RESUMO
BACKGROUND: The objective of this study was to analyze the effects of sedation administration on clinical parameters, comfort status, intubation requirements, and the pediatric intensive care unit (PICU) length of stay (LOS) in children with acute respiratory failure (ARF) receiving noninvasive ventilation (NIV). METHODS: Thirteen PICUs in Spain participated in a prospective, multicenter, observational trial from January to December 2021. Children with ARF under the age of five who were receiving NIV were included. Clinical information and comfort levels were documented at the time of NIV initiation, as well as at 3, 6, 12, 24, and 48 h. The COMFORT-behavior (COMFORT-B) scale was used to assess the patients' level of comfort. NIV failure was considered to be a requirement for endotracheal intubation. RESULTS: A total of 457 patients were included, with a median age of 3.3 months (IQR 1.3-16.1). Two hundred and thirteen children (46.6%) received sedation (sedation group); these patients had a higher heart rate, higher COMFORT-B score, and lower SpO2/FiO2 ratio than did those who did not receive sedation (non-sedation group). A significantly greater improvement in the COMFORT-B score at 3, 6, 12, and 24 h, heart rate at 6 and 12 h, and SpO2/FiO2 ratio at 6 h was observed in the sedation group. Overall, the NIV success rate was 95.6%-intubation was required in 6.1% of the sedation group and in 2.9% of the other group (p = 0.092). Multivariate analysis revealed that the PRISM III score at NIV initiation (OR 1.408; 95% CI 1.230-1.611) and respiratory rate at 3 h (OR 1.043; 95% CI 1.009-1.079) were found to be independent predictors of NIV failure. The PICU LOS was correlated with weight, PRISM III score, respiratory rate at 12 h, SpO2 at 3 h, FiO2 at 12 h, NIV failure and NIV duration. Sedation use was not found to be independently related to NIV failure or to the PICU LOS. CONCLUSIONS: Sedation use may be useful in children with ARF treated with NIV, as it seems to improve clinical parameters and comfort status but may not increase the NIV failure rate or PICU LOS, even though sedated children were more severe at technique initiation in the present sample.
Assuntos
Unidades de Terapia Intensiva Pediátrica , Ventilação não Invasiva , Insuficiência Respiratória , Humanos , Ventilação não Invasiva/métodos , Ventilação não Invasiva/estatística & dados numéricos , Estudos Prospectivos , Feminino , Masculino , Lactente , Unidades de Terapia Intensiva Pediátrica/estatística & dados numéricos , Unidades de Terapia Intensiva Pediátrica/organização & administração , Insuficiência Respiratória/terapia , Espanha , Pré-Escolar , Hipnóticos e Sedativos/uso terapêutico , Hipnóticos e Sedativos/administração & dosagem , Sedação Consciente/métodos , Sedação Consciente/estatística & dados numéricosRESUMO
Challenge tests are commonly employed to evaluate the growth behavior of L. monocytogenes in food matrices; they are known for being expensive and time-consuming. An alternative could be the use of predictive models to forecast microbial behavior under different conditions. In this study, the growth behavior of L. monocytogenes in different fresh produce was evaluated using a predictive model based on the Gamma concept considering pH, water activity (aw), and temperature as input factors. An extensive literature search resulted in a total of 105 research articles selected to collect growth/no growth behavior data of L. monocytogenes. Up to 808 L. monocytogenes behavior values and physicochemical characteristics were extracted for different fruits and vegetables. The predictive performance of the model as a tool for identifying the produce commodities supporting the growth of L. monocytogenes was proved by comparing with the experimental data collected from the literature. The model provided satisfactory predictions on the behavior of L. monocytogenes in vegetables (>80% agreement with experimental observations). For leafy greens, a 90% agreement was achieved. In contrast, the performance of the Gamma model was less satisfactory for fruits, as it tends to overestimate the potential of acid commodities to inhibit the growth of L. monocytogenes.
