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.

Human Listeriosis

Listeria monocytogenes is a Gram-positive facultative intracellular pathogen that can cause severe invasive infections upon ingestion with contaminated food. Clinically, listerial disease, or listeriosis, most often presents as bacteremia, meningitis or meningoencephalitis, and pregnancy-associated infections manifesting as miscarriage or neonatal sepsis. Invasive listeriosis is life-threatening and a main cause of foodborne illness leading to hospital admissions in Western countries. Sources of contamination can be identified through international surveillance systems for foodborne bacteria and strains' genetic data sharing. Large-scale whole genome studies have increased our knowledge on the diversity and evolution of L. monocytogenes, while recent pathophysiological investigations have improved our mechanistic understanding of listeriosis. In this article, we present an overview of human listeriosis with particular focus on relevant features of the causative bacterium, epidemiology, risk groups, pathogenesis, clinical manifestations, and treatment and prevention.

Deterministic Approach and Monte Carlo Simulation to Predict Listeria monocytogenes Time to Grow on Refrigerated Ham: A Study Supporting Risk-based Decisions for Consumers' Health

This study assessed the growth of Listeria monocytogenes in ready-to-eat (RTE) ham during storage under conditions simulating domestic practices with the intention to offer support in the elaboration of food safety policies that should better protect consumers against food poisoning at home. RTE ham, artificially contaminated at either medium (10²-10³ CFU/g) or high (10⁴-10⁵ CFU/g) concentration, was stored at both isothermal (4℃ in a refrigerator able to maintain a relatively constant temperature and 5℃ and 7℃ in a refrigerator with fluctuating temperature) and dynamic (5℃ and 7℃ with intermittent exposure to ambient temperature, e.g. 25℃) conditions. Under isothermal conditions, the increasing storage temperature determined a significantly increased (p < 0.05) capacity of L. monocytogenes to grow. The kinetic growth parameters were derived by fitting the Baranyi and Roberts model to the experimental data and, based on the maximum specific growth rates, it was estimated the temperature dependence of L. monocytogenes growth in RTE ham. At medium contamination level, sanitary risk time calculation revealed that, unlike storage at 5℃ and 7℃, storage at 4℃ of the RTE ham extends the time period during which the product is safe for consumption by ∼40 and 52%, respectively. However, the real temperature fluctuations included in the Monte Carlo simulations at low L. monocytogenes counts (1, 5 and 10 CFU/g) have shortened the safety margins. Stochastic models also proved to be useful tools for describing the pathogen's behavior when refrigeration of the RTE ham alternates with periods of ham being kept at room temperature, considered dynamic conditions of growth.

Challenge Test as Special Tool to Estimate the Dynamic of Listeria monocytogenes and Other Foodborne Pathogens

Over 23 million cases of foodborne disease (FBD) occur in Europe each year, with over 4700 deaths. Outbreaks of FBD have a significant impact on our society due to the high economic losses they cause (hospital treatment of affected patients and destruction of contaminated food). Among its health objectives, the European Union has set itself the goal of reducing the incidence of the main FBDs, approving various regulations that codify requirements in order to produce food that is “safe” for human consumption. Among these rules, Regulation 2005/2073 establishes precise food safety criteria for foods that are judged to be most at risk of causing episodes of FBD. The food business operator (FBO) must know their food better and know how to estimate whether a food can support the growth of food pathogens or if they are able to hinder it during the food’s shelf life. It is becoming crucial for each FBO to schedule specific laboratory tests (challenge tests) to establish the growth potential of individual pathogens and their maximum growth rate. In 2008 the European Union published the guidelines for programming the challenge tests for Listeria monocytogenes in RTE foods. These guidelines were further implemented in 2014 and again in 2019. In June 2019 the UNI EN ISO 20976-1 was published, which contains indications for setting up and carrying out challenge tests for all foodborne pathogens in all foods. In this article, we compare the three official documents to highlight their common aspects and differences, highlighting the advantages and disadvantages that each of them offers for those who have to set up a challenge test for the various foodborne pathogens. Our conclusion is that the challenge test is today the most effective tool to estimate the dynamics and growth potential of pathogenic microorganisms in food, if it is designed and implemented in a scrupulous way. It is important to develop a rational experimental design for each challenge test, and for each food, and this requires professionals who are experts in this specific field of study and who must be properly trained.

