Transfer of Campylobacter and Salmonella from Poultry Meat onto Poultry Preparation Surfaces

Cross-contamination in the kitchen: A model for quantitative microbiological risk assessment

A quantitative microbiological risk assessment model for the cross-contamination transmission route in the kitchen (KCC) is presented. Bacteria are transmitted from contaminated (chicken) meat to hands, kitchen utensils, and other surfaces, subsequently contaminating a salad. The model aims to estimate the fraction of bacteria on the meat that is ingested due to cross-contamination, determine the importance of the different transmission routes, and assess the effect of scenarios (interventions) on the fraction ingested. The cross-contamination routes defined, bacterial source-to-recipient transfer fractions as available and derived from literature, and important characteristics (e.g., washing in cold water vs. hot water with soap) shaped the KCC model. With this model, 32 scenarios of an eight-step preparation of a "meat and salad" meal in a domestic kitchen were stochastically simulated. The "cutting board-salad" route proved dominant and the salad plays a major role in the final exposure. A realistic scenario (washing hands, cutting board, and knife with cold water after cutting the meat) estimates that a mean fraction of 3.2E - 3 of the bacteria on the meat is ingested. In the case of "hand washing with hot water and soap" and "cutting board and knife replacement," the mean fraction ingested is 3.6E - 6. For a subsequent meal, where the contaminated sources were kitchen fomites, the estimated mean fraction is 4.3E - 4. In case of hamburger, part of the bacteria is unavailable for cross-contamination, resulting in a mean fraction ingested of about 5.4E - 5. The role of the dishcloth in cross-contamination transmission proved to be minor.

Cross-Contamination to Surfaces in Consumer Kitchens with MS2 as a Tracer Organism in Ground Turkey Patties

ABSTRACT

It is estimated that one in five cases of foodborne illnesses is acquired in the home. However, how pathogens move throughout a kitchen environment when consumers are preparing food is not well characterized. The purpose of this study was to determine the prevalence and degree of cross-contamination across a variety of kitchen surfaces during a consumer meal preparation event. Consumers (n = 371) prepared a meal consisting of turkey patties containing the bacteriophage MS2 as a tracer organism and a ready-to-eat lettuce salad. Half were shown a video on proper thermometer use before the trial. After meal preparation, environmental sampling and detection were performed to assess cross-contamination with MS2. For most surfaces, positivity did not exceed 20%, with the exception of spice containers, for which 48% of the samples showed evidence of MS2 cross-contamination. Spice containers also had the highest MS2 concentrations, at a mean exceeding 6 log viral genome equivalent copies per surface. The high level of MS2 on spice containers drove the significant differences between surfaces, suggesting the significance of spice containers as a vehicle for cross-contamination, despite the absence of previous reports to this effect. The thermometer safety intervention did not affect cross-contamination. The efficiency of MS2 transfer, when expressed as a percentage, was relatively low, ranging from an average of 0.002 to 0.07%. Quantitative risk assessment work using these data would aid in further understanding the significance of cross-contamination frequency and efficiency. Overall, these data will help create more targeted consumer messaging to better influence consumer cross-contamination behaviors.

HIGHLIGHTS

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.

Modelling and magnitude estimation of cross-contamination in the kitchen for quantitative microbiological risk assessment (QMRA)

In the kitchen of the consumer, two main transmission routes are relevant for quantitative microbiological risk assessment (QMRA): the cross-contamination route, where a pathogen on a food product may evade heating by transmission via hands, kitchen utensils and other surfaces, e.g. to non-contaminated products to be consumed raw; and the heating route, where pathogens remain on the food product and are for the most part inactivated through heating. This project was undertaken to model and estimate the magnitude of cross-contamination in the domestic environment. Scientific information from the relevant literature was collected and analyzed, to define the cross-contamination routes, to describe the variability sources and to extract and harmonise the transfer fractions to be included as model parameters. The model was used to estimate the relative impact of the cross-contamination routes for different scenarios. In addition, the effectiveness of several interventions in reducing the risk of food-borne diseases due to cross-contamination was investigated. The outputs of the model showed that the cutting board route presents a higher impact compared to other routes and replacement of the kitchen utensils is more effective than other interventions investigated; the transfer to other surfaces and objects, which can house bacteria in the environment, is also described. Laboratory cross-contamination trials have been performed to estimate bacterial transfer via cutting, from the external surface of the meat to the cutting surfaces and to the knife. The results, obtained from the laboratory trials, show magnitudes of and differences in the bacterial transfer fraction to the knife and the cutting surface in relation to which side of the meat is contaminated. Despite the complexity of factors which influence bacterial transfer, the combination of laboratory work with mathematical modelling enhanced scientific understanding and appreciation of the uncertainty of the estimates. QMRA methodology results in magnitude estimation of cross-contamination in the kitchen and evaluation of intervention strategies.

