Pre-Harvest Food Safety Challenges in Food-Animal Production in Low- and Middle-Income Countries.

Food safety remains a significant global public health concern, with the risk of unsafe food varying worldwide. The economies of several low- and middle-income countries (LMICs) heavily rely on livestock, posing a challenge to ensuring the production of safe food. This review discusses our understanding of pre-harvest critical issues related to food safety in LMICs, specifically focusing on animal-derived food. In LMICs, food safety regulations are weak and inadequately enforced, primarily concentrating on the formal market despite a substantial portion of the food sector being dominated by informal markets. Key critical issues at the farm level include animal health, a low level of good agriculture practices, and the misuse of antimicrobials. Effectively addressing foodborne diseases requires a comprehensive One Health framework. Unfortunately, the application of the One Health approach to tackle food safety issues is notably limited in LMICs. In conclusion, considering that most animal-source foods from LMICs are marketed through informal channels, food safety legislation and policies need to account for this context. Interventions aimed at reducing foodborne bacterial pathogens at the farm level should be scalable, and there should be strong advocacy for the proper implementation of pre-harvest interventions through a One Health approach.

Retail Chicken Carcasses as a Reservoir of Multidrug-Resistant Salmonella.

Salmonella is a major cause of foodborne disease outbreaks worldwide, mainly through poultry. Recently, there has been an increase in multidrug-resistant (MDR) Salmonella infections globally. The increased drug resistance results in increased costs and poorer health outcomes due to unavailability or delayed treatment. This study aims to determine the prevalence of Salmonella in retail raw chicken meat and identify their antimicrobial resistance profiles. A total of 270 retail raw chicken carcasses (local and imported) were collected from three hypermarket chains in Qatar between November 2017 and April 2018. Thirty carcasses were contaminated with Salmonella (11.11%). The prevalence of Salmonella in locally produced chicken was higher than in imported chicken (OR = 2.56, 95% CI: 1.18-5.53, p = 0.016). No significant differences were found between the prevalence and storage temperature or hypermarket chain. The highest resistance rates in the isolates were reported to tetracycline (73.7%) followed by nitrofurantoin (53.3%), ampicillin (50%), amoxicillin-clavulanic acid, ceftriaxone (26.7%), and ciprofloxacin (23.3%). Eight isolates were potential extended-spectrum ß-lactamase-producers, all in imported frozen chicken (p < 0.0001). Additionally, 43.3% of the isolates were MDR and associated with frozen chicken (OR = 16.88, 95% CI: 2.55-111.47, p = 0.002). The findings indicate that while the prevalence of Salmonella in retail chicken in Qatar is moderate, a large proportion of them are MDR.

Excess all-cause mortality and COVID-19 reported fatality in Iran (April 2013-September 2021): age and sex disaggregated time series analysis.

OBJECTIVE: The actual impact of the pandemic on COVID-19 specific mortality is still unclear due to the variability in access to diagnostic tools. This study aimed to estimate the excess all-cause mortality in Iran until September 2021 based on the national death statistics. RESULTS: The autoregressive integrated moving average was used to predict seasonal all-cause death in Iran (R-squared = 0.45). We observed a 38.8% (95% confidence interval (CI) 29.7%-40.1%) rise in the all-cause mortality from 22 June 2020 to 21 June 2021. The excess all-cause mortality per 100,000 population were 178.86 (95% CI 137.2-220.5, M:F ratio = 1.3) with 49.1% of these excess deaths due to COVID-19. Comparison of spring 2019 and spring 2021 revealed that the highest percent increase in mortality was among men aged 65-69 years old (77%) and women aged 60-64 years old (86.8%). Moreover, the excess mortality among 31 provinces of Iran ranged from 109.7 (Hormozgan) to 273.2 (East-Azerbaijan) per 100,000 population. In conclusion, there was a significant rise in all-cause mortality during the pandemic. Since COVID-19 fatality explains about half of this rise, the increase in other causes of death and underestimation in reported data should be concerned by further studies.