Pathogenicity and virulence of Listeria monocytogenes: A trip from environmental to medical microbiology

Listeria monocytogenes is a saprophytic gram-positive bacterium, and an opportunistic foodborne pathogen that can produce listeriosis in humans and animals. It has evolved an exceptional ability to adapt to stress conditions encountered in different environments, resulting in a ubiquitous distribution. Because some food preservation methods and disinfection protocols in food-processing environments cannot efficiently prevent contaminations, L. monocytogenes constitutes a threat to human health and a challenge to food safety. In the host, Listeria colonizes the gastrointestinal tract, crosses the intestinal barrier, and disseminates through the blood to target organs. In immunocompromised individuals, the elderly, and pregnant women, the pathogen can cross the blood-brain and placental barriers, leading to neurolisteriosis and materno-fetal listeriosis. Molecular and cell biology studies of infection have proven L. monocytogenes to be a versatile pathogen that deploys unique strategies to invade different cell types, survive and move inside the eukaryotic host cell, and spread from cell to cell. Here, we present the multifaceted Listeria life cycle from a comprehensive perspective. We discuss genetic features of pathogenic Listeria species, analyze factors involved in food contamination, and review bacterial strategies to tolerate stresses encountered both during food processing and along the host's gastrointestinal tract. Then we dissect host-pathogen interactions underlying listerial pathogenesis in mammals from a cell biology and systemic point of view. Finally, we summarize the epidemiology, pathophysiology, and clinical features of listeriosis in humans and animals. This work aims to gather information from different fields crucial for a comprehensive understanding of the pathogenesis of L. monocytogenes.

Review: Pork quality attributes from farm to fork. Part II. Processed pork products

Pork is often consumed in a very wide variety of products, processed from integral cuts or minced meat using different conservation methods (curing, smoking, cooking, drying, fermenting). Quality of pork products results from a combination between the properties of the raw material and the processing conditions to elaborate the final products. The influence of primary production factors, slaughtering and carcass processing on the quality of fresh pork has been reviewed (part 1), considering quality as an integrative combination of various attributes: commercial, organoleptic, nutritional, technological, convenience, and societal image, the latter denotes cultural, ethical (including animal welfare) and environment dimensions related to the way pork is produced, processed, and its geographical origin. This review (part 2) focuses on the influence of primary production factors and processing techniques on the quality of two important and economically significant processed pork products issued from contrasting processing techniques: cooked ham and dry-cured ham. As with fresh pork, many factors influence the quality of processed products, and one factor can affect several attributes. Moreover, in the case of processed products, numerous factors in both animal production and processing steps interact to determine their quality attributes. The quality of cooked ham depends on the properties of the raw material (in particular pH, colour, water holding capacity, presence of destructured meat defect, etc.) which are determined by pig husbandry practices (especially the genotype), pre-, postslaughter and processing conditions including the composition of curing mixture (ingredients, additives), salting, mixing and heat treatment. Processing techniques of cooked ham aim at homogenising the product quality within a given quality category (e.g. 'standard' or 'superior') or brand. Therefore, the variability of raw material is problematic for the cooked ham processing industry, which generally seeks uniformity and homogeneity of fresh hams. Likewise, pig husbandry conditions exert even greater impact on dry-cured ham quality. Indeed, the properties of raw material (including weight of fresh ham, fat thickness, pH, intramuscular fat and antioxidants content, fatty acid profile, etc.) that result from combined effects of primary production factors (genotype, feeding, production system, etc.) interact with processing conditions (salting, drying, ripening conditions and duration, etc.) to elaborate the quality attributes of the final products. Synergies can be sought between the primary production factors and processing techniques leading to specific organoleptic characteristics (texture, taste, aroma, flavour, etc.) that can be valued by quality labels. Quality of products is thus built along the whole chain from farm to fork.

