NARMS Now: Tool shows changes in foodborne pathogen antibiotic resistance

A new interactive tool from CDC makes it easier and quicker to see how antibiotic resistance for four germs spread commonly through food—Campylobacter, E. coli O157, Salmonella, and Shigella—has changed over the past 18 years.

Each year in the United States, antibiotic-resistant germs cause 2 million illnesses and 23,000 deaths. Antibiotic-resistant infecnarms.now.fbitions from germs spread commonly through food cause an estimated 440,000 of those illnesses.

The NARMS Now: Human Data tool contains information from the National Antimicrobial Resistance Monitoring System (NARMS).

NARMS Now: Human Data allows users to access antibiotic resistance data by bacterial serotype, antibiotic, year (1996-2013), and geographic region. Users can view data on an interactive map or in tables. NARMS Now: Human Data plans to provide access to the most up-to-date antibiotic resistance results by uploading data regularly.

NARMS Now: Human Data can be used to:

–  Inform regulatory agency action.

FDA withdrew approval for Enrofloxacin (a fluoroquinolone) used in poultry after the data showed an increase in fluoroquinolone-resistant Campylobacter infections in humans.

–  Examine the geographic distribution of resistance.

Researchers have used the data to investigate the geographic distribution of multidrug-resistant Salmonella Typhimurium and Newport infections in the United States.

narmsnow-digitaldevices_cropMonitor changing trends in resistance.

Investigators are using NARMS data to help uncover the reason for increasing antibiotic resistance in a type of Salmonella, I 4,[5],12,:i:-, which has emerged recently in the United States.

Timely Access to Data

CDC developed NARMS Now: Human Data in response to requests from Congress, consumer groups, academia, and the public for timely access to data on antibiotic resistance. The tool is an important step towards President Obama’s Open Government Initiative to foster openness in government and establish a culture of transparency, public participation, and collaboration.

The FDA, on behalf of all the NARMS partner agencies, is also making data available online, NARMS Now: Integrated Data. That data helps users to access antibiotic resistance information from isolates from retail meat and animals, and will soon add Campylobacter and non-typhoidal Salmonella from humans.

Bad idea: Raw oysters in nursing homes

With at least 67 sick from Vibrio parahaemolyticus linked to raw oysters in Canada and a full recall being launched by the Canadian Food Inspection Agency, one has to wonder why raw oysters would be served in a nursing home.

oystersBut that’s what happened in France in 2012.

Researchers report that the presence of norovirus in shellfish is a public health concern in Europe. Here, we report the results of an investigation into a norovirus gastroenteritis outbreak following a festive lunch which affected 84 (57%) residents and staff members of a nursing home in January 2012 in France. Individuals who had eaten oysters had a significantly higher risk of developing symptoms in the following 2·5 days than those who had not, the risk increasing with the amount eaten [relative risk 2·2 (1·0–4·6) and 3·3 (1·6–6·6) for 3–4 and 5–12 oysters, respectively].

In healthy individuals during those days, 29 (32%) subsequently became ill, most of whom were staff members performing activities in close contact with residents. Genogroup II noroviruses were detected in fecal samples, in a sample of uneaten oysters and in oysters from the production area. Identifying a norovirus’s infectious dose may facilitate the health-related management of contaminated shellfish.

A norovirus oyster-related outbreak in a nursing home in France, January 2012

Epidemiology and Infection / Volume 143 / Issue 12 / September 2015, pp 2486-2493

Loury, F. S. Le Guyader, J. C. Le Saux, K. Ambert-Balay, P. Parrot and B. Hubert

http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9888431&utm_source=Issue_Alert&utm_medium=RSS&utm_campaign=HYG

Handwashing intervention in daycares doesn’t reduce illness

Either the employees were already real good at hand hygiene, or the interventions didn’t resonate with people.

dirty.jobs.daycare.e.coliInfections are common in children attending daycare centres (DCCs). We evaluated the effect of a hand hygiene (HH) intervention for caregivers on the incidence of gastrointestinal and respiratory infections in children. The intervention was evaluated in a two-arm cluster randomized controlled trial.

Thirty-six DCCs received the intervention including HH products, training sessions, and posters/stickers. Thirty-five control DCCs continued usual practice. Incidence of episodes of diarrhea and the common cold in children was monitored by parents during 6 months. Using multilevel Poisson regression, incidence rate ratios (IRRs) with 95% confidence intervals (CIs) were obtained. Diarrheal incidence was monitored in 545 children for 91 937 days. During follow-up, the incidence was 3·0 episodes per child-year in intervention DCCs vs. 3·4 in control DCCs (IRR 0·90, 95% CI 0·73–1·11). Incidence of the common cold was monitored in 541 children for 91 373 days. During follow-up, the incidence was 8·2 episodes per child-year in intervention DCCs vs. 7·4 in control DCCs (IRR 1·07, 95% CI 0·97–1·19).

