Biomedical subjects
Publications and source records attributed to M F Stringer.
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Under the Agreement on the Application of Sanitary and Phytosanitary Measures that came into force in 1995, it was stipulated that all World Trade Organisation (WTO) members are required to ensure that their sanitary and phytosanitary measures are based on assessment of the risks to human, animal or plant life or health. In doing so, they must take into account risk assessment techniques developed by relevant international organisations. WHO and FAO are two such international organisations that are of very high standard and influence. Their executive body, the Codex Alimentarius Commission has developed the concept of Microbiological Risk Assessment (MRA) in a wider framework called Risk Analysis. The aim of Risk Analysis is to provide a global standard for the interpretation of the acceptability of risks associated to foods to which consumers might be exposed. Microbiological Risk Assessment is an essential element of Risk Analysis because it specifies risks related to pathogenic micro-organisms in the food chain on the basis of sound science, combining qualitative and quantitative data in the areas of epidemiology and pathogenicity of micro-organisms with food production and handling. The concept is still in its infancy but is gaining wide acceptance globally. This paper will describe an inventory of MRA developments in Europe carried out under auspicion of the European Commission. It also gives the results of a literature survey concerning scientific publications on the topic MRA in which the activities in Europe are compared to those elsewhere.
The SET-RPLA is a commercially available kit for the detection of staphyloccal enterotoxins in foods. Previous reports have shown that non-specific reactions occur on use of the kit with cheeses and thereby restrict its use. In this study a variety of dairy products were tested and non-specific reactions were found to be associated with those products rennetted during manufacture. These reactions can be obviated by addition of 10 mM sodium hexametaphosphate to the diluent provided in the kit, without affecting the ability to detect staphyloccal enterotoxins in dairy products. The sensitivity of the SET-RPLA was demonstrated to be 0.25 ng/ml.
Toxin production by four strains of Aeromonas hydrophila grown at 30 and 37 degrees C in two laboratory media and prawn purée was studied. Three different cell lines were used to test for cytotoxic activity, haemolytic activity was tested against rabbit and guinea pig erythrocytes, proteolytic activity was assayed with azo-casein and enterotoxic activity using the suckling mouse assay. Results showed reduced cytotoxic and haemolytic activities in prawn purée compared with the two media, but in most cases increased proteolytic activity. No enterotoxic activity was observed in prawn purée although it was occasionally detectable in both laboratory media.
A model system was designed and constructed to investigate the mechanisms of food container leakage. Factors which were found to affect the leakage of microorganisms into the container, included the presence of a vacuum, the size and shape of the leakage channel and the volume of liquid passing through the channel. Differences were observed among the test organisms used.
A method was evaluated which has the potential to detect a food sample which has been irradiated. The technique will give an indication of the total number of viable micro-organisms present before irradiation. It is based on the comparison of an aerobic plate count (APC) with a count obtained using the Direct Epifluorescent Filter Technique (DEFT). When the APC of an irradiated sample was compared with the DEFT count on the same sample, the APC was considerably lower than that obtained by DEFT. The count of orange fluorescing cells after irradiation, however, correlated well with an APC of the same sample before irradiation. For the samples examined the DEFT count determined the viable microbial population in the sample before irradiation. The difference between the APC and the DEFT count gave the number of organisms rendered non-viable by the process.
The effects of irradiation of Clostridium botulinum neurotoxin type A (BNTA) and staphylococcal enterotoxin A (SEA) in gelatin phosphate buffer and cooked mince beef slurries were investigated. Estimation of toxins by immunoassays showed that in buffer, toxins were destroyed by irradiation at 8.0 kGy; in mince slurries however, 45% of BTNA and 27-34% of SEA remained after this level of irradiation. At 23.7 kGy, over twice the dose of irradiation proposed for legal acceptance in the UK, 15% of BNTA and 16-26% of SEA still remained. Increasing concentrations of mince conferred increased protection against the effect of irradiation on both toxins. The biological activity of BNTA was more sensitive to irradiation than the immunological activity. Staphylococcal enterotoxin was more resistant to irradiation than BNTA. Irradiation should therefore only be used in conjunction with good manufacturing practices to prevent microbial proliferation and toxin production prior to irradiation.
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A total of 114 Clostridium perfringens isolates were serotyped and examined for plasmids. Fifty-two strains were from hospitalized patients with diarrhea or from hospital environments, and 62 epidemiologically unrelated isolates were obtained from food poisoning outbreaks. All strains were screened for bacteriocin production against a common indicator strain of C. perfringens. In the one significant hospital outbreak of C. perfringens diarrhea, three to five plasmid types were found in strains of the predominant serotype, but no similar correlation between serotype and plasmid type was found in random isolates from a variety of sources. All of the strains associated with the diarrhea outbreak produced bacteriocins, whereas 63% of the strains from various sources produced bacteriocins. The typing data suggest a promising differentiating capability for plasmid analysis in the epidemiological study of outbreaks of food poisoning, diarrhea, or infections caused by C. perfringens.