The utilisation of tools to facilitate cross-border communication during international food safety events, 1995-2020: a realist synthesis

Efficient communication and coordination are needed between countries to prevent, detect and respond to international food safety events. While communication tools, networks and systems exist, current evidence suggests that they are only useful within particular contexts and several only target specific geographic areas. There is a need to unpack and explore the mechanisms of how and in what context such communication tools and their components are effective at facilitating international communication and coordination to keep food safe and mitigate the burden of foodborne disease around the world.

A realist synthesis was undertaken to understand how and why certain processes and structures of communication tools, used during international food safety events, influence their utility and effectiveness according to different contextual factors. The focus of this review was explanatory and aimed to develop and refine theory regarding how contextual factors trigger specific processes and mechanisms to produce outcomes. Using the realist context–mechanism–outcome configuration of theory development, a range of sources was used to develop an initial programme theory, including the authors’ experience, a scoping review of published papers and grey literature and input from an expert reference committee. Literature was then systematically located and synthesised from several databases with input from the expert reference committee to refine the programme theory.

The programme theory developed indicates that when a country has interests in food import or export, has the technical infrastructure to detect and respond to food safety events, and is governed in accordance with regional and/or global laws and regulations relating to food control and global health security, then specific mechanisms will facilitate various outcomes. Mechanisms include trust, experience, support, awareness, understanding, a sense of community, standardisation and intersectoral collaboration. The outcomes include using communication tools to relay information abroad and the prevention of foodborne diseases, among others.

Components of such communication tools may be adapted according to different contextual factors to promote, support and improve their use. Improving international coordination and communication during international food safety events is in the interest of global health security and can mitigate the global burden of foodborne disease.

Environmental dissemination of pathogenic Listeria monocytogenes in flowing surface waters in Switzerland

Listeria monocytogenes is an opportunistic pathogen that is widely distributed in the environment. The aquatic environment may represent a potential source for the transmission of L. monocytogenes to animals and the food chain. The present study assessed the occurrence of L. monocytogenes in 191 surface water samples from rivers, streams and inland canals throughout Switzerland. Twenty-five (13%) of the surface water samples contained L. monocytogenes. Whole genome sequence (WGS) data were used to characterize the 25 isolates. The isolates belonged to major lineages I and II, with the majority assigned to either serotype 1/2a (48%), or 4b (44%). The predominant CCs identified were the hypervirulent serotype 4b clones CC1 and CC4, and the serotype CC412; all three have been implicated in listeriosis outbreaks and sporadic cases of human and animal infection worldwide. Two (8%) of the isolates belonged to CC6 which is an emerging hypervirulent clone. All isolates contained intact genes associated with invasion and infection, including inlA/B and prfA. The four CC4 isolates all harbored Listeria pathogenicity island 4 (LIPI-4), which confers hypervirulence. The occurrence of L. monocytogenes in river ecosystems may contribute to the dissemination and introduction of clinically highly relevant strains to the food chain.

Potassium Lactate as a Strategy for Sodium Content Reduction without Compromising Salt-Associated Antimicrobial Activity in Salami

