Food Safety Practices Linked with Proper Refrigerator Temperatures in Retail Delis

Distance and destination of retail meat alter multidrug resistant contamination in the United States food system

Antibiotic-resistant infections are a global concern, especially those caused by multidrug-resistant (MDR) bacteria, defined as those resistant to more than three drug classes. The animal agriculture industry contributes to the antimicrobial resistant foodborne illness burden via contaminated retail meat. In the United States, retail meat is shipped across the country. Therefore, understanding geospatial factors that influence MDR bacterial contamination is vital to protect consumers and inform interventions. Using data available from the United States Food and Drug Administration's National Antimicrobial Resistance Monitoring System (NARMS), we describe retail meat shipping distances using processor and retailer locations and investigated this distance as a risk factor for MDR bacteria meat contamination using log-binomial regression. Meat samples collected during 2012-2014 totaled 11,243, of which 4791 (42.61%) were contaminated with bacteria and 835 (17.43%) of those bacteria were MDR. All examined geospatial factors were associated with MDR bacteria meat contamination. After adjustment for year and meat type, we found higher prevalence of MDR contamination among meat processed in the south (relative adjusted prevalence ratio [aPR] 1.35; 95% CI 1.06-1.73 when compared to the next-highest region), sold in Maryland (aPR 1.12; 95% CI 0.95-1.32 when compared to the next-highest state), and shipped from 194 to 469 miles (aPR 1.59; 95% CI 1.31-1.94 when compared to meats that traveled < 194 miles). However, sensitivity analyses revealed that New York sold the meat with the highest prevalence of MDR Salmonella contamination (4.84%). In this secondary analysis of NARMS data, both geographic location where products were sold and the shipping distance were associated with microbial contamination on retail meat.

Prevalence of food thermometers usage and temperature control in restaurants in Dammam, Saudi Arabia

The Saudi Ministry of Municipal and Rural Affairs is planning to initiate a hazard analysis critical control point (HACCP) system in restaurants and cafeterias to manage issues of food safety in Saudi Arabia. One of the most important elements in the HACCP system is the monitoring temperature of cooked and stored food. The present study aimed to investigate the prevalence and use of refrigerators/freezers and food thermometers among food handlers in local and international restaurants in Dammam, Saudi Arabia. A cross-sectional study was conducted in municipality-licensed restaurants. The temperatures of refrigerator and freezer were checked, and the survey form was completed by the researcher according to logbook entries. We then checked for the presence of a food thermometer, and if a functional thermometer was present, the chef was asked to complete an online questionnaire using Survey Monkey website on a tablet. The response rate of the survey was 68% (238/350 restaurants). We found that 88.1% of restaurants used a thermometer to check the temperature of their refrigerators and freezers. Thirty-one restaurants (13.0%) had a regular temperature-monitoring record available for both the refrigerator and freezer. International restaurants had significantly greater temperature-monitoring data than local restaurants (88.1% vs 63.3%; p = .0001). The prevalence of food thermometers in restaurants was 53.4% (127/238 restaurants), with significantly higher prevalence in international restaurants than in local restaurants (96.6% vs 10.8%; p = .0001). The practice of using food thermometer "always" when meat turned brown was significantly associated with the chef's age and education level. The study results showed poor monitoring and documentation of refrigerator and freezer temperatures along with a low prevalence of food thermometer use. The study result provides an insight into one of the barriers to the implementation of the HACCP system in Dammam.

Domestic refrigerators: An overlooked breeding ground of antibiotic resistance genes and pathogens

Domestic refrigerator is a widely used appliance to keep food fresh and retard food spoilage in household. However, our understanding of microbial health risk associated with food under such circumstance still remains very poor. Here, typical types of food (vegetable, fish, and pork) were kept in a domestic refrigerator at 4 °C for 3-30 days. Temporal dynamics of antibiotic resistome, pathogens, bacterial and fungal communities during this period were investigated via high-throughput quantification and Illumina sequencing technologies. Results showed that a large number (21-134) of antibiotic resistance genes (ARGs) and mobile genetic elements (MGEs) were detected across the three food types, including 10.06 % of high-risk ARGs classified by their risk ranks. Moreover, four bacterial pathogens (i.e., Bacillus cereus, Cronobacter spp., Klebsiella pneumoniae and Staphylococcus aureus) targeted by marker genes including the pathogen-specific genes or virulence factor genes, and some potential fungal pathogens (e.g., Fusarium, Candida, and Aspergillus) were detected, indicating the occurrence of microbial risk even at the normally regarded safe storage temperature. Among all food types, the total bacterial density and ARG abundances in fish rapidly increased after only 3 days, much faster than vegetable and pork after 10 days. In addition, fish samples contained the highest ARG and pathogen abundances, indicating its potentially higher health risk than other food types. Finally, the shifts of ARG pattern were mainly contributed by bacterial communities and MGEs. This study highlights that food preserved in refrigerator at 4 °C could still be an unneglected microbial risk, and raises awareness of improving food safety in domestic environment.