Molecular Characterization of MCR-1 Producing Enterobacterales Isolated in Poultry Farms in the United Arab Emirates.

Data on the prevalence of MCR-producing Enterobacterales of animal origin are scarce from the Arabian Peninsula. We investigated the presence and variety of such strains from fecal specimens of poultry collected in four farms in the United Arab Emirates. Colonies from ten composite samples per farm grown on colistin-supplemented plates were PCR-screened for alleles of the mcr gene. Thirty-nine isolates selected based on species, colony morphology, and plasmid profile were subjected to whole genome sequencing. The panel of their resistance and virulence genes, MLST and cgMLST were established. Transferability and incompatibility types of the MCR-plasmids were determined. mcr-1.1 positive strains were identified in 36 of the 40 samples. Thirty-four multi-drug resistant Escherichia coli of 16 different sequence types, two Escherichia albertii, two Klebsiella pneumoniae and one Salmonella minnesota were identified. Beyond various aminoglycoside, tetracycline, and co-trimoxazole resistance genes, seven of them also carried ESBL genes and one blaCMY-2. Six IncHI2, 26 IncI2 and 4 IncX4 MCR-plasmids were mobilized, in case of the IncHI2 plasmids co-transferring ampicillin, chloramphenicol and tetracycline resistance. The diversity of mcr-1 positive strains suggest a complex local epidemiology calling for a coordinated surveillance including animals, retail meat and clinical cases.

Bromate concentrations and pH values in bottled drinking water in Kuwait.

The study objectives were to assess bromate concentrations in bottled drinking water sold at retail in Kuwait and assess pH values relationship to bromate concentrations. A cross-sectional study was conducted in 2019 where 120 bottled water samples were collected from supermarkets across six governorates in Kuwait. Samples represented local brands that used distilled or mineral water as well as imported brands that used mineral water only. The samples were analyzed for bromate concentrations and pH values. The overall mean bromate concentration was 4.02 µg/L (95% CI: 3.35-4.69) with concentration of 4.45 µg/L in locally distilled water significantly (P < 0.05) higher than that in imported mineral water samples (i.e., 1.34 µg/L). The overall bromate percent positive was 41.7% (n = 120) with 35.8% in locally distilled samples, significantly higher than that in imported mineral samples (5.8%). None of the local mineral bottled water samples had detectable bromate. Bromate concentrations in our samples were within the international allowable limits of less than 10 µg bromate/L (except for one local distilled sample that contained 14.9 µg bromate/L). The mean pH value was 7.39 (95% CI: 7.33-7.45). There was no significant relationship between pH values and bromate concentrations in our samples. Our findings proved that local and imported bottled water sold at retail in Kuwait was bromate safe.

Antimicrobial resistance pattern in clinical Escherichia coli and Pseudomonas aeruginosa isolates obtained from a secondary-care hospital prior to and during the COVID-19 pandemic in Kuwait.

