Cronobacter sakazakii: A Deadly Pathogen with a Complex History

This blog article was created with Perplexity.ai, using the following prompt. The initial draft was only about 1 000 words long. Perplexity was then asked to double the length and include information on case histories. It then increased the word count by approximately 50%, as per below. Create a 2000 word blog article on Cronobacter sakazakii. Include information on history, taxonomy, when it changed name from Enterobacter, natural sources of this species, prevalence around the world, some notable outbreaks that are not linked to infant formula, while infant formula is such a common vehicle of infection, some typical case histories to show the clinical presentation and mortality rate, ways it can be controlled and options for treating the disease along with vaccination. Include cited sources of information. Cronobacter sakazakii is a foodborne pathogen that has gained significant attention in recent years due to its association with severe infections, particularly in infants. This comprehensive article delves into the history, taxonomy, prevalence, and clinical significance of C. sakazakii, as well as strategies for control and treatment. Historical Background The story of C. sakazakii begins in 1950 when a strain of Enterobacteriaceae was isolated from a tin of dried milk and deposited in England’s National Collection of Type Cultures (NCTC). This strain, designated NCTC 8155, would later be identified as C. sakazakii biogroup 1 and represents the earliest documented isolate of Cronobacter from a food source7. The first strain isolated from a human clinical specimen was in 1953, but it wasn’t until 1958 that the first documented case of neonatal meningitis occurred7. In 1961, Urmenyi and Franklin reported the first Cronobacter infection, though at the time it was misidentified as a yellow-pigmented Enterobacter cloacae. It wasn’t until 1980 that John J. Farmer III proposed the name Enterobacter sakazakii for this organism, honoring Japanese bacteriologist Riichi Sakazaki. This marked the beginning of a new era in understanding this pathogen and its impact on human health. Taxonomy and Reclassification For nearly three decades, from 1980 to 2007, Enterobacter sakazakii was considered a single well-defined bacterial species with 15 biogroups. However, advances in molecular biology techniques led to a significant taxonomic revision in 2007. The use of 16S ribosomal RNA gene sequencing, hsp60 sequencing, and polyphasic analysis revealed that E. sakazakii isolates actually represented distinct species. DNA-DNA hybridization and phenotyping confirmed these findings, leading to the creation of the new genus Cronobacter. The genus Cronobacter was named after Cronos, the Titan of Greek mythology who devoured his children as they were born – a grim allusion to the organism’s impact on infants. C. sakazakii became the type species of this new genus. Current Taxonomy Today, the genus Cronobacter contains 10 different species: The clinically relevant species can be divided into two groups: The other six species are primarily environmental commensals and appear to be of little clinical significance. Natural Sources and Prevalence C. sakazakii is naturally found in the environment and is particularly adept at surviving in low-moisture, dry foods. Common sources include: A meta-analysis of prevalence studies revealed that Cronobacter spp. are more prevalent in plant-related sources (20.1%, 95% CI 0.168–0.238) compared to animal-originated sources (8%, 95% CI 0.066–0.096)1. Alarmingly, a recent survey in the United States found that approximately 26.9% of homes were contaminated with C. sakazakii, particularly in kitchen settings. Common sites of contamination include: This widespread presence in the domestic environment creates clear opportunities for contamination of food and infant formula, potentially leading to foodborne illnesses. Notable Outbreaks and Case Histories While Cronobacter infections are often associated with powdered infant formula, outbreaks have occurred in various settings and age groups. Here are some notable cases and outbreaks: The Netherlands, 1977-1981 One of the first large series of neonatal infections was reported in the Netherlands, comprising eight cases of meningitis and sepsis over a 4-year period1. Reykjavik, Iceland, 1986-1987 Three cases of C. sakazakii infections in neonates were reported in Reykjavik, Iceland1: Case 1: A male born on March 18, 1986, after 36 weeks of gestation, with a birth weight of 3 144 g. Initially healthy, he was fed breast milk and powdered infant formula. On day 5, his health deteriorated, and C. sakazakii was isolated from spinal fluid and blood. Despite treatment with multiple antibiotics, the patient suffered severe neurological impairment. Case 2: A male born December 14, 1986, with Down’s syndrome, developed a C. sakazakii infection after being fed reconstituted powdered infant formula. Despite treatment, the patient did not survive. Case 3: A male twin born on January 6, 1987, developed a fever on day 6. C. sakazakii was isolated from cerebrospinal fluid samples. Oklahoma City, Oklahoma, 1981 A five-week-old male was admitted to the hospital with fever, grunting, and fatigue. C. sakazakii was detected in cerebrospinal fluid, blood, and urine samples. The patient was treated with antibiotics and discharged in good condition after 14 days1. United States, 2021-2022 Two recent cases highlight the ongoing threat of C. sakazakii infections2: Case 1 (September 2021): A full-term male infant developed fever, irritability, and excessive crying at 14 days old. C. sakazakii was isolated from cerebrospinal fluid. The infant was treated with intravenous antibiotics for 21 days and made a full recovery. Case 2 (February 2022): A preterm male infant in the neonatal intensive care unit developed apneic and bradycardic episodes, temperature elevation, and seizures at 20 days old. Despite treatment, the patient died 13 days after illness onset. Egypt, 2017-2018 A study conducted in Egypt reported 12 cases of neonatal sepsis caused by C. sakazakii out of 100 cases examined. This marked the first reported cases of C. sakazakii-induced neonatal sepsis in Egypt3. Infant iormula as a vehicle of infection Powdered infant formula (PIF) has been a common vehicle for C. sakazakii infections in infants for several reasons: In the 2021 case mentioned earlier, whole genome sequencing (WGS) revealed that the C. sakazakii isolate from the patient was closely genetically related (0 SNPs apart) to an isolate from the powdered formula consumed by the infant2. Clinical Presentation and Mortality Rate C. sakazakii

