Clean and sanitize your thermometers with the correct compounds

This one isn’t food safety, but there’s something for the microbiology nerds to learn here. Thermometers moving from person-to-person (or in our world, food-to-food) can move pathogens around.

According to the New England Journal of Medicine, a fungal outbreak at a hospital was linked to skin probe thermometers being reused. Fun part is that they were being sanitized between use, just not using the correct compound (in this case they used quat sanitizer) but this was against the manufacturer’s instructions. 

End result: 70 patients with Candida auris over a 2 year period.

A Candida auris Outbreak and Its Control in an Intensive Care Setting

04.Oct.18
New England Journal of Medicine
Eyre DW., Sheppard A., Madder H., Moir I., Moroney R., Quan TP., Griffiths D., GEORGE S., Butcher L., Morgan M., Newnham R., Sunderland M., Clarke T., Foster D., Hoffman P., Borman A., Johnson E., Moore G., Brown C., Walker A., Peto T., Crook D., Jeffery K.
Abstract
BACKGROUND
Candida auris is an emerging and multidrug-resistant pathogen. Here we report the epidemiology of a hospital outbreak of C. auris colonization and infection.
METHODS
After identification of a cluster of C. auris infections in the neurosciences intensive care unit (ICU) of the Oxford University Hospitals, United Kingdom, we instituted an intensive patient and environmental screening program and package of interventions. Multivariable logistic regression was used to identify predictors of C. auris colonization and infection. Isolates from patients and from the environment were analyzed by whole-genome sequencing.
RESULTS
A total of 70 patients were identified as being colonized or infected with C. auris between February 2, 2015, and August 31, 2017; of these patients, 66 (94%) had been admitted to the neurosciences ICU before diagnosis. Invasive C. auris infections developed in 7 patients. When length of stay in the neurosciences ICU and patient vital signs and laboratory results were controlled for, the predictors of C. auris colonization or infection included the use of reusable skin-surface axillary temperature probes (multivariable odds ratio, 6.80; 95% confidence interval [CI], 2.96 to 15.63; P<0.001) and systemic fluconazole exposure (multivariable odds ratio, 10.34; 95% CI, 1.64 to 65.18; P=0.01). C. auris was rarely detected in the general environment. However, it was detected in isolates from reusable equipment, including multiple axillary skin-surface temperature probes. Despite a bundle of infection-control interventions, the incidence of new cases was reduced only after removal of the temperature probes. All outbreak sequences formed a single genetic cluster within the C. auris South African clade. The sequenced isolates from reusable equipment were genetically related to isolates from the patients.
CONCLUSIONS
The transmission of C. auris in this hospital outbreak was found to be linked to reusable axillary temperature probes, indicating that this emerging pathogen can persist in the environment and be transmitted in health care settings. (Funded by the National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at Oxford University and others.)

 

 

E. coli (and Salmonella and Norovirus) aftermath: Chipotle sales and revenue plummet in the second quarter

Chipotle Mexican Grill reported a steep drop in second-quarter earnings Thursday and missed analysts’ estimates as the fast-casual restaurant struggles to regain its footing after a series of food safety scares, and the recent arrest of one of its executives for drug possession.

chipotle.earning.jul.16The restaurant chain’s profit plunged to $25.6 million in the quarter ended June 30, down 81% from $140.2 million from the same period a year ago. Revenue dropped to $998.4 million, off 16.6% from $1.2 billion compared to 2015. Analysts had expected sales of $1.05 billion, according to S&P Global Market Intelligence.

Earnings per share plummeted to 87 cents versus $4.45 per share in the second quarter of last year. That was also below earnings per share estimates of 90 cents.

Sales at stores open at least a year, a key metric for the industry, fell 23.6%. That was a slightly milder drop than than the nearly 30% fall Chipotle reported in the first quarter.

It’s been a slow climb back to normalcy for the Mexican restaurant, which has been aggressively trying to court favor with its formerly loyal fans.

“Our entire company is focused on restoring customer trust and reestablishing customer frequency,” said co-CEO Steve Ellis in a statement.

The company has employed an expansive comeback strategy, including using coupons, promotional discounts and even a short animated film about the perils of big food operations to get customers back buying burritos again. It implemented new food safety standards and shook up its long-unchanged menu with a new item: chorizo, a spicy chicken and pork sausage available in select locations.

