Exploring the biological basis for Salmonella persistence in food manufacturing environments

The persistence of Salmonella spp. in low moisture foods is a challenge for the food industry as despite control strategies already in place, notable outbreaks still occur. The aim of this study was to characterise isolates of Salmonella, known to be persistent in the food manufacturing environment, by comparing their microbiological characteristics with a panel of matched clinical and veterinary isolates. The gross morphology of the challenge panel was phenotypically characterised in terms of cellular size, shape and motility. In all the parameters measured, the factory isolates were indistinguishable from the human, clinical and veterinary strains. Further detailed metabolic profiling was undertaken using the biolog Microbial ID system. Multivariate analysis of the metabolic microarray revealed differences in metabolism of the factory isolate of S.Montevideo, based on its upregulated ability to utilise glucose and the sugar alcohol groups. The remainder of the serotype-matched isolates were metabolically indistinguishable. Temperature and humidity are known to influence bacterial survival and through environmental monitoring experimental parameters were defined. The results revealed Salmonella survival on stainless steel was affected by environmental temperatures that may be experienced in a food processing environment; with higher survival rates (D25=35.4) at temperatures at 25°C and lower humidity levels of 15% RH, however a rapid decline in cell count (D10=3.4) with lower temperatures of 10°C and higher humidity of 70% RH. Several resident factories strains survived in higher numbers on stainless steel (D25=29.69) compared to serotype matched clinical and veterinary isolates (D25=22.98). Factory isolates of Salmonella did not show an enhanced growth rate in comparison to serotype matched solates grown in Luria broth, Nutrient broth and M9 minimal media indicating that as an independent factor, growth was unlikely to be a major factor driving Salmonella persistence. Using a live / dead stain coupled with fluorescence microscopy revealed that when no longer culturable, isolates of S.Schwarzengrund entered into a viable nonculturable state. The biofilm forming capacity of the panel was characterised and revealed that all were able to form biofilms. None of the factory isolates showed an enhanced capability to form biofilms in comparison to serotype-matched isolates. In disinfection studies, planktonic cells were more susceptible to disinfectants than cells in biofilm and all the disinfectants tested were successful in reducing bacterial load. Contact time was one of the most important factors for reducing bacterial populations in a biofilm. The genomes of eight strains were sequenced. At the nucleotide and amino acid level the food factory isolates were similar to those of isolates from other environments; no major genomic rearrangements were observed, supporting the conclusions of the phenotypic and metabolic analysis. In conclusion, having investigated a variety of morphological, biochemical and genomic factors, it is unlikely that the persistence of Salmonella in the food manufacturing environment is attributable to a single phenotypic, metabolic or genomic factor. Whilst a combination of microbiological factors may be involved it is also possible that strain persistence in the factory environment is a consequence of failure to apply established hygiene management principles

Fight antibiotic resistance - it's in your hands to improve antibiotic stewardship

The public health threat emanating from the emergence and spread of multidrug-resistant bacteria is well known. Each year the World Health Organization (WHO) SAVE LIVES: Clean Your Hands campaign promotes a different theme; the call to action in this year’s annual ‘Global Hand Hygiene Day’ on May 7th, 2017, is ‘Fight antibiotic resistance – it’s in your hands’.1 Good hand hygiene is widely acknowledged as the single most important measure to prevent infections in hospital. However, it would be naive to believe that hand hygiene alone will solve the problems posed by multidrug-resistant Gram-negative bacteria (MDR-GNB)

Are academics wrongly assuming bioscience students have the transferable skills and IT competency they need to be successful beyond the degree?

Acquisition and development of key transferable skills is an important requirement for all graduate employees. The aim of the current study was to investigate a potential skills shortage in bioscience students and, if revealed, explore ways of addressing it. A research questionnaire, which included mixed methodology, was used to collate information from a cohort of students across levels four, five, and six enrolled on biological and biomedical science undergraduate programs. A total of 131 students participated in the study. The questionnaire was designed to establish students’ confidence using packages such as the Microsoft Office Suite and whether they required additional support with certain programs; further areas explored students’ self-assessment of key skills such as written communication, referencing, self-confidence, presentation skills, and team working. No statistically significant gender differences (males n = 49; females n = 82) were observed in participant responses (p > 0.05). Of the total number of students included in the survey, 91% rated themselves as competent using Word and 64% felt least confident using statistical software and performing statistical analysis in Microsoft Excel. Comparing responses by year of study revealed no statistical differences in reported abilities (p > 0.05). These findings indicate areas of potential key skills shortages, particularly using data handling software, which may not be sufficiently addressed if prior knowledge is incorrectly assumed. Nearly half of students (50% of level six students) who were graduating felt unprepared performing statistical analysis in Excel. Inclusion of an IT component to support skills development in data handling software at Level 4 is recommended and teaching key software packages are necessary. Furthermore, opportunities for students to develop their presentation skills and report writing abilities are required. This in turn should improve the student experience and develop the transferable skills, which are increasingly sought by employers