Introduction: The study objective was to compare the prevalence of antimicrobial resistance (AMR) in clinical Escherichia coli and Pseudomonas aeruginosa isolates obtained from a secondary-care hospital prior to and during the COVID-19 pandemic in Kuwait. Methods: A retrospective descriptive study was conducted based on AMR profiles of clinical Escherichia coli and Pseudomonas aeruginosa isolates. The AMR data represented isolates from five specimen types (body fluids; blood; respiratory; wound, bone, or other tissues; and urine) of patients admitted to four wards (surgical, medical, pediatric, and maternal-postnatal). Tested isolates between January 2019 and February 2020 represented the pre-COVID-19 pandemic period in Kuwait, whereas those from February 2020 until April 2021 represented the 'during COVID-19' period. Results: A total of 1,303 isolates (57.2% E. coli and 42.8% P. aeruginosa) were analyzed. For ceftazidime, ertapenem and meropenem, the prevalence of AMR in E. coli was significantly (p<0.05) lower in pre-COVID-19 wards compared to that during COVID-19, whereas for other antibiotics (i.e., cefepime, gentamicin, and trimethoprim/sulfamethoxazole), the prevalence of AMR in pre-COVID-19 was significantly higher than that during COVID-19. The prevalence of AMR to gentamicin in P. aeruginosa isolates from non-COVID-19 wards (52.8%) was significantly higher (p<0.001) than that from COVID-19 wards (35.0%) and from the pre-COVID-19 period (32.9%). The multidrug-resistance (MDR) prevalence was 37.4% for E. coli and 32.1% for P. aeruginosa isolates. The odds of MDR in E. coli isolates from the COVID-19 medical wards were significantly lower (OR=0.27, [95%CI: 0.09-0.80], p=0.018) compared to the pre-COVID-19 wards. The odds of MDR E. coli and P. aeruginosa isolates by COVID-19 status stratified by specimen type were not different (p>0.05). Conclusions: No major differences in AMR in E. coli and P. aeruginosa prevalence by specimen type and wards prior to and during the COVID-19 pandemic was observed at this hospital. The high reported MDR prevalence calls for better infection control and prevention.

Effectiveness of BNT162b2 and ChAdOx1 Vaccines against Symptomatic COVID-19 among Healthcare Workers in Kuwait: A Retrospective Cohort Study.

BACKGROUND: Estimating vaccine effectiveness (VE) against severe, acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among healthcare workers (HCWs) is necessary to demonstrate protection from the disease. Between 24 December 2020 and 15 June 2021, we determined the factors associated with vaccine coverage and estimated VE against SARS-CoV-2 infection in HCWs at a secondary hospital in Kuwait. METHODS: We extracted sociodemographic, occupational, SARS-CoV-2 infection, and vaccination data for eligible HCWs from the hospital records. Vaccine coverage percentages were cross-tabulated with the HCW factors. Cox regression was used to estimate hazard ratios in vaccinated versus unvaccinated. RESULTS: 3246 HCWs were included in the analysis, of which 82.1% received at least one vaccine dose (50.4% only one dose of ChAdOx1, 3.3% only one dose of BNT162b2, and 28.3% two doses of BNT162b2). However, 17.9% of HCWs were unvaccinated. A significantly lower vaccination coverage was reported amongst female HCWs, younger age group (20-30 years), and administrative/executive staff. The adjusted VE of fully vaccinated HCWs was 94.5% (95% CI = 89.4-97.2%), while it was 75.4% (95% CI = 67.2-81.6%) and 91.4% (95% CI = 65.1-97.9%) in partially vaccinated for ChAdOx1 and BNT162b2, respectively. CONCLUSIONS: BNT162b2 and ChAdOx1 vaccines prevented most symptomatic infections in HCWs across age groups, nationalities, and occupations.

Epidemiology and Microbiological Profile of Common Healthcare Associated Infections among Patients in the Intensive Care Unit of a General Hospital in Kuwait: A Retrospective Observational Study.

BACKGROUND: Patients admitted to the Intensive Care Unit (ICU) are prone to develop nosocomial infections due to Multidrug-Resistant (MDR) organisms. Inappropriate and overuse of antibiotics play an important role in the emergence of MDR organisms, which cause life-threatening infections resulting in significant morbidity and mortality. METHODS: Retrospective surveillance-based study on healthcare-associated infections. The study conducted over two consecutive years 2018 and 2019, looking at ICU related infections of a regional secondary care general hospital and the data were recorded using the methods and definitions of the Kuwait National Healthcare-associated infections Surveillance System (KNHSS). RESULTS: A total of 1408 patients, admitted to ICU for 7922 days during the 2 years period. Eighty-nine patients were included in this study, where 48 developed one Hospital-acquired Infections (HAI) in the ICU while 25 and two patients presented with two and three HAIs, respectively. The HAIs included Bloodstream Infections (BSI) - 42.3%, pneumonia - 28.8%, Urinary Tract Infections (UTI) - 15.3%, skin and soft tissue infections - 9.6% and Clostridium difficile infection - 3.4%. The overall infection rate was 13.14 per 1000 patient-days. The rates for Device-associated (DA)-HAIs were 6.27 for Central Line-associated BSI (CLABSI) per 1000 Central Line (CL)-days, 4.21 for Ventilator-associated Pneumonia (VAP) per 1000 Mechanical Ventilator (MV)-days, and 1.91 Catheter-associated UTI (CAUTI) per 1000 Urinary Catheter (UC)-days. Data showed that device use ratios for CL, MV, and UC were 0.81, 0.74, and 0.98, respectively. Acinetobacter baumannii and Klebsiella pneumoniae were the most common organisms isolated from the ICU infections with highest rates of antibiotic resistance. CONCLUSION: Among DA-HAIs CLABSI was found to be most common in our ICU, followed by VAP and CAUTI. Gram-negative organisms with A. baumannii and K. pneumoniae being the leading causative agents with high antimicrobial resistance profiles.