Assuntos
Microbiologia de Alimentos , Frutas , Listeria monocytogenes , Verduras , Listeria monocytogenes/crescimento & desenvolvimento , Verduras/microbiologia , Verduras/crescimento & desenvolvimento , Frutas/microbiologia , Concentração de Íons de Hidrogênio , Temperatura , Modelos Biológicos , Água/metabolismo , Contagem de Colônia Microbiana , Contaminação de Alimentos/análiseRESUMO
Weather affects key aspects of bacterial behavior on plants but has not been extensively investigated as a tool to assess risk of crop contamination with human foodborne pathogens. A novel mechanistic model informed by weather factors and bacterial state was developed to predict population dynamics on leafy vegetables and tested against published data tracking Escherichia coli O157:H7 (EcO157) and Salmonella enterica populations on lettuce and cilantro plants. The model utilizes temperature, radiation, and dew point depression to characterize pathogen growth and decay rates. Additionally, the model incorporates the population level effect of bacterial physiological state dynamics in the phyllosphere in terms of the duration and frequency of specific weather parameters. The model accurately predicted EcO157 and S. enterica population sizes on lettuce and cilantro leaves in the laboratory under various conditions of temperature, relative humidity, light intensity, and cycles of leaf wetness and dryness. Importantly, the model successfully predicted EcO157 population dynamics on 4-week-old romaine lettuce plants under variable weather conditions in nearly all field trials. Prediction of initial EcO157 population decay rates after inoculation of 6-week-old romaine plants in the same field study was better than that of long-term survival. This suggests that future augmentation of the model should consider plant age and species morphology by including additional physical parameters. Our results highlight the potential of a comprehensive weather-based model in predicting contamination risk in the field. Such a modeling approach would additionally be valuable for timing field sampling in quality control to ensure the microbial safety of produce. IMPORTANCE Fruits and vegetables are important sources of foodborne disease. Novel approaches to improve the microbial safety of produce are greatly lacking. Given that bacterial behavior on plant surfaces is highly dependent on weather factors, risk assessment informed by meteorological data may be an effective tool to integrate into strategies to prevent crop contamination. A mathematical model was developed to predict the population trends of pathogenic E. coli and S. enterica, two major causal agents of foodborne disease associated with produce, on leaves. Our model is based on weather parameters and rates of switching between the active (growing) and inactive (nongrowing) bacterial state resulting from prevailing environmental conditions on leaf surfaces. We demonstrate that the model has the ability to accurately predict dynamics of enteric pathogens on leaves and, notably, sizes of populations of pathogenic E. coli over time after inoculation onto the leaves of young lettuce plants in the field.
Assuntos
Escherichia coli O157 , Salmonella enterica , Humanos , Tempo (Meteorologia) , Verduras , Lactuca/microbiologia , Plantas , Folhas de Planta/microbiologia , Modelos Teóricos , Contagem de Colônia Microbiana , Microbiologia de Alimentos , Contaminação de Alimentos/análiseRESUMO
Some water disinfection treatments, such as chlorine and chlorine dioxide, used in the fresh-cut industry to maintain the microbiological quality of process water (PW), inactivate bacterial cells in the water but they also lead to the induction of an intermediate state between viable and non-viable known as viable but non-culturable (VBNC) state. Viable cells can participate in cross-contamination events but the significance of VBNC cells in PW, transfer to the product and potential resuscitation capacity during storage is unclear. The present study aims to determine first, if VBNC cells present in PW can cross-contaminate leafy greens during washing and secondly its potential revival during shelf-life. Process water characterized by a high chemical oxygen demand, due to the presence of high levels of organic matter, was inoculated with Listeria monocytogenes or Escherichia coli O157:H7. Inoculated PW was then treated for 1 min with chlorine dioxide (3 mg/L) or chlorine (5 mg/L) to generate VBNC cells. Absence of culturable cells was confirmed by plate count and VBNC cells by viability quantitative polymerase chain reaction (v-qPCR) complemented with two dyes, ethidium (EMA) and propidium (PMAxx) monoazide. Cross-contamination of shredded lettuce was demonstrated by monitoring the VBNC cells after washing the product for 1 min in the contaminated PW and during shelf life (15 days at 7 °C). In the case of L. monocytogenes, considering the total concentration of L. monocytogenes VBNC cells present in the PW, only a low proportion of cells were able to cross-contaminate the product during washing. VBNC L. monocytogenes cells were able to resuscitate on the product during shelf life, although levels of cultivable bacteria, close to the limit if detection (0.7 ± 0.0 log CFU/g), were only detected at the end of storage. On the other hand, VBNC cells of E. coli O157:H7 present in PW were not able to cross-contaminate shredded lettuce during washing. Moreover, when shredded lettuce was artificially inoculated with VBNC E. coli O157:H7, resuscitation of the VBNC cells during storage (15 days at 7 °C) was not observed. Based on the results obtained, injured L. monocytogenes cells present in the PW are able to be transferred to the product during washing. If VBNC L. monocytogenes cells present in leafy greens (shredded lettuce and baby spinach), they can resuscitate, although cultivable numbers remained very low. Taking all the results together, it could be concluded that under industrial conditions, VBNC cells can be transferred from water to product during washing, but their capacity to resuscitate in the leafy greens during storage is low.