Reformulating recipes of ready-to-eat meat products such as salami to reduce salt content can mitigate the negative health impacts of a high salt diet. We evaluated the potential of potassium lactate (KL) as a sodium chloride (NaCl) replacer during salami production. NaCl and KL stress tolerance comparisons showed that four food-derived Listeria innocua isolates were suitable as biologically safe Listeria monocytogenes surrogates. Effects of the high salt (4% NaCl) concentration applied in standard salami recipes and a low salt (2.8% NaCl) plus KL (1.6%) combination on product characteristics and growth of contaminating Listeria and starter culture were compared. Simulated salami-ripening conditions applied in meat simulation broth and beef showed that the low salt plus KL combination retained similar to superior anti-Listeria activity compared to the high salt concentration treatment. Salami challenge tests showed that the low NaCl plus KL combination had comparable anti-Listeria activity as the high NaCl concentration during ripening and storage. No significant differences were detected in starter culture growth profiles and product characteristics between the high NaCl and low NaCl plus KL combination treated salami. In conclusion, KL replacement enabled a 30% NaCl reduction without compromising the product quality and antimicrobial benefits of high NaCl concentration inclusion.

New Insights on the Role of the pLMST6 Plasmid in Listeria monocytogenes Biocide Tolerance and Virulence

Listeria monocytogenes the causative agent of listeriosis is an important public health concern and food safety challenge. Increased tolerance of this bacterium to benzalkonium chloride (BC), an antibacterial agent widely used in industrial settings, is a growing issue. Plasmid pLMST6 harboring the gene of the multidrug efflux pump protein EmrC has been recently linked to enhanced BC tolerance and meningitis due to L. monocytogenes ST6 strains. In this study, occurrence and contribution of this plasmid to BC tolerance was examined using PCR, plasmid curing and transformation, RT-qPCR and proteome analysis, respectively. Furthermore, the substrate specificity of the pLMST6 associated EmrC efflux pump and the impact of the plasmid on L. monocytogenes virulence were investigated. pLMST6 was detected in 7 (1.6%) of 439 L. monocytogenes strains isolated from different sources. A phenotypic role of this plasmid in conferring increased BC tolerance was confirmed by showing that plasmid cure increases BC susceptibility whereas plasmid complementation and transformation increased BC tolerance in different L. monocytogenes genetic backgrounds and L. innocua. RT-qPCR showed that BC stress exposure strongly induces the expression of mRNAs associated with pLMST6 genes for EmrC and a TetR transcription regulator. A full proteome analysis in a plasmid harboring L. monocytogenes strain revealed that the pLMST6 encoded putative TetR family transcription regulator protein is the most upregulated protein in response to BC stress exposure. An investigation into the EmrC efflux pump's substrate spectrum showed that while pLMST6 confers increased tolerance to other quaternary ammonium compounds (QACs) based disinfectants it has no impact on the sensitivity of L. monocytogenes to non-QAC disinfectants as well as on antibiotics such as ampicillin, tetracycline and gentamicin. A reduction in the survival of zebrafish embryos infected with pLMST6 plasmid harboring L. monocytogenes strains was observed when compared with plasmid cured variants of the same strains suggesting that some pLMST6 harbored genes might contribute to increased virulence capacity. Overall these results confirm the phenotypic contribution of pLMST6 plasmid in promoting and dissemination of BC tolerance in L. monocytogenes as well as provide new insights on different molecular levels of pLMST6 associated genes in response to BC stress.

Structural change in GadD2 of Listeria monocytogenes field isolates supports nisin resistance

The lantibiotic nisin is used as a food additive to effectively inactivate a broad spectrum of Gram-positive bacteria such as Listeria monocytogenes. In total, 282 L. monocytogenes field isolates from German ready-to-eat food products, food-processing environments and patient samples and 39 Listeria reference strains were evaluated for their susceptibility to nisin. The MIC₉₀ value was <1500 IU ml^-1. Whole genome sequences (WGS) of four nisin susceptible (NS; growth <200 IU ml^-1) and two nisin resistant L. monocytogenes field isolates (NR; growth >1500 IU ml^-1) of serotype IIa were analyzed for DNA sequence variants (DSVs) in genes putatively associated with NR and its regulation. WGS of NR differed from NS in the gadD2 gene encoding for the glutamate decarboxylase system (GAD). Moreover, homology modeling predicted a protein structure of GadD2 in NR that promoted a less pH dependent GAD activity and may therefore be beneficial for nisin resistance. Likewise NR had a significant faster growth rate compared to NS in presence of nisin at pH 7. In conclusion, results contributed to ongoing debate that a genetic shift in GAD supports NR state.