In this study, no evidence for an effect of the intervention was demonstrated on the incidence of episodes of diarrhea and the common cold.

A hand hygiene intervention to reduce infections in child daycare: a randomized controlled trial

Epidemiology and Infection / Volume 143 / Issue 12 / September 2015, pp 2494-2502

P. Zomer, V. Erasmus, C. W. Looman, A. Tjon-A-Tsien, E. F. Van Beeck, J. M. De Graaf, A. H. E. Van Beeck, J. H. Richardus and H. A. C. M. Voeten

http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9888395&utm_source=Issue_Alert&utm_medium=RSS&utm_campaign=HYG

Leafs are bumpy: Change in disinfecting spinach, salad greens could reduce illness

Cross contamination in commercial processing facilities that prepare spinach and other leafy greens for the market can make people sick. But researchers are reporting a new, easy-to-implement method that could eliminate or reduce such incidences.

howcleanisyoThe scientists will present their work at the 250th National Meeting & Exposition of the American Chemical Society (ACS).

Spinach or other leafy salad greens were responsible for 18 food-poisoning outbreaks over the last decade.

Greens are washed by commercial processes before they head to the grocery store. But these methods, which can include water and bleach rinses or irradiation, are not completely effective, says Nichola Kinsinger, Ph.D. She says scientists have estimated that 99 percent of food-borne illnesses from leafy greens can be traced back to disinfection issues. As a result, they have searched for and developed a different approach to attacking the bacteria, most notably E. coli, which is the cause of many outbreaks.

“Despite current disinfection rinsing, bacteria are surviving on the leaf and causing cross contamination, resulting in the numerous outbreaks we hear about in the media,” Kinsinger says. She is a postdoc in the lab of Sharon Walker, Ph.D., at the University of California, Riverside. “Pathogens can come from irrigation waters or from water used during processing, and they can adhere to spinach leaves. If these bacteria are not all killed in the disinfection process, they can continue to live, grow, spread and contaminate other surfaces within the facility and other leaves.”

Using a parallel-plate flow chamber system that Walker developed, the researchers tested the real-time attachment and detachment of bacteria to the outer layer of spinach leaves. At low bleach concentrations, the bacteria fell off the leaves, but remained alive. At the higher concentrations used commercially, however, all of the bacteria were killed. “This result was perplexing,” Walker says. “Our experiments were telling us that commercial bleach rinses should be much more effective than they are. But then we studied the leaf itself in more detail.”

A spinach leaf is not perfectly smooth, she notes. So, the team modeled how the bleach would move across the surface of a spinach leaf, taking its bumps and grooves into account. Surprisingly, the model revealed that the concentrations of bleach on leaves may not be consistent.

“We found that because of the topology of the spinach leaf, nearly 15 percent of the surface may ‘see’ a bleach concentration that is 1,000-times less than that of the rinse solution,” Kinsinger says. In some cases, that translated to a 90 percent bacterial survival in their tests—and a high risk for cross contamination.

To reduce that risk, the researchers are optimizing an inexpensive titanium dioxide (TiO2) photocatalyst that companies could add to the rinse water or use to coat equipment surfaces that come into contact with the leaves as they are processed. When TiO2 absorbs light, it produces a strong oxidant that kills bacteria.

The scientists now plan to conduct more studies on the photocatalyst, and they will look at a broader range of foods, engineered surfaces and pathogens.

 

‘It’s something in the pool. But I’m not a doctor’ Hundreds of Dutch tourists fall ill in Macedonia

Dozens of Dutch tourists are spending their holiday in Macedonia in the bathroom rather than at the pool or the beach. A mysterious virus from the nearby Skopje has two-thirds of the Dutch tourists in the Izgrev Spa & Aqua Park in Ohrid stuck in their hotel rooms.

the Izgrev Spa & Aqua Park in OhridThe hotel has room for about 700 guests, 332 of them are Dutch tourists who traveled through travel agency Corendon. So far only about 20 people reported to the company that they were sick. All of them were treated for diarrhea. CEO Atilay Uslu told the Telegraaf that the virus has to do with “something in the pool. But I’m not a doctor.”

Giant Argentinian ants heading to the UK ‘will bring danger of salmonella’

As if food premises didn’t have enough pet control problems, hundreds of Argentinian ants which carry diseases such as salmonella and streptococcus, have invaded Britain this summer.