Indiana Cottage Food Law and Food Safety Training in the United States

This article was originally published on 5 May 2024 by Gavin Van De Walle of FoodSafePal, under the title, Indiana Cottage Food Law: Food safety training requirements. It is reproduced here, with permission. FoodSafePal is a trusted collaborative partner of ours, who provides food handler training in the United States. If you need food safety training to become a food handler in the United States, then do consider FoodSafePal – they can ensure your compliance with the cottage food laws in your state. Plus, as a special bonus, if you do take up food handler training from FoodSafePal, you can obtain $5 USD off the training, just by entering the discount code “foodsafety1”. Food that you make at home and sell directly to people is known as cottage food. Each state has its own cottage food law that determines the types of foods you can sell, to whom and how you can sell them, and how much revenue you can earn each year from the sale of your homemade goods. Before you can start a cottage food business, most states have certain requirements, a major one being the completion of an approved food safety training course. This article discusses the Indiana cottage food law, and whether you need food safety training to sell homemade food. Indiana cottage food production Indiana allows the production and sale of homemade goods that don’t require time or temperature controls to keep them safe. Examples of approved foods include:  baked items, like cookies, cakes, fruit pies, cupcakes, bars, yeast breads, fruit breads, baguettes (no creme or pumpkin pies)  candy and confections, like caramels, chocolate, fudge, peanut brittle, chocolate covered fruits, bon bons, buckeyes, chocolate covered nuts  unprocessed fruits and vegetables  tree nuts and legumes  pickled cucumbers processed using a traditional method (no vinegar or acidifier)  in-shell chicken eggs (with Egg Board license and labeling)  some rabbit and poultry (with restrictions)  honey, molasses, sorghum, maple syrup Except with certain restrictions, you cannot sell meats and other animal products. Indiana requires that you sell the allowed foods directly to Indiana residents in person, by mail order, or through the internet. Indiana regulates cottage food businesses — called home based vendors — different than retail food establishments like restaurants, so you don’t need a license or permit and the department of health also won’t routinely inspect your home kitchen. However, the department of health can inspect your inspection if the receive customer complaints about the safety of the food you sell or to investigate foodborne illness outbreaks potentially linked with your products. Misbranding your product is also grounds for the state to inspect your kitchen. Indiana has no restriction on the annual revenue you can earn from the sale of your homemade goods. Do you need food safety training to sell homemade food in Indiana? Indiana requires that you obtain a food handler certificate from a certificate issuer that is accredited by the ANSI-National Accreditation Board (ANAB). A food handlers certificate proves that you have completed a course on basic food safety principles and passed a test about these principles. FoodSafePal’s Food Handler course is ANAB accredited so it meets Indiana’s cottage food law requirements for food safety training. FoodSafePal’s Food Handler course is designed for food workers in retail food establishments so some of the content isn’t applicable to cottage food operators. Still, it covers the important food safety principles you must know to keep your homemade products safe from disease-causing organisms called pathogens that can make people sick. After you complete the course content, you must take a test and answer at least 28 (70%) out of 40 multiple-choice question to pass and earn your food handlers certificate and card. You can learn and test in under two hours completely online. Upon passing, you can immediately download or print it as proof that you have completed the training. Keep this certificate in a safe and easily accessible place as you must provide a copy as requested by the state department of health or a customer. You must maintain the training by retaking and passing the course every three years. Labeling requirements Indiana’s cottage food law requires that each food is properly labeled with certain information. This information allow people to whom you sell contact you in the case of an illness potentially linked to your product. It also informs customers of allergens that may be present and that the food is produced in a home kitchen not routinely inspected by the health department. This label must include the following information:  your business name and address  the common or usual name of the product  the ingredients listed in descending order of predominance by weight  the net weight or volume of the food by standard measure or numerical count  the statement in 10 point type: This product is home produced and processed and the production area has not been inspected by the state department of health. NOT FOR RESALE. If you have a website, you must post the label of each product on it. The bottom line Under the Indiana cottage food law, you can produce and sell foods that don’t require time or temperature controls like baked and other dry goods directly to people throughout the state. If you want to start a cottage food business in Indiana, you must first earn a food handlers card by completing and passing an ANAB-accredited food handler training course, such as the one offered by FoodSafePal. After you complete the course and pass the test, you will be issued a certificate as proof of completion. You must maintain this certificate by retaking an approved food safety course every three years. Each food you make and sell must also have a label with the required information. Gavin Van De Walle, MS, RDN Gavin Van De Walle holds a master’s degree in human nutrition and food science. He is also a registered dietitian nutritionist who aims to make food safety intuitive and accessible for everyone.