Chipotle has moved away from testing some ingredients in central kitchens for pathogens because doing so resulted in lower quality, co-Chief Executive Steve Ells said on Thursday.

south.park.dead.celebrities.chipotle“Cutting bell peppers for testing in a central kitchen degraded the peppers,” Mr. Ells said, adding that the company has reversed testing for bell peppers, lettuce and other ingredients because its new food-safety czar James Marsden has developed other interventions to sanitize ingredients. The bell peppers are now blanched in the restaurants, a process Mr. Ells said kills pathogens.

Bell peppers and lettuce are now being chopped again in the restaurants and food quality complaints have decreased, co-Chief Executive Monty Moran said.

NY resort closed due to norovirus outbreak; ill patrons share stories using #MoChunk hashtag

Upstate New York in February is not something that makes me think resort vacation. But what do I know. Mohonk Mountain House, a popular getaway spot in the Catskills, is also the site of a big norovirus outbreak. According to NPR, hundreds of visitors and staff have become ill in the past 10 days.

[The resort]  closed Friday afternoon so that cleaning crews from a company that specializes in disaster responses can scour the place after an outbreak of intestinal illness. The cleanup is expected to take a week. Screen Shot 2014-02-07 at 10.36.36 PM

Kyle Bonner, a 21-year-old graduate student at Monmouth University, and his partner were among the guests who got sick. They stayed at the resort last weekend, checking out Sunday morning. “I’m still not feeling well. I was sick all day Monday and Tuesday,” he tells Shots. His partner was treated for dehydration at a hospital ER in New Jersey after they got home.

“What bothers me the most is that there was a large conference a few days before we arrived and many of the participants contracted the same virus,” Bonner in a review on the website TripAdvisor.

Bonner [says] that he didn’t need to go to Mohonk last weekend. The resort should have told him and other guests that there was a “fast-moving virus” on the premises so they could have changed their plans.

Quite a few attendees of a meeting of at the resort late last week got sick. Many made the best of it with on Twitter. You can read their accounts by searching for the evocative hashtag #MoChunk.

A message to the resort’s staff was reprinted in the Times Herald-Record and included the below explination for closing:

Over the course of the last few days, it has become increasingly clear to us that the virus that has caused illness among staff and guests is very persistent.

Working with the Ulster County and New York State Departments of Health, we have already implemented many recommended measures to address this issue and have determined that further action needs to be taken.

After careful consideration of our options, we have decided that the best course of action is to close for a week and hire a contractor that specializes in this type of work to sanitize the property.

Mohonk Mountain House is taking a unique step to close for a week to clean and sanitize the site; actions like that are often only seen on cruise ships. An unstated benefit of closing for a week is that any staff who are ill should have time to recover from their symptoms and get past the high-shedding stage – without the temptation to show up to work sick.

Memo to Australian retailers: provide sanitizing wipes in stores or pay to clean my shorts

This is going to be transformed into dinner in about 12 hours, traditional comfort food as the people of Brisbane bundle up with lows as low as 59F and highs of only 69F with rain (people are dressed like it was Feb. in Saskatoon).

But when I picked the bird out of the cooler case yesterday, blood ran down my hand. I looked for something to help clean up the mess and could only find my shorts.

The same thing happened a few weeks ago with some marked-down packaged chicken pieces. I happened to pick a checkout aisle that was being manned by the manager. I asked Mr. Megalomart Manager if he had something form me to wipe my hands on.

Nope.

I asked about the bloody drippings now on the checkout conveyor. He looked around but couldn’t find the sanitizing solution he insisted was at every checkout.

I said, in the U.S. and Canada, it has become routine to find disposable sanitizing wipes not only near the meat counter, but any raw product such as produce, along with a variety of contraptions and wipes for sanitizing shopping carts.

Manager thought the wipes were a decent idea; they had a weekly food safety meeting and he’d bring it up with corporate.

Corporate trashed the idea because of cost and waste.

Something to keep in mind next time a vp of something proclaims, “food safety is our top priority.”

If the hygiene hypothesis is real, does it matter?

The most frequently asked question with public and scientific crowds at any food safety jamfest I’ve done over the past 20 years: Is food too clean?

It comes from that adage, what doesn’t kill you makes you stronger.

But what if it kills you? Or causes irreparable damage, like 8-year-old Brit, Elisabeth Willoughby, who contracted toxocariasis, probably from contact with dog doo while crawling in the park as an infant. Her right eye was permanently scarred by the roundworm parasite.

