Prevalence of Pathogens and Indicator Organisms in Home Kitchens and Correlation with Unsafe Food Handling Practices and Conditions

Home Delivery Meal Kits Online Food Safety-Related Information: A Perspective

The recent popularity of home delivery meal kits (HMK) has prompted concerns about its integrity and safety. On the basis of a food safety-related information evaluation of the common US-based HMK vendors' websites, this perspective highlights opportunities for improvement with the adequacy and accessibility of relevant information on HMK websites, an important resource for communicating food safety best practices to consumers. Identified gaps in information and inadequate delivery protocols potentially increase the risk of offering unsafe food to consumers. Suggestions for future research and recommendations for vendors, policymakers, and regulators to help protect consumers from potential foodborne illness risks are also discussed.

Clinical Outcome and Factors with Dietary Behaviors in Pregnant Women with Listeria monocytogenes: A Hospital-Based Case-Control Study in Shanghai

Listeriosis is a globally rare foodborne disease that causes fetal-placental infection, leading to adverse pregnancy outcome, while limited research among pregnant women is available in China. This study was therefore aimed at analyzing the incidence, clinical manifestations, and clinical outcome of listeriosis among pregnant women and its associated dietary behavior risk factors in prevention. A hospital-based case-control study had been conducted from January 2017 to December 2021. Clinical data, laboratory information, and questionnaires including dietary behaviors and personal hygiene were collected within 2 days after case diagnosis. There were 48 pregnant women, including 12 cases and 36 controls, with an average age of 31.19 ± 3.75 years. The incidence of admission-based listeriosis among pregnant women was 1.6058 per 10,000. The 12 strains were divided into 3 serotypes: 1/2a(83.33%), 1/2b(8.33%), and 4b(8.33%). Among the cases, 5 cases (41.67%) resulted in abortion, 3 cases (25%) induced preterm labor, and 4 cases (33.33%) had full-term deliveries after treatment. There were 7 live births in the case group, among which 6 were admitted to the neonatal intensive care unit (NICU), while 1 case had a healthy fetal outcome. All patients in the control group gave birth to live fetuses. Epidemiological investigation revealed that pregnant women dining at restaurants three or more times per week might increase the risk of having Listeria infection. There were no significant differences in dietary consumed behaviors, hand hygiene, and refrigerator usage behaviors between case and control groups. The study suggested that dining at restaurants might be associated with Listeria infection among pregnant women. Therefore, it is essential to enhance education on listeriosis serious consequences and promote healthy dietary and hygiene habits among pregnant women.

Survival strategies of Listeria monocytogenes to environmental hostile stress: biofilm formation and stress responses

Listeria monocytogenes is a critical foodborne pathogen that causes listeriosis and threatens public health. This pathogenic microorganism forms a transmission cycle in nature, food industry, and humans, expanding the areas of contamination among them and influencing food safety. L. monocytogenes forms biofilms to protect itself and promotes survival through stress responses to the various stresses (e.g., temperature, pH, and antimicrobial agents) that may be inflicted during food processing. Biofilms and mechanisms of resistance to hostile external or general stresses allow L. monocytogenes to survive despite a variety of efforts to ensure food safety. The current review article focuses on biofilm formation, resistance mechanisms through biofilms, and external specific or general stress responses of L. monocytogenes to help understand the unexpected survival rates of this bacterium; it also proposes the use of obstacle technology to effectively cope with it in the food industry.

Food Safety Attitudes, Behaviors, and Hygiene Measures among Predominantly Low-Income Parents in Houston, Texas