A theory of change for a technology-enhanced education system in Bangladesh

The first of a trilogy of Theories of Change (TOCs) that focuses on learners as the main beneficiaries of an increasingly technology-enhanced education system in Bangladesh. Initially created with stakeholders to support the monitoring and evaluation of programmes designed to offer distance learning during the 2020 Covid-19 school closures, the TOC describes how access to educational activities of different modalities (TV, Radio, Smartphone, online platforms etc.) should lead to improved educational outcomes for learners in Classes 1-12

Microbiological study of used cosmetic products:highlighting possible impact on consumer health

AIMS: To investigate the nature and extent of microbial contamination in five categories of used cosmetic products (lipstick, lip gloss, eyeliners, mascaras and beauty blenders) and highlight the potential risk posed to consumers in the UK. METHODS AND RESULTS: Used products were donated and microbial contents were determined by microbial culture and identification. About 79-90% of all used products were contaminated with bacteria, with bacterial loads ranging between 10 2 and 10 3 CFU per ml, beauty blenders contained an average load of >10 6 CFU per ml. Presence of Staphylococcus aureus, Escherichia coli and Citrobacter freundii was detected. Enterobacteriaceae and fungi were detected in all product types, and were prevalent in beauty blenders (26·58 and 56·96% respectively). Ninety-three per cent of beauty blenders had not been cleaned and 64% had been dropped on the floor and continued to be used. CONCLUSIONS: Significant levels of microbial contamination occur during use of cosmetic products and presence of pathogenic organisms pose a potential risk to health. SIGNIFICANCE AND IMPACT OF THE STUDY: The nature and high level of contamination in used cosmetic products indicate that greater user awareness and education are required. Manufacturers should ensure that product expiry dates are prominently displayed and consumers can identify the symbols used on product packaging

Critical points in the pathway of antibiotic prescribing in a children’s hospital:the Antibiotic Mapping of Prescribing (ABMAP) study

Background The WHO has identified Antimicrobial Resistance (AMR) as one of the most significant global risks facing modern medicine. Interventions to improve antibiotic prescribing have so far had limited impact. Aim To understand the barriers to effective antibiotic prescribing. Methods Mixed methodologies were used to investigate prescribing behaviours to identify the critical points in the antibiotic prescribing pathway for hospital inpatients. We assessed knowledge, experience or empowerment of prescribers, organisational factors and use of the laboratory. Phase 1 was an online survey to map barriers and facilitators to antibiotic prescribing (56 participants). Phase 2 consisted of focus groups and interviews to gain more understanding of prescribing behaviours (10 participants). Phase 3 was an online survey to obtain opinions on possible solutions (22 participants). Results Barriers to prescribing were: laboratory factors 71.6%, resource issues 40%, time constraints 17.5%, pressure from others 52%. Ninety-three percent of prescribers were concerned about AMR. In three scenarios only 9% were confident not to prescribe antibiotics for a patient without bacterial infection; 53% would prescribe unnecessarily broad spectrum antibiotics for pneumonia. Only 5% would de-escalate antibiotics in a microbiologically-confirmed bacteraemia. Despite concerns about AMR, prescribers did not perceive continuing antibiotics for individual patients might promote resistance. Prescribers were unwilling to change antibiotics out of hours and reported they preferred professional support for antibiotic prescribing. Conclusions There was a marked disparity between prescribers self-reporting of prescribing behaviour and responses to clinical scenarios. It was not clear whether training alone would change behaviours. Prescribers desired a directive mechanism to support antibiotic prescribing and stewardship

Quantitative Assessment of Microbial Contamination and Patterns of Public Behaviour with Used Toothbrushes:Implications of Storage and Replacement

Introduction: Toothbrushes can readily become contaminated with microbes during use and storage. They present a potential hazard of cross-contamination and subsequent infection. Aims: To investigate the nature and level of microbial contamination of used toothbrushes and influence of participant lifestyle. Methods and Results: 103 used toothbrushes were donated, and microbial contents were determined by microbial culture and identification. 97% of toothbrushes revealed contamination. The microbial loads ranged from 0-1010 cfu/brush with median values of around 107, with Candida isolated in the highest levels. 90% of toothbrushes were stored in bathrooms presumably exposed to environmental contamination and 72% revealed the presence of enteric bacteria including Klebsiella, Serratia and Enterobacter. 50% of participants kept toothbrushes for >3 months and 40% retained toothbrushes for 4-6 months; microbial loads were fully established during the first three months of use and did not increase further with prolonged use. Only 57% of participants brushed their teeth twice a day and 41% brushed once a day. Conclusion: Used toothbrushes are heavily contaminated and the presence of potentially pathogenic microorganisms constitutes a potential health risk. Significance and Impact of Study: There is an under-recognised risk of cross-contamination/infection, especially when multiple users store toothbrushes in close contact. Guidance on toothbrush age, brushing frequency and storage is not being followed. Further education is required to improve public awareness

