Prioritization of vegetable-borne biological hazards in Argentina using a multicriteria decision analysis tool.

Vegetables, especially those eaten raw, have been implicated in several foodborne disease outbreaks. Since multiple vegetable matrices and hazards are involved, risk managers have to prioritize those with the greatest impact on public health to design control strategies. In this study, a scientific-based risk ranking of foodborne pathogens transmitted by leafy green vegetables in Argentina was performed. The prioritization process included hazard identification, evaluation criteria identification and definition, criteria weighting, expert survey design and selection and call for experts, hazard score calculation, hazard ranking and variation coefficient, and result analysis. Regression tree analysis determined four risk clusters: high (Cryptosporidum spp., Toxoplasma gondii, Norovirus), moderate (Giardia spp., Listeria spp., Shigella sonnei), low (Shiga toxin-producing Escherichia coli, Ascaris spp., Entamoeba histolytica, Salmonella spp., Rotavirus, Enterovirus) and very low (Campylobacter jejuni, hepatitis A virus and Yersinia pseudotuberculosis). Diseases caused by Norovirus, Cryptosporidium spp. and T. gondii do not require mandatory notification. Neither viruses nor parasites are included as microbiological criteria for foodstuff. The lack of outbreak studies did not allow to accurately identify vegetables as a source of Norovirus disease. Information on listeriosis cases or outbreaks due to vegetable consumption was not available. Shigella spp. was the main responsible for bacterial diarrhea, but it has not been epidemiologically associated with vegetable consumption. The quality of the available information for all hazards studied was very low and low. The implementation of good practice guidelines throughout the entire vegetable production chain could prevent the presence of the identified hazards. The current study allowed the identification of vacancy areas and could help reinforce the need for performing epidemiological studies on foodborne diseases potentially associated with vegetable consumption in Argentina.

Molecular subtyping of Salmonella spp. strains in provincial abattoirs with no hazard analysis critical control point from Buenos Aires, Argentina / Subtipificación molecular de Salmonella spp. en frigoríficos provinciales sin análisisde peligros y puntos críticos de control ubicados en Buenos Aires, Argentina

Abstract We subtyped 32 Salmonella enterica strains isolated from carcasses (n = 10), theenvironment (n = 14), head meat (n = 1) and viscera washing and chilling water (n = 7) in provin-cial abattoirs with no Hazard Analysis Critical Control Point (HACCP) system from Buenos Aires,Argentina, before and after implementing improvement actions. Pulsed-field gel electrophore-sis (PFGE) was carried out using the XbaI restriction enzyme. Strains belonged to six serovars,from which 10 restriction patterns were obtained (five unique patterns and five clusters). Wefound different clones of S. enterica serovars in the same abattoir by XbaI-PFGE. In addition topromoting good hygiene practices, the implementation of an HACCP plan is necessary to meetthe zero-tolerance criteria for Salmonella on beef.

Resumen Subtipificamos en total 32 cepas de Salmonella enterica aisladas de carcasas(n = 10), medio ambiente (n = 14), carne de cabeza (n = 1) y agua de lavado y enfriamientode vísceras (n = 7) en frigoríficos provinciales de Buenos Aires (Argentina) sin análisis de peli-gros y puntos críticos de control (hazard analysis critical control point [HACCP]); la toma demuestras se efectuó antes y después de implementar acciones de mejora. Se llevó a cabo elec-troforesis en gel de campo pulsado (PFGE) utilizando la enzima de restricción XbaI. Las cepaspertenecían a 6 serovares y presentaron 10 patrones de restricción (5 patrones únicos y 5 clus-ters). Demostramos la presencia de diferentes serovares de S. enterica en un mismo frigorífico.

Molecular subtyping of Salmonella spp. strains in provincial abattoirs with no hazard analysis critical control point from Buenos Aires, Argentina.