Two rapid methods were evaluated for their extraction of plasmids from Clostridium perfringens. The first method involved lysis of 1 to 2 ml of C. perfringens culture by treatment with hyaluronidase, lysozyme, and sarcosyl. DNA, extracted with phenol-chloroform, was treated with RNase, boiled, and electrophoresed in a 1.2% agarose gel. The second method involved lysis of 2 ml of culture by lysozyme treatment and extraction with alkaline sodium dodecyl sulfate (SDS). Extracted DNA was treated with RNase, boiled, and electrophoresed in a 0.7% agarose gel. Of 57 strains of C. perfringens analyzed by both extraction procedures, 11 were shown to have plasmids by the alkaline SDS method which were missed by the phenol-chloroform extraction method. These new plasmids were of higher molecular mass and ranged up to 68 megadaltons. Use of the DNase inhibitor diethyl pyrocarbonate did not further improve the yield of plasmid DNA. An additional 159 isolates of C. perfringens screened by the alkaline SDS method revealed plasmids up to 80 megadaltons in mass and an overall plasmid carriage rate of 69%.
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The numbers and serotypes of Clostridium perfringens present in the faeces of three groups of hospital patients and young healthy laboratory workers were examined in studies lasting between 10 and 13 weeks. In one hospital some long-stay geriatric patients carried relatively high numbers of C. perfringens (greater than 10(7)/g) most of the time and it was not unusual in any one week for the majority of these patients to carry the same serotype(s). However, the numbers of C. perfringens in the faeces of young long-stay patients in the same hospital were in the range of 10(3)-10(4)/g and carriage of common serotypes was not observed. These results were similar to the findings with the young laboratory workers. This investigation indicates that two of the laboratory criteria often used in the investigation of C. perfringens food poisoning, i.e. faecal counts of greater than or equal to 10(5) C. perfringens/g and patients carrying the same serological type need to be interpreted with caution with suspected outbreaks involving some groups of geriatric long-stay hospital patients.
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Enterotoxigenic strains of Clostridium perfringens have recently been implicated in some cases of antibiotic-associated diarrhoea. We present here the results of an epidemiological study of this disease. Five cases of diarrhoea caused by C. perfringens serotype 41 occurred during a 9-week period, and then during a 6-week period there were three cases due to serotype 27 and two due to serotype 24; in all but one case two geriatric wards were involved. In total there were 16 cases in 22 months. All cases were identified by the detection of C. perfringens enterotoxin in the faeces. The mean number of C. perfringens in these cases was 10(8.8) cfu/g of faeces. Of 37 patients who had negative test results for C. perfringens enterotoxin, 18 had positive cultures for C. perfringens, with mean faecal counts of 10(5.3) cfu/g, and nine of these patients had diarrhoea. Thirteen different serotypes were isolated from these 18 patients, including type 41 from seven patients and type 27 from one. Hand carriage of the offending serotype was demonstrated in three of four infected patients, none of four controls and two of 14 ward staff. C. perfringens of serotypes causing disease was isolated from 59% of environmental areas where there was active disease, 27% of areas where there had been disease which had since resolved and 9% of areas where there was no history of disease. The findings imply that cross infection may occur.
An enzyme linked immunosorbent assay (ELISA) has been developed to quantitate faecal Clostridium perfringens enterotoxin in the investigation of C perfringens food poisoning. The sandwich ELISA could be carried out in 24 h and was sensitive enough to detect as little as 5 ng/g of enterotoxin in faeces. Specificity of the assay was shown by comparing results with those obtained from other standard toxin assays, such as double gel diffusion and counterimmunoelectrophoresis, and by the assay of faecal material from control groups. By means of the ELISA method, 515 faecal samples from 50 separate outbreaks of C perfringens food poisoning were examined, together with 21 food samples from 12 of the outbreaks. A clear distinction was noted between faecal samples collected on the first two days of an outbreak, where 77% were enterotoxin positive, and those specimens collected later than the second day, when only 33% had detectable enterotoxin. The ELISA is recommended as a valuable tool in the investigation of C perfringens foodborne illness.
Free Clostridium perfringens enterotoxin was detected in the stools of 11 patients with diarrhoea. All had high faecal counts of enterotoxigenic strains of C perfringens, mostly of serotypes not commonly associated with food poisoning. 10 of these 11 patients had severe or prolonged diarrhoea which had developed after antibiotic treatment. Enterotoxigenic C perfringens appears to be one of the causes of antibiotic-associated diarrhoea.
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A rapidly fatal case of enteritis necroticans in a 24 year old man with diabetes was caused by Clostridium perfringens type C. The role of beta toxin in the disease is discussed. This type has not been previously described as a causative agent in necrotising bowel disease of man outside endemic areas.