Assuntos
Escherichia coli O157 , Listeria monocytogenes , Cloro/farmacologia , Cloro/análise , Manipulação de Alimentos/métodos , Contaminação de Alimentos/prevenção & controle , Contaminação de Alimentos/análise , Lactuca/microbiologia , Água/análise , Contagem de Colônia Microbiana , Microbiologia de AlimentosRESUMO
Since 2020, there is a new European Regulation (EU, 2020/741) on minimum requirements for water reuse, where routine and validation monitoring requirements (log reductions of indicator microorganisms and reference pathogens) have been established. Many reclamation facilities that are already in operation might have difficulties to comply with these performance targets. Existing disinfection systems must be expanded and upgraded. In the case of UV disinfection systems, fluence requirements must be determined to properly design with a focus on the safety and economic-environmental viability of reclaimed water. This study can be used as a reference to develop fluence-response curves for Clostridium perfringens spores, Escherichia coli, and total and F-specific coliphages, indicator microorganisms referred to in the new European Regulation. Eight UV-LED collimated beam tests were performed. Samples were obtained from filtered effluent of secondary treatment from two wastewater treatment plants (WWTPs) which ranged between 30 and 54%. Results showed UV sensitivity of 33.46 mJ/cm2 log I for C. perfringens spores and 2.86 mJ/cm2 log I for E. coli, both from environmental origin. Coliphages were inactivated below the limit of quantitation. The non-dominance of MS2 phages in environmental F-specific coliphages was observed.
Assuntos
Desinfecção , Escherichia coli , ÁguaRESUMO
A previously healthy 12-year-old boy had severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related multisystem inflammatory syndrome (MIS-C) that was rapidly fatal. Autopsy revealed the presence of a large intracardiac thrombus. SARS-CoV-2 spike protein was detected in intestinal cells, supporting the hypothesis that viral presence in the gut may be related to the immunologic response of MIS-C.
Assuntos
COVID-19 , Intestinos , Glicoproteína da Espícula de Coronavírus , COVID-19/complicações , COVID-19/patologia , Criança , Evolução Fatal , Humanos , Intestinos/virologia , Masculino , SARS-CoV-2 , Síndrome de Resposta Inflamatória SistêmicaRESUMO
Since its first identification in the United Kingdom in late 2020, the highly transmissible B.1.1.7 variant of SARS-CoV-2 has become dominant in several countries raising great concern. We developed a duplex real-time RT-qPCR assay to detect, discriminate, and quantitate SARS-CoV-2 variants containing one of its mutation signatures, the ΔHV69/70 deletion, and used it to trace the community circulation of the B.1.1.7 variant in Spain through the Spanish National SARS-CoV-2 Wastewater Surveillance System (VATar COVID-19). The B.1.1.7 variant was detected earlier than clinical epidemiological reporting by the local authorities, first in the southern city of Málaga (Andalucía) in week 20_52 (year_week), and multiple introductions during Christmas holidays were inferred in different parts of the country. Wastewater-based B.1.1.7 tracking showed a good correlation with clinical data and provided information at the local level. Data from wastewater treatment plants, which reached B.1.1.7 prevalences higher than 90% for ≥2 consecutive weeks showed that 8.1 ± 2.0 weeks were required for B.1.1.7 to become dominant. The study highlights the applicability of RT-qPCR-based strategies to track specific mutations of variants of concern as soon as they are identified by clinical sequencing and their integration into existing wastewater surveillance programs, as a cost-effective approach to complement clinical testing during the COVID-19 pandemic.