Variable Carbon Source Utilization, Stress Resistance, and Virulence Profiles Among Listeria monocytogenes Strains Responsible for Listeriosis Outbreaks in Switzerland

A combination of phenotype microarrays, targeted stress resistance and virulence assays and comparative genome analysis was used to compare a set of Listeria monocytogenes strains including those involved in previous Swiss foodborne listeriosis outbreaks. Despite being highly syntenic in gene content these strains showed significant phenotypic variation in utilization of different carbon (C)-sources as well as in resistance of osmotic and pH stress conditions that are relevant to host and food associated environments. An outbreak strain from the 2005 Swiss Tomme cheese listeriosis outbreak (Lm3163) showed the highest versatility in C-sources utilized whereas the strain responsible for the 1983 to 1987 Vacherin Montd'or cheese listeriosis outbreak (LL195) showed the highest tolerance to both osmotic and pH stress conditions among the examined strains. Inclusion of L-norvaline led to enhanced resistance of acidic stress in all the examined strains and there were strain-strain-specific differences observed in the ability of other amino acids and urea to enhance acid stress resistance in L. monocytogenes. A strain dependent inhibition pattern was also observed upon inclusion of β-phenylethylamine under alkaline stress conditions. In targeted phenotypic analysis the strain-specific differences in salt stress tolerance uncovered in phenotypic microarrays were corroborated and variations in host cell invasion and virulence among the examined strains were also revealed. Outbreak associated strains representing lineage I serotype 4b showed superior pathogenicity in a zebrafish infection model whilst Lm3163 a lineage II serotype 1/2a outbreak strain demonstrated the highest cellular invasion capacity amongst the tested strains. A genome wide sequence comparison of the strains only revealed few genetic differences between the strains suggesting that variations in gene regulation and expression are largely responsible for the phenotypic differences revealed among the examined strains. Our results have generated data that provides a potential basis for the future design of improved Listeria specific media to enhance routine detection and isolation of this pathogen as well as provide knowledge for developing novel methods for its control in food.

Epidemiology and Clinical Manifestations of Listeria monocytogenes Infection

Listeria monocytogenes is a Gram-positive pathogenic bacterium which can be found in soil or water. Infection with the organism can develop after ingestion of contaminated food products. Small and large outbreaks of listeriosis have been described. Listeria monocytogenes can cause a number of clinical syndromes, most frequently sepsis, meningitis, and rhombencephalitis, particularly in immunocompromised hosts. The latter syndrome mimics the veterinary infection in ruminants called "circling disease". Neonatal infection can occur as a result of maternal chorioamnionitis ("early onset" sepsis) or through passage through a birth canal colonized with Listeria from the gastrointestinal tract. ("late onset" meningitis). Treatment of listeriosis is usually with a combination of ampicillin and an aminoglycoside but other regimens have been used. The mortality rate is high, reflecting the combination of an immunocompromised host and an often delayed diagnosis.

Analysis of consumer food purchase data used for outbreak investigations, a review

BackgroundInvestigations of food-borne outbreaks are frequently unsuccessful and new investigation methods should be welcomed. Aim: Describe the use of consumer purchase datasets in outbreak investigations and consider methodological and practical difficulties. Methods: We reviewed published papers describing the use of consumer purchase datasets, where electronic data on the foods that case-patients had purchased before onset of symptoms were obtained and analysed as part of outbreak investigations. Results: For the period 2006-17, scientific articles were found describing 20 outbreak investigations. Most outbreaks involved salmonella or Shiga toxin-producing Escherichia coli and were performed in eight different countries. The consumer purchase datasets were most frequently used to generate hypotheses about the outbreak vehicle where case-interviews had not been fruitful. Secondly, they were used to aid trace-back investigation, where a vehicle was already suspected. A number of methodological as well as (in some countries) legal and practical impediments exist. Conclusions: Several of the outbreaks were unlikely to have been solved without the use of consumer purchase datasets. The method is potentially powerful and with future improved access to big data purchase information, may become a widely applicable tool for outbreak investigations, enabling investigators to quickly find hypotheses and at the same time estimate odds ratios or relative risks hereof. We suggest using the term 'consumer purchase data' to refer to the approach in the future.

