挪威肉类连锁店中产志贺毒素大肠杆菌(STEC)的风险评估,重点是干腌香肠

E. Rimstad, L. Håvarstein, G. Kapperud, J. Lassen, B. Lunestad, T. Nesbakken, L. Robertson, E. Skjerve, Y. Wasteson
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引用次数: 4

摘要

大肠杆菌是人类和动物正常胃肠道微生物菌群的一部分。引起肠道/腹泻疾病的大肠杆菌根据其对人类的毒力特性和致病性特征被分为不同的组。肠出血性大肠杆菌(EHEC)是引起人类出血性腹泻和溶血性尿毒综合征(HUS)的大肠杆菌菌株,并具有明确的人畜共患关系。肠出血性大肠杆菌(也是溶血性尿毒综合征的实际原因)的主要毒力因子是产生志贺毒素(Stx)的能力,因此被称为产志贺毒素大肠杆菌(STEC)。患有肠致病性大肠杆菌(EPEC),这些患者的腹泻是由于肠上皮的附着和消退(A/E)病变。这一风险评估是在2006年与受污染的干发酵香肠有关的产肠毒素大肠杆菌O103人间暴发之后进行的。挪威食品安全局(Mattilsynet)要求挪威食品安全科学委员会(vitenskapskomitsamen for mattrygghet)生物危害小组对挪威肉类链中产生志贺毒素的大肠杆菌(STEC)进行风险评估,重点是干腌香肠。为此,任命了一个特设专家工作组,其任务是起草关于这一问题的风险评估报告。目前的报告通过跟踪和分析整个过程来完成这项任务,从肉类在农场一级的起源,到干腌香肠的最终生产和储存。该报告的总体目标是确定和描述在这一链的各个部分的潜在干预方案。风险评估的主要结论如下:不可能对目前与食用干腌香肠有关的风险给出任何可靠的定量估计。在过去十年中,没有明确的迹象表明挪威人类产志贺毒素大肠杆菌感染的流行病学有任何普遍变化。没有文献表明,在过去十年中,家畜储存库中各种产志贺毒素大肠杆菌的发生率有任何变化。适当的屠宰卫生和对羊、牛和猪尸体进行热消毒相结合是减少产肠毒素感染的有效方法。这种方法不仅会降低产肠毒素大肠杆菌的污染水平,而且还会对其他肠道病原体(如沙门氏菌和小肠结肠炎耶尔森菌)的水平产生普遍有益的影响。在发酵过程中适当使用发酵剂,再加上较高的发酵温度,将降低受污染的干腌香肠中产大肠杆菌生长的可能性。较高的发酵温度、过程中较低的pH值和最终产品的热处理相结合,应有效消除因食用干腌香肠而传播产大肠杆菌感染的潜在风险。减少5个对数是可能的。现有的技术选择可以显著减少潜在病原体通过肉类,特别是通过干腌香肠的传播。最重要的数据缺口是缺乏关于挪威人类产肠毒素大肠杆菌感染实际发生情况的信息。有必要改进实验室诊断程序和流行病学监测,同时在卫生保健系统中改进报告和追踪。建议对各种家畜进行适当设计的基线研究,以提供关于各种血清型的发生及其存在的毒力因子的数据。此外,这将为与人类分离株进行比较提供更好的基础。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Risk Assessment of Shiga Toxin-producing Escherichia coli (STEC) in the Norwegian Meat Chain with Emphasis on Dry-cured Sausages
coli is part of the normal gastrointestinal microbial flora of humans and animals. E. coli bacteria causing enteric/diarrhoeal disease are categorized into different groups based on their virulence properties and pathogenic features in humans. Enterohaemorrhagic E. coli (EHEC) are E. coli strains that  cause bloody diarrhoea  and haemolytic uraemic  syndrome  (HUS)  in humans, and have a defined zoonotic association. The major virulence factor of EHEC (and the actual  cause  of HUS)  is  the  ability  to  produce Shiga  toxins  (Stx),  thus  the  name Shiga Toxin Producing E. coli (STEC).  With enteropathogenic Escherichia  coli  (EPEC),  the diarrhoea in these  patients  is  due  to  attaching  and  effacing  (A/E)  lesions  in  the  enteric epithelium.    This risk assessment  was  conducted  after  a  human  outbreak  of  STEC  O103  in  2006, associated with contaminated dry-fermented sausages.   The Norwegian Scientific Committee for Food Safety (Vitenskapskomitéen for mattrygghet), Panel on  Biological  Hazards,  was  asked  by  the  Norwegian  Food  Safety  Authority (Mattilsynet) for  a  risk  assessment  regarding  shiga  toxin-producing  E.  coli  (STEC)  in  the Norwegian meat chain, with emphasis on dry-cured sausages. In response, an ad hoc Working Group  of  experts was  appointed with  the mandate  to  draft  a  risk  assessment  regarding  this issue.   The current report approaches the task by following and analysing the entire process, from the origin of the meats at farm level, to the final production and storage of dry-cured sausages. An overall  aim of  the  report has been  to  identify  and describe potential  intervention options  in various parts of this chain.     The main conclusions from the risk assessment are as follows:   It is  not  possible  to  give  any  reliable  quantitative  estimates  of  the  current  risk associated with consumption of dry-cured sausages.    There are  no  clear  indications  of  any  general  change  in  the  epidemiology  of  STEC  infections in humans in Norway over the last decade.   There is no documentation that there has been any change in the occurrence of various STEC in the domestic animal reservoir during the last decade.   The combination of proper slaughter hygiene and use of  thermal decontamination of sheep,  cattle  and  pig  carcasses  represents  an  efficient  way  to  reduce  STEC contamination. This approach would not only cause a reduction in the contamination level of STEC, but also provide a general beneficial effect on the level of other enteric pathogens, such as Salmonella and Yersinia enterocolitica.   Proper use  of  starter  cultures  in  fermentation,  combined  with  higher  fermentation temperatures,  will  reduce  the  probability  of  growth  of  STEC  in  contaminated  drycured sausages.   A combination  of  higher  fermentation  temperatures,  a  lower  pH  during  the  process, and heat-treatment of  the  final product should effectively eliminate  the potential  risk for transmission of STEC infections from consumption of dry-cured sausages. A 5 log reduction is possible.   Technological options  are  available  to  reduce  significantly  the  transfer  of  potential pathogens through meats in general, and specifically through dry-cured sausages.    The most important data gap is the lack of information about the actual occurrence of STEC infections  in  humans  in Norway.  Improved  laboratory  diagnostic  procedures and  epidemiological  surveillance,  combined with  better  reporting  and  tracing  in  the health care system are necessary.    The implementation  of  properly  designed  base-line  studies  of  various  domestic animals,  to  provide  data  on  the  occurrence  of  various  serotypes  and  their  virulence factors  present  is  recommended.  Also,  this  would  provide  a  better  basis  for comparison with human isolates. 
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