Assuntos
COVID-19 , SARS-CoV-2 , Humanos , Pandemias , Águas ResiduáriasRESUMO
The elaboration of guidelines for the industry to establish minimum concentration to prevent cross-contamination during washing practices based on operational limits is the core of the recommended criteria for the use of sanitizers. Several studies have evidenced that sanitizers reduced the levels of foodborne pathogens. However, they might lead to the progress into a viable but non-culturable (VBNC) state of the cells. This evidence has raised concerns regarding the effectiveness of the recommended washing practices for the inactivation of microbial cells present in the process wash water (PWW). The present study evaluated if the most commonly used sanitizers, including sodium hypochlorite (chlorine), peroxyacetic acid (PAA) and chlorine dioxide (ClO2) at established operational limits induced the VBNC stage of Listeria monocytogenes and Escherichia coli O157:H7. Prevention of cross-contamination was examined in four different types of PWW from washing shredded lettuce and cabbage, diced onions, and baby spinach under simulated commercial conditions of high organic matter and 1 min contact time. The results obtained for chlorine showed that recommended operational limits (20-25 mg/L free chlorine) were effective in inactivating L. monocytogenes and E. coli O157:H7 in the different PWWs. However, the operational limits established for PAA (80 mg/L) and ClO2 (3 mg/L) reduced the levels of culturable pathogenic bacteria but induced the VBNC state of the remaining cells. Consequently, the operational limits for chlorine are satisfactory to inactivate foodborne pathogens present in PWW and prevent cross-contamination but higher concentrations or longer contact times should be needed for PAA and ClO2 to reduce the likelihood of the induction of VBNC bacteria cells, as it represents a hazard.
Assuntos
Compostos Clorados/farmacologia , Cloro/farmacologia , Desinfetantes/farmacologia , Escherichia coli O157/efeitos dos fármacos , Listeria monocytogenes/efeitos dos fármacos , Óxidos/farmacologia , Ácido Peracético/farmacologia , Contagem de Colônia Microbiana , Escherichia coli O157/crescimento & desenvolvimento , Manipulação de Alimentos/instrumentação , Listeria monocytogenes/crescimento & desenvolvimento , Viabilidade Microbiana/efeitos dos fármacosRESUMO
The monthly retrospective search for unreported acute flaccid paralysis (AFP) cases conducted as a complementary component of the Spanish AFP surveillance system identified a case of AFP in a child admitted in Spain from Senegal during August 2021. Vaccine-derived poliovirus 2 was identified in the stool in September 2021. We present public health implications and response undertaken within the framework of the National Action Plan for Polio Eradication and the Public Health Emergency of International Concern.
Assuntos
Poliomielite , Poliovirus , Criança , Humanos , Paralisia , Poliomielite/epidemiologia , Poliomielite/prevenção & controle , Vacina Antipólio Oral/efeitos adversos , Vigilância da População , Saúde Pública , Estudos Retrospectivos , Espanha/epidemiologiaRESUMO
The Food Safety Modernization Act (FSMA) includes a time-to-harvest interval following the application of noncompliant water to preharvest produce to allow for microbial die-off. However, additional scientific evidence is needed to support this rule. This study aimed to determine the impact of weather on the die-off rate of Escherichia coli and Salmonella on spinach and lettuce under field conditions. Standardized, replicated field trials were conducted in California, New York, and Spain over 2 years. Baby spinach and lettuce were grown and inoculated with an â¼104-CFU/ml cocktail of E. coli and attenuated Salmonella Leaf samples were collected at 7 time points (0 to 96 h) following inoculation; E. coli and Salmonella were enumerated. The associations of die-off with study design factors (location, produce type, and bacteria) and weather were assessed using log-linear and biphasic segmented log-linear regression. A segmented log-linear model best fit die-off on inoculated leaves in most cases, with a greater variation in the segment 1 die-off rate across trials (-0.46 [95% confidence interval {95% CI}, -0.52, -0.41] to -6.99 [95% CI, -7.38, -6.59] log10 die-off/day) than in the segment 2 die-off rate (0.28 [95% CI, -0.20, 0.77] to -1.00 [95% CI, -1.16, -0.85] log10 die-off/day). A lower relative humidity was associated with a faster segment 1 die-off and an earlier breakpoint (the time when segment 1 die-off rate switches to the segment 2 rate). Relative humidity was also found to be associated with whether die-off would comply with FSMA's specified die-off rate of -0.5 log10 die-off/day.IMPORTANCE The log-linear die-off rate proposed by FSMA is not always appropriate, as the die-off rates of foodborne bacterial pathogens and specified agricultural water quality indicator organisms appear to commonly follow a biphasic pattern with an initial rapid decline followed by a period of tailing. While we observed substantial variation in the net culturable population levels of Salmonella and E. coli at each time point, die-off rate and FSMA compliance (i.e., at least a 2 log10 die-off over 4 days) appear to be impacted by produce type, bacteria, and weather; die-off on lettuce tended to be faster than that on spinach, die-off of E. coli tended to be faster than that of attenuated Salmonella, and die-off tended to become faster as relative humidity decreased. Thus, the use of a single die-off rate for estimating time-to-harvest intervals across different weather conditions, produce types, and bacteria should be revised.