Bacteriocins as Antibiofilm Agents: An Analysis of Feasibility 

Biofilm formation is a significant challenge in the food manufacturing industry. These microbial communities, encased in a self-produced matrix of extracellular polymeric substances (EPS), are notoriously difficult to eliminate. They can adhere to food contact surfaces, leading to contamination and posing severe risks to food safety. Traditional cleaning and sanitising methods are often ineffective against biofilms, making it essential to explore novel strategies for their control. Among the emerging solutions, bacteriocins garnered considerable attention due to their potential as antibiofilm agents. Understanding Bacteriocins and Their Mechanism of Action Bacteriocins are produced by various bacterial species, primarily lactic acid bacteria (LAB), which are commonly found in fermented foods. These peptides exhibit a broad spectrum of antimicrobial activity against closely related bacterial strains and, in some cases, even against more distantly related bacteria. The primary mechanism by which bacteriocins exert their antibacterial effects is through pore formation in the target cell membrane, leading to cell lysis and death. However, the role of bacteriocins in disrupting biofilms goes beyond simple bacterial killing. Recent studies have demonstrated that bacteriocins can interfere with biofilm formation at multiple stages, including initial adhesion, maturation, and dispersion. This multifaceted mode of action makes bacteriocins promising candidates for biofilm control in food processing environments. Efficacy of Bacteriocins Against Foodborne Pathogen Biofilms Several studies have investigated the effectiveness of bacteriocins against biofilms formed by foodborne pathogens. For instance, bacteriocin-producing strains such as Lactobacillus plantarum have shown the ability to inhibit the biofilm formation of Listeria monocytogenes, a notorious foodborne pathogen. The bacteriocins produced by these strains were found to disrupt the EPS matrix, rendering the biofilm structure more susceptible to sanitizing agents (Pang et al., 2022). Similarly, nisin, one of the most well-characterized bacteriocins, has been extensively studied for its antibiofilm properties. Nisin has been shown to inhibit the growth of biofilms formed by Staphylococcus aureus and Escherichia coli, two pathogens commonly associated with foodborne illnesses. The peptide’s ability to penetrate the biofilm matrix and disrupt the membrane integrity of embedded cells makes it an effective tool for biofilm control (Simons et al., 2020). Challenges and Considerations in Implementing Bacteriocins in Food Manufacturing Despite the promising results, the application of bacteriocins as antibiofilm agents in food manufacturing is not without challenges. One of the primary concerns is the potential development of resistance among target bacteria. Just as with antibiotics, prolonged exposure to sub-lethal concentrations of bacteriocins could select for resistant strains, potentially undermining their efficacy. Moreover, the stability of bacteriocins under various food processing conditions, such as high temperatures and varying pH levels, needs to be carefully evaluated. While some bacteriocins are relatively stable, others may lose their activity when exposed to harsh processing environments. This variability in stability must be accounted for when designing bacteriocin-based interventions. Another critical factor is the regulatory landscape. The use of bacteriocins in food products is subject to strict regulations, which vary by region. Manufacturers must navigate these regulations to ensure that their use of bacteriocins complies with safety standards and does not pose risks to consumers. Future Directions and Conclusion The feasibility of using bacteriocins as antibiofilm agents in food manufacturing is supported by a growing body of evidence. These peptides offer a natural and potentially effective means of controlling biofilms, which could complement existing sanitation practices and enhance food safety. However, further research is needed to address the challenges associated with their application, including the risk of resistance development, stability under processing conditions, and regulatory compliance. As the food industry continues to seek innovative solutions to ensure the safety and quality of food products, bacteriocins represent a promising avenue for exploration. By leveraging the natural antimicrobial properties of these peptides, manufacturers can potentially reduce the incidence of biofilm-related contamination, ultimately protecting public health and preserving the integrity of the food supply chain. References:

