Effects of intense pulsed light on Cronobacter sakazakii and Salmonella surrogate Enterococcus faecium inoculated in different powdered foods.

Cronobacter sakazakii and Salmonella spp. are foodborne pathogens associated with low moisture foods. An intense pulsed light (IPL) system is being developed as an alternative novel method to pasteurize powdered food. The aim of the study is to investigate the microorganism inactivation in different powdered foods and a variety of related variables using a vibratory-assisted IPL system. The results showed that C. sakazakii on non-fat dry milk (NFDM), wheat flour, and egg white powder were significantly inactivated by 5.27, 4.92, and 5.30 log10 CFU/g, respectively, after 3 or 4 passes of IPL treatments. For decontamination of E. faecium, 3-4 passes of IPL treatments reduced the E. faecium level on NFDM, wheat flour, and egg white by 3.67, 2.79, 2.74 log10 CFU/g, respectively. These results demonstrated that the enhanced microbiological inactivation can be achieved using this vibratory-assisted IPL system after multiple passes.

Quantitative study about the role of environmental conditions in the survival capability of multidrug-resistant bacteria.

BACKGROUND: Healthcare-associated infections (HAIs) caused by multidrug-resistant bacteria (MDRB) are of global concern and hospital textiles can contribute to their transmission. MDRB are able to survive on textiles for more than enough time to spread in the environment. Some studies summarized the effect of environmental factors on the duration of bacterial survival, but it remained an open question how these factors influence the quantity of surviving bacteria in a period of a few days, which is relevant from the perspective of HAIs. Investigating this effect can contribute to better understand the spread of MDRB and the emergence of hospital outbreaks. METHODS: We investigated quantitatively the survival capability of 15 vancomycin-resistant Enterococcus faecium (VRE), 15 methicillin-resistant Staphylococcus aureus (MRSA), 15 multidrug-resistant Acinetobacter baumannii (MACI) and 15 multidrug-resistant Klebsiella pneumoniae (MRKP) in five environmental conditions using the plate count method. We examined the role of nutrients, textile types, temperature and level of relative humidity on bacterial survival after 1-7days of incubation. RESULTS: Each bacterial group showed higher survival capability on 100% cotton towel than on 100% cotton sheet (P<0.01). MRSAs and VREs showed higher (P<0.01), MACIs showed lower (P=0.02) CFU/swatch values on 100% polyester sheet than on cotton sheet. The survival capability of MRKPs and MRSAs was higher inoculated in nutrient broth than in saline solution (P<0.01). Each bacterial group showed lower survival capability (P<0.01) at body condition (T=35°C, Rh=83%) than at control (T=25°C, Rh=52%). CONCLUSIONS: Towels proved to be excellent conditions for each bacteria to survive, however chemical composition of the textiles affected differently the survival of Gram-positive and Gram-negative bacteria. These findings could be useful in searching for the source of outbreaks. Organic contamination of the textiles can increase the survival of desiccation-sensitive bacteria, therefore nutrient-rich inoculating medium is recommended in survival studies.

Effectiveness of automated ultraviolet-C light for decontamination of textiles inoculated with Enterococcus faecium.

Healthcare textiles are increasingly recognized as potential vehicles for transmission of hospital-acquired infections. This study tested the ability of an automated ultraviolet-C (UV-C) room disinfection device (Tru-D Smart UV-C) to decontaminate textiles inoculated with Enterococcus faecium in a clinical setting. Contaminated polycotton (50/50 polyester/cotton) swatches were distributed to predefined locations in a ward room and exposed to UV-C light. UV-C decontamination reduced E. faecium counts by a mean log10 reduction factor of 1.37 (all P = 0.005, Wilcoxon signed rank test). UV-C decontamination may be a feasible adjunctive measure to conventional laundering to preserve the cleanliness of healthcare textiles in ward rooms.

Ultraviolet (UV-C) inactivation of Enterococcus faecium, Salmonella choleraesuis and Salmonella typhimurium in porcine plasma.

