Hospital-acquired listeriosis linked to a persistently contaminated milkshake machine
Eyob MazengiaVance KawakamiKrista RietbergMeagan KayPeter A. WymanChristine SkiltonAbebe G. AberraJim BoonyaratanakornkitAjit P. LimayeSteven A. PergamEstella WhimbeyRobin J. Olsen-ScribnerJeffrey S. Duchin
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Abstract:
SUMMARY One case of hospital-acquired listeriosis was linked to milkshakes produced in a commercial-grade shake freezer machine. This machine was found to be contaminated with a strain of Listeria monocytogenes epidemiologically and molecularly linked to a contaminated pasteurized, dairy-based ice cream product at the same hospital a year earlier, despite repeated cleaning and sanitizing. Healthcare facilities should be aware of the potential for prolonged Listeria contamination of food service equipment. In addition, healthcare providers should consider counselling persons who have an increased risk for Listeria infections regarding foods that have caused Listeria infections. The prevalence of persistent Listeria contamination of commercial-grade milkshake machines in healthcare facilities and the risk associated with serving dairy-based ice cream products to hospitalized patients at increased risk for invasive L. monocytogenes infections should be further evaluated.Keywords:
Pasteurization
Contaminated food
Using the so-called holding technique of pasteurization (61.7 °C., 35 minutes) it was shown that when known numbers of viable Listeria monocytogenes are added to samples of fresh sterile milk, organisms may be recovered whenever the initial number of bacteria added is 5 × 10 4 /ml. or greater. No significant differences in heat resistance among representatives of various Listeria monocytogenes was observed. After 48 hours at room temperature (22 °C.) survivors multiply in such "pasteurized" milk and viable bacterial counts reach 10 8 per ml. without producing any grossly detectable changes in the milk or suspicious odors.
Pasteurization
Heat Resistance
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Monitoring of Listeria monocytogenes, the causative agent of listeriosis, in food is inportant for public health. The Korean Food Standards Codex has adopted a ‘zero-tolerance’ policy for L. monocytogenes. The standard detection method of L. monocytogenes is based on enrichment. Thus, proper enrichment methods need to be instituted to ensure quality control of the detection procedures. In this study, the growth of L. monocytogenes and Listeria innocua as a mixed culture in Listeria enrichment broth (LEB) was monitored during artificial contamination of enrichment culture. We confirmed competitive growth or interspecies inhibitory activity of L. monocytogenes and L. innocua. Interspecies growth differences and the inhibitory activity of different inoculation and mixtures L. innocua against L. monocytogenes were examined. The concentration of L. monocytogenes must be 2.0 log CFU/mL or more than L. innocua to grow better than L. innocua. It is known that Listeria spp. and L. monocytogenes show growth difference during LEB, resulting in the risk of false-negative results. The inhibition of L. monocytogenes by L. innocua was always observed when present at lower concentrations. However, it was confirmed that L. innocua suppressed when L. monocytogenes was present at a higher concentration. Therefore if a mixture of Listeria spp. is present, detecting L. monocytogenes is difficult. Thus, a new enrichment broth to improve the detection rate of L. monocytogenes is needed.
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Milk from cows inoculated with Listeria monocytogenes was pooled for 2 to 4 days and then heated at 71.7 to 73.9 degrees C for 16.4 s or at 76.4 to 77.8 degrees C for 15.4 s in a high-temperature, short-time plate heat exchanger pasteurization unit. L. monocytogenes was isolated from milk after heat treatment in six of nine pasteurization trials done at 71.7 to 73.9 degrees C and in none of three trials done at 76.4 to 77.8 degrees C. An average of 1.5 to 9.2 L. monocytogenes cells was seen in each milk polymorphonuclear leukocyte before heat treatment in 11 of 12 pasteurization trials. Noticeable degradation of leukocytes with intracellular listeria was detected in unpasteurized milk after 3 days of storage at 4 degrees C, and by 4 days of storage leukocytes had deteriorated to cellular debris, suggesting that holding unpasteurized milk refrigerated for 4 or more days would eliminate a protective effect leukocytes may provide for increasing heat resistance of L. monocytogenes. Results indicate that under the conditions of this study, L. monocytogenes can survive the minimum high-temperature, short-time treatment (71.7 degrees C, 15 s) required by the U.S. Food and Drug Administration for pasteurizing milk.
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The effect of prior heat shock (48 degrees C for 15 min) on the thermotolerance of Listeria monocytogenes at the minimal high-temperature, short-time (71.7 degrees C for 15 s) parameters required by the Pasteurized Milk Ordinance was examined. The mean D71.7 degrees C value for heat-shocked L. monocytogenes was 4.6 +/- 0.5 s (control D = 3.0 +/- 1.0 s); the ratio of D to control D was 1.5. The increased thermotolerance of heat-shocked Listeria cells was not significant and appeared unlikely to have practical implications, in terms of risk assessment, for the safety of pasteurized milk.
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This is to select solid selective culture media suitable for detection of listeria monocytogenes.The verification of culture media in ISO/TS 11133-2 was introduced and modified.Three solid selective culture media were compared.The OXA and listeria CHROMagar had equal effect,while listeria monocytogenes and listeria ivanovii had typical colony on the listeria CHROMagar.It concluded that OXA and listeria CHROMagar have excellent effect and are well suitable for detection of listeria monocytogenes.Their combined application is considered to be more efficacious.
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