Cottage food production, food manufacturing entrepreneurship, and support services in Utah, USA.

Introduction, information sources and context The information below was compiled using DeepSeek-V3 with the following prompt: Write me about 800 words on cottage food production, food manufacturing entrepreneurship and organisations or extension services available in the USA state of Utah. It is intended for general information only. For the most authoritative source on the cottage food law aspect, we strongly encourage you to access the Utah cottage food law blog article by Gavin Van De Walle of FoodSafePal. Above is a pdf of the blog article for download. FoodSafePal is our collaborative partner for food handler training in the United States. We strongly encourage you to complete your training with them. If you do so, please use our discount code ‘foodsafety1‘. This will give you a $5 USD discount off the training feee during the registration process. The cottage food industry has become an increasingly popular avenue for entrepreneurs in the United States, allowing individuals to produce and sell certain low-risk food products from their homes. In Utah, cottage food production is regulated under the Utah Cottage Food Law, which provides opportunities for small-scale food entrepreneurs to start businesses with minimal overhead costs. Alongside cottage food production, Utah also supports food manufacturing entrepreneurship through various organisations, extension services, and resources designed to help entrepreneurs navigate the complexities of starting and growing a food business. This article explores cottage food production in Utah, the broader food manufacturing entrepreneurship landscape, and the organizations and extension services available to support these ventures. Cottage food production in Utah Cottage food production refers to the preparation and sale of food products made in a home kitchen rather than a commercial facility. In Utah, the Cottage Food Law allows individuals to produce and sell certain non-potentially hazardous foods without requiring a commercial kitchen or a food establishment license. This law is designed to encourage small-scale entrepreneurship and provide a pathway for individuals to turn their culinary skills into a business. Key features of Utah’s cottage food law: Cottage food production is an excellent entry point for aspiring food entrepreneurs, as it requires minimal startup costs and allows individuals to test their products in the market before investing in a commercial facility. Food manufacturing entrepreneurship in Utah For entrepreneurs looking to scale beyond cottage food production, Utah offers a supportive environment for food manufacturing businesses. Food manufacturing involves producing food products on a larger scale, often requiring commercial kitchen facilities, compliance with federal and state regulations, and more sophisticated business planning. Steps to start a food manufacturing business in Utah: Utah’s food manufacturing sector benefits from the state’s strong entrepreneurial culture, access to agricultural resources, and a growing demand for locally produced and artisanal food products. Organisations and extension services supporting food entrepreneurs in Utah Utah is home to several organizations and extension services that provide resources, training, and support to cottage food producers and food manufacturing entrepreneurs. These entities play a crucial role in helping entrepreneurs navigate regulatory requirements, develop business skills, and access funding opportunities. 1. Utah Department of Agriculture and Food (UDAF) 2. Utah State University (USU) Extension 3. Women’s Business Center of Utah 4. Small Business Development Center (SBDC) Network 5. Local food networks and associations 6. Shared commercial kitchens 7. Funding and grant opportunities Challenges and Opportunities While Utah offers a supportive environment for food entrepreneurs, there are challenges to consider. Cottage food producers may face limitations in the types of products they can sell and the scale of their operations. Food manufacturing entrepreneurs must navigate complex regulations and invest in commercial facilities, which can be costly. However, the growing demand for locally produced, artisanal, and specialty food products presents significant opportunities for entrepreneurs who can differentiate their offerings and build strong brands. Conclusion Cottage food production and food manufacturing entrepreneurship are thriving in Utah, thanks to supportive regulations, a strong entrepreneurial culture, and access to resources and organisations that provide guidance and support. Whether starting with a small-scale cottage food operation or scaling up to a full-fledged food manufacturing business, entrepreneurs in Utah have access to the tools and networks needed to succeed. By leveraging the resources available through the UDAF, USU Extension, and other organisations, food entrepreneurs can turn their passion for food into a successful and sustainable business. RELATED BLOG ARTICLES Arizona Cottage Food Law: Food Safety Training Requirements Should Australia have cottage food laws? Training for food handlers in the United States

