Underestimated Risks of Infantile Infectious Disease from the Caregiver's Typical Handling Practices of Infant Formula
Underestimated Risks of Infantile Infectious Disease from the Caregiver's Typical Handling Practices of Infant Formula
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DOI：
10.1038/s41598-019-46181-0
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发表时间：
2019-07-05
影响因子：
4.6
通讯作者：
Rhee, Min Suk
中科院分区：
文献类型：
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作者：
Choi, Tee Jin;Hwang, Ji Yeon;Rhee, Min Suk
作为病原体储存库的对婴儿照顾者的影响尚未从婴儿配方奶粉(PIF)的角度加以开发。在这里，我们揭示了病原体通过手勺传播的新途径，甚至在照料者、PIF的处理和PIF容器中的喂食勺储存的典型做法中都意外地发生了这种情况。模拟手勺-PIF污染路径，分析病原菌的转移和随后的存活。与婴幼儿致命性疾病相关的主要病原体(阪崎慢杆菌、肠沙门氏菌、金黄色葡萄球菌)在长期存活(3周；PIF使用截止日期)后，很容易通过勺子从皮肤(3-6logCFU/手)传播到PIF，因为感染剂量过高，突出了疾病的直接发病。皮肤上的低细菌负荷(约1logCFU/手)可以防止PIF的交叉污染，但在勺子上转移的病原体至少存活72h证明了PIF再次污染的可能性。据我们所知，这是第一次调查与粉状食品接触的餐具的交叉污染。手部的细菌负荷是病原体传播的关键决定因素，风险程度取决于物种。这些证据结果重新定义了照料者做法的风险，并有助于将交叉污染纳入风险评估，作为低估的感染途径。
The impact on infant caregiver as a reservoir of pathogens has not been exploited with perspective to powdered infant formula (PIF). Here we reveal novel route of pathogen transfer through handspoon-PIF unexpectedly occurred by even typical practices of caregivers, handling of PIF and storage of feeding-spoon in PIF container. Hand-spoon-PIF contamination route was simulated to analyze the transfer and subsequent survival of pathogens. Major pathogens associated with infantile fatal diseases (Cronobacter sakazakii, Salmonella enterica, Staphylococcus aureus) were readily transmitted to PIF from skin (3-6 log CFU/hand) via spoons following long-term survival of transferred pathogens (3 weeks; use-by date of PIF) as the excessive level of infectious dose, highlighting direct onset of diseases. Low bacterial load on skin (ca. 1 log CFU/hand) could prevent cross-contamination of PIF, however, at least 72 h survival of transferred pathogen on spoons demonstrated the probability on re-contamination of PIF. To our knowledge, this is the first study to investigate the cross-contamination of utensils in contact with powdered-foods. Bacterial load on hands is the key determinant of pathogen transfer and the extent of risk are species-dependent. These evidential results redefine risk of caregivers' practices and facilitate incorporation of cross-contamination into risk-assessment as underestimated route of infection.