We subtyped 32 Salmonella enterica strains isolated from carcasses (n=10), the environment (n=14), head meat (n=1) and viscera washing and chilling water (n=7) in provincial abattoirs with no Hazard Analysis Critical Control Point (HACCP) system from Buenos Aires, Argentina, before and after implementing improvement actions. Pulsed-field gel electrophoresis (PFGE) was carried out using the XbaI restriction enzyme. Strains belonged to six serovars, from which 10 restriction patterns were obtained (five unique patterns and five clusters). We found different clones of S. enterica serovars in the same abattoir by XbaI-PFGE. In addition to promoting good hygiene practices, the implementation of an HACCP plan is necessary to meet the zero-tolerance criteria for Salmonella on beef.

Analysis of scenarios to reduce the probability of acquiring hemolytic uremic syndrome associated with beef consumption.

The objective of this study was to develop a quantitative microbial risk assessment (QMRA) model to evaluate potential risk mitigation strategies to reduce the probability of acquiring hemolytic uremic syndrome (HUS) associated with beef consumption in Argentina. Five scenarios were simulated to evaluate the effect of interventions on the probability of acquiring HUS from Shiga toxin-producing Escherichia coli (STEC)-contaminated ground beef and commercial hamburger consumption. These control strategies were chosen based on previous results of the sensitivity analysis of a baseline QMRA model. The application of improvement actions in abattoirs not applying Hazard Analysis and Critical Control Points (HACCP) for STEC would result 7.6 times lower in the probability that consumers acquired HUS from ground beef consumption, while the implementation of improvements in butcher shops would lead to a smaller reduction. In abattoirs applying HACCP for STEC, the risk of acquiring HUS from commercial hamburger consumption was significantly reduced. Treatment with 2% lactic acid, hot water and irradiation reduced 4.5, 3.5 and 93.1 times the risk of HUS, respectively. The most efficient interventions, in terms of case reduction, being those that are applied in the initial stages of the meat chain.

Quantitative risk assessment of haemolytic uremic syndrome associated with beef consumption in Argentina.

We developed a quantitative microbiological risk assessment (QMRA) of haemolytic uremic syndrome (HUS) associated with Shiga toxin-producing Escherichia coli (STEC)-contaminated beef (intact beef cuts, ground beef and commercial hamburgers) in children under 15 years of age from Argentina. The QMRA was used to characterize STEC prevalence and concentration levels in each product through the Argentinean beef supply chain, including cattle primary production, cattle transport, processing and storage in the abattoir, retail and home preparation, and consumption. Median HUS probability from beef cut, ground beef and commercial hamburger consumption was <10-15, 5.4x10-8 and 3.5x10-8, respectively. The expected average annual number of HUS cases was 0, 28 and 4, respectively. Risk of infection and HUS probability were sensitive to the type of abattoir, the application or not of Hazard Analysis and Critical Control Points (HACCP) for STEC (HACCP-STEC), stx prevalence in carcasses and trimmings, storage conditions from the abattoir to retailers and home, the joint consumption of salads and beef products, and cooking preference. The QMRA results showed that the probability of HUS was higher if beef cuts (1.7x) and ground beef (1.2x) were from carcasses provided by abattoirs not applying HACCP-STEC. Thus, the use of a single sanitary standard that included the application of HACCP-STEC in all Argentinean abattoirs would greatly reduce HUS incidence. The average number of annual HUS cases estimated by the QMRA (n = 32) would explain about 10.0% of cases in children under 15 years per year in Argentina. Since other routes of contamination can be involved, including those not related to food, further research on the beef production chain, other food chains, person-to-person transmission and outbreak studies should be conducted to reduce the impact of HUS on the child population of Argentina.

Characterization and molecular subtyping of Shiga toxin-producing Escherichia coli strains in provincial abattoirs from the Province of Buenos Aires, Argentina, during 2016-2018.