ABSTRACT

Foodborne infections in the United States affect racial-ethnic minority and low-income populations at higher rates than the general population. To identify the prevalence of food safety behaviors and demographic characteristics associated with food handling practices among a susceptible, high-risk population, a cross-sectional survey was administered to 106 parents with children enrolled at two elementary schools serving predominantly low-income families in Houston, Texas. Relationships between demographic characteristics and food safety behavioral outcomes were examined using cross-tabulations and Fisher's exact test. Most respondents were female (93.4%), Hispanic, Latino, or Mexican American (94.9%), and had no previous food handling employment experience (75.0%). The primary source of food safety information reported was the Internet (32.7%), and nearly half of parents (42.7%) reported that they did not consider contamination of food with germs a serious food safety problem. Hand washing before food preparation was more common (98.0%) than before touching the refrigerator handle (66.3%), after electronic device use (55.6%), or after handling raw animal proteins (77.6%). The prevalence of fresh fruit (98.0%) and vegetable (97.9%) washing and appropriate contaminated cutting board handling (89.0%) was high among parents. Self-reported gaps in food handling behaviors identified included lack of food thermometer ownership (80.4%), use of reusable cleaning tools (71.0%), inappropriate defrosting methods (67.4%), and washing of raw poultry (86.3%), seafood (84.9%), and meat (74.7%). Hand washing after electronic device use and defrosting methods were observed to vary significantly according to demographic characteristics. Food safety education with messages targeted to specific demographic groups may be necessary to reduce the risk of foodborne disease among low-income parents and young children.

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Food Handling Practices for Apple Drying in Home Kitchens in the United States: A Survey

ABSTRACT

Fruit drying has traditionally received little food safety attention in spite of Salmonella outbreaks and recalls involving low-moisture foods. This study was conducted to assess the food safety implications during the home drying process, with dried apples as an example. A cohort of home apple dryers (n = 979) participated in an online survey through Qualtrics XM in May 2021. The results showed that participants' knowledge of safe food handling practices regarding dried fruit was low. On average, participants used only 8 of 18 identified food safety practices during apple drying. The survey revealed inadequate frequency of hand washing during apple preparation, potential points of cross-contamination from kitchen tools, lack of hurdle technology without a pretreatment step, failure to incorporate a thermal kill step during drying, and a lack of objective measurements to ensure that target parameters are attained. Participants mainly pretreated apples for sensory improvement instead of microbial reduction. When presented with some benefits of pretreatment, participants who did not pretreat their apples considered doing so to kill bacteria. The use of safe food handling practices differed within demographic groups. Participants 18 to 39 years old (mean = 7.47; 95% confidence interval [CI] = 7.26, 7.67) and 40 to 59 years old (mean = 7.43; 95% CI = 7.16, 7.70) reported using fewer safe practices than did those >60 years old (mean = 8.49; 95% CI = 8.22, 8.75), and participants who identified as male (mean = 7.38; 95% CI = 7.16, 7.60) reported using fewer safe practices than did those identifying as female (mean = 7.92; 95% CI = 7.74, 8.11). The findings of this study provide food handling data to support the development of more accurate food safety risk assessment models and to guide the development of food safety education for consumers who dehydrate produce in the home.

HIGHLIGHTS

Evaluation of the kitchen microbiome and food safety behaviors of predominantly low-income families

Bacterial pathogens in the domestic environment present a risk to residents, particularly among susceptible populations. However, the impact of consumer demographic characteristics and food handling methods on kitchen microbiomes is not fully understood. The domestic kitchen bacterial communities of ten predominantly low-income families in Houston, TX, were assessed in conjunction with a cross-sectional food safety survey to evaluate differences in household and surface-specific microbiomes and bacterial foodborne pathogen presence. Three kitchen surfaces within each household, including the sink drain, the refrigerator handle, and the counter, were environmentally sampled and metataxonomically evaluated via targeted 16S rRNA sequencing. Disposable dish sponges were also acquired and examined. Results indicated that alpha diversity did not vary by the households, sampling locations, or demographic characteristics evaluated. Significant differences in beta diversity were observed among the bacterial communities of five pairs of households and between refrigerator handle and disposable dish sponge microbiomes. A total of 89 unique bacterial foodborne pathogens were identified across surface types. Each household contained at least one contaminated surface, and the most common bacterial foodborne pathogens identified were Escherichia coli, Staphylococcus aureus, and Klebsiella pneumoniae. All parents reported washing their hands before meal preparation, washing fresh fruits and vegetables, and washing cutting boards with soap after use to prepare raw animal proteins. Gaps in food safety behaviors identified included a lack of serious concern for food contamination with germs and inappropriate handwashing, food handling, and cleaning behaviors. The number of unique bacterial foodborne pathogens identified within households was significantly higher among households whose respondent parent reported that they did not consider food contamination with germs to be a serious food safety problem (median: 41.0 species) compared to households whose respondent parent did consider food contamination to be a serious food safety problem (median: 3.0 species; p value = 0.0218). These results demonstrate that domestic kitchen taxonomic abundance profiles vary according to household and surface type. Data suggest that low-income consumers may be at risk of foodborne pathogen exposure from contaminated home kitchen surfaces, and that food safety attitudes may directly contribute to this hazard.