Analysis of intervention effectiveness using early outbreak transmission dynamics to guide future pandemic management and decision-making in Kuwait.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a World Health Organization designated pandemic that can result in severe symptoms and death that disproportionately affects older patients or those with comorbidities. Kuwait reported its first imported cases of COVID-19 on February 24, 2020. Analysis of data from the first three months of community transmission of the COVID-19 outbreak in Kuwait can provide important guidance for decision-making when dealing with future SARS-CoV-2 epidemic wave management. The analysis of intervention scenarios can help to evaluate the possible impacts of various outbreak control measures going forward which aim to reduce the effective reproduction number during the initial outbreak wave. Herein we use a modified susceptible-exposed-asymptomatic-infectious-removed (SEAIR) transmission model to estimate the outbreak dynamics of SARS-CoV-2 transmission in Kuwait. We fit case data from the first 96 days in the model to estimate the effective reproduction number and used Google mobility data to refine community contact matrices. The SEAIR modelled scenarios allow for the analysis of various interventions to determine their effectiveness. The model can help inform future pandemic wave management, not only in Kuwait but for other countries as well.

Modeling the effect of lockdown timing as a COVID-19 control measure in countries with differing social contacts.

The application, timing, and duration of lockdown strategies during a pandemic remain poorly quantified with regards to expected public health outcomes. Previous projection models have reached conflicting conclusions about the effect of complete lockdowns on COVID-19 outcomes. We developed a stochastic continuous-time Markov chain (CTMC) model with eight states including the environment (SEAMHQRD-V), and derived a formula for the basic reproduction number, R0, for that model. Applying the [Formula: see text] formula as a function in previously-published social contact matrices from 152 countries, we produced the distribution and four categories of possible [Formula: see text] for the 152 countries and chose one country from each quarter as a representative for four social contact categories (Canada, China, Mexico, and Niger). The model was then used to predict the effects of lockdown timing in those four categories through the representative countries. The analysis for the effect of a lockdown was performed without the influence of the other control measures, like social distancing and mask wearing, to quantify its absolute effect. Hypothetical lockdown timing was shown to be the critical parameter in ameliorating pandemic peak incidence. More importantly, we found that well-timed lockdowns can split the peak of hospitalizations into two smaller distant peaks while extending the overall pandemic duration. The timing of lockdowns reveals that a "tunneling" effect on incidence can be achieved to bypass the peak and prevent pandemic caseloads from exceeding hospital capacity.

Prevalence of antimicrobial resistance in Gram-negative clinical isolates from a major secondary hospital in Kuwait: a retrospective descriptive study.