Bacteriocins as food preservatives: Challenges and emerging horizons

The increasing demand for fresh-like food products and the potential health hazards of chemically preserved and processed food products have led to the advent of alternative technologies for the preservation and maintenance of the freshness of the food products. One such preservation strategy is the usage of bacteriocins or bacteriocins producing starter cultures for the preservation of the intended food matrixes. Bacteriocins are ribosomally synthesized smaller polypeptide molecules that exert antagonistic activity against closely related and unrelated group of bacteria. This review is aimed at bringing to lime light the various class of bacteriocins mainly from gram positive bacteria. The desirable characteristics of the bacteriocins which earn them a place in food preservation technology, the success story of the same in various food systems, the various challenges and the strategies employed to put them to work efficiently in various food systems has been discussed in this review. From the industrial point of view various aspects like the improvement of the producer strains, downstream processing and purification of the bacteriocins and recent trends in engineered bacteriocins has also been briefly discussed in this review.

Listeria monocytogenes in Food-Processing Facilities, Food Contamination, and Human Listeriosis: The Brazilian Scenario

Listeria monocytogenes is a foodborne pathogen that contaminates food-processing environments and persists within biofilms on equipment, utensils, floors, and drains, ultimately reaching final products by cross-contamination. This pathogen grows even under high salt conditions or refrigeration temperatures, remaining viable in various food products until the end of their shelf life. While the estimated incidence of listeriosis is lower than other enteric illnesses, infections caused by L. monocytogenes are more likely to lead to hospitalizations and fatalities. Despite the description of L. monocytogenes occurrence in Brazilian food-processing facilities and foods, there is a lack of consistent data regarding listeriosis cases and outbreaks directly associated with food consumption. Listeriosis requires rapid treatment with antibiotics and most drugs suitable for Gram-positive bacteria are effective against L. monocytogenes. Only a minority of clinical antibiotic-resistant L. monocytogenes strains have been described so far; whereas many strains recovered from food-processing facilities and foods exhibited resistance to antimicrobials not suitable against listeriosis. L. monocytogenes control in food industries is a challenge, demanding proper cleaning and application of sanitization procedures to eliminate this foodborne pathogen from the food-processing environment and ensure food safety. This review focuses on presenting the L. monocytogenes distribution in food-processing environment, food contamination, and control in the food industry, as well as the consequences of listeriosis to human health, providing a comparison of the current Brazilian situation with the international scenario.

Local Outbreak of Listeria monocytogenes Serotype 4b Sequence Type 6 Due to Contaminated Meat Pâté

In January and February 2016, five cases of confirmed and two cases of probable infection due to Listeria monocytogenes serotype 4b, sequence type (ST) 6 belonging to a single pulsed-field gel electrophoresis pulsotype pattern were registered in a region of southern Switzerland. L. monocytogenes was detected in blood samples (four cases) and pleural fluid (one case). Furthermore, L. monocytogenes 4b ST6 was detected in a stool sample of an asymptomatic person exposed to a common food. Forthwith, the food safety authority and a local gourmet meat producer reported L. monocytogenes contamination of meat pâté. Analysis of further food and environmental samples from the premises of the producer yielded isolates matching the clinical strains and confirmed the presence of L. monocytogenes 4b ST6 in the mincing machine as the cause of the food contamination.

