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Brazil-Antimicrobial substances produced by coliform strains active against foodborne pathogens
Foodborne Pathogens and Disease [edited][FSNet]
Luana Rocha Fleming, Dayana Nascimento Bolzan, Janaína dos Santos Nascimento
In the present study, 31 coliform strains were isolated from salad, cheese, and meat products sold in commercial establishments in Rio de Janeiro city, and were tested for antibiotic resistance and antimicrobial substance production. Thirteen strains (41.9%) were resistant to at least one antibiotic tested, among which one presented resistance to nine different antibiotics. Two strains (6.4%) exhibited inhibitory activity against the indicator strains,Escherichia coliLMIFRJ andSalmonella entericaI. The antimicrobial substances that they produced were sensitive to proteolytic enzymes, suggesting that they might be bacteriocins. The producer strains were identified as Klebsiella ozaenae and Raoultella terrigena. Although they had similar spectrums of action, the bacteriocins were shown to be different. Both of them were able to inhibitE. coli,Klebsiella,Enterobacter, andSalmonellastrains, including antibiotic-resistant ones. Our results suggest that these bacteriocins, named klebicin K and raoultellin L, could have potential use against some foodborne pathogens.
Foodborne Pathogens and Disease [edited][FSNet]
Luana Rocha Fleming, Dayana Nascimento Bolzan, Janaína dos Santos Nascimento
In the present study, 31 coliform strains were isolated from salad, cheese, and meat products sold in commercial establishments in Rio de Janeiro city, and were tested for antibiotic resistance and antimicrobial substance production. Thirteen strains (41.9%) were resistant to at least one antibiotic tested, among which one presented resistance to nine different antibiotics. Two strains (6.4%) exhibited inhibitory activity against the indicator strains,Escherichia coliLMIFRJ andSalmonella entericaI. The antimicrobial substances that they produced were sensitive to proteolytic enzymes, suggesting that they might be bacteriocins. The producer strains were identified as Klebsiella ozaenae and Raoultella terrigena. Although they had similar spectrums of action, the bacteriocins were shown to be different. Both of them were able to inhibitE. coli,Klebsiella,Enterobacter, andSalmonellastrains, including antibiotic-resistant ones. Our results suggest that these bacteriocins, named klebicin K and raoultellin L, could have potential use against some foodborne pathogens.
Bovine vaccinia outbreaks: Detection and isolation of vaccinia virus in milk samples
05 Nov 2009
Foodborne Pathogens and Disease. November 2009, 6(9): 1141-1146
Jônatas S. Abrahão, Tércia M.L. Oliveira et. al
The vaccinia virus (VACV), which causes exanthemous lesions in dairy cattle and humans, has been associated with several bovine vaccinia outbreaks in Brazil. Currently, no data are available about the safety of milk produced in VACV-affected areas. In this study, 47 milk samples were collected during bovine vaccinia outbreaks and submitted to viral isolation, DNA detection, and nucleotide sequencing of the conserved tk gene. The appearance of characteristic white pocks on the chorioallantoic membranes of chicken eggs, in association with viral cytopathic effects in chicken embryo fibroblasts and phylogenetic data, strongly suggest milk contamination by VACV. This is the first report of VACV detection in and isolation from milk.
05 Nov 2009
Foodborne Pathogens and Disease. November 2009, 6(9): 1141-1146
Jônatas S. Abrahão, Tércia M.L. Oliveira et. al
The vaccinia virus (VACV), which causes exanthemous lesions in dairy cattle and humans, has been associated with several bovine vaccinia outbreaks in Brazil. Currently, no data are available about the safety of milk produced in VACV-affected areas. In this study, 47 milk samples were collected during bovine vaccinia outbreaks and submitted to viral isolation, DNA detection, and nucleotide sequencing of the conserved tk gene. The appearance of characteristic white pocks on the chorioallantoic membranes of chicken eggs, in association with viral cytopathic effects in chicken embryo fibroblasts and phylogenetic data, strongly suggest milk contamination by VACV. This is the first report of VACV detection in and isolation from milk.
