Temporal pattern of microbial indicators of ready-to-eat rocket salads during shelf life

 Introduction. From 2001-2009 there have been numerous community alerts and notifications about the rocket salad produced in Italy and distributed in Europe. Our study describes the evolution of the microbial quality of ready to eat rocket salad during shelf life among three different Italian producers.Material and methods. Total Mesophilic Count (TMC) and Escherichia coli (EC) count were measured in 248 samples. We used Wilcoxon test to compare the median values of TMC and EC counts and Kruskal Wallis test to compare the producers. Results. The TMC and EC values differed among producers at the stages of raw material and in the finished product (Kruskall Wallis test, p < 0.05). The evolution of bacterial charges had significant differences among producers at expiration date (Wilcoxon test, p < 0.05). More than half of the samples (54.8%) exceed reference standard for TMC after 48 h from packaging.Conclusion. Differences among producers may linked to the different minimal processing technologies adopted after harvesting. 

Ready-to-eat vegetables production with low-level water chlorination. An evaluation of water quality and of its impact on end products

Introduction: We evaluated the microbiological impact of low-level chlorination (1 ppm free chlorine) on the production of ready-to-eat (RTE) vegetables by monitoring the microbiological quality of irrigation and processing water in two production plants over a 4-season period, as well as the microbiological quality of unprocessed vegetables and RTE product. Water samples were also characterized in terms of some chemical and physico-chemical parameters of relevance in chlorination management. Materials and methods: Both producers use water with maximum 1 ppm free chlorine for vegetables rinsing, while the two processes differ by the number of washing cycles. Results and conclusions: Salmonella spp and Campylobacter spp were detected once in two different irrigation water samples out of nine from one producer. No pathogens were found in the vegetable samples. As expected, the procedure encompassing more washing cycles performed slightly better in terms of total mesophilic count (TMC) when comparing unprocessed and RTE vegetables of the same batch. However, data suggest that low-level chlorination may be insufficient in preventing microbial build-up in the washing equipment and/or batch-to batch cross-contamination.Abstract Introduction: We evaluated the microbiological impact of low-level chlorination (1 ppm free chlorine) on the production of ready-to-eat (RTE) vegetables by monitoring the microbiological quality of irrigation and processing water in two production plants over a 4-season period, as well as the microbiological quality of unprocessed vegetables and RTE product. Water samples were also characterized in terms of some chemical and physico-chemical parameters of relevance in chlorination management. Materials and methods: Both producers use water with maximum 1 ppm free chlorine for vegetables rinsing, while the two processes differ by the number of washing cycles. Results and conclusions: Salmonella spp and Campylobacter spp were detected once in two different irrigation water samples out of nine from one producer. No pathogens were found in the vegetable samples. As expected, the procedure encompassing more washing cycles performed slightly better in terms of total mesophilic coun

Detection of Escherichia coli O157 in raw and cooked meat: comparison of conventional direct culture method and Enzyme Linked Fluorescent Assay (ELFA)

&lt;p&gt;&lt;strong&gt;Abstract&lt;/strong&gt;&lt;br /&gt;&lt;strong&gt;Background&lt;/strong&gt;: Verocytotoxin Escherichia coli is a frequent and important cause of diarrhea and haemolytic uremic syndrome all over the world. Consumption of ground beef, lettuce, and other kinds of food have been associated with outbreaks.&lt;br /&gt;The aim of this study was to detect the presence of E. coli O157 in meat products collected from hospital food catering services in Rome, using a rapid detection method in comparison with a standard culture method to verify the effectiveness of HACCP system.&lt;br /&gt;&lt;strong&gt;Methods&lt;/strong&gt;: Three hundred and ten food samples (80 of cooked and 230 of raw meat) were screened for E.coli O157 by ISO culture method and by enzyme-linked-fluorescent-assay (ELFA)-based methods&lt;br /&gt;(VIDAS®system, bioMérieux). All isolates obtained were tested for VT1 and VT2 genes by PCR. The statistical analysis considered absolute frequencies and percentages. The K statistic was applied to assess agreement between direct culture method and the VIDAS system.&lt;br /&gt;&lt;strong&gt;Results&lt;/strong&gt;: A total of 6 (1,9%) E.coli O157 isolates were recovered from raw meat samples by the culture method; of these only four were identified by PCR as VTEC producers. A total of 9 (2,9%) E.coli O157 isolates were recovered from raw meat samples by the VIDAS® system. No E.coli O157 was detected in cooked products. All comparisons between the direct culture method and the VIDAS system were&lt;br /&gt;statistically significant (K= 0,795; p&amp;lt;0.001).&lt;br /&gt;&lt;strong&gt;Conclusions&lt;/strong&gt;: The present study showed how ELFA-based methods are highly specific and rapid for the detection of E.coli O157 in food samples compared with the direct culture method. ELFA method is useful to verify the effectiveness of the HACCP system in the risk management of potential contaminating hazards during the preparation of foods for susceptible persons.&lt;/p&gt