The objective of this study was to assess the effectiveness of an ultraviolet (UV-C, 254 nm) irradiation system on reducing the load of Salmonella typhimurium (S. typhimurium), Salmonella choleraesuis (S. choleraesuis) resistant to streptomycin and Enterococcus faecium (E. faecium) inoculated in sterile porcine plasma and then subjected to different UV-C irradiation doses (750, 1500, 3000, 6000 and 9000 J/L) using a pilot plant UV-C device working under turbulent flow. Results indicated that UV-C treatment induced a viability reduction of 0.38, 1.18, 3.59, 4.72 and 5.06 log10 S. typhimurium when irradiated at 750, 1500, 3000, 6000 and 9000 J/L, respectively. The observed log10 reduction of S. choleraesuis was 1.44, 2.68, 5.55, 7.07 and 7.97 at 750, 1500, 3000, 6000 and 9000 J/L, respectively. The best-fit inactivation for S. choleraesuis was the Weibull distribution curve, while the best-fit curve for S. typhimurium was the Weibull plus tail model, indicating that around 102 cfu/mL resistant S. typhimurium was detected when the liquid plasma was UV-C irradiated at doses up to 9000 J/L. Viability reduction for E. faecium was 0.44, 1.01, 3.70, 5.61 and 6.22 log10 when irradiated at 750, 1500, 3000, 6000 and 9000 J/L, respectively, with no bacterial resistance observed with UV-C doses of 6000 J/L or higher. The biphasic model was the best fit model for the inactivation curve for E. faecium. For the three microorganisms tested, about a 4 log-unit reduction was achieved when the liquid plasma was irradiated at 3000J/L. Overall results demonstrate the usefulness of the UV-C system to inactivate bacteria in liquid plasma before spray-drying. We conclude that the UV-C system can provide an additional biosafety feature that can be incorporated into the manufacturing process for spray-dried animal plasma.

Evaluation of Low-Dose Ultraviolet Light C for Reduction of Select ESKAPE Pathogens in a Canine Skin and Muscle Model.

OBJECTIVE: This study aimed at comparing the ability of low-dose UVC, 0.05% chlorhexidine, and combined UVC with 0.05% chlorhexidine to reduce colony-forming units (CFUs) on select ESKAPE pathogens (Staphylococcus aureus, Klebsiella pneumoniae, and Enterococcus faecium) in a canine skin and muscle model. BACKGROUND DATA: Surgical site infections (SSIs) result in increased morbidity and cost. UVC damages DNA, rendering bacteria nonviable and does not discriminate between drug-sensitive and multi-drug-resistant organisms. MATERIALS AND METHODS: Specimens were inoculated with one of three pathogens. Samples were treated with a 254 nm UVC mercury lamp or a 270 nm UVC LED light at 0.015, 0.03, or 0.04 J/cm(2) doses; 0.05% and 2% chlorhexidine were used as positive controls. To evaluate synergism, 0.05% chlorhexidine was used with 0.015 J/cm(2) of UVC. CFUs were counted and compared against the negative control. RESULTS: There were no significant differences in CFU counts between samples of the same tissue type treated with different light sources of the same UVC dose. UVC significantly decreased CFUs when compared against all negative controls in both skin and muscle. There was no consistently superior bactericidal UVC dose identified for individual bacteria or for tissue type. The bactericidal activity of UVC at 0.015 J/cm(2) versus 0.05% chlorhexidine was not different in muscle for any bacteria. The bactericidal activity of UVC at 0.015 J/cm(2) was superior to 0.05% chlorhexidine in skin for S. aureus and K. pneumonia, but not E. faecium. Combination of UVC and 0.05% chlorhexidine showed synergy against E. faecium when evaluated on skin. CONCLUSIONS: Low-dose UVC shows promise as a rapid, effective, and synergistic means of reducing bacterial burdens, which may decrease the incidence of SSIs. It should be further evaluated for use when 2% chlorhexidine would be contraindicated or impractical, such as open wounds or surgical sites.

Safety of the surrogate microorganism Enterococcus faecium NRRL B-2354 for use in thermal process validation.

Enterococcus faecium NRRL B-2354 is a surrogate microorganism used in place of pathogens for validation of thermal processing technologies and systems. We evaluated the safety of strain NRRL B-2354 based on its genomic and functional characteristics. The genome of E. faecium NRRL B-2354 was sequenced and found to comprise a 2,635,572-bp chromosome and a 214,319-bp megaplasmid. A total of 2,639 coding sequences were identified, including 45 genes unique to this strain. Hierarchical clustering of the NRRL B-2354 genome with 126 other E. faecium genomes as well as pbp5 locus comparisons and multilocus sequence typing (MLST) showed that the genotype of this strain is most similar to commensal, or community-associated, strains of this species. E. faecium NRRL B-2354 lacks antibiotic resistance genes, and both NRRL B-2354 and its clonal relative ATCC 8459 are sensitive to clinically relevant antibiotics. This organism also lacks, or contains nonfunctional copies of, enterococcal virulence genes including acm, cyl, the ebp operon, esp, gelE, hyl, IS16, and associated phenotypes. It does contain scm, sagA, efaA, and pilA, although either these genes were not expressed or their roles in enterococcal virulence are not well understood. Compared with the clinical strains TX0082 and 1,231,502, E. faecium NRRL B-2354 was more resistant to acidic conditions (pH 2.4) and high temperatures (60°C) and was able to grow in 8% ethanol. These findings support the continued use of E. faecium NRRL B-2354 in thermal process validation of food products.