The Continuous Challenge of Characterizing the Foodborne Pathogen Listeria monocytogenes

Listeria monocytogenes is an important foodborne pathogen commonly isolated from food processing environments and food products. This organism can multiply at refrigeration temperatures, form biofilms on different materials and under various conditions, resist a range of environmental stresses, and contaminate food products by cross-contamination. L. monocytogenes is recognized as the causative agent of listeriosis, a serious disease that affects mainly individuals from high-risk groups, such as pregnant women, newborns, the elderly, and immunocompromised individuals. Listeriosis can be considered a disease that has emerged along with changing eating habits and large-scale industrial food processing. This disease causes losses of billions of dollars every year with recalls of contaminated foods and patient medical treatment expenses. In addition to the immune status of the host and the infecting dose, the virulence potential of each strain is crucial for the development of disease symptoms. While many isolates are naturally virulent, other isolates are avirulent and unable to cause disease; this may vary according to the presence of molecular determinants associated with virulence. In the last decade, the characterization of genetic profiles through the use of molecular methods has helped track and demonstrate the genetic diversity among L. monocytogenes isolates obtained from various sources. The purposes of this review were to summarize the main methods used for isolation, identification, and typing of L. monocytogenes and also describe its most relevant virulence characteristics.

Whole-genome Sequencing Used to Investigate a Nationwide Outbreak of Listeriosis Caused by Ready-to-eat Delicatessen Meat, Denmark, 2014

BACKGROUND

Listeriosis is a serious foodborne infection. Outbreaks of listeriosis occur rarely, but have often proved difficult to solve. In June 2014, we detected and investigated a listeriosis outbreak in Denmark using patient interviews and whole-genome sequencing (WGS).

METHODS

We performed WGS on Listeria monocytogenes isolates from patients and available isolates from ready-to-eat foods and compared them using single-nucleotide polymorphism (SNP) analysis. Case patients had L. monocytogenes with ≤3 SNPs (the outbreak strain) isolated in September 2013-December 2014. Through interviews, we established case patients' food and clinical histories. Food production facilities were inspected and sampled, and we performed trace-back/trace-forward of food delivery chains.

RESULTS

In total, 41 cases were identified; 17 deaths occurred (41%). An isolate from a delicatessen meat (spiced meat roll) from company A was identical to the outbreak strain. Half of the patients were infected while hospitalized/institutionalized; institutions were supplied food by company A. The outbreak strain was repeatedly isolated from further samples taken within this company and within companies in its distribution chain. Products from company A were traced and recalled from >6000 food establishments, after which the outbreak ended.

CONCLUSIONS

Ready-to-eat spiced meat roll from a single production facility caused this outbreak. The product, served sliced and cold, is popular among the elderly; serving it at hospitals probably contributed to the high case-fatality rate. WGS used for patient isolates and isolates from food control inspections, coupled with routine epidemiological follow-up, was instrumental in swiftly locating the source of infections, preventing further illnesses and deaths.

Genome Sequences of Listeria monocytogenes Strains Responsible for Cheese- and Cooked Ham Product-Associated Swiss Listeriosis Outbreaks in 2005 and 2011

The complete genome sequences of three Listeria monocytogenes serotype 1/2a strains, Lm 3136, Lm 3163, and Lm N1546, which were responsible for listeriosis outbreaks in 2005 and 2011 in Switzerland, are presented here.

Complete Genome Sequence of Listeria monocytogenes N2306, a Strain Associated with the 2013-2014 Listeriosis Outbreak in Switzerland

We present the complete genome sequence of Listeria monocytogenes N2306, a serotype 4b clinical strain isolated during the 2013-2014 nationwide listeriosis outbreak in Switzerland.