Assuntos
Irrigação Agrícola , Escherichia coli/fisiologia , Lactuca/microbiologia , Salmonella typhimurium/fisiologia , Spinacia oleracea/microbiologia , Águas Residuárias/microbiologia , Tempo (Meteorologia) , California , Microbiologia de Alimentos , New York , Folhas de Planta/microbiologia , EspanhaRESUMO
The washing stage from a bell pepper commercial packinghouse was assessed to study some of the critical control points related to bacterial cross-contamination. The washing line comprised two overhead spray bars applications: a pre-wash step without peroxyacetic acid (PAA), and a wash step with PAA. The physicochemical characteristics of the wash water and the bacterial quality and safety of the wash water and bell peppers (including aerobic mesophilic bacteria (AMB), Salmonella spp., and Shiga-toxigenic E. coli (STEC)) were studied. Additionally, the performance of commercial test methods (reflectometry, amperometric probe, chronoamperometric sensor) for measuring the residual concentration of PAA was examined. The bacterial load of the pre-wash water (8.7 ± 1.3 log cfu/100 mL AMB) was very high and thus peppers after the pre-wash showed a significantly higher bacterial load (4.9 ± 0.9 log cfu/g AMB) than the unwashed (3.8 ± 0.7 log cfu/g AMB) or the washed peppers (3.3 ± 0.8 log cfu/g AMB) (p < 0.05). However, no pathogenic bacteria were detected in bell pepper samples (n = 40), and only one water sample was confirmed positive for STEC (n = 64, 1.6% prevalence). The chronoamperometric sensor (PAASense) and the online amperometric probe showed similar results, while the reflectometry (Quantofix) significantly sub estimated (p < 0.05) PAA concentration. The results obtained highlight the need for interventions to improve hygiene in the washing line to ensure the microbiological quality and safety of bell peppers. The maintenance of optimal PAA concentrations in all the washing steps is critical for reducing the chance of water-mediated cross-contamination.
Assuntos
Bactérias/efeitos dos fármacos , Capsicum/microbiologia , Desinfetantes/farmacologia , Contaminação de Alimentos/prevenção & controle , Microbiologia de Alimentos/métodos , Ácido Peracético/farmacologia , Bactérias/crescimento & desenvolvimento , Carga Bacteriana , Contagem de Colônia Microbiana , Escherichia coli O157/efeitos dos fármacos , Indústria Alimentícia/métodos , Concentração de Íons de Hidrogênio , Salmonella/efeitos dos fármacos , Água/análiseRESUMO
Fresh produce causes most foodborne outbreaks in the USA, and it is also considered a hazardous food product in other areas of the world such as Europe. The outbreaks attributed to fresh produce increase the focus of producers on hygiene to minimize exposure to food hazards. The fresh produce industry has the urgent need to detect if there are production lots contaminated with pathogenic microorganisms before distribution. Although the industry is mostly using end-product testing for the detection of target microorganisms, previous studies have evaluated the suitability of different sampling points within the production line of a fresh-cut processing plant. In the present study, the centrifuge effluent water was assessed as an alternative sampling point to end-product testing. E. coli was selected as an index microorganism of the presence of pathogens. The presence of E. coli was assessed in centrifuge effluent water, and fresh-cut lettuce from a commercial fresh-cut produce processing line (nâ¯=â¯95). The rate of false positives and negatives, as well as the specificity, sensitivity, and efficiency of the alternative method were calculated. The mean population of E. coli in positive water samples was 0.86 log cfu/100â¯mL, while the mean population of E. coli in positive fresh-cut lettuce samples was 0.23 log cfu/g. The proportion of positive samples in centrifuge effluent water and lettuce was similar (≈20%), and most of the results in both matrices were coincident (81.1%). However, the alternative method was not reliable due to its low sensitivity, as only 47.6% of the lettuce samples positive for E. coli could be matched with positive water samples.