INTRODUCTION: Building an antimicrobial resistance (AMR) surveillance system in a country requires analysis of available data on AMR in clinical isolates. This study's objective was to determine the AMR prevalence of Gram-negative bacterial (GNB) isolates cultured from clinical specimens at a major general hospital in Kuwait. METHODS: A retrospective descriptive study was conducted on AMR profiles of GNB clinical isolates (n=5290) between January and December 2018. Data were extracted from the laboratory information system in the hospital. The GNB organisms (i.e., Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii) were isolated from five main locations at the hospital (i.e., intensive care units [ICUs], surgical wards, medical wards, pediatric wards, and outpatient polyclinics). RESULTS: Overall, high AMR prevalence (>50%) against ampicillin, cefuroxime, cefotaxime, ceftazidime, ciprofloxacin, and trimethoprim/sulfamethoxazole, were observed across the GNB organisms. However, low resistance prevalence (<10%) were observed against amikacin, ertapenem, meropenem, and piperacillin/tazobactam. In general, AMR prevalence in E. coli isolates from ICU, medical and surgical wards was significantly (p<0.05) higher compared to other locations, whereas, AMR prevalence in P. aeruginosa isolates from pediatric ward was higher (p<0.05) compared to other locations. The overall multidrug resistance (MDR) prevalence was 38.7% (95% CI: 37.4-40.0). The highest MDR prevalence was among E. coli isolates from respiratory specimens (48%); wounds, bones, or other tissues (47.7%); and body fluids (47.1%). Similarly, MDR prevalence in K. pneumoniae, P. aeruginosa, and A. baumannii isolated from respiratory specimens was significantly (p<0.05) higher compared to other specimen types. The most frequent MDR phenotypes in the four GNB organisms and across the different specimen types included three antimicrobial drug classes: penicillins, cephalosporins, and fluroquinolones. CONCLUSIONS: Our findings demonstrate high AMR prevalence among common Gram-negative bacteria at this major hospital. Monitoring data on antimicrobial susceptibility of common bacterial organisms is critical for assessing trends in AMR at hospitals and for informing policy decisions.

Prevalence of smoking in the Kuwaiti adult population in 2014: a cross-sectional study.

The study objective was to assess tobacco smoking prevalence in Kuwaiti adults in relation to sociodemographic characteristics. A cross-sectional study survey was conducted in 2014 on 3917 Kuwaiti citizens (18-69 years) following the World Health Organization (WHO) STEPwise Approach to Surveillance (STEPS) methodology. The study assessed prevalence of self-reported ever-smoking or currently smoking tobacco products and exposure to secondhand smoke in relation to demographic and smoking-related characteristics. The prevalence of "ever smoker" in men and women was 49.9% and 4.4%, respectively, whereas the prevalence of "current smoker" was 39.2% and 3.3%, respectively. Sex (adjusted OR [AOR], 19.2 [95% confidence interval (CI) 13.0-28.3], male versus female) was significantly associated with current smoking. Among daily smokers, 87.1% used manufactured cigarettes. The average daily number of manufactured cigarettes for men and women was 21.8 and 13.0, respectively. Mean age at smoking initiation was 17.5 years (95% CI 17.2-17.9). The prevalence of secondhand smoke at home and work was 38.6% and 29.9%, respectively. Half of Kuwaiti men have smoked at some point in their life with most of these being current smokers. Secondhand smoke is a common exposure at home and work, posing serious health risks to the population.

Molecular Epidemiology of Candida Auris Outbreak in a Major Secondary-Care Hospital in Kuwait.