We characterized Shiga toxin-producing Escherichia coli (STEC) O157 (n = 20) and non-O157 (n = 68) isolated from carcasses (n = 54), the environment (n = 20), head meat (n = 3) and viscera washing and chilling water (n = 11) in provincial abattoirs before and after implementing improvement actions. The strains were tested for eae, saa, ehxA and fliCH7 genes. Variants stx1 and stx2 were also determined. Pulsed-field gel electrophoresis (PFGE) was carried out with restriction enzymes XbaI and BlnI. All twenty O157 STEC strains [H7; H21; HNM] carried genes rfbO157 and ehxA; 90.0 % were positive for eae and 15.0 % were negative for fliCH7 and positive for saa. Results of PFGE showed 17 XbaI patterns, of which 14 were unique and three formed clusters. From the 68 non-O157 STEC strains, 66.2 %, 55.9 % and 2.9 % were positive for ehxA, saa and eae genes, respectively. Fifty-three XbaI patterns were obtained (49 unique and four forming clusters). Cross-contamination between products and between the environment and products was confirmed in all abattoirs. While the proposed improvements reduced the risk of contamination, Good Hygiene Practices and Good Manufacturing Practices should be implemented in provincial abattoirs, stressing the importance of having a uniform national food safety standard.

Prevalence of Campylobacter jejuni and Campylobacter coli from broilers at conventional and kosher abattoirs and retail stores / Prevalencia de Campylobacter jejuni y Campylobacter coli en carcasas de pollo procedentes de frigoríficos, faena tradicional y kosher, y de locales de expendio

Abstract We studied and compared the prevalence of Campylobacter jejuni and Campylobacter coli in chicken carcasses from conventional and kosher broiler abattoirs and retail stores. The prevalence of thermotolerant Campylobacter-positive carcasses was 94.0 (kosher) and 32.0% (conventional) (p< 0.0001), while the prevalence of samples contaminated with C. jejuni, C. coli and simultaneously with both species was 36.0, 2.0 and 56.0% (kosher) and 26.0, 4.0 and 2.0% (conventional) (p< 0.0001), respectively. Samples of chicken carcasses (n = 25) and food contact surfaces (tables, n = 25; knives, n=25) from 25 retails were collected and risk quantification was performed. Retails were categorized as high-risk (n = 11), moderate-risk (n = 11) and low-risk (n = 3). Nineteen (76.0%) carcasses, 20 (80.0%) tables and 18 (72.0%) knives were Campylobacter-positive. Retails and abattoirs proved to be sources of carcass contaminaron with Campylobacter spp. Carcasses from kosher abattoirs were mostly contaminated with Campylobacter spp., whereas C. coli was the most prevalent species isolated from carcasses in retail stores.

Resumen El objetivo del estudio fue determinar y comparar la prevalencia de Campylobacter jejuni y Campylobacter coli en carcasas de pollo obtenidas en frigoríficos por faena convencional y kosher, y en locales de expendio. La prevalencia de Campylobacter spp. termotolerante fue del 94,0 (kosher) y del 32,0% (convencional) (p< 0,0001). La prevalencia de muestras contaminadas con C. jejuni, C. coli y con ambas especies fue del 36,0, del 2,0 y del 56,0% (Kosher) y del 26,0, del 4,0 y del 2,0% (convencional) (p< 0,0001), respectivamente. Se tomaron muestras de carcasas (n = 25) y superficies (tablas, n = 25; cuchilla, n = 25) en 25 locales. Los locales fueron categorizados como de riesgo alto (n = 11), moderado (n = 11) y bajo (n = 3). Diecinueve (76,0%) carcasas, 20 (80,0%) tablas y 18 (72,0%) cuchillas fueron positivas para Campylobacter spp. Frigoríficos y locales fueron fuente de contaminación de carcasas con Campylobacter spp. La prevalencia de Campylobacter spp. fue mayor en carcasas kosher. Campylobacter coli fue la especie más prevalente en carcasas de locales.

Comprehensive evaluation and implementation of improvement actions in bovine abattoirs to reduce pathogens exposure.