Biofilm formation on polystyrene under different temperatures by antibiotic resistant Enterococcus faecalis and Enterococcus faecium isolated from food.

The ability of antibiotic resistant E. faecalis and E. faecium isolated from food to form biofilm at different temperatures in the absence or presence of 0.75% glucose was evaluated. A synergistic effect on biofilm at 10 °C, 28 °C, 37 °C and 45 °C and glucose was observed for E. faecalis and E. faecium.

Photodynamic and antibiotic therapy impair the pathogenesis of Enterococcus faecium in a whole animal insect model.

Enterococcus faecium has emerged as one of the most important pathogens in healthcare-associated infections worldwide due to its intrinsic and acquired resistance to many antibiotics, including vancomycin. Antimicrobial photodynamic therapy (aPDT) is an alternative therapeutic platform that is currently under investigation for the control and treatment of infections. PDT is based on the use of photoactive dye molecules, widely known as photosensitizer (PS). PS, upon irradiation with visible light, produces reactive oxygen species that can destroy lipids and proteins causing cell death. We employed Galleria mellonella (the greater wax moth) caterpillar fatally infected with E. faecium to develop an invertebrate host model system that can be used to study the antimicrobial PDT (alone or combined with antibiotics). In the establishment of infection by E. faecium in G. mellonella, we found that the G. mellonella death rate was dependent on the number of bacterial cells injected into the insect hemocoel and all E. faecium strains tested were capable of infecting and killing G. mellonella. Antibiotic treatment with ampicillin, gentamicin or the combination of ampicillin and gentamicin prolonged caterpillar survival infected by E. faecium (P = 0.0003, P = 0.0001 and P = 0.0001, respectively). In the study of antimicrobial PDT, we verified that methylene blue (MB) injected into the insect followed by whole body illumination prolonged the caterpillar survival (P = 0.0192). Interestingly, combination therapy of larvae infected with vancomycin-resistant E. faecium, with antimicrobial PDT followed by vancomycin, significantly prolonged the survival of the caterpillars when compared to either antimicrobial PDT (P = 0.0095) or vancomycin treatment alone (P = 0.0025), suggesting that the aPDT made the vancomycin resistant E. faecium strain more susceptible to vancomycin action. In summary, G. mellonella provides an invertebrate model host to study the antimicrobial PDT and to explore combinatorial aPDT-based treatments.

Biofilm formation on polystyrene under different temperatures by antibiotic resistant Enterococcus faecalis and Enterococcus faecium isolated from food

The ability of antibiotic resistant E. faecalis and E. faecium isolated from food to form biofilm at different temperatures in the absence or presence of 0.75% glucose was evaluated. A synergistic effect on biofilm at 10 °C, 28 °C, 37 °C and 45 °C and glucose was observed for E. faecalis and E. faecium.

Application of a molecular biology concept for the detection of DNA damage and repair during UV disinfection.

As nucleic acids are major targets in bacteria during standardised UV disinfection (254 nm), inactivation rates also depend on bacterial DNA repair. Due to UV-related DNA modifications, PCR-based approaches allow for a direct detection of DNA damage and repair during UV disinfection. By applying different primer sets, the correlation between amplicon length and PCR amplification became obvious. The longer the targeted DNA fragment was, the more UV-induced DNA lesions inhibited the PCR. Regeneration of Pseudomonas aeruginosa, Enterococcus faecium, and complex wastewater communities was recorded over a time period of 66 h. While phases of intensive repair and proliferation were found for P. aeruginosa, no DNA repair was detected by qPCR in E. faecium. Cultivation experiments verified these results. Despite high UV mediated inactivation rates original wastewater bacteria seem to express an enhanced robustness against irradiation. Regeneration of dominant and proliferation of low-abundant, probably UV-resistant species contributed to a strong post-irradiation recovery accompanied by a selection for beta-Proteobacteria.

Effect of extracellularly generated singlet oxygen on gram-positive and gram-negative bacteria.

In the separated surface-sensitizer system, a photosensitizer is physically separated from the substrate by a thin air layer under such conditions that only singlet oxygen can reach and oxidize the substrate, preventing the competition by type I photosensitized processes. This method has been used to study the reaction of singlet oxygen with Gram-positive (Streptococcus faecium) and Gram-negative (Escherichia coli) bacterial strains. Studies on cell samples exposed to singlet oxygen for different periods of time show a drastic decrease in survival for S. faecium, while E. coli becomes sensitive only when the integrity of the outer membrane is altered by treatment with CaCl2 or tris(hydroxymethyl)aminomethane-ethylenediaminetetraacetic acid (Tris-EDTA). Biochemical and ultrastructural analyses suggest that the cytoplasmic membrane and the genetic material are the main sites damaged by singlet oxygen.