The emerging, often multidrug-resistant Candida auris is increasingly being associated with outbreaks in healthcare facilities. Here we describe the molecular epidemiology of a C. auris outbreak during 18 months, which started in 2018 in the high dependency unit (HDU) of a secondary-care hospital in Kuwait. Demographic and clinical data for candidemia and colonized patients were prospectively recorded. Clinical and environmental isolates were subjected to phenotypic and molecular identification; antifungal susceptibility testing by broth microdilution method; PCR-sequencing of ERG11 and FKS1 for resistance mechanisms to triazoles and echinocandins, respectively; and molecular fingerprinting by short tandem repeat (STR) analyses. Seventy-one (17 candidemic and 54 colonized) patients including 26 with candiduria and seven environmental samples yielded C. auris. All isolates were identified as C. auris by Vitek2, MALDI-TOF MS, PCR amplification and/or PCR-sequencing of rDNA. Twelve candidemia and 26 colonized patients were admitted or exposed to HDU. Following outbreak recognition, an intensive screening program was instituted for new patients. Despite treatment of all candidemia and 36 colonized patients, 9 of 17 candidemia and 27 of 54 colonized patients died with an overall crude mortality rate of ~50%. Nearly all isolates were resistant to fluconazole and contained the Y132F mutation in ERG11 except one patient's isolates, which were also distinct by STR typing. Only urine isolates from two patients developed echinocandin resistance with concomitant FKS1 mutations. The transmission of C. auris in this outbreak was linked to infected/colonized patients and the hospital environment. However, despite continuous surveillance and enforcement of infection control measures, sporadic new cases continued to occur, challenging the containment efforts.

Prevalence of Antibiotic-Resistant Escherichia coli Isolates from Local and Imported Retail Chicken Carcasses.

ABSTRACT: The spread of antibiotic resistance among bacterial strains has been associated with consumption of food contaminated with both pathogenic and nonpathogenic bacteria. The objective of this study was to determine the prevalence of antibiotic resistant Escherichia coli isolates in local and imported retail raw chicken meat in Qatar. A total of 270 locally produced (chilled) and imported (chilled or frozen) whole chicken carcasses were obtained from three Hypermarket stores in Qatar. The 216 E. coli isolates recovered from the chicken samples were subjected to antibiotic susceptibility testing with the disk diffusion method. Extended-spectrum ß-lactamase (ESBL) production was evaluated with the double disk synergy test. Isolates harboring colistin resistance were identified with a multiplex PCR assay and DNA sequencing. Nearly 89% (192) of the 216 isolates were resistant to at least one of the 18 antibiotics tested. Isolates from local and imported chicken carcasses had relatively higher resistance to sulfamethoxazole (62% of isolates), tetracycline (59.7%), ampicillin and trimethoprim (52.3% each), ciprofloxacin (47.7%), cephalothin (45.4%), and colistin (31.9%). Less resistance was found to amoxicillin-clavulanic acid (6%), ceftriaxone (5.1%), nitrofurantoin (4.2%), piperacillin-tazobactam (4.2%), cefepime (2.3%), meropenem (1.4%), ertapenem (0.9%), and amikacin (0.9%). Nine isolates (4.2%) were ESBL producers, and 137 (63.4%) were multidrug resistant. The percentages of multidrug-resistant, ESBL-producing, and colistin resistant isolates were significantly higher among isolates from local chilled than from imported chilled and frozen chicken samples. Our findings indicate the high prevalence of antibiotic-resistant E. coli in chicken meat sold at retail in Qatar.

Early estimation of the epidemiological parameters of novel coronavirus disease (COVID-2019) outbreak in Iran: 19 Feb-15 March, 2020.

AIM: To estimate the epidemiological parameters related to the Covid-19 outbreak in Iran. BACKGROUND: Estimating the epidemiological parameters of new public health threat (COVID-19) is essential to support and inform public health decision-making in different communities including Iran. METHODS: We established a mathematical model to estimate the epidemiological parameters from 19 Feb to 15 March based on daily COVID-19 confirmed cases in Iran. Then, we estimated the effect of early traffic restriction on our estimation. RESULTS: We estimated the R0 at 2.11 (95% CI, 1.87-2.50) and the infected number at 92,260 (95% CI: 59,263 -152,212) by 15 March. Our estimate for the ascertainment rate was about 1.2% (95% CI: 1.1-1.4). The latent period estimation was 4.24 (95% CI: 2.84-6.65). We observed a decline in our estimate after considering the traffic restriction. CONCLUSION: Our results suggest that health authorities in Iran must take impactful strategies to control the COVID-19 outbreak to reach R0<1. Therefore, the establishment of complementary, multilateral, and cost-effective measures for the treatment of symptomatic and early diagnosis and isolation of asymptomatic cases/contacts are strongly recommended because of low ascertainment rate and large number of infected cases. We additionally recommend that traffic restriction be combined with other controlling measures.