Challenges and Opportunities towards the Development of Risk Assessment at the Consumer Phase in Developing Countries-The Case of Campylobacter Cross-Contamination during Handling of Raw Chicken in Two Middle Eastern Countries

In many low- and middle-income countries, data limitations are a major challenge facing the development of food safety risk assessment. In the present study, a questionnaire data collection tool was designed with an emphasis on gathering specific data points required by a risk modeller for simulating a scenario of Campylobacter cross-contamination during handling of raw chicken meat at the consumer phase. The tool was tested in practice to support its value and applicability in settings where data limitations are a challenge. The study subjects were 450 consumers in two Middle Eastern settings: Alexandria in Egypt (n = 200) and Thi-Qar in Iraq (n = 250). The majority (78.5%) of respondents in Egypt opted for wet markets/live bird shops as their preferred source of chicken meat. In contrast, 59.6% of Iraqi respondents preferred to buy chicken meat from supermarkets. Added to that, 73.0% of consumers in Egypt and 56.8% of consumers in Iraq viewed the quality of frozen chicken as “inferior” to that of chicken from wet markets. Almost all respondents in both Egypt and Iraq shared the practice of washing chicken in water before cooking. The percentage of consumers who ‘very frequently’ or ‘frequently’ prepare chicken prior to making the salad was 32.5% and 55.2% in Egypt and Iraq, respectively. A sizeable proportion of respondents in Iraq (40.8%) reported that they did not consider washing their hands with soapy water after touching raw chicken and preparing a salad in their home kitchen. Finally, 28.8% and 6.5% of respondents in Iraq and Egypt, respectively, indicated that they would not consider using a separate cutting board to avoid cross-contamination between raw chicken and salad. The data collection tool used in this study was designed in the first instance to match a conceptualised risk assessment framework, and that enabled the simultaneous collection of data points on consumption frequency, serving sizes, purchasing patterns, retail chain diversity and food handling practices. Results from such study design could be used for future development of a quantitative risk assessment model and to support food safety promotion efforts for domestic consumers in two of the most populated Middle Eastern countries.

Decontamination of Chicken Thigh Meat by Pulsed Ultraviolet Light

Foodborne illness outbreaks associated with chicken can be reduced with effective decontamination interventions. The effectiveness of pulsed ultraviolet (PUV) light for destruction of Salmonella, E. coli, and Campylobacter on the surface of chicken thigh meat was investigated. Chicken thighs were inoculated to 6 to 7 log10 CFU/cm2 before exposure to PUV light for each of the above-mentioned pathogens. Treatment variables included the distance from the quartz window of the PUV light (8 and 13 cm) and treatment time (0, 5, 15, 30, and 45 s). Comparison of treated samples to control (0 s) samples allowed for quantification of microbial reduction due to PUV light treatment. Microbial reduction on lean surface chicken thighs (P < 0.05) with increasing duration of PUV light exposure for E. coli, Campylobacter, and Salmonella. Exposure to PUV light for 5 and 45 s on lean surface thighs resulted in log10 CFU/cm2 reductions of 1.22 and 2.02 for E. coli, 1.45 and 2.09 for Campylobacter, and 1.55 and 2.42 for Salmonella, respectively. Pulsed UV light exposure for 5 and 45 s on skin surface thighs resulted in log10 reductions of 1.19 and 1.96 for E. coli; 1.08 and 1.85 for Campylobacter, and 0.90 and 1.82 for Salmonella, respectively. Results indicate that PUV light is effective for reductions of bacterial populations on the surface of raw chicken meat.

Underestimated Risks of Infantile Infectious Disease from the Caregiver's Typical Handling Practices of Infant Formula

The impact on infant caregiver as a reservoir of pathogens has not been exploited with perspective to powdered infant formula (PIF). Here we reveal novel route of pathogen transfer through hand-spoon-PIF unexpectedly occurred by even typical practices of caregivers, handling of PIF and storage of feeding-spoon in PIF container. Hand-spoon-PIF contamination route was simulated to analyze the transfer and subsequent survival of pathogens. Major pathogens associated with infantile fatal diseases (Cronobacter sakazakii, Salmonella enterica, Staphylococcus aureus) were readily transmitted to PIF from skin (3−6 log CFU/hand) via spoons following long-term survival of transferred pathogens (3 weeks; use-by date of PIF) as the excessive level of infectious dose, highlighting direct onset of diseases. Low bacterial load on skin (ca. 1 log CFU/hand) could prevent cross-contamination of PIF, however, at least 72 h survival of transferred pathogen on spoons demonstrated the probability on re-contamination of PIF. To our knowledge, this is the first study to investigate the cross-contamination of utensils in contact with powdered-foods. Bacterial load on hands is the key determinant of pathogen transfer and the extent of risk are species-dependent. These evidential results redefine risk of caregivers’ practices and facilitate incorporation of cross-contamination into risk-assessment as underestimated route of infection.

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.

Older Adults and Parents of Young Children Have Different Handling Practices for Raw Poultry

Salmonella and Campylobacter are among the most common causes of foodborne disease in the United States. Most illnesses are associated with eating raw or undercooked poultry or cross-contamination. Young children and older adults are more susceptible to contracting foodborne illness and have serious infections compared with other age groups. We conducted a Web-based survey of parents of young children ( n = 1,957) and older adults ( n = 1,980) to estimate adherence to recommended food safety practices for raw poultry and to identify differences in practices between the two groups. The findings present adherence rates for 20 practices. In both groups, less than 50% of respondents reported adherence to seven practices; thus, improvements are needed in these areas. Parent respondents were significantly more likely than older adult respondents to report following eight practices, with most related to avoiding cross-contamination and using a food thermometer. For example, parents (39%) were significantly more likely than older adults (31%) to report not rinsing or washing raw poultry ( P < 0.001). Older adult respondents were significantly more likely than parent respondents to report following seven practices, with most related to chilling to proper temperatures and thawing. For example, older adults (87%) were significantly more likely than parents (69%) to report cooking, freezing, or discarding raw poultry within 1 to 2 days of purchase as recommended ( P < 0.001). For the remaining five practices, no differences were found between groups. To motivate behavior change, food safety messages and materials must target specific at-risk populations as their practices are different. Additional research is needed to better understand how parents of young children and older adults like to receive food safety information and how to tailor the information to different generations.