The Critical Role of Consumers in the Prevention of Foodborne Diseases: An Ethnographic Study of Italian Families

A high incidence of foodborne diseases occurs in the home setting because consumers adopt inappropriate preparation, consumption, and storage procedures. The present study applies an ethnographic approach to identify inadequate practices that could increase the incidence of foodborne diseases. Techniques related to the ethnographic approach were used: participant observation, kitchens mapping, collection of photographic material, and informal interviews in natural settings. A sample of 14 families was involved through the snowball sampling technique. This study identifies habitual practices and routine behaviour as the main risk factors. The inadequacies most frequently encountered related to the microbiological risks are incorrect handwashing, the presence in the kitchen spaces of objects unrelated to food preparation, the improper use of dishcloths and sponges, the inappropriate washing of utensils and food, the incorrect storage of food in the fridge, and the presence of children and pets without an adequate administration of the spaces. The practices that can expose consumers to chemical risk include food preservation through unsuitable containers/materials, food overcooking, and detergents contamination. The data underline the need to implement communicative and training interventions that give precise and targeted indications about correct safety practices in the home setting.

A Systematic Review of Listeria Species and Listeria monocytogenes Prevalence, Persistence, and Diversity throughout the Fresh Produce Supply Chain

Listeria monocytogenes is an increasing food safety concern throughout the produce supply chain as it has been linked to produce associated outbreaks and recalls. To our knowledge, this is the first systematic literature review to investigate Listeria species and L. monocytogenes prevalence, persistence, and diversity at each stage along the supply chain. This review identified 64 articles of 4863 candidate articles obtained from four Boolean search queries in six databases. Included studies examined naturally detected/isolated Listeria species and L. monocytogenes in fresh produce-related environments, and/or from past fresh produce associated outbreaks or from produce directly. Listeria species and L. monocytogenes were detected in each stage of the fresh produce supply chain. The greatest prevalence of Listeria species was observed in natural environments and outdoor production, with prevalence generally decreasing with each progression of the supply chain (e.g., packinghouse to distribution to retail). L. monocytogenes prevalence ranged from 61.1% to not detected (0.00%) across the entire supply chain for included studies. Listeria persistence and diversity were also investigated more in natural, production, and processing environments, compared to other supply chain environments (e.g., retail). Data gaps were identified for future produce safety research, for example, in the transportation and distribution center environment.

Consumer practices and prevalence of Campylobacter, Salmonella and norovirus in kitchens from six European countries

