THE COSTS ARISING FROM THE CONTAMINATION
OF THE FOOD BY STAPHYLOCOCCUS AUREUS
AND PRODUCTION OF ALOE TISSUE
AS ANTI-STAPHYLOCOCCAL ADDITION
TO FERMENTED DAIRY PRODUCTS
Anita Kukułowicz
Gdynia Maritime University Poland
ABSTRACT
The development of new technologies allows the emergence of new food ingredients, which may have an impact on the nutritional value of the products and safety of consumers health. Thanks to its antibacterial properties, Aloe Vera can effectively improve the microbiological quality of fermented milk products.
Keywords: Staphylococcus aureus, food poisonings, Aloe Vera.
INTRODUCTION
The development of new technologies allows the emergence of new food ingredients, which may have an impact on the nutritional value of the products and safety of consumers health. Thanks to the new food ingredients, it is possible to receive innovative products with better organoleptic and health properties. In order to achieve a high level of protection of human life and health, it is recommended to provide consumers with safe food quality through constant control of the presence in it of harmful substances and bacteria, parasites, viruses and prions [12, 20]. Frequent results of consumption of contaminated food products are food poisonings. They are diseases of the gastrointestinal tract with an acute course, caused by consumption of contaminated food with inter alia bacteria, toxins, parasites and fungi. In children usually occur poisonings caused by rotaviruses, while in adults those caused by Salmonella spp, Campylobacter, Staphylococcus
aureus, which are considered to be one of the three most important causes of
food-borne diseases reported in the world. A potential consumer is not able to determine whether particular food product is contaminated with pathogenic microorganisms, since their presence in food does not necessarily affects its looks, taste and scent.
In Poland poisonings are subject to notification and registration in accordance with the law on infectious diseases and infections, dated 6th September 2001 [5, 11]. Staphylococcal food poisonings are a significant social burden in terms of the expenditure related to the absence of patients at work, the cost of hospital treatment and the problems and costs associated with the removal of contaminated foods [11].
The aim of the study was to show the costs borne by the Country budget and consumers as a result of the consumption of foods contaminated with staphylococci and the possibility of using plant components such as Aloe Vera in fermented dairy products as a preventive factor against food poisonings.
Pathogen factor that causes staphylococcal food poisonings of intoxication type are heat-resistant enterotoxins produced by micro-organisms in the food products. It is estimated that over 30% of poisonings are caused by strains of Staphylococcus
aureus.
Most food poisonings occur as a result of the consumption of food contaminated with enterotoxin of A and D type, and to a lesser extent with enterotoxin of B and C type. The literature sources report that enterotoxins should be marked when the number of coagulase-positive Staphylococcus aureus in the product is on the level above 105 cfu/g, because only crossing that level may launch production of quantities of enterotoxins able to cause food poisoning [19]. Characteristic symptoms of poisoning with staphylococci pathogens are rapidly appearing (after 2-6 hours): diarrhea, vomiting and abdominal pain, which are usually accompanied by fever. These symptoms may lead to a dangerous loss of water and electrolytes, as well as drop in blood pressure, impaired kidney seepage and quickly growing acidosis, sometimes it may also lead to the state of shock. People with such ailments are most often hospitalized. The severity of symptoms of poisoning depends on the amount of absorbed enterotoxin. Sometimes symptoms of poisoning with staphylococci wear off after few hours. In case of suspicion of poisoning with staphylococci, it is important to specify the consumed foods and the time which has elapsed since the consumption to the moment when the symptoms occurred. Treatment is based on rapid completion of the loss of water and electrolytes. Application of antibiotics is not necessary. After the symptoms described above wear off, it is necessary to introduce a strict diet for a period of two days and then continue with the light diet that should be gradually expanded. The most common sources of poisonings can be milk and dairy products, confectionery with creams, meat and fish products, vegetable products and salads [2, 5, 7, 19].
However, the most common source of staphylococci among food products are milk fermented products.
Figure 1 presents the amount of food poisonings caused by Staphylococcus in Poland in the years 2009–2013. The data comes from the bulletin “Contagious diseases and infections in Poland” by National Institute of Hygiene [3].
In the presented charts it can be observed, that there are no clear growing or decreasing trends in the number of staphylococcal food poisonings except for the year 2011 [Fig. 1]. However, cases of poisonings with Staphylococcus aureus are not often reported, hence the following data can be inaccurate [13].
0 50 100 150 200 250 300 2013 2012 2011 2010 2009 year s No of cases No of in-patients
Fig. 1. The number of illnesses caused by Staphylococcus and the number of in-patients in Poland in the years 2009–2013 (data by NIH) [3]
In recent years, about 50% of infected people had to be hospitalized [Fig. 1], which is