Assuntos
Escherichia coli O157/isolamento & purificação , Contaminação de Alimentos/análise , Microbiologia de Alimentos/métodos , Lactuca/microbiologia , Água/análise , Centrifugação , Contagem de Colônia Microbiana , Manipulação de Alimentos/métodos , Alimentos Crus/microbiologiaRESUMO
The effects of factors such as weather conditions, leaf age and irrigation water disinfection on the main bacterial genera (total bacterial, Enterobacteriaceae and Pseudomonas) of baby spinach were studied. Culture-dependent and independent quantification techniques were compared. Cultivation was carried out over two consecutive trials in commercial open field divided in two plots: 1) baby spinach irrigated with untreated surface water and 2) baby spinach irrigated with chlorine dioxide (ClO2) treated water. In all the cases, higher concentrations of bacteria were detected using molecular quantification in comparison with culture dependent techniques. Based on the obtained results, wind speed, solar radiation and relative humidity seem to have an impact on the levels of total bacterial, Enterobacteriaceae and Pseudomonas during cultivation of baby spinach. However, further studies would be needed to confirm this tendency. Water disinfection treatments (ClO2), when applied to irrigation water, impacted differently the bacterial genera evaluated in the present study. Thus, although no significant effects were observed in total bacterial enumerations of baby spinach irrigated with ClO2 treated water; significant reductions were detected in Enterobacteriaceae (19%) and Pseudomonas spp. (14%) levels. These results were also confirmed using specific culture-dependent methods. On the other hand, leaf age did not influence the levels of the main bacterial genera of baby spinach. Considering that, a large proportion of foodborne and pathogenic bacteria associated to fresh produce belong to the Enterobacteriaceae family and Pseudomonas genera, reductions in these bacterial groups could be beneficial. However, these groups are very diverse, making difficult to link the measurement of Enterobacteriaceae and Pseudomonas levels with the presence/abundance of potential pathogenic and spoilage microorganisms.
Assuntos
Enterobacteriaceae/isolamento & purificação , Folhas de Planta/microbiologia , Pseudomonas/isolamento & purificação , Spinacia oleracea/microbiologia , Tempo (Meteorologia) , Irrigação Agrícola , Agricultura/métodos , Compostos Clorados/farmacologia , Desinfecção/métodos , Enterobacteriaceae/efeitos dos fármacos , Enterobacteriaceae/genética , Umidade , Microbiota , Óxidos/farmacologia , Folhas de Planta/efeitos dos fármacos , Folhas de Planta/fisiologia , Pseudomonas/efeitos dos fármacos , Pseudomonas/genética , Spinacia oleracea/efeitos dos fármacos , Spinacia oleracea/fisiologia , Células-Tronco , Água/química , Água/farmacologia , Microbiologia da Água , VentoRESUMO
Among the many vascular complications of sickle cell disease (SCD), retinopathy is the most prevalent and represents a leading cause of blindness. Hydroxycarbamide therapy ameliorates many symptoms of SCD, and high fetal haemoglobin (HbF) levels have been shown to protect against the development of retinopathy in children with HbSS. Its effect on adults with SCD, who are at a much higher risk of developing retinopathy, has not been studied. We aimed to investigate the effect of hydroxycarbamide use and HbF level on sickle cell retinopathy development in adults. We performed a retrospective cross-sectional study and collected demographics, comorbidities, and ocular and haematological data from 300 adult sickle cell subjects examined at the Henkind Eye Institute at Montefiore Medical Center during a 5-year period, from October 2012 to November 2017. The cohort was comprised mainly of Black and Hispanic subjects with all SCD genotypes, aged 18-71 years. Results show that in HbSS patients treated with hydroxycarbamide, those with retinopathy had significantly lower HbF levels compared to patients without retinopathy (P = 0·018). Our study identified the optimal HbF cut-off point for retinopathy protection to be 14·87%. Thus, a HbF level of 15% appears to be the threshold above which the odds for developing retinopathy in SS patients are reduced by 50%.
Assuntos
Anemia Falciforme/complicações , Hemoglobina Fetal/metabolismo , Doenças Retinianas/prevenção & controle , Adolescente , Adulto , Idoso , Anemia Falciforme/sangue , Anemia Falciforme/tratamento farmacológico , Antidrepanocíticos/uso terapêutico , Estudos Transversais , Feminino , Humanos , Hidroxiureia/uso terapêutico , Masculino , Pessoa de Meia-Idade , Doenças Retinianas/sangue , Doenças Retinianas/etiologia , Estudos Retrospectivos , Resultado do Tratamento , Adulto JovemRESUMO
The use of Quantitative Microbial Exposure Assessment (QMEA) modelling of faecal hygiene indicator microorganisms (e.g. E. coli), is proposed as an alternative approach to the use of Quantitative Microbiological Risk Assessment (QMRA) models of enteric pathogenic microorganisms in the fresh produce chain. As more field data and quantitative microbial models become available, the potential use of QMEA models as a tool to assess the impact of different risk mitigation strategies increases helping growers to make the right decisions. This paper focuses on the pros and cons of previously published QMRAs as well as on the proposal of an alternative approach based on the use of a quantitative microbial contamination modelling to investigate how the selection of the irrigation water sources affect the E. coli loads in leafy greens at harvest. The modified model describes the final E. coli levels of baby spinach when different water sources with different contamination levels are applied and the impact of seasonality. Substantial differences were observed between the irrigation water sources while seasonality only had small effects on the simulated levels of E. coli in the harvested baby spinach. Based on the results, the produce grown using irrigation water from drainage ditches show E. coli levels above threshold levels (2 log CFU/g) while less than 1% of baby spinach irrigated with water obtained from water reservoirs where above this limit. The use of this QMEA model will help growers in the decision-making process to reduce microbial contamination of leafy greens.