The slaughter process plays an important role in animal welfare, meat quality, safety and public health through the meat production chain. In this study, we performed a three-stage evaluation: I) comprehensive evaluation, II) implementation of improvement actions and III) verification of the success of the actions implemented in three abattoirs from Argentina during 2016-2018. Risk was estimated using two checklists, quantified on a 1-100 scale and classified as high (1-40), moderate (41-70) and low (71-100). In stages I and III, Salmonella spp., E. coli O157:H7 and non-O157 STEC were detected and isolated in samples from carcasses (n = 252), the environment (n = 252); head meat (n = 21) and viscera washing and chilling water (n = 105). Carcass samples were analyzed for mesophilic aerobic organisms, coliforms and E. coli enumeration. Of 201 water samples taken, 42.0-75.6 % were non-potable quality. After the implementation of improvement actions in stage II (building, processes, systems for water purification and training), the estimation of risk of contamination was reduced from high to moderate in all three abattoirs, the count of indicator microorganisms decreased in two abattoirs, and the presence of pathogens significantly decreased. Salmonella spp. was not isolated from any of the samples collected in two abattoirs. Isolation of E. coli O157:H7 decreased in carcass and was not isolated from viscera washing and chilling water. Isolation of non-O157 STEC decreased in carcass but not in environmental samples. Finally, 75.0-95.0 % of water samples were of potable quality. Although this was only the first step in the process of change and improvement of abattoirs, the assessment of the situation and the proposal of solutions to correct deviations in a joint effort with the health authorities helped to implement a work model for enhancing food safety before meat reaches consumers.

Prevalence of Campylobacter jejuni and Campylobacter coli from broilers at conventional and kosher abattoirs and retail stores.

We studied and compared the prevalence of Campylobacter jejuni and Campylobacter coli in chicken carcasses from conventional and kosher broiler abattoirs and retail stores. The prevalence of thermotolerant Campylobacter-positive carcasses was 94.0 (kosher) and 32.0% (conventional) (p<0.0001), while the prevalence of samples contaminated with C. jejuni, C. coli and simultaneously with both species was 36.0, 2.0 and 56.0% (kosher) and 26.0, 4.0 and 2.0% (conventional) (p<0.0001), respectively. Samples of chicken carcasses (n=25) and food contact surfaces (tables, n=25; knives, n=25) from 25 retails were collected and risk quantification was performed. Retails were categorized as high-risk (n=11), moderate-risk (n=11) and low-risk (n=3). Nineteen (76.0%) carcasses, 20 (80.0%) tables and 18 (72.0%) knives were Campylobacter-positive. Retails and abattoirs proved to be sources of carcass contamination with Campylobacter spp. Carcasses from kosher abattoirs were mostly contaminated with Campylobacter spp., whereas C. coli was the most prevalent species isolated from carcasses in retail stores.

Evaluation of intervention measures at different stages of the production chain in Argentinian exporting abattoirs.

Antimicrobial treatments could help to decrease the transmission of microorganisms to beef carcasses and abattoir environments. The aim of this study was to evaluate the effectiveness of interventions in reducing Shiga toxin genes (stx1 and stx2) presence in a commercial abattoir. Intervention measures included the application of electrolytically generated hypochlorous acid to steer pens (experiment 1), chlorinated water, electrolytically generated hypochlorous acid, and isoclor to steer pens (experiment 2), electrolytically generated hypochlorous acid to knocking pens (experiment 3), and aqueous ozone and electrolytically generated hypochlorous acid onto beef carcasses (experiment 4). Detection of stx in samples was performed with BAX® System Real-Time PCR Assay. Our results showed that treatment with pressurized electrolytically generated hypochlorous acid and isoclor were effective to reduce stx presence from hides on steer pens. Although there is no single strategy to ensure the reduction of stx presence in a commercial abattoir, the combined application of several antimicrobial interventions would be ideal.