Knowledge, attitude and behaviour toward MRSA: Results from a survey among biomedical students and the general population

Background: The spread of methicillin-resistant Staphylococcus aureus (MRSA) is of increasing concern, especially for particular populations such as school or university students. This study compares the knowledge, attitudes and behaviour towards MRSA skin infections between a group of medical and public health students who attend courses and practice in a teaching hospital setting to a general population group represented by their family members, cohabitants and friends. Methods: In the period March-April 2009, a survey was conducted on 166 students and their cohabitants (182). After informed consent, a self-administered questionnaire was given to each participant, containing questions concerning socio-demographic (age, gender, educational level, job activity) and leisure-time items (physical activity) as well as knowledge regarding the localisation, symptoms, means of transmission of a MRSA infection, susceptible groups, therapeutic and diagnostic aspects, and the correct behaviour for preventing transmission to others. All the students were belonging to medical and public health Technician school in a teaching hospital setting. Results: Study participants were 116 biomedical students and 182 family members, cohabitants and friends. The comparison among the levels of knowledge revealed a significant difference between the two groups. One-third (30.1%, 50/166) p = 0,006 of biomedical students ignore the anatomical site of MRSA infection while 20.5% (34/166) do not known the determinants involved in increasing the risk and ignore the possible development resistance to the antibiotics of S. aureus causing intractable infection (p = 0,001). Regarding attitude and behaviour toward MRSA, the distribution of answers were statistically different among the two groups in the questions regarding the diagnosis, the choice of the person to be seen if infected and the question on the prevention measures to be adopted in case of infection. Moreover, more than half of the participants are willing to pay 100 € (the maximum amount proposed) to have the best care in case of staph infection. Conclusion: Most of the participants had a poor or even a very poor knowledge of the pathogen, mechanism of transmission, risk determinants and preventive measures. There is a strong need to implement targeted educational programs within current university curricula and for the general population. © 2011 Springer-Verlag

Efficacy of contrast medium induced Pd/Pa ratio in predicting functional significance of intermediate coronary artery stenosis assessed by fractional flow reserve: insights from the RINASCI study

Aims: The need of adenosine administration for the achievement of maximal hyperaemia limits the widespread application of fractional flow reserve (FFR) in the real world. We hypothesised that Pd/Pa ratio registered during submaximal reactive hyperaemia induced by conventional non-ionic radiographic contrast medium (contrast medium induced Pd/Pa ratio: CMR) can be sufficient for the assessment of physiological severity of stenosis in the vast majority of cases. The aim of the present study was to test the accuracy of CMR in comparison to FFR. Methods and results: Eighty patients with 104 intermediate coronary stenoses were prospectively and consecutively enrolled. CMR was obtained after intracoronary injection of 6 ml of radiographic contrast medium, while FFR was measured after administration of adenosine. Despite the fact that CMR values were significantly higher than FFR values (0.88 [IR 0.80-0.92] vs. 0.87 [IR 0.83-0.94], p&lt;0.001), a strong correlation between CMR and FFR values was observed (r=0.94, p&lt;0.001) with a close agreement at Bland-Altman analysis (95% CI of disagreement: -0.029 to 0.072). ROC curve analysis showed an excellent accuracy of CMR cut-off of &lt;0.83 in predicting FFR value &lt;0.80 (AUC 0.97 [95% CI: 0.91-0.99, specificity 96.1, sensitivity 85.7]). Moreover, no FFR value &lt;0.80 corresponded to a CMR &gt;0.88. Conclusions: CMR is accurate in predicting the functional significance of coronary stenosis. This could allow limiting the use of adenosine to obtain FFR to doubtful cases. In particular, we suggest considering a CMR value &lt;0.83 to be significant, a CMR. value &gt;0.88 as not significant, and inducing maximal hyperaemia using adenosine for FFR assessment when CMR is between 0.84 and 0.87

Three-dimensional quantitative coronary angiography and quantification of jeopardised myocardium to predict functional significance of intermediate coronary artery stenosis