Bacterial contamination of hands increases risk of cross-contamination among low-income Puerto Rican meal preparers
20.oct.09
Foodborne Pathogens and Disease [edited][FSNet]
Oscar G. Gómez-Duarte, Octavio Arzuza, Delfina Urbina, Jing Bai, Julio Guerra, Oscar Montes, Marta Puello, Ketty Mendoza, Gregorio Y. Castro
Acute diarrheal disease is a leading cause of childhood morbidity and mortality in the developing world andEscherichia coliintestinal pathogens are important causative agents. Information on the epidemiology ofE. coliintestinal pathogens and their association with diarrheal disease is limited because no diagnostic testing is available in countries with limited resources. To evaluate the prevalence ofE. coliintestinal pathogens in a Caribbean–Colombian region,E. coliclinical isolates from children with diarrhea were analyzed by a recently reported two-reaction multiplex polymerase chain reaction. This is the first report on the molecular characterization ofE. colidiarrheogenic isolates in Colombia and the first report on the potential role ofE. coliin childhood diarrhea in this geographic area.
Pasteurized milk: Efficiency of pasteurization and its microbiological conditions in Brazil
28 Sep 2009
Foodborne Pathogens and Disease [edited][FSNet]
Ramon Silva, Adriano G. Cruz, José A.F. Faria, Miriam M.L. Moura, Lúcia M.J. Carvalho, Eduardo H.M. Water, Anderson S. Sant'Ana This study aimed to verify the pasteurization efficiency and the microbiological quality of milk sold in the city of Rio de Janeiro, Brazil. The microbial quality of pasteurized milk samples was assessed by sample testing for the presence ofSalmonella spp., coliforms at 35°C, coliforms at 45°C, and mesophilic bacterial counts. In addition, the pasteurization efficiency was verified through tests of neutral phosphatase and peroxidase enzymes.Salmonellaspp. were not detected in any (100%) of the analyzed samples. However, 85 (70.8%) and 69 (57.5%) of the samples were noncompliant with current legal standards for coliforms at 35°C and 45°C, respectively. As for the aerobic mesophilic bacteria, 48 (40.0%) of the samples were noncompliant. From the 120 samples of pasteurized milk studied, 100% were negative for neutral phosphatase, whereas 12 (10.0%) were negative for peroxidase. Logistic regression indicated the absence of relationship between present lactoperoxidase and all the microbiological parameters studied, which suggested that the quality of pasteurized milk was associated with factors related to steps before or after heat treatment
Chile-Salmon farmers used more than 300 tons of antibiotics
27 Jul 2009
FIS [edited][FSNet]
Oceana, an international marine conservation organization, presented a report drafted by the Ministry of the Economy that indicates the national salmon farming industry used 325.6 tons of antibiotics over the past year, and 385.6 tons in 2007.
According to the official report, florfenicol (used in 56.7 percent of the total, or 184 tons) and flumequine (in 9.9 percent, or 32.2 tons) were the antimicrobials most used in 2008, among others.
Two years ago, florfenicol had been used in 37 percent (143 tons) of the stock; and oxytetracycline in 23.1 percent (89.3 tons), among other antimicrobials.
Essential oils against foodborne pathogens and spoilage bacteria in minced meat
06 Jul 2009
Foodborne Pathogens and Disease, Volume 6, Number 6
The antimicrobial activity of essential oils of oregano, thyme, basil, marjoram, lemongrass, ginger, and clove was investigated in vitro by agar dilution method and minimal inhibitory concentration (MIC) determination against Gram-positive (Staphylococcus aureusandListeria monocytogenes) and Gram-negative strains (Escherichia coliandSalmonella Enteritidis). MIC90% values were tested against bacterial strains inoculated experimentally in irradiated minced meat and against natural microbiota (aerobic or facultative, mesophilic, and psychrotrophic bacteria) found in minced meat samples. MIC90% values ranged from 0.05%v/v (lemongrass oil) to 0.46%v/v (marjoram oil) to Gram-positive bacteria and from 0.10%v/v (clove oil) to 0.56%v/v (ginger oil) to Gram-negative strains. However, the MIC90% assessed on minced meat inoculated experimentally with foodborne pathogen strains and against natural microbiota of meat did not show the same effectiveness, and 1.3 and 1.0 were the highest log CFU/g reduction values obtained against tested microorganisms.
Costa Rica:Street food found highly contaminated with fecal matter
22 Jun 2009
Inside Costa Rica [edited] [FSNet]
Food purchased from street vendors has been found to have a high level of fecal contamination, according to a study by the university.
The study reveals that the poor cleanliness of hands, utensils and consumables used vendors in the preparation and sale of the food, as the main cause.