Detección y caracterización de Escherichia coli productor de toxina Shiga en ninos atendidos en un hospital pediátrico interzonal de la ciudad de La Plata / Detection and characterization of Shiga toxin-producing Escherichia coli in children treated at an inter-zonal pediatric hospital in the city of La Plata

Escherichia coli productor de toxina Shiga (STEC) es un patógeno transmitido por alimentos que puede causar diarrea acuosa, diarrea sanguinolenta (DS) y síndrome urémico hemolítico (SUH). El objetivo de este estudio fue determinar las características fenotípicas y genotípicas de cepas STEC aisladas de niños con DS y SUH atendidos en un hospital pediátrico de la ciudad de La Plata en el período 2006-2012 y establecer la relación clonal de los aislamientos O157: H7 mediante electroforesis de campo pulsado. El porcentaje de muestras positivas fue de 4,9 y 39,2% en los pacientes que presentaron DS y SUH, respectivamente. Se aislaron 77 cepas STEC de 10 serotipos distintos, con el 100% de recuperación de colonias. El serotipo más frecuente fue O157: H7 (71,4%), seguido por O145: NM (15,6%). El 98,2% de los aislamientos O157: H7 correspondió al biotipo C y fue sensible a los antibióticos ensayados. Todos esos aislamientos presentaron el genotipo stx2, eae, fliC H7, ehxA, iha, efa, toxB, lpfA1-3 y lpfA2-2.Al estudiar la relación clonal de las cepas O157: H7, se identificaron un total de 42 patrones con al menos un 88% de similitud y se establecieron 6 clústeres que agruparon cepas con perfiles idénticos. Los aislamientos eae negativos pertenecieron a los serotipos O59: H19, O102: H6, O174: NM y O174: H21. Las cepas O59: H19 y O174: H21 fueron positivas para el gen aggR. Este estudio muestra que en la ciudad de La Plata y alrededores circulan STEC de diferentes serotipos y genotipos. A pesar de la diversidad genética observada entre los aislamientos O157: H7, algunos fueron indistinguibles por las técnicas de subtipificación utilizadas.

Shiga toxin-producing Escherichia coli (STEC) is a foodborne pathogen that can cause watery diarrhea, bloody diarrhea (BD), and hemolytic uremic syndrome (HUS). The objective of this study was to determine the phenotypic and genotypic profiles of STEC strains isolated from children with BD and HUS treated at a pediatric hospital in the city of La Plata in the period 2006-2012, and to establish the clonal relationship of O157: H7 isolates by pulsed field electrophoresis. The percentage of positive samples was 4.9% and 39.2% in patients with BD and HUS, respectively. Seventy-seven STEC strains from 10 different serotypes were isolated, with 100% colony recovery, O157: H7 being the most frequent (71.4%) serotype, followed by O145: NM (15.6%). An average of 98.2% of O157: H7 isolates belonged to biotype C and were sensitive to all the antibiotics tested. All of them (100%) carried genotype stx2, eae, fliC H7, ehxA, iha, efa, toxB, lpfA1-3 and lpfA2-2. When the clonal relationship of the O157: H7 strains was studied, a total of 42 patterns with at least 88% similarity were identified, and 6 clusters with identical profiles were established. The eae-negative isolates belonged to serotypes O59: H19, O102: H6, O174: NM and O174: H21. The strains O59: H19 and O174: H21 were positive for the aggR gene. This study shows that STEC of different serotypes and genotypes circulate in the city of La Plata and surroundings. Despite the genetic diversity observed between the O157: H7 isolates, some were indistinguishable by the subtyping techniques used.

Evaluation of decontamination efficacy of commonly used antimicrobial interventions for beef carcasses against Shiga toxin-producing Escherichia coli.