Aims: Despite the fact that fractional flow reserve (FFR) is better than angiography in guiding PCI, in the real world the choice to perform PCI is generally based on angiography. Three-dimensional quantitative coronary angiography (3D-QCA) may increase the accuracy of angiography, especially in intermediate coronary artery stenosis (ICAS). The aim of the study was to assess the best cut-off values of area stenosis % (AS%) and the extent of jeopardised myocardium for predicting FFR and for excluding the need to perform FFR. Methods and results: FFR, AS% and Myocardial Jeopardy Index (MJI) were assessed in 211 ICAS. MJI (beta=-0.36; p=0.001), AS% (beta=-0.35; p=0.001) and presence of a chronic total occlusion (CTO) (beta=-0.15; p=0.01) were independent predictors of FFR. In patients without CTO (174 lesions), the best cut-offs for the detection of FFR &lt;= 0.80 for AS% and MJI were 61% (AUC=0.76; p&lt;0.001) and 30% (AUC=0.71; p&lt;0.001), respectively. More importantly, the cut-offs of AS% safely to exclude (100% sensitivity) an FFR &lt;= 0.80 were 40% (AUC=0.85, p&lt;0.001) for an MJI &gt;= 30% and 50% (AUC=0.70, p&lt;0.04) for an MJI &lt;30%, respectively. Conclusions: AS%, MJI and the presence of a CTO predicted FFR values. 3D-QCA in addition to MA allows the safe exclusion of FFR &lt;= 0.80, limiting FFR assessment to doubtful cases with considerable reduction of costs

Three-dimensional quantitative coronary angiography and quantification of jeopardised myocardium to predict functional significance of intermediate coronary artery stenosis

Aims: Despite the fact that fractional flow reserve (FFR) is better than angiography in guiding PCI, in the real world the choice to perform PCI is generally based on angiography. Three-dimensional quantitative coronary angiography (3D-QCA) may increase the accuracy of angiography, especially in intermediate coronary artery stenosis (ICAS). The aim of the study was to assess the best cut-off values of area stenosis % (AS%) and the extent of jeopardised myocardium for predicting FFR and for excluding the need to perform FFR. Methods and results: FFR, AS% and Myocardial Jeopardy Index (MJI) were assessed in 211 ICAS. MJI (beta=-0.36; p=0.001), AS% (beta=-0.35; p=0.001) and presence of a chronic total occlusion (CTO) (beta=-0.15; p=0.01) were independent predictors of FFR. In patients without CTO (174 lesions), the best cut-offs for the detection of FFR &lt;= 0.80 for AS% and MJI were 61% (AUC=0.76; p&lt;0.001) and 30% (AUC=0.71; p&lt;0.001), respectively. More importantly, the cut-offs of AS% safely to exclude (100% sensitivity) an FFR &lt;= 0.80 were 40% (AUC=0.85, p&lt;0.001) for an MJI &gt;= 30% and 50% (AUC=0.70, p&lt;0.04) for an MJI &lt;30%, respectively. Conclusions: AS%, MJI and the presence of a CTO predicted FFR values. 3D-QCA in addition to MA allows the safe exclusion of FFR &lt;= 0.80, limiting FFR assessment to doubtful cases with considerable reduction of costs

Three-dimensional quantitative coronary angiography and quantification of jeopardised myocardium to predict functional significance of intermediate coronary artery stenosis.

Aims: Despite the fact that fractional flow reserve (FFR) is better than angiography in guiding PCI, in the real world the choice to perform PCI is generally based on angiography. Three-dimensional quantitative coronary angiography (3D-QCA) may increase the accuracy of angiography, especially in intermediate coronary artery stenosis (ICAS). The aim of the study was to assess the best cut-off values of area stenosis % (AS%) and the extent of jeopardised myocardium for predicting FFR and for excluding the need to perform FFR. Methods and results: FFR, AS% and Myocardial Jeopardy Index (MJI) were assessed in 211 ICAS. MJI (β=-0.36; p=0.001), AS% (β=-0.35; p=0.001) and presence of a chronic total occlusion (CTO) (β=-0.15; p=0.01) were independent predictors of FFR. In patients without CTO (174 lesions), the best cut-offs for the detection of FFR ≤0.80 for AS% and MJI were 61% (AUC=0.76; p&lt;0.001) and 30% (AUC=0.71; p&lt;0.001), respectively. More importantly, the cut-offs of AS% safely to exclude (100% sensitivity) an FFR ≤0.80 were 40% (AUC=0.85, p&lt;0.001) for an MJI ≥30% and 50% (AUC=0.70, p&lt;0.04) for an MJI &lt;30%, respectively. Conclusions: AS%, MJI and the presence of a CTO predicted FFR values. 3D-QCA in addition to MJI allows the safe exclusion of FFR ≤0.80, limiting FFR assessment to doubtful cases with considerable reduction of costs