Argentinian antsThe tropical insects, said to be covered in red hair, have sparked warnings from pest control experts after reports of attacks on animals and crops.

The spread has been blamed, among other things, on the increase in flats and tower blocks. Black and 3mm long, they hide in cracks in walls, and between timbers.

Pest control experts advise pouring a kettle of boiling water over the nest site before puffing an insecticidal powder product into the hole in order to destroy a nest.

UK bakery fined £8,500 after finding mouse droppings, mould and dirt

A Croydon bakery has been slapped with a fine of £8,500 after hygiene inspectors uncovered mouse droppings, mould, dirt, dust and grime.

bloomers.bakeryThe grim discovery at Bloomers Bakery was made by Croydon Council food safety officers following a routine inspection at the company’s shop in Lower Addiscombe Road in June 2014.

On July 1 a visit to the main bakery premises in Tait Road revealed evidence of a mouse infestation and dirty conditions in a number of areas.

Councillor Mark Watson, cabinet member for communities, safety and justice said: “This is an established Croydon bakery, serving many members of the community, and it’s disappointing that standards were allowed to fall to such a degree.

“Our food safety team worked to put matters right and it’s heartening to note the comments of the district judge who realised the potential danger to customers and imposed a suitably severe financial penalty.”

Arizona diners can look up restaurant inspections on smart phones

Maricopa County Environmental Services has just rolled out a new mobile restaurant ratings tool that can be accessed from any smartphone.

rest.inspection.smartphoneDivision manager Andrew Linton said the restaurant tool allows anyone, anywhere to look up specific restaurant inspection reports for any of the 22,000 food service establishments across the Maricopa County.

“If you are out on the go and decide to eat at a restaurant that you are not familiar with,  you see how they do on their inspections,” said Linton. “This is a really easy way to get an idea of how they are doing.”

The restaurant ratings tool is different from your basic phone app, said Linton.

To access it, all users have to do is go to the county’s website at www.maricopa.gov.

Users can then do a search of a specific restaurant or look up all restaurants within a one-mile radius of their location.

Users will see a map that they can then use to look up an individual restaurant, and see its latest health inspection report.

According to Linton, another benefit of the restaurant ratings tool is that if diners have a bad experience going out to eat, they can file a complaint right from their smart phone.

‘We can do better’ More transparency for LA restaurant grading

For more than a decade, thelarry.david.rest.inspec NBC4 I-Team has been investigating Los Angeles County’s restaurant grading system.

Big changes were recommended for the food safety program Tuesday by the Interim Director of L.A. County’s Public Health Department, many of them addressing concerns that the I-Team investigations raised.

In May, an investigation revealed how the public is rarely told about foodborne illness outbreaks. In fact, more about those outbreaks could be gleaned from websites like Yelp and Trip Advisor than from county health officials.

When questioned about the lack of transparency back in May, Angelo Bellomo, who supervises the county’s food safety program, said there were ways that officials could improve the system.

“We could be doing a better job in many areas,” he said.

The proposed changes to the county’s restaurant grading system would address many of the existing shortcomings that have been the focus of NBC4 reports over the years, including:

-Preventing a restaurant from receiving an “A” grade if they receive two major violations during an inspection.

-The online disclosure of all restaurant closures and those restaurants believed to be associated with a foodborne illness.

-Revoking more restaurant permits for businesses with “chronic unsafe practices.”

The changes to the food facility grading system were included in a memo sent to the Los Angeles County Board of Supervisors and obtained by the I-Team.

Public Health plans on implementing these changes immediately and say they will work with the Board of Supervisors if any laws needed to be revised.

E. coli O91 in elderly patient

Hemolytic-uremic syndrome due to enterohemorrhagic Escherichia coli, belonging to serogroup O91 has rarely been described. We report here a case of post-diarrheal HUS due to EHEC O91 in an elderly patient for whom diagnosis was delayed given a previously diagnosed C. difficile infection. This case highlights the usefulness of Shiga-toxin detection.

Fatal case of hemolytic-uremic syndrome in an adult due to a rare serogroup O91 Entero hemorrhagic Escherichia coli associated with a Clostridium difficile infection. More than meets the eye

International Journal of Infectious Diseases

Thomas Guillard, Anne Limelette, Elisabeth Le Magrex-Debar, Alain Wynckel, Malika Gouali, Patricia Mariani-Kurkdjian, Charlotte Guyot-Colosio, Christophe de Champs

http://www.ijidonline.com/article/S1201-9712%2815%2900149-6/fulltext