In Argentina, Shiga toxin producing Escherichia coli (STEC) serogroups O157, O26, O103, O111, O145 and O121 are adulterant in ground beef. In other countries, the zero-tolerance approach to all STEC is implemented for chilled beef. Argentinean abattoirs are interested in implementing effective interventions against STEC on carcasses. Pre-rigor beef carcasses were used to determine whether nine antimicrobial strategies effectively reduced aerobic plate, coliform and E. coli counts and stx and eae gene prevalence. These strategies were: citric acid (2%; automated), acetic acid (2%; manual and automated), lactic acid (LA 2%; manual and automated), LA (3%; automated), electrolytically-generated hypochlorous acid (400 ppm; manual), hot water (82 °C; automated) and INSPEXX (0.2%; automated). Automated application of 2% LA after 30-60-min aeration and 3% LA at 55 °C were the most effective interventions. Automated application was more effective than manual application. Decontamination of beef carcasses through automated application of lactic acid and hot water would reduce public health risks associated with STEC contamination.

[Detection and characterization of Shiga toxin-producing Escherichia coli in children treated at an inter-zonal pediatric hospital in the city of La Plata]. / Detección y caracterización de Escherichia coli productor de toxina Shiga en niños atendidos en un hospital pediátrico interzonal de la ciudad de La Plata.

Shiga toxin-producing Escherichia coli (STEC) is a foodborne pathogen that can cause watery diarrhea, bloody diarrhea (BD), and hemolytic uremic syndrome (HUS). The objective of this study was to determine the phenotypic and genotypic profiles of STEC strains isolated from children with BD and HUS treated at a pediatric hospital in the city of La Plata in the period 2006-2012, and to establish the clonal relationship of O157:H7 isolates by pulsed field electrophoresis. The percentage of positive samples was 4.9% and 39.2% in patients with BD and HUS, respectively. Seventy-seven STEC strains from 10 different serotypes were isolated, with 100% colony recovery, O157:H7 being the most frequent (71.4%) serotype, followed by O145:NM (15.6%). An average of 98.2% of O157:H7 isolates belonged to biotype C and were sensitive to all the antibiotics tested. All of them (100%) carried genotype stx2, eae, fliCH7, ehxA, iha, efa, toxB, lpfA1-3 and lpfA2-2. When the clonal relationship of the O157:H7 strains was studied, a total of 42 patterns with at least 88% similarity were identified, and 6 clusters with identical profiles were established. The eae-negative isolates belonged to serotypes O59:H19, O102:H6, O174:NM and O174:H21. The strains O59:H19 and O174:H21 were positive for the aggR gene. This study shows that STEC of different serotypes and genotypes circulate in the city of La Plata and surroundings. Despite the genetic diversity observed between the O157:H7 isolates, some were indistinguishable by the subtyping techniques used.

Development and In-House Validation of a Real-Time Polymerase Chain Reaction for the Detection of Listeria monocytogenes in Meat.

Listeriosis is a foodborne disease caused by Listeria monocytogenes. The aims of this work were to develop and validate an in-house real-time polymerase chain reaction (RT-PCR) for the detection of L. monocytogenes, and to determine its prevalence in raw ground beef samples from 53 butcheries that also sell ready-to-eat foods. One set of primers and one hydrolysis probe were designed for hly gene detection and then challenged with pure strains. The detection was successful for all L. monocytogenes strains analyzed and negative for all non-L. monocytogenes strains (detection limit, 10 colony forming unit [CFU]/mL). Inclusivity, exclusivity, and analytical accuracy were 100%. L. monocytogenes was detected in 41.5% of raw ground beef samples from the 53 butcheries analyzed. This RT-PCR may be a valuable method for rapid detection of L. monocytogenes in meat.

Isolation and characterization of non-O157 Shiga toxin-producing Escherichia coli from beef carcasses, cuts and trimmings of abattoirs in Argentina.