Assuntos
Irrigação Agrícola , Fezes/microbiologia , Contaminação de Alimentos/análise , Folhas de Planta/crescimento & desenvolvimento , Spinacia oleracea/microbiologia , Microbiologia da Água , Escherichia coli/crescimento & desenvolvimento , Escherichia coli/isolamento & purificação , Higiene , Modelos Biológicos , Folhas de Planta/microbiologia , Estações do Ano , Spinacia oleracea/crescimento & desenvolvimentoRESUMO
The effects of relative humidity (RH), fluctuating climate conditions, inoculum size and carrier on the survival of Salmonella enterica serovar Typhimurium on baby lettuce in environmental test chambers were studied. Buffered peptone water (BPW), distilled water (DW), and irrigation water (IW) were compared as inoculum carriers. Additionally, survival of Salmonella in suspensions prepared using filtered and unfiltered IW was assessed. Salmonella Typhimurium survived better on baby lettuce plants at high RH independently of the inoculum size. When lettuce plants were grown under fluctuating environmental conditions, Salmonella survival was similar under both RH conditions. Regarding the inoculum carrier, the inoculated microorganism survived better on lettuce plants when BPW was used as carrier both at high and low RH. Survival rate of Salmonella in IW was affected by the presence of native microbiota. Native microbiota present in IW did not affect survival of Salmonella or the levels of mesophilic bacteria on the baby lettuce leaves. The information obtained in the present study contributes to the knowledge on the effect of environmental conditions on pathogenic bacteria survival on growing edible plants. These results are useful when selecting the methodology to carry out experimental studies on the survival of microbial pathogens under different pre-harvest conditions.
Assuntos
Bactérias/isolamento & purificação , Lactuca/microbiologia , Microbiota , Salmonella typhimurium/crescimento & desenvolvimento , Bactérias/classificação , Bactérias/genética , Bactérias/crescimento & desenvolvimento , Contaminação de Alimentos/análise , Umidade , Lactuca/química , Folhas de Planta/microbiologia , Água/análiseRESUMO
Reclaimed water obtained from urban wastewater is currently being used as irrigation water in water-scarce regions in Spain. However, wastewater can contain enteric viruses that water reclamation treatment cannot remove or inactivate completely. In the present study, greenhouse-grown baby lettuce ( L.) was irrigated with secondary treatment effluent from a wastewater treatment plant untreated and treated using chlorine dioxide (ClO). The effect of ClO treatment on the physicochemical characteristics and the presence of enteric viruses in irrigation water and lettuce was assessed. The presence of human noroviruses genogroups I and II (NoV GI and NoV GII), and human astroviruses (HAstV), was analyzed by real-time polymerase chain reaction (RT-qPCR). Additionally, to check for the loss of infectivity induced by the disinfection treatment, positive samples were re-analyzed after pretreatment with the intercalating dye PMAxx before RNA extraction and RT-qPCR. There were no significant differences in the proportion of positive samples and the concentration of enteric viruses between treated and untreated reclaimed water without PMAxx pretreatment ( > 0.05). A significantly lower concentration of NoV GI was detected in ClO-treated water when samples were pretreated with PMAxx ( < 0.05), indicating that inactivation was due to the disinfection treatment. Laboratory-scale validation tests indicated the suitability of PMAxx-RT-qPCR for discrimination between potentially infectious and ClO-damaged viruses. Although the applied ClO treatment was not able to significantly reduce the enteric virus load of the secondary effluent from the wastewater treatment plant, none of the lettuce samples analyzed ( = 36) was positive for the presence of NoV or HAstV.