Observed Potential Cross-Contamination in Retail Delicatessens

ABSTRACT

Listeria monocytogenes is a persistent public health concern in the United States and is the third leading cause of death from foodborne illness. Cross-contamination of L. monocytogenes (between contaminated and uncontaminated equipment, food, and hands) is common in delicatessens and likely plays a role in the foodborne illness associated with retail deli meats. In 2012, the Centers for Disease Control and Prevention's Environmental Health Specialists Network conducted a study to describe deli characteristics related to cross-contamination with L. monocytogenes. The study included 298 retail delis in six state and local health departments' jurisdictions and assessed how well deli practices complied with the U.S. Food and Drug Administration Food Code provisions. Among delis observed using wet wiping cloths for cleaning, 23.6% did not store the cloths in a sanitizing solution between uses. Observed potential cross-contamination of raw meats and ready-to-eat foods during preparation (e.g., same knife used on raw meats and ready-to-eat foods, without cleaning in between) was present in 9.4% of delis. In 24.6% of delis with a cold storage unit, raw meats were not stored separately from ready-to-eat products in containers, bins, or trays. A proper food safety management plan can reduce gaps in cross-contamination prevention and should include adopting procedures to minimize food safety risks, instituting training with instruction and in-person demonstrations and certifying staff on those procedures, and monitoring to ensure the procedures are followed.

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Retail Deli Characteristics Associated with Sanitizing Solution Concentrations

ABSTRACT

Listeria monocytogenes is commonly found in retail delicatessen environments. Proper types and concentrations of sanitizers must be used to eliminate this pathogen from surfaces and reduce the consumer's risk for infection. In 2012, the Environmental Health Specialists Network of the Centers for Disease Control and Prevention completed a study on practices in retail delis that can help prevent cross-contamination and growth of L. monocytogenes. The present study focuses on the sanitizing solution used in delis, given its importance to cleaning and reducing pathogen contamination in retail food environments. We identified deli, manager, and worker characteristics associated with use of improper concentrations of sanitizing solution to wipe down food contact surfaces; 22.8% of sanitizing solutions used for wiping food contact surfaces were at improper concentrations. Independent delis were more likely to use improper concentrations of sanitizing solution, as were delis that sold fewer chubs (plastic tubes of meat) per week. Use of improper sanitizing solution concentrations was associated with required food safety training for managers; additional analyses suggest that this relationship is significant for independent but not chain delis. Cleaning and sanitizing must be emphasized in food safety efforts focused on independent and smaller delis.

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Restaurant Policies and Practices Related to Norovirus Outbreak Size and Duration

ABSTRACT

Norovirus is the leading cause of foodborne illness outbreaks in the United States, and restaurants are the most common setting of foodborne norovirus outbreaks. Therefore, prevention and control of restaurant-related foodborne norovirus outbreaks is critical to lowering the burden of foodborne illness in the United States. Data for 124 norovirus outbreaks and outbreak restaurants were obtained from Centers for Disease Control and Prevention surveillance systems and analyzed to identify relationships between restaurant characteristics and outbreak size and duration. Findings showed that restaurant characteristics, policies, and practices were linked with both outbreak size and outbreak duration. Compared with their counterparts, restaurants that had smaller outbreaks had the following characteristics: managers received food safety certification, managers and workers received food safety training, food workers wore gloves, and restaurants had cleaning policies. In addition, restaurants that provided food safety training to managers, served food items requiring less complex food preparation, and had fewer managers had shorter outbreaks compared with their counterparts. These findings suggest that restaurant characteristics play a role in norovirus outbreak prevention and intervention; therefore, implementing food safety training, policies, and practices likely reduces norovirus transmission, leading to smaller or shorter outbreaks.

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Restaurant Characteristics Associated With the Use of Specific Food-Cooling Methods

Pathogen growth caused by improper or slow cooling of hot foods was a contributing factor in 504 of restaurant- and deli-related outbreaks in the U.S. from 1998-2008. Little is known, however, about restaurant cooling practices. To fill this gap, the Centers for Disease Control and Prevention's Environmental Health Specialists Network (EHS-Net) conducted an observational study to identify and understand factors that might determine which methods restaurants follow to rapidly cool food. These methods include refrigerating food at ≤41 °F, at shallow depths, and in containers that are ventilated, unstacked, and have space around them. EHS-Net personnel collected data through manager interviews and observation of cooling processes in 420 randomly selected restaurants. Regression analyses revealed characteristics of restaurants most likely to use the cooling methods assessed. These characteristics included ownership by restaurant chains, manager food safety training and certification, few foods cooled at a time, many meals served daily, and a high ratio of workers to managers. These findings suggest that regulatory food safety programs and the retail industry might improve cooling methods-and reduce outbreaks-by providing and encouraging manager food safety training and certification, and by focusing intervention efforts on independent and smaller restaurants.