The report indicates that seven of the twelve foods (58%) analyzed by their laboratory contained fecal matter.
The samples were taken last Wednesday, June 17, from street vendors in Zapote, Desamaparados, La Sabana park and downtown San José.
In addition to contaminated papaya slices, results showed contamination of freshly squeezed orange juice. The lab results also indicated a high level of contamination of "arroz con leche" (rice pudding) and "jugo de caña" (sugarcane juice), purchased by UCR staff.
Chile-Study onCampylobacterin Chilean poultry plants
22 May 2009
The Poultry Site [edited] [ProMed]
At an average of 54 percent, the levels ofCampylobactercontamination on broiler carcasses in processing plants were similar to those found in studies in other countries, and the highest rates were found after evisceration.
ThermotolerantCampylobacterare among the more prevalent bacterial pathogens that cause foodborne diseases.
This study aimed at evaluating the occurrence of thermotolerantCampylobactercontamination in chicken carcasses and processing plant stations (chilling water, scalding water, de-feathering machinery, evisceration machine and transport crates) in two of the Chilean main slaughterhouses.
In addition, the isolation rates of thermotolerantCampylobacterduring evisceration and following chiller processing were compared.
The overall slaughterhouse contamination with thermotolerantCampylobacterwas 54 percent. Differences were evident when the results from each plant were compared: plants A and B were 72 percent and 36 percent, respectively.
The sampling points with the greatest contamination rates in both plants were after evisceration (90 percent and 54 percent, for plants A and B, respectively).
The decrease of thermotolerantCampylobactercontamination after chilling was significant.
The findings indicate that chilling process has a limited effect in the final productsCampylobactercontamination because poultry enter the slaughter processing with high counts of contamination. This may represent a health risk to consumers if proper cooking practices are not employed.
The level and frequencies ofCampylobacterfound during the processing of Chilean poultry appear to be similar to those reported elsewhere in the world.
Brazil -Foodborne pathogens and microbiological characteristics of raw milk soft cheese produced and on retail sale
27 Feb 2009
Foodborne Pathogens and Disease
Paula Mendonça Moraes, Gabriela Nogueira Viçosa, Anderson Keizo Yamazi, Maria Beatriz Tassinari Ortolani, Luís Augusto Nero
Abstract
The consumption of raw milk soft cheeses (RMSC), which are typically manufactured in small dairy farms under unsatisfactory hygiene conditions, is common in Brazil. Due to these production characteristics, this type of cheese is a potential carrier of pathogenic microorganisms, such asListeria monocytogenes,Salmonella, and enterotoxin-producingStaphylococcusspp. Considering these characteristics, in this work, we aimed to detect the presence of these pathogenic microorganisms in RMC and to evaluate their microbiological quality. Fifty-five samples of this product were collected from different noninspected commercial establishments and submitted to the enumeration of mesophilic aerobes (MA), total coliforms (TC),Escherichia coli, and coagulase-positiveStaphylococci(CPS), and detection ofL. monocytogenesandSalmonellaspp. All analyzed samples were negative forSalmonellaspp. andL. monocytogenes. All samples presented counts of MA higher than 106 colony forming units/g (CFU/g; range, 3.0×106 to 4.0×109). TC were present at levels between 1.0×103 and 1.8×108CFU/g, andE. colibetween 1.0×102 and 3.5×106CFU/g. CPS were detected in 17 (30.9%) samples at levels higher than 104CFU/g. These results confirm the poor microbiological quality of raw milk used in the manufacturing of RMC samples, and also the inadequate production conditions. Therefore, the evaluation of microbiological safety and quality of these products must be constantly reported to alert the official agencies about the significance of proper inspection.