Assuntos
Irrigação Agrícola/métodos , Compostos Clorados/toxicidade , Desinfetantes/toxicidade , Desinfecção/métodos , Óxidos/toxicidade , Águas Residuárias/virologia , Norovirus/efeitos dos fármacos , Eliminação de Resíduos Líquidos/métodosRESUMO
The DESERT-prototype, a state-of-the-art compact combination of water treatment technologies based on filtration and solar-based renewable energy, was employed to reclaim water for agricultural irrigation. Water reclaimed through the DESERT-prototype (PW) from a secondary effluent of a wastewater treatment plant, as well as conventional irrigation water (CW) and the secondary effluent (SW) itself, were employed to cultivate baby romaine lettuces in a greenhouse in Murcia (Spain), by means of drip and sprinkler irrigation methods, thus establishing six treatments. Assessments of physicochemical and microbiological quality of irrigation water, as well as agronomic and microbiological quality of crops from all treatments, showed that results associated to PW complied in all cases with relevant standards and guidelines. In contrast, results linked to SW and CW presented certain non-compliance cases of water and crop microbiological quality. These assessments lead to conclude that the DESERT-prototype is an appropriate technology for safe water reclamation oriented to agricultural production, that can be complemented by a proper irrigation method in reaching safety targets.
Assuntos
Irrigação Agrícola , Eliminação de Resíduos Líquidos , Águas Residuárias , Agricultura , Espanha , ÁguaRESUMO
BACKGROUND: Treatments for the disinfection of irrigation water have to be evaluated by demonstration tests carried out under commercial settings taking into account not only their antimicrobial activity but also the potential phytotoxic effects on the crop. The consequences of the treatment of irrigation water with chlorine dioxide (ClO2 ) used for sprinkler irrigation of baby spinach in two commercial agricultural fields was assessed. RESULTS: Residual ClO2 levels at the sprinklers in the treated field were always below 1 mg L-1 . ClO2 treatment provoked limited but statistically significant reductions in culturable Escherichia coli counts (0.2-0.3 log reductions), but not in the viable E. coli counts in water, suggesting the presence of viable but non-culturable cells (VBNC). Although disinfected irrigation water did not have an impact on the microbial loads of Enterobacteriaceae nor on the quality characteristics of baby spinach, it caused the accumulation of chlorates (up to 0.99 mg kg-1 in plants) and the reduction of the photosynthetic efficiency of baby spinach. CONCLUSION: Low concentrations of ClO2 are effective in reducing the culturable E. coli present in irrigation water but it might induce the VBNC state. Presence of disinfection by-products and their accumulation in the crop must be considered to adjust doses in order to avoid crop damage and chemical safety risks. © 2017 Society of Chemical Industry.
Assuntos
Compostos Clorados/farmacologia , Desinfetantes/farmacologia , Água Doce/química , Óxidos/farmacologia , Spinacia oleracea/efeitos dos fármacos , Irrigação Agrícola , Compostos Clorados/química , Desinfetantes/química , Desinfecção , Escherichia coli/efeitos dos fármacos , Escherichia coli/crescimento & desenvolvimento , Contaminação de Alimentos/análise , Água Doce/microbiologia , Óxidos/química , Spinacia oleracea/química , Spinacia oleracea/crescimento & desenvolvimento , Spinacia oleracea/microbiologiaRESUMO
BACKGROUND: Irrigation water disinfection reduces the microbial load but it might lead to the formation and accumulation of disinfection by-products (DBPs) in the crop. If DBPs are present in the irrigation water, they can accumulate in the crop, particularly after the regrowth, and be affected by the postharvest handling such as washing and storage. To evaluate the potential accumulation of DBPs, baby lettuce was grown using irrigation water treated with electrolysed water (EW) in a commercial greenhouse over three consecutive harvests and regrowths. The impact of postharvest practices such as washing and storage on DBP content was also assessed. RESULTS: Use of EW caused the accumulation of chlorates in irrigation water (0.02-0.14 mg L-1 ), and in the fresh produce (0.05-0.10 mg kg-1 ). On the other hand, the disinfection treatment had minor impact regarding the presence of trihalomethanes (THMs) in water (0.3-8.7 µg L-1 max), and in baby lettuce (0.3-2.9 µg kg-1 max). CONCLUSIONS: Disinfection of irrigation water with EW caused the accumulation of chlorates in the crop reaching levels higher than the current maximum residual limit established in the EU legislation for leafy greens. © 2017 Society of Chemical Industry.