Watching daughter Sorenne slowly recover from whatever made her stronger the other night via 14 vomits and five diarrheal episodes reinforced, to me, how little is known.

The concept of exposing people to germs at an early age to build immunity is known as the hygiene hypothesis.

I’m not an immunologist, but the idea makes biological sense; I do, however, get concerned with the details, and generalizations.

Medical types have suggested that the hygiene hypothesis explains the global increase of allergic and autoimmune diseases in urban settings. It has also been suggested that the hypothesis explains the changes that have occurred in society and environmental exposures, such as giving antibiotics early in life.

Researchers at Brigham and Women’s Hospital (BWH) reported in Science last month that exposing germ-free mice to microbes during their first weeks of life, but not when exposed later in adult life, led to a normalized immune system and prevention of diseases.

Moreover, the protection provided by early-life exposure to microbes was long-lasting, as predicted by the hygiene hypothesis.

"These studies show the critical importance of proper immune conditioning by microbes during the earliest periods of life," said Richard Blumberg, MD, chief for the BWH Division of Gastroenterology, Hepatology and Endoscopy, and co-senior study author, in collaboration with Dennis Kasper, MD, director of BWH’s Channing Laboratory and co-senior study author. "Also now knowing a potential mechanism will allow scientists to potentially identify the microbial factors important in determining protection from allergic and autoimmune diseases later in life."

Does that mean if your kid gets an infectious disease later in life, parents are negligent for not exposing them to a little infectious disease earlier in life?

It all sounds romantically agrarian – a little dirt is good for you – until specifics get in the way; specifics like, it’s your kid.

My answer to questioning minds goes something like this:

We know immune systems take several years to develop in young children, and things start to go downhill after 55. (Freedom 55?) A little dirt may be good for kids, but there will always be some who, through genetics, environment and other unknowns, will be more susceptible to disease than others. And we’re not smart enough to know who those individuals are. The good ole’ days usually included stories about a family that lost a kid. And it was probably some kind of infectious disease. Western societies have enough science and enough affluence to decide, one is too many.

Then there’s the policy. I can’t image the agriculture minister or secretary announcing that investments in a lot of this food safety stuff would be better spent on other societal priorities. We’ve done a cost-benefit analysis and decided it’s better for everyone to get a little sick. We’re going to lose a few, and we don’t know who those few (or many) are, but it’s a cost-effective approach.

T. Olszak, D. An, S. Zeissig, M. P. Vera, J. Richter, A. Franke, J. N. Glickman, R. Siebert, R. M. Baron, D. L. Kasper, R. S. Blumberg. Microbial exposure during early life has persistent effects on natural killer T cell function. Science, 2012; DOI: 10.1126/science.1219328

Secret of safe sprouts is in the seeds

The secret to keeping sprouts free of foodborne pathogens lies in industry’s intense attention to cleanliness of seeds.

"Once seeds have germinated, it’s too late. Sprouts are extremely complex structures with a forest-like root system that conceals microorganisms. Just a few E. coli cells can grow to a substantial population during germination and sprouting, and it’s very difficult to get rid of them all," said Hao Feng, a University of Illinois associate professor of food and bioprocess engineering.

Feng’s study is the cover story of the August 2011 issue of the Journal of Food Science. Two other papers that detail his work with sprouts will appear in upcoming issue of that journal and in the Journal of Food Protection.

In his experiments, Feng used both the FDA-recommended dose of chlorine to kill microorganisms and a new sanitizer that was a combination of surfactant and organic acid. He used a laser-scanning confocal microscope to look at micro-slices of seeds, then employed computer software to get a three-dimensional view of their surface structure. This allowed him to calculate each seed’s surface roughness.

Although E. coli could be eliminated on the alfalfa seeds because of their relatively smooth surface, broccoli and radish seeds have rough surfaces. Their texture renders these rougher seeds more susceptible to the attachment of pathogens and makes these microorganisms very difficult to remove, he said.

Feng assured consumers that sprouts are carefully tested for the presence of pathogens. "When there is one positive result, the entire batch is thrown out," he said.

Feng said this research demonstrates the importance of eliminating all pathogens on seeds before sprouting.

"The food industry must maintain very strict control in the sprout production process, focusing on the cleanliness of seeds and expending money and effort on prevention. Then consumers can be assured that these nutritious food products are safe to eat," Feng said.

But with no food safety marketing at retail, how do consumers know which sprouts came from safe(erer) seeds?