Brazil -Enterobacter sakazakiiin dried infant formulas and milk kitchens of maternity wards in São Paulo
01 Jan 2009
Journal of Food Protection®, Volume 72, Number 1, January 2009 , pp. 37-42(6)
Palcich, Gabriela; de Moraes Gillio, Cintia; Aragon-Alegro, Lina Casale; Pagotto, Franco J.; Farber, Jeffrey M.; Landgraf, Mariza; Destro, Maria Teresa
This study was the first conducted in Brazil to evaluate the presence ofEnterobacter sakazakiiin milk-based powdered infant formula manufactured for infants 0 to 6 months of age and to examine the conditions of formula preparation and service in three hospitals in São Paulo State, Brazil. Samples of dried and rehydrated infant formula, environments of milk kitchens, water, bottles and nipples, utensils, and hands of personnel were analyzed, andE. sakazakiiandEnterobacteriaceaepopulations were determined. All samples of powdered infant formula purchased at retail containedE. sakazakiiat <0.03 most probable number (MPN)/100 g. In hospital samples,E. sakazakiiwas found in unopened formula can (0.3 MPN/100 g) and in the residue from nursing bottle from hospital A. All other cans of formula from the same lot bought at a retail store containedE. sakazakiiat <0.03 MPN/100 g. The pathogen also was found in cleaning sponge from hospital B. Enterobacteriaceaepopulations ranged from 101 to 105 CFU/g in cleaning aids and <5 CFU/g in all formula types (dry or rehydrated), except for the sample that containedE. sakazakii,which also was contaminated withEnterobacteriaceaeat 5 CFU/g.E. sakazakiiisolates were not genetically related. In an experiment in which rehydrated formula was used as the growth medium, the temperature was that of the neonatal intensive care unit (25°C), and the incubation time was the average time that formula is left at room temperature while feeding the babies (up to 4 h), a 2-log increase in levels ofE. sakazakiiwas found in the formula. Visual inspection of the facilities revealed that the hygienic conditions in the milk kitchens needed improvement. The length of time that formula is left at room temperature in the different hospitals while the babies in the neonatal intensive care unit are being fed (up to 4 h) may allow for the multiplication ofE. sakazakiiand thus may lead to an increased health risk for infants.
Sources and Terms of Use
01 Nov 2009
Journal of Nutrition Education and Behavior, Volume 41, Issue 6, Pages 389-397 Jigna Morarji Dharod, PhD, Stefania Paciello, MS, Angela Bermúdez-Millán, PhD et al. [edited][FSNet]
Before starting meal preparation, participants' hands were tested to estimate total bacterial and coliform counts and the presence ofCampylobacter, Salmonella,Listeria,andStaphylococcus aureus(S. aureus). Microbiological testing was conducted on samples from kitchen/utensil surfaces, and on food ingredients obtained before and during meal preparation. Participants considering food safety as “very important” were less likely to test positive forS. aureuson hands. Meal preparer's hands can be a vehicle of pathogen transmission during meal preparation.
Detection ofEscherichia colienteropathogens by multiplex polymerase chain reaction from children's diarrheal stools in two Carribean-Colombian cities20.oct.09
Foodborne Pathogens and Disease [edited][FSNet]
Oscar G. Gómez-Duarte, Octavio Arzuza, Delfina Urbina, Jing Bai, Julio Guerra, Oscar Montes, Marta Puello, Ketty Mendoza, Gregorio Y. Castro
Acute diarrheal disease is a leading cause of childhood morbidity and mortality in the developing world andEscherichia coliintestinal pathogens are important causative agents. Information on the epidemiology ofE. coliintestinal pathogens and their association with diarrheal disease is limited because no diagnostic testing is available in countries with limited resources. To evaluate the prevalence ofE. coliintestinal pathogens in a Caribbean–Colombian region,E. coliclinical isolates from children with diarrhea were analyzed by a recently reported two-reaction multiplex polymerase chain reaction. This is the first report on the molecular characterization ofE. colidiarrheogenic isolates in Colombia and the first report on the potential role ofE. coliin childhood diarrhea in this geographic area.
Pasteurized milk: Efficiency of pasteurization and its microbiological conditions in Brazil
28 Sep 2009
Foodborne Pathogens and Disease [edited][FSNet]
Ramon Silva, Adriano G. Cruz, José A.F. Faria, Miriam M.L. Moura, Lúcia M.J. Carvalho, Eduardo H.M. Water, Anderson S. Sant'Ana This study aimed to verify the pasteurization efficiency and the microbiological quality of milk sold in the city of Rio de Janeiro, Brazil. The microbial quality of pasteurized milk samples was assessed by sample testing for the presence ofSalmonella spp., coliforms at 35°C, coliforms at 45°C, and mesophilic bacterial counts. In addition, the pasteurization efficiency was verified through tests of neutral phosphatase and peroxidase enzymes.Salmonellaspp. were not detected in any (100%) of the analyzed samples. However, 85 (70.8%) and 69 (57.5%) of the samples were noncompliant with current legal standards for coliforms at 35°C and 45°C, respectively. As for the aerobic mesophilic bacteria, 48 (40.0%) of the samples were noncompliant. From the 120 samples of pasteurized milk studied, 100% were negative for neutral phosphatase, whereas 12 (10.0%) were negative for peroxidase. Logistic regression indicated the absence of relationship between present lactoperoxidase and all the microbiological parameters studied, which suggested that the quality of pasteurized milk was associated with factors related to steps before or after heat treatment
Chile-Salmon farmers used more than 300 tons of antibiotics
27 Jul 2009
FIS [edited][FSNet]
Oceana, an international marine conservation organization, presented a report drafted by the Ministry of the Economy that indicates the national salmon farming industry used 325.6 tons of antibiotics over the past year, and 385.6 tons in 2007.
