed and examined the results for inclusion of articles in the meta-analysis. Data (prevalence and/or concentration of Salmonella spp. and E. coli O157:H7 on lettuce, sample characteristic, country of origin, and Salmonella identified serovars) were extracted, and meta-analysis was performed using Open Meta-Analyst, Task Order # 2 software. Although only one work reported the presence of E coli O157:H7 on lettuce, several reports indicated the presence of other, distinct enterohemorrhagic E. coli (EHEC) strains, with a mean prevalence of 0.041 (95% CI: 0.005-0.078) and concentration varying from <3.0 MPN/g to >1100 MPN/g. Furthermore, the mean prevalence of Salmonella spp. on lettuce was 0.041 (95% CI: 0.030-0.052), with reported concentrations varying between 0.054 ± 0.058 CFU/g to 218.78 MPN/g. In addition, subgroup analysis of the presence of Salmonella spp. in lettuce revealed a mean prevalence of the bacteria of 0.028 (95% CI: 0.014-0.042) in developed nations and 0.064 (0.041-0.087) in developing nations, with reports varying from 0.001 in Japan to 0.5 in Burkina Faso. Despite a relatively low prevalence, consumption of lettuce is inherently risky because it usually is eaten raw, without thermal treatment to inactivate pathogens. This potential risk further supports performance of quantitative risk assessments to quantify the probability of FBD caused by Salmonella spp. and E. coli O157:H7 transmitted to lettuce.

Longitudinal Study of Shiga Toxin-Producing Escherichia coli and Campylobacter jejuni on Finnish Dairy Farms and in Raw Milk

Shiga toxin-producing Escherichia coli (STEC) and Campylobacter jejuni are notable health hazards associated with the consumption of raw milk. These bacteria may colonize the intestines of asymptomatic cattle and enter bulk tank milk via fecal contamination during milking. We studied the frequency of STEC O157:H7 and C. jejuni contamination in tank milk (n = 785) and the in-line milk filters of milking machines (n = 631) versus the frequency of isolation from cattle feces (n = 257) on three Finnish dairy farms for 1 year. Despite simultaneous isolation of STEC O157:H7 (17%) or C. jejuni (53%) from cattle, these bacteria were rarely isolated from milk filters (2% or <1%, respectively) and milk (0%). As revealed by phylogenomics, one STEC O157:H7 strain at a time was detected on each farm and persisted for ≤12 months despite rigorous hygienic measures. C. jejuni strains of a generalist sequence type (ST-883 and ST-1080) persisted in the herds for ≥11 months, and several other C. jejuni types were detected sporadically. The stx gene carried by STEC was detected more frequently from milk filters (37%) than from milk (7%), suggesting that milk filters are more suitable sampling targets for monitoring than milk. A questionnaire of on-farm practices suggested lower stx contamination of milk when major cleansing in the barn, culling, or pasturing of dairy cows was applied, while a higher average outdoor temperature was associated with higher stx contamination. Because pathogen contamination occurred despite good hygiene and because pathogen detection from milk and milk filters proved challenging, we recommend heat treatment for raw milk before consumption.IMPORTANCE The increased popularity of raw milk consumption has created demand for relaxing legislation, despite the risk of contamination by pathogenic bacteria, notably STEC and C. jejuni However, the epidemiology of these milk-borne pathogens on the herd level is still poorly understood, and data are lacking on the frequency of milk contamination on farms with cattle shedding these bacteria in their feces. This study suggests (i) that STEC contamination in milk can be reduced, but not prevented, by on-farm hygienic measures while fecal shedding is observable, (ii) that milk filters are more suitable sampling targets for monitoring than milk although pathogen detection from both sample matrices may be challenging, and (iii) that STEC and C. jejuni genotypes may persist in cattle herds for several months. The results can be utilized in developing and targeting pathogen monitoring and risk management on the farm level and contributed to the revision of Finnish legislation in 2017.

The prevalence of Campylobacter spp. in vegetables, fruits, and fresh produce: a systematic review and meta-analysis

There are a number of reports indicating correlation between outbreaks of campylobacteriosis and the consumption of raw vegetables. This study is a meta-analysis on the prevalence of Campylobacter in fresh vegetables and fruits without any location limitation, which was performed through a documented review of the available resources. Relevant literature was reviewed by trained reviewers, who examined the results for the inclusion of articles in the meta-analysis. The prevalence of Campylobacter in raw vegetables, the sample source, the Campylobacter species, and the method of detection were extracted. The prevalence of Campylobacter in vegetables, fruits, and fresh produce were estimated to be 0.53%. Analysis of the various sample groups initially showed that the bean and sprouts group was the vegetable with the highest prevalence of Campylobacter (11.08%). The rate of contamination was higher when both the molecular and conventional methods were employed. The highest prevalence of Campylobacter was found in Asia (33.4%). Despite the low prevalence, consumption of raw vegetables is inherently risky because no treatment is used to inactivate the pathogens. Therefore, proper sanitation methods are recommended to treat the raw products.

Salmonella and Campylobacter biofilm formation: a comparative assessment from farm to fork

It takes several steps to bring food from the farm to the fork (dining table), and contamination with food-borne pathogens can occur at any point in the process. Campylobacter spp. and Salmonella spp. are the main microorganisms responsible for foodborne disease in the EU. These two pathogens are able to persist throughout the food supply chain thanks to their ability to form biofilms. Owing to the high prevalence of Salmonella and especially of Campylobacter in the food supply chain and the huge efforts of food authorities to reduce these levels, it is of great importance to fully understand their mechanisms of persistence. Diverse studies have evaluated the biofilm-forming capacity of foodborne pathogens isolated at different steps of food production. Nonetheless, the principal obstacle of these studies is to reproduce the real conditions that microorganisms encounter in the food supply chain. While there are a wide number of Salmonella biofilm studies, information on Campylobacter biofilms is still limited. A comparison between the two microorganisms could help to develop new research in the field of Campylobacter biofilms. Therefore, this review evaluates relevant work in the field of Salmonella and Campylobacter biofilms and the applicability of the data obtained from these studies to real working conditions. © 2018 Society of Chemical Industry.

Bacteriophages in the Dairy Environment: From Enemies to Allies

The history of dairy farming goes back thousands of years, evolving from a traditional small-scale production to the industrialized manufacturing of fermented dairy products. Commercialization of milk and its derived products has been very important not only as a source of nourishment but also as an economic resource. However, the dairy industry has encountered several problems that have to be overcome to ensure the quality and safety of the final products, as well as to avoid economic losses. Within this context, it is interesting to highlight the role played by bacteriophages, or phages, viruses that infect bacteria. Indeed, bacteriophages were originally regarded as a nuisance, being responsible for fermentation failure and economic losses when infecting lactic acid bacteria, but are now considered promising antimicrobials to fight milk-borne pathogens without contributing to the increase in antibiotic resistance.