About 40% of foodborne infections are acquired in the home. The aim of the present study was to track contamination of pathogens during domestic food preparation and link the contamination to preparation practices. Research participants from 87 households in six European countries were observed and interviewed during shopping and preparation of a chicken and vegetable meal. The presence of Salmonella spp., Campylobacter spp. and norovirus on raw chicken, kitchen surfaces, cloths and sponges was determined. The prevalence of Campylobacter on raw chicken varied from 8.3% in Norway (NO) to 80% in France (FR) and Portugal (PT), with a mean prevalence of 57%. Campylobacter was found on half of the products that had been frozen and appeared to be less prevalent on chicken from supermarkets than other sources. Salmonella was found in 8.6% of raw chicken samples, exclusively from Hungary (HU). A relationship between observed practices and spread of pathogens to kitchen surfaces was found only for the use of cutting boards for chicken and/or vegetables. After food preparation, Campylobacter and Salmonella were isolated from 23% (samples derived from HU, RO, UK) and 8.7% (HU), respectively of cutting boards. Research participants in France and Portugal were more likely to buy products that fitted their recipe, with less need for using cutting boards. Using the same board and knife for vegetables after using it for chicken and without washing with detergent was common in Portugal and Romania, but not in the other countries. Contamination with Campylobacter to other kitchen surfaces or washing utensils were found in five households (UK, RO, PT). Rinsing chicken in sinks was common in three countries (PT, HU, RO), and washing vegetables in the same sink was also usual. Prevalence of Norovirus was low, with detection in one out of 451 samples. The participants' awareness of the risk posed by pathogens from raw chicken differed among the six countries, with higher awareness in Norway and the UK than the other countries studied. In conclusion, practices intended to avoid cross-contamination from chicken to kitchen surfaces and washing utensils are not established among consumers in all European countries. Nevertheless, cross-contamination events that disseminate infectious doses of pathogens seems to be rare, probably due to the relatively low levels of pathogens in food combined with food preferences. Food safety interventions must consider the national food culture, preferences, practices and the prevalence and levels of pathogens in food. Emphasis should be on providing and promoting chicken products with lower risk (prevalence of pathogens, ready-to-cook) and safe use of cutting boards.

An Investigation into the Critical Factors Influencing the Spread of Campylobacter during Chicken Handling in Commercial Kitchens in China

Campylobacteriosis is the most common cause of bacterial gastroenteritis worldwide. Consumption of chicken meat is considered the main route for human infection with Campylobacter. This study aimed to determine the critical factors for Campylobacter cross-contamination in Chinese commercial kitchens during chicken handling. Five commercial kitchens were visited to detect Campylobacter occurrence from 2019 to 2020. Chicken samples (n = 363) and cotton balls from the kitchen surfaces (n = 479) were collected, and total bacterial counts and Campylobacter spp. were detected. Genotypic characterization of 57 Campylobacter jejuni isolates was performed by multilocus sequence typing (MLST). In total, 77.41% of chicken carcass samples and 37.37% of kitchen surfaces showed Campylobacter spp. contamination. Before chicken preparation, Campylobacter spp. were already present in the kitchen environment; however, chicken handling significantly increased Campylobacter spp. prevalence (p < 0.05). After cleaning, boards, hands, and knives still showed high bacterial loads including Campylobacter spp., which related to poor sanitary conditions and ineffective handling practices. Poor sanitation conditions on kitchen surfaces offer greater opportunities for Campylobacter transmission. Molecular typing by MLST revealed that Campylobacter cross-contamination occurred during chicken preparation. The most prevalent sequence types, ST693 and ST45, showed strong biofilm formation ability. Consequently, sanitary condition of surfaces and biofilm formation ability of isolates were the critical points contributing to spread of Campylobacter in kitchen environment. These results provide insight into potential targeted control strategies along the farm-to-plate chain and highlight the necessity for improvements in sanitary conditions. The implementation of more effective cleaning measures should be considered to decrease the campylobacteriosis risk.

Dishwashing sponges and brushes: Consumer practices and bacterial growth and survival