Several foods contaminated with Shiga toxin-producing Escherichia coli (STEC) are associated with human diseases. Some countries have established microbiological criteria for non-O157 STEC, thus, the absence of serogroups O26, O45, O103, O104, O111, O121, and O145 in sprouts from the European Union or ground beef and beef trimmings from the United States is mandatory. While in Argentina screening for O26, O103, O111, O145 and O121 in ground beef, ready-to-eat food, sausages and vegetables is mandatory, other countries have zero-tolerance for all STEC in chilled beef. The aim of this study was to provide data on the prevalence of non-O157 STEC isolated from beef processed in eight Argentinean cattle slaughterhouses producing beef for export and local markets, and to know the non-O157 STEC profiles through strain characterization and genotypic analysis. Samples (n = 15,965) from 3,205 beef carcasses, 9,570 cuts and 3,190 trimmings collected between March and September 2014 were processed in pools of five samples each. Pools of samples (n = 3,193) from 641 carcasses, 1,914 cuts and 638 trimming were analyzed for non-O157 STEC isolation according to ISO/CEN 13136:2012. Of these, 37 pools of carcasses (5.8%), 111 pools of cuts (5.8%) and 45 pools of trimmings (7.0%) were positive for non-O157 STEC. STEC strains (n = 200) were isolated from 193 pools of samples. The most prevalent serotypes were O174:H21, O185:H7, O8:H19, O178:H19 and O130:H11, and the most prevalent genotypes were stx2c(vh-b) and stx2a/saa/ehxA. O103:H21 strain was eae-positive and one O178:H19 strain was aggR/aaiC-positive. The prevalence of non-O157 STEC in beef carcasses reported here was low. None of the non-O157 STEC strains isolated corresponded to the non-O157 STEC serotypes and virulence profiles isolated from human cases in Argentina in the same study period. The application of microbiological criteria for each foodstuff should be determined by risk analysis in order to have a stringent monitoring system. Likewise, zero-tolerance intervention measures should be applied in beef, together with GMP and HACCP. Further, collaborative efforts for risk assessment, management and communication are extremely important to improve the safety of foodstuffs.

Characterization and Molecular Subtyping of Shiga Toxin-Producing Escherichia coli Strains in Butcher Shops.

Shiga toxin-producing Escherichia coli (STEC) are important emerging foodborne human pathogens. Ruminants are the main animal reservoir of STEC currently known, and meat can become contaminated at different stages of the production chain. The aim of this work was to subtype and establish the epidemiological relatedness of non-O157 STEC strains isolated from ground beef and the environment in butcher shops before (evaluation stage, 2010-2011 period) and after (verification stage, 2013) implementing improvement actions. Sixty-eight non-O157 STEC strains were tested for eae, saa, ehxA, iha, efa1, toxB, subAB, cdt-V, astA, aggR, and aaiC genes, and stx1 and stx2 variants were determined. Pulsed-field gel electrophoresis (PFGE) was carried out with XbaI and XmaJI. From the 68 strains, 92.6%, 75.0%, 58.8%, 53.5%, 10.3%, 7.3%, and 4.4% were positive for iha, ehxA, subAB, saa, cdt-V, astA, and eae, respectively. All strains were aggR/aaiC-negative. PFGE showed that 19 strains grouped in 9 clusters and 41 showed unique XbaI patterns. During the evaluation stage (2010-2011), we identified clonal strains in different samples, circulating clones in different butcher shops, and more than one different strain in the same butcher shop. The bovine origin of meat and its manufacturing process could not ensure the total absence of all non-O157 STEC serotypes in this foodstuff. Most strains isolated during the evaluation (2010-2011) and verification (2013) stages did not exhibit a genotypic profile associated with human disease. It is necessary to conduct periodic reviews of the new epidemiological information and verify that the analyses of non-O157 STEC in food are appropriate to identify strains affecting the population.

Comprehensive Evaluation and Implementation of Improvement Actions in Butcher Shops.