Characterization of Listeria monocytogenes strains isolated during 2011-2013 from human infections in Switzerland

Listeria monocytogenes, an emerging foodborne pathogen, can cause in the population at risk severe infections that are associated with high case fatality rates. A total of 93 L. monocytogenes strains isolated from different patients in Switzerland from July 2011 to September 2013 were further characterized. Septicemia was reported for 74.2% of the patients, meningitis for 10.8%, and abortion for 3.2%. The majority of the strains belonged to serotype 1/2a (n=58) followed by serotype 4b (n=28), 1/2b (n=5), and 1/2c (n=2). The strains represented 35 multilocus sequence typing sequence types, 8 of which were designated for the first time. Sequence analysis of the inlA gene in the 35 sequence types showed that most of the strains encoded full-length proteins. Screening for Listeriolysin S showed the presence of this virulence factor in 29 of the 33 genetic lineage I strains. By using ApaI and AscI for pulsed-field gel electrophoresis, most strains showed distinguishable patterns.

Identification of the significant factors in food safety using global sensitivity analysis and the accept-and-reject algorithm: application to the cold chain of ham

Deterministic models describing heat transfer and microbial growth in the cold chain are widely studied. However, it is difficult to apply them in practice because of several variable parameters in the logistic supply chain (e.g., ambient temperature varying due to season and product residence time in refrigeration equipment), the product's characteristics (e.g., pH and water activity) and the microbial characteristics (e.g., initial microbial load and lag time). This variability can lead to different bacterial growth rates in food products and has to be considered to properly predict the consumer's exposure and identify the key parameters of the cold chain. This study proposes a new approach that combines deterministic (heat transfer) and stochastic (Monte Carlo) modeling to account for the variability in the logistic supply chain and the product's characteristics. The model generates a realistic time-temperature product history , contrary to existing modeling whose describe time-temperature profile Contrary to existing approaches that use directly a time-temperature profile, the proposed model predicts product temperature evolution from the thermostat setting and the ambient temperature. The developed methodology was applied to the cold chain of cooked ham including, the display cabinet, transport by the consumer and the domestic refrigerator, to predict the evolution of state variables, such as the temperature and the growth of Listeria monocytogenes. The impacts of the input factors were calculated and ranked. It was found that the product's time-temperature history and the initial contamination level are the main causes of consumers' exposure. Then, a refined analysis was applied, revealing the importance of consumer behaviors on Listeria monocytogenes exposure.

Emerging infectious colitis

PURPOSE OF REVIEW

The present review will highlight recent advances in the knowledge of emerging pathogens causing infectious colitis and provide a description of the most important food-borne outbreaks.

RECENT FINDINGS

Outbreaks of enteric disease caused by Salmonella spp., Campylobacter spp., and Shiga toxin-producing Escherichia coli (STEC) continue to surprise with new epidemiological findings or changing virulence characteristics. These pathogens evolve to exploit novel opportunities for spread and transmission, such as fresh produce within the food chain, and generate new public health challenges. Organic sprouts were recently considered as the source responsible for a large German disease outbreak comprising 3842 patients. The outbreak strain was identified as an enteroaggregative STEC O104:H4 (EAggC), a rare hybrid pathogen that harbours the phage encoded Shiga toxin gene and antibiotic resistance in an EAggEC background. Clostridium difficile PCR ribotype 078 is emerging across Europe, causing severe disease outside healthcare facilities as well as disease in farm animals, indicating that the species border has been crossed. Although the global impact of cryptosporidiosis is less pronounced, these organisms have been responsible for large outbreaks of infectious diarrhoea, often not reported. Invasive listeriosis is a serious food-borne illness and was found recently in 28 US states affecting 147 patients, associated with eating contaminated cantaloupe. Outbreaks of gastroenteritis caused by Listeria monocytogenes are most likely severely underestimated. Centralized surveillance of food-borne enteropathogens is essential for the early detection of disease outbreaks and for the organization of an immediate and appropriate response.

SUMMARY

An improved understanding of the pathogenesis, pathology and epidemiology of emerging enteropathogens causing infectious colitis will provide new approaches for disease prevention and control.