According to the official report, florfenicol (used in 56.7 percent of the total, or 184 tons) and flumequine (in 9.9 percent, or 32.2 tons) were the antimicrobials most used in 2008, among others.
Two years ago, florfenicol had been used in 37 percent (143 tons) of the stock; and oxytetracycline in 23.1 percent (89.3 tons), among other antimicrobials.
Essential oils against foodborne pathogens and spoilage bacteria in minced meat
06 Jul 2009
Foodborne Pathogens and Disease, Volume 6, Number 6
The antimicrobial activity of essential oils of oregano, thyme, basil, marjoram, lemongrass, ginger, and clove was investigated in vitro by agar dilution method and minimal inhibitory concentration (MIC) determination against Gram-positive (Staphylococcus aureusandListeria monocytogenes) and Gram-negative strains (Escherichia coliandSalmonella Enteritidis). MIC90% values were tested against bacterial strains inoculated experimentally in irradiated minced meat and against natural microbiota (aerobic or facultative, mesophilic, and psychrotrophic bacteria) found in minced meat samples. MIC90% values ranged from 0.05%v/v (lemongrass oil) to 0.46%v/v (marjoram oil) to Gram-positive bacteria and from 0.10%v/v (clove oil) to 0.56%v/v (ginger oil) to Gram-negative strains. However, the MIC90% assessed on minced meat inoculated experimentally with foodborne pathogen strains and against natural microbiota of meat did not show the same effectiveness, and 1.3 and 1.0 were the highest log CFU/g reduction values obtained against tested microorganisms.
Costa Rica:Street food found highly contaminated with fecal matter
22 Jun 2009
Inside Costa Rica [edited] [FSNet]
Food purchased from street vendors has been found to have a high level of fecal contamination, according to a study by the university.
The study reveals that the poor cleanliness of hands, utensils and consumables used vendors in the preparation and sale of the food, as the main cause.
The report indicates that seven of the twelve foods (58%) analyzed by their laboratory contained fecal matter.
The samples were taken last Wednesday, June 17, from street vendors in Zapote, Desamaparados, La Sabana park and downtown San José.
In addition to contaminated papaya slices, results showed contamination of freshly squeezed orange juice. The lab results also indicated a high level of contamination of "arroz con leche" (rice pudding) and "jugo de caña" (sugarcane juice), purchased by UCR staff.
Chile-Study onCampylobacterin Chilean poultry plants
22 May 2009
The Poultry Site [edited] [ProMed]
At an average of 54 percent, the levels ofCampylobactercontamination on broiler carcasses in processing plants were similar to those found in studies in other countries, and the highest rates were found after evisceration.
ThermotolerantCampylobacterare among the more prevalent bacterial pathogens that cause foodborne diseases.
This study aimed at evaluating the occurrence of thermotolerantCampylobactercontamination in chicken carcasses and processing plant stations (chilling water, scalding water, de-feathering machinery, evisceration machine and transport crates) in two of the Chilean main slaughterhouses.
In addition, the isolation rates of thermotolerantCampylobacterduring evisceration and following chiller processing were compared.
The overall slaughterhouse contamination with thermotolerantCampylobacterwas 54 percent. Differences were evident when the results from each plant were compared: plants A and B were 72 percent and 36 percent, respectively.
The sampling points with the greatest contamination rates in both plants were after evisceration (90 percent and 54 percent, for plants A and B, respectively).
The decrease of thermotolerantCampylobactercontamination after chilling was significant.