Bacteriocins as Antibiofilm Agents: The Mode of Actions

Biofilms, complex communities of microorganisms encased in a self-produced extracellular polymeric substance (EPS), pose significant challenges in various industries, including food safety. These biofilms confer enhanced resistance to antibiotics and other antimicrobial agents, making them a persistent problem. In recent years, bacteriocins, a group of antimicrobial peptides produced by bacteria, have garnered attention for their potential to disrupt and prevent biofilm formation. This article delves into the mechanisms by which bacteriocins act as antibiofilm agents, based on insights from recent research. Understanding Biofilms Biofilms are structured communities of microbial cells that adhere to surfaces and are embedded in a protective EPS matrix. This matrix not only shields the bacteria from environmental stresses but also facilitates communication and nutrient exchange among the cells. Biofilms can form on both biotic and abiotic surfaces, including medical devices, food processing equipment, and natural environments. The inherent resistance of biofilms to conventional antibiotics and disinfectants is a major concern, particularly in clinical and food safety settings. Mechanisms of Antibiofilm Action Bacteriocins utilise multiple strategies to combat biofilms, targeting different stages of biofilm development: 1. Inhibition of Initial Adhesion Bacteriocins can prevent the initial attachment of bacterial cells to surfaces, a critical first step in biofilm formation. By interfering with cell surface structures and reducing surface hydrophobicity, bacteriocins hinder the ability of bacteria to adhere to surfaces. 2. Disruption of EPS Matrix The EPS matrix is essential for biofilm stability and protection. Bacteriocins can degrade components of the EPS, such as polysaccharides and proteins, thereby weakening the biofilm structure and making the embedded bacteria more susceptible to antimicrobial agents. 3. Pore Formation in Cell Membranes Many bacteriocins, such as nisin, exert their antimicrobial effects by forming pores in the bacterial cell membrane. This leads to the leakage of cellular contents, disruption of membrane potential, and ultimately cell death. This mechanism is particularly effective against biofilm cells, which are often in a dormant state and resistant to other antimicrobials. 4. Interference with Quorum Sensing: Quorum sensing is a cell-to-cell communication mechanism that regulates biofilm formation and maintenance. Bacteriocins can interfere with quorum sensing signals, disrupting the coordination required for biofilm development and maintenance. 5. Synergistic Effects with Other Antimicrobials: Bacteriocins can enhance the efficacy of other antimicrobial agents when used in combination. This synergistic effect can help overcome the resistance of biofilm-associated bacteria, making it a promising strategy for biofilm control. Applications in Food Safety In the food industry, biofilms can lead to contamination and spoilage, posing significant health risks. The use of bacteriocins as natural preservatives and biofilm control agents offers a promising solution. For instance, nisin-coated surfaces have been shown to effectively reduce biofilm formation by Listeria monocytogenes and Staphylococcus aureus on food processing equipment. Additionally, bacteriocins can be incorporated into packaging materials to extend the shelf life of food products by preventing biofilm formation. To explore more about how bacteriocins contribute to food safety and their broader applications in the industry, check out our related articles: Conclusion Bacteriocins represent a potent and versatile tool in the fight against biofilms. Their ability to target multiple stages of biofilm development and their synergistic effects with other antimicrobials make them valuable in both clinical and food safety applications. Continued research into the mechanisms of action and the development of novel bacteriocins will further enhance our ability to control biofilms and improve public health outcomes. By leveraging the natural antimicrobial properties of bacteriocins, we can develop more effective strategies to combat biofilm-related issues, ensuring safer food production and processing environments. Stay Ahead in Biofilm Control and Food Safety Bacteriocins are proving to be powerful tools in tackling biofilms, but their full potential is still being explored. As industries continue to adopt innovative antimicrobial strategies, staying informed is crucial. Want to keep up with the latest advancements in food microbiology and biofilm control? Subscribe to our newsletter or follow us for more research insights and practical applications in food safety. Let’s work towards safer and more sustainable food production—one breakthrough at a time!

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