Sponges are frequently used in kitchens and have been shown to harbor large numbers of bacteria, occasionally also pathogens. Less is known about kitchen brushes regarding usage and presence of bacteria. In the present study, the use of sponges and brushes was studied in a survey among 9966 European consumers in ten countries, and growth and survival of bacteria in sponges and brushes were examined in laboratory experiments. Sponges were the preferred hand-cleaning utensils for washing-up in the majority of countries, while brushes were most frequently used in Denmark and Norway. Consumers mostly change their sponges at regular times, but also sensory cues (looks dirty, smelly, slimy) and usage occurrences such as wiping up meat juices may trigger replacement. Besides cleaning the dishes, over a quarter of the dish brush users also use it to clean a chopping board after soilage from chicken meat juices. The water uptake and drying rate varied considerably, both between different sponges and between brushes and sponges, where brushes dried fastest. Campylobacter survived one day in all sponges and Salmonella more than seven days in two of three types of sponges. In the type of sponge that dried slowest, Salmonella grew on the first day and was always found in higher levels than in the other sponges. Non-pathogenic bacteria grew in the sponges and reached levels around 9 log CFU/sponge. In brushes all types of bacteria died over time. Campylobacter and Salmonella were reduced by more than 2.5 log to below the detection limit after one and three days, respectively. Bacteriota studies revealed a tendency for a dominance by Gram-negative bacteria and a shift to high relative prevalence of Pseudomonas over time in sponges. Both enumeration by agar plating and bacteriota analysis confirmed that the pathogens were in a minority compared to the other bacteria. Treatments of sponges and brushes with chlorine, boiling or in the dishwasher were effective to reduce Salmonella. We conclude that brushes are more hygienic than sponges and that their use should be encouraged. Contaminated sponges or brushes should be replaced or cleaned when they may have been in contact with pathogenic microorganisms, e.g. used on raw food spills. Cleaning of sponges and brushes with chlorine, boiling or dishwasher may be a safe alternative to replacing them with new ones.

Reducing antibiotic prescribing and addressing the global problem of antibiotic resistance by targeted hygiene in the home and everyday life settings: A position paper

Antimicrobial resistance (AMR) continues to threaten global health. Although global and national AMR action plans are in place, infection prevention and control is primarily discussed in the context of health care facilities with home and everyday life settings barely addressed. As seen with the recent global SARS-CoV-2 pandemic, everyday hygiene measures can play an important role in containing the threat from infectious microorganisms. This position paper has been developed following a meeting of global experts in London, 2019. It presents evidence that home and community settings are important for infection transmission and also the acquisition and spread of AMR. It also demonstrates that the targeted hygiene approach offers a framework for maximizing protection against colonization and infections, thereby reducing antibiotic prescribing and minimizing selection pressure for the development of antibiotic resistance. If combined with the provision of clean water and sanitation, targeted hygiene can reduce the circulation of resistant bacteria in homes and communities, regardless of a country's Human Development Index (overall social and economic development). Achieving a reduction of AMR strains in health care settings requires a mirrored reduction in the community. The authors call upon national and international policy makers, health agencies, and health care professionals to further recognize the importance of targeted hygiene in the home and everyday life settings for preventing and controlling infection, in a unified quest to tackle AMR.

Evaluation of bacterial and fungal contamination of kitchens of Birjand University of Medical Sciences

Objective

This study aims to evaluate the total bacterial and fungal count of tools, devices and surfaces of kitchens of the centers affiliated to Birjand University of Medical Sciences. In this study, 200 samples from four kitchens of Birjand University of Medical Sciences were obtained. After the preparation of serial dilutions, samples were cultured in plate count agar (PCA) plates and Sabouraud dextrose agar (SDA). After incubation at 37 and 25 °C for 24–48 and 72–96 h respectively, the microbial and fungal colonies were counted.

Results

The mean bacterial and fungal count of kitchens was 7.7 * 10⁷ and 7.6 * 10⁴, respectively. The highest and lowest levels of bacterial contamination were related to tools/devices and cover of tools/work clothes and the highest and lowest levels of fungal count were related to forks and spoons and the tools and devices of the storage site. The rate of contamination in the kitchens of Birjand University of Medical Sciences was relatively high. Thus, serious, continuous and accurate monitoring of the units, training of people working in all stages of cooking and disinfection the tools and devices are essential for control and prevention of disease transmission.