The findings indicate that chilling process has a limited effect in the final productsCampylobactercontamination because poultry enter the slaughter processing with high counts of contamination. This may represent a health risk to consumers if proper cooking practices are not employed.
The level and frequencies ofCampylobacterfound during the processing of Chilean poultry appear to be similar to those reported elsewhere in the world.
Brazil -Foodborne pathogens and microbiological characteristics of raw milk soft cheese produced and on retail sale
27 Feb 2009
Foodborne Pathogens and Disease
Paula Mendonça Moraes, Gabriela Nogueira Viçosa, Anderson Keizo Yamazi, Maria Beatriz Tassinari Ortolani, Luís Augusto Nero
Abstract
The consumption of raw milk soft cheeses (RMSC), which are typically manufactured in small dairy farms under unsatisfactory hygiene conditions, is common in Brazil. Due to these production characteristics, this type of cheese is a potential carrier of pathogenic microorganisms, such asListeria monocytogenes,Salmonella, and enterotoxin-producingStaphylococcusspp. Considering these characteristics, in this work, we aimed to detect the presence of these pathogenic microorganisms in RMC and to evaluate their microbiological quality. Fifty-five samples of this product were collected from different noninspected commercial establishments and submitted to the enumeration of mesophilic aerobes (MA), total coliforms (TC),Escherichia coli, and coagulase-positiveStaphylococci(CPS), and detection ofL. monocytogenesandSalmonellaspp. All analyzed samples were negative forSalmonellaspp. andL. monocytogenes. All samples presented counts of MA higher than 106 colony forming units/g (CFU/g; range, 3.0×106 to 4.0×109). TC were present at levels between 1.0×103 and 1.8×108CFU/g, andE. colibetween 1.0×102 and 3.5×106CFU/g. CPS were detected in 17 (30.9%) samples at levels higher than 104CFU/g. These results confirm the poor microbiological quality of raw milk used in the manufacturing of RMC samples, and also the inadequate production conditions. Therefore, the evaluation of microbiological safety and quality of these products must be constantly reported to alert the official agencies about the significance of proper inspection.
Brazil -Enterobacter sakazakiiin dried infant formulas and milk kitchens of maternity wards in São Paulo
01 Jan 2009
Journal of Food Protection®, Volume 72, Number 1, January 2009 , pp. 37-42(6)
Palcich, Gabriela; de Moraes Gillio, Cintia; Aragon-Alegro, Lina Casale; Pagotto, Franco J.; Farber, Jeffrey M.; Landgraf, Mariza; Destro, Maria Teresa
This study was the first conducted in Brazil to evaluate the presence ofEnterobacter sakazakiiin milk-based powdered infant formula manufactured for infants 0 to 6 months of age and to examine the conditions of formula preparation and service in three hospitals in São Paulo State, Brazil. Samples of dried and rehydrated infant formula, environments of milk kitchens, water, bottles and nipples, utensils, and hands of personnel were analyzed, andE. sakazakiiandEnterobacteriaceaepopulations were determined. All samples of powdered infant formula purchased at retail containedE. sakazakiiat <0.03 most probable number (MPN)/100 g. In hospital samples,E. sakazakiiwas found in unopened formula can (0.3 MPN/100 g) and in the residue from nursing bottle from hospital A. All other cans of formula from the same lot bought at a retail store containedE. sakazakiiat <0.03 MPN/100 g. The pathogen also was found in cleaning sponge from hospital B. Enterobacteriaceaepopulations ranged from 101 to 105 CFU/g in cleaning aids and <5 CFU/g in all formula types (dry or rehydrated), except for the sample that containedE. sakazakii,which also was contaminated withEnterobacteriaceaeat 5 CFU/g.E. sakazakiiisolates were not genetically related. In an experiment in which rehydrated formula was used as the growth medium, the temperature was that of the neonatal intensive care unit (25°C), and the incubation time was the average time that formula is left at room temperature while feeding the babies (up to 4 h), a 2-log increase in levels ofE. sakazakiiwas found in the formula. Visual inspection of the facilities revealed that the hygienic conditions in the milk kitchens needed improvement. The length of time that formula is left at room temperature in the different hospitals while the babies in the neonatal intensive care unit are being fed (up to 4 h) may allow for the multiplication ofE. sakazakiiand thus may lead to an increased health risk for infants.
Sources and Terms of Use