Pet Food Factory Isolates of Salmonella Serotypes Do Not Demonstrate Enhanced Biofilm Formation Compared to Serotype-Matched Clinical and Veterinary Isolates

Environmentally persistent Salmonella in the pet food factory environment has been described, with biofilm formation suggested as a candidate mechanism contributing to their persistence. In this study the ability of a panel of Salmonella isolates from factory, clinical, and veterinary sources was investigated for their ability to form biofilms at 24 and 48 hours. The effect of nutrient availability and incubation time on biofilm formation was investigated using full strength and diluted 1/20 TSB media at 37°C, 25°C, 15°C, and 10°C. Results highlighted that all the Salmonella isolates were able to form biofilms in both nutrient conditions and this was highly correlated with temperature. At 25°C, biofilm formation was enhanced in diluted 1/20 TSB and increased incubation time (48h) (p= <0.001). However, this was not observed at 10°C, 15°C, or 37°C. None of the factory isolates demonstrated enhanced biofilm formation in comparison to serotype-matched isolates from veterinary and clinical sources. Salmonella enterica Senftenberg 775W was the strongest biofilm former at 15°C, 25°C, and 37°C in all the conditions tested (p=<0.05). Biofilm formation is an important mechanism of environmental persistence in the food manufacturing environment; however, there is no evidence of an enhanced biofilm-producing phenotype in factory persistent strains

An Innovative Workshop Embedding Pathology Service Users into the Undergraduate Biomedical Science Curriculum

The integration of pathology service users into the biomedical science curriculum has been driven by the refinement of the Health and Care Professions Council (HCPC) Standards of Proficiency. This study aimed to design and implement a novel and innovative service user event with a reflective assessment to enhance students’ knowledge and understanding of the impact of pathology laboratory results on the patient pathway. The 4-h workshop consisted of a series of service users. Patients discussed how pathology services had contributed to their diagnosis and treatment, while service providers—a Microbiology Consultant, a director of primary care, and the patient referral optimisation officer—discussed their roles and their interactions with pathology services. Post-event, students completed a 750-word reflective assessment, highlighting challenges experienced by service users and providing suggestions for improving the delivery of pathology services. In total, 57.5% of respondents (57/99) completed a post-reflection survey, which included open- and closed-ended questions. Quantitative analysis of the survey data revealed that over 87.7% of respondents had increased knowledge and understanding of the revised HCPC standards. Following the assessment, students reported a significant increase in their confidence with respect to reflective writing (p < 0.001), with over 90% of respondents agreeing that the reflective assessment had increased their knowledge and understanding of the limitations that may negatively impact service users and patient care. Moreover, respondents highlighted how advancements in point-of-care testing (POCT) and improvements in communication can improve patient experiences. Thematic analysis revealed that respondents agreed that embedding patients into the curriculum reinforced the importance of there being a patient behind every sample. Respondents reported that reflecting upon service user experiences enabled them to identify improvements to the delivery of pathology services while recognising the essential role that Biomedical Scientists play in the patient pathway. This successful workshop has created a platform encompassing a range of pathology service users in the undergraduate curriculum. We recommend that other accredited biomedical science programmes adopt and embed this innovative workshop and reflective assessment into their programmes to help them meet these standards relating to service users while fostering important transferable skills in their students

Post-COVID-19 Adaptations; the Shifts Towards Online Learning, Hybrid Course Delivery and the Implications for Biosciences Courses in the Higher Education Setting

The Covid-19 pandemic has created challenges and caused disruption across the Higher Education sector; university campuses closed, and face-to-face teaching and assessment shifted to an online format. Learning from our students’ experience during this period will help us shape future hybrid delivery so that it best fits Bioscience students. This pedagogical study explored Aston University’s Bioscience students’ experiences of studying from home, and the impact of the lockdown on mental wellbeing and quality of life. 151 students completed an online survey during August 2020, which included open and closed questions. Analysis of survey data revealed that a majority of students reported positive experiences of online open-book assessments and most would welcome this format in the future. The majority of students faced no technical issues, predominantly stating that they also had good internet connectivity. Shifting to remote learning and online classrooms uncovered conflicting preferences; despite wanting more interactive lectures, only half of the students were comfortable interacting using video cameras. Free text responses provided an insight into how some students reported an inadequate home working space/environment and lacked necessary items such as a desk, highlighting how remote working may intensify social and digital inequality - particularly for students from more deprived households. Wider detrimental experiences of lockdown included dissatisfaction with access to healthcare, decreased concentration, sleeping difficulties and a decline in mental wellbeing. Education strategies going forward will need to address the mental health needs of students who have suffered during the pandemic. Our university, amongst others, is embracing hybrid course delivery, which could offer a solution to ensuring Bioscience students receive hands-on laboratory experience and face-to-face contact to remain motivated and benefit from the on-campus facilities and support, whilst allowing students some of the flexibility afforded by remote study. In the current competitive higher education market where student retention is key, it is important to consider student demographics and digital equity to ensure an appropriate approach is applied to cater for all students