Domestic Kitchen Microbiological Contamination and Self-Reported Food Hygiene Practices of Older Adult Consumers

Because of increased susceptibility, older adults have an increased risk of foodborne infection, and data suggest elevated incidence; therefore, food hygiene is essential to reduce the risk. Research suggests older adults' inadequate knowledge and negative attitudes toward food hygiene may increase implementation of unsafe food practices. Data on microbiological contamination of domestic kitchens of older adults are lacking. Therefore, this study aimed to determine microbiological contamination of domestic kitchens of older adults. Food contact surfaces and equipment (n = 1,292) in domestic kitchens (n = 100) of older adults (≥60 years) were analyzed to isolate aerobic bacteria, Enterobacteriaceae, Staphylococcus aureus, and Listeria spp.; self-reported hygiene practices were also recorded. Highest contamination levels were determined on in-use cleaning equipment (dish brushes, dishcloths, sponges) with aerobic bacteria <9.3 log CFU per item, Enterobacteriaceae <8.8 log CFU per item, and S. aureus <7.0 log CFU per item. Reported usage length of dish brushes was significantly correlated (P < 0.05) with Enterobacteriaceae contamination. Significant correlations (P < 0.05) were determined between contamination and reported cleaning frequency of refrigerators. Contamination of hand towels in single-occupant households was significantly greater (P < 0.05) than in multioccupant households. The study facilitates novel comparison between reported hygiene practices with microbial contamination, suggesting older adults fail to implement adequate and regular hygiene practices that may increase the possibility of cross-contamination in the domestic kitchen and the associated risk of foodborne illness. Data from this study have determined a need for older adults to improve food hygiene practices in the domestic kitchen.

Self-disinfecting surfaces and infection control

According to World Health Organization, every year in the European Union, 4 million patients acquire a healthcare associated infection. Even though some microorganisms represent no threat to healthy people, hospitals harbor different levels of immunocompetent individuals, namely patients receiving immunosuppressors, with previous infections, or those with extremes of age (young children and elderly), requiring the implementation of effective control measures. Public spaces have also been found an important source of infectious disease outbreaks due to poor or none infection control measures applied. In both places, surfaces play a major role on microorganisms' propagation, yet they are very often neglected, with very few guidelines about efficient cleaning measures and microbiological assessment available. To overcome surface contamination problems, new strategies are being designed to limit the microorganisms' ability to survive over surfaces and materials. Surface modification and/or functionalization to prevent contamination is a hot-topic of research and several different approaches have been developed lately. Surfaces with anti-adhesive properties, with incorporated antimicrobial substances or modified with biological active metals are some of the strategies recently proposed. This review intends to summarize the problems associated with contaminated surfaces and their importance on infection spreading, and to present some of the strategies developed to prevent this public health problem, namely some already being commercialized.

Consumers' Use of Personal Electronic Devices in the Kitchen

Smartphones, tablets, and other personal electronic devices have become ubiquitous in Americans' daily lives. These devices are used by people throughout the day, including while preparing food. For example, a device may be used to look at recipes and therefore be touched multiple times during food preparation. Previous research has indicated that cell phones can harbor bacteria, including opportunistic human pathogens such as Staphylococcus and Klebsiella spp. This investigation was conducted with data from the 2016 Food Safety Survey (FSS) and from subsequent focus groups to determine the frequency with which consumers use personal electronic devices in the kitchen while preparing food, the types of devices used, and hand washing behaviors after handling these devices. The 2016 FSS is the seventh wave of a repeated cross-sectional survey conducted by the U.S. Food and Drug Administration in collaboration with the U.S. Department of Agriculture. The goal of the FSS is to evaluate U.S. adult consumer attitudes, behaviors, and knowledge about food safety. The FSS included 4,169 adults that were contacted using a dual-frame (land line and cell phone interviews) random-digit-dial sampling process. The personal electronics module was the first of three food safety topics discussed by each of eight consumer focus groups, which were convened in four U.S. cities in fall 2016. Results from the 2016 FSS revealed that of those individuals who use personal electronic devices while cooking, only about one third reported washing hands after touching the device and before continuing cooking. This proportion is significantly lower than that for self-reported hand washing behaviors after touching risky food products such as raw eggs, meat, chicken, or fish. Results from the focus groups highlight the varied usage of these devices during food preparation and the related strategies consumers are using to incorporate personal electric devices into their cooking routines.