Foodborne pathogens can cause acute and chronic diseases and produce a wide range of symptoms. Since the consumption of ground beef is a risk factor for infections with some bacterial pathogens, we performed a comprehensive evaluation of butcher shops, implemented improvement actions for both butcher shops and consumers, and verified the impact of those actions implemented. A comprehensive evaluation was made and risk was quantified on a 1-100 scale as high-risk (1-40), moderate-risk (41-70) or low-risk (71-100). A total of 172 raw ground beef and 672 environmental samples were collected from 86 butcher shops during the evaluation (2010-2011) and verification (2013) stages of the study. Ground beef samples were analyzed for mesophilic aerobic organisms, Escherichia coli and coagulase-positive Staphylococcus aureus enumeration. Salmonella spp., E. coli O157:H7, non-O157 Shiga toxin-producing E. coli (STEC), and Listeria monocytogenes were detected and isolated from all samples. Risk quantification resulted in 43 (50.0%) high-risk, 34 (39.5%) moderate-risk, and nine (10.5%) low-risk butcher shops. Training sessions for 498 handlers and 4,506 consumers were held. Re-evaluation by risk quantification and microbiological analyses resulted in 19 (22.1%) high-risk, 42 (48.8%) moderate-risk and 25 (29.1%) low-risk butcher shops. The count of indicator microorganisms decreased with respect to the 2010-2011 period. After the implementation of improvement actions, the presence of L. monocytogenes, E. coli O157:H7 and stx genes in ground beef decreased. Salmonella spp. was isolated from 10 (11.6%) ground beef samples, without detecting statistically significant differences between both study periods (evaluation and verification). The percentage of pathogens in environmental samples was reduced in the verification period (Salmonella spp., 1.5%; L. monocytogenes, 10.7%; E. coli O157:H7, 0.6%; non-O157 STEC, 6.8%). Risk quantification was useful to identify those relevant facts in butcher shops. The reduction of contamination in ground beef and the environment was possible after training handlers based on the problems identified in their own butcher shops. Our results confirm the feasibility of implementing a comprehensive risk management program in butcher shops, and the importance of information campaigns targeting consumers. Further collaborative efforts would be necessary to improve foodstuffs safety at retail level and at home.

Isolation of Shiga Toxin-Producing Escherichia coli from Ground Beef Using Multiple Combinations of Enrichment Broths and Selective Agars.

Shiga toxin-producing Escherichia coli (STEC) are foodborne pathogens, and beef cattle are recognized as the principal reservoir. The aims of this study were (1) to identify the most sensitive combination of selective enrichment broths and agars for STEC isolation in artificially inoculated ground beef samples, and (2) to evaluate the most efficient combination(s) of methods for naturally contaminated ground beef samples. A total of 192 ground beef samples were artificially inoculated with STEC and non-stx bacterial strains. A combination of four enrichment broths and three agars were evaluated for sensitivity, specificity, and positive predictive value for STEC isolation from experimentally inoculated samples. Enrichments with either modified tryptic soy broth (mTSB) containing 8 mg/L novobiocin (mTSB-8) or modified Escherichia coli (mEC) broth followed by isolation in MacConkey agar were the most sensitive combinations for STEC isolation of artificially inoculated samples. Independently, both enrichments media followed by isolation in MacConkey were used to evaluate ground beef samples from 43 retail stores, yielding 65.1% and 58.1% stx-positive samples by RT-PCR, respectively. No difference was observed in the isolate proportions between these two methods (8/25 [32%] and 8/28 [28.6%]). Identical serotypes and stx genotypes were observed in STEC strains isolated from the same samples by either method. In this study, no single enrichment protocol was sufficient to detect all STEC in artificially inoculated samples and had considerable variation in detection ability with naturally contaminated samples. Moreover, none of the single or combinations of multiple isolation agars used were capable of identifying all STEC serogroups in either artificially inoculated or naturally occurring STEC-contaminated ground beef. Therefore, it may be prudent to conclude that there is no single method or combination of isolation methods capable of identifying all STEC serogroups.