Prevalence of enteric non-typhoidal Salmonella in humans in the Middle East and North Africa: A systematic review and meta-analysis.

To enhance efforts related to controlling foodborne pathogens in the Middle East and North Africa (MENA), information on epidemiology of non-typhoidal Salmonella enterica (hereafter termed "Salmonella") is limited. We quantified the overall regional and country-specific Salmonella prevalence in different human populations and identified the most common serotypes. Published literature of Salmonella prevalence was systematically reviewed and reported following the Preferred Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Pooled Salmonella prevalence measures were estimated using a random-effects model. We identified 46 research reports that reported 84 Salmonella prevalence measures in 15 out of 24 countries in MENA. There were 252,831 tested humans with 6,356 Salmonella-positive cases. The pooled Salmonella prevalence in MENA was estimated at 6.6% (95% confidence interval (CI): 5.4%-7.9%). The highest pooled Salmonella prevalence measures were in Morocco (17.9%, 95% CI: 5.7%-34.8%, 1997-2012), Tunisia (10.2%, 95% CI: 4.3%-18.0%, 1988-2009) and Sudan (9.2%, 95% CI: 6.5%-12.2%, 2006-2008), while the lowest were in Jordan (1.1%, 95% CI: 0.1%-3.0%, 1993-2010), Oman (1.2%, 95% CI: 1.2%-1.3%, 1998-2002) and Palestine (1.2%, 95% CI: 0.4%-2.1%, 1999-2011). In MENA, Salmonella pooled prevalence in gastrointestinal symptomatic, gastrointestinal asymptomatic and food handlers population groups was 13.0% (95% CI: 7.6%-19.6%), 11.4% (95% CI: 2.2%-25.7%) and 3.8% (95% CI: 1.0%-8.0%), respectively. Salmonella prevalence was 14.5% (95% CI: 8.7%-26.1%) in studies tested <100 subjects, whereas 4.6% (95% CI: 3.6%-5.8%) in studies tested ≥100 subjects. Salmonella Enteritidis (29.8%) and Typhimurium (23.6%) were the most common serotypes. Salmonella was a common foodborne pathogen in MENA countries, particularly in North African countries. Findings inform the scientific community, the public and the decision-makers with Salmonella prevalence and gaps in evidence in MENA to support control and prevention strategies and could leverage more research studies.

Simple Visualized Detection Method of Virulence-Associated Genes of Vibrio cholerae by Loop-Mediated Isothermal Amplification.

Vibrio cholerae is a leading waterborne pathogenic bacterium worldwide. It can cause human cholera that is still pandemic in developing nations. Detection of V. cholerae contamination in drinking water and aquatic products is imperative for assuring food safety. In this study, a simple, sensitive, specific, and visualized method was developed based on loop-mediated isothermal amplification (LAMP) (designated sssvLAMP) to detect virulence-associated (ctxA, tcpA, hapA, mshA, pilA, and tlh) and species-specific (lolB) genes of V. cholerae. Three pairs of oligonucleotide primers (inner, outer, and loop primers) were designed and or synthesized to target each of these genes. The optimal conditions of the sssvLAMP method was determined, and one-step sssvLAMP reaction was performed at 65°C for 40 min. Positive results were simply read by the naked eye via color change (from orange to light green) under the visible light, or by the production of green fluorescence under the UV light (260 nm). The sssvLAMP method was more efficient in detecting 6.50 × 101-6.45 × 104-fold low number of V. cholerae cells, and more sensitive in V. cholerae genomic DNA (1.36 × 10-2-4.42 × 10-6 ng/reaction) than polymerase chain reaction (PCR) method. Among 52 strains of V. cholerae and 50 strains of non-target species (e.g., other Vibrios and common pathogens) examined, the sensitivity and specificity of the sssvLAMP method were 100% for all the target genes. Similar high efficiency of the method was observed when tested with spiked samples of water and aquatic products, as well as human stool specimens. Water from various sources and commonly consumed fish samples were promptly screened by this simple and efficient visualized method and diversified variation in the occurrence of the target genes was observed. V. cholerae strains could be mostly detected by the presence of hapA and tlh alone or in combination with other genes, indicating a variable risk of potentially pathogenic non-O1/O139 strains in edible food products. This novel LAMP method can be a promising tool to address the increasing need of food safety control of aquatic products.

Prevalence of antibiotic resistant Escherichia coli isolates from fecal samples of food handlers in Qatar.

Background: It is well documented that food handlers harbor and shed enteric foodborne pathogens causing foodborne disease outbreaks. However, little known on enteric antibiotic resistant (AR) bacteria carriage in food handlers. The objective of this study was to establish a baseline prevalence of fecal AR E. coli among food handlers in Qatar. Methods: Fecal samples were collected from 456 migrant food handlers of different nationalities arriving in Qatar on a work permit between January 2015 and December 2016. These samples (25 g each) were collected based on the availability and examination schedule at the Medical Commission facility from those consented to participate. Isolated E. coli bacteria were tested for antibiotic susceptibility against nine antibiotics using the E-test method and Double Disc Synergy Test (DDST) for extended-spectrum beta-lactamase (ESBL) production. Results: From the 78 E. coli positive samples (17.1%, n = 456), 60% of the isolates were resistant to at least one antibiotic, whereas, 27% were multi-drug resistant (MDR). Seven isolates (9%, n = 78) were ESBL producers of which five were MDR. Individual AR E. coli frequencies to the nine antibiotics were not significantly (P > 0.05) different by nationality. Conclusions: Based on our findings, we revealed that individual resistant E. coli and MDR resistant E. coli were common in fecal samples of food handlers in Qatar. This may indicate that food handlers can potentially contaminate foods with AR E. coli, a possible public health concern.

Prevalence of Virulence Genes in Extended-Spectrum ß-lactamases (ESBLs)-Producing Salmonella in Retail Raw Chicken in China.

Extended-spectrum ß-lactamases (ESBLs)-producing Salmonella is a tremendous hazard to food safety and public health. The objective of this study was to determine the prevalence of 30 virulence genes (avrA, sipA, sseC, marT, rhuM, siiE, pipA, pipD, envR, gogB, gtgA, sodC1, sseI, irsA, sopE2, spvC, rck, spvR, fhuA, msgA, pagK, srfj, stkc, fimA, lpfD, pefA, stcC, steB, stjB, and tcfA) in 156 ESBLs-producing Salmonella isolates that belonged to 21 serotypes. These isolates were recovered from retail raw chicken samples collected from 5 provinces and 2 national cities in China between 2007 and 2012. The results indicated that 154 (98.7%) ESBLs-producing Salmonella isolates carried at least 1 virulence gene, 138 (88.5%) simultaneously carried at least 5 virulence genes, 107 (68.6%) carried 10 or more, and 20 (12.8%) carried 15 or more virulence genes. The most frequently detected virulence genes were marT (n = 127, 81.4%), siiE (n = 126, 80.8%), msgA (n = 121, 77.6%), and sipA (n = 121, 77.6%). Significant difference was identified between detection percentages of virulence genes of rhuM, pipD, envR, sopE2, pagK, lpfD, steB, and stjB in S. Indiana, S. Thompson, S. Enteritidis, S. Typhimurium, S. Shubra, S. Edinburg, and S. Agona isolates. Distribution of virulence genes were significantly influenced by sampling districts (P < 0.01), especially for sodC1 and pipD, and then were msgA and sopE2. The heatmap showed the frequencies of virulence genes in ESBLs-producing isolates from retail chickens in southern, central, and northern regions of China were completely different from each other. Based on our findings, ESBLs-producing Salmonella of retail chicken origin were common carriers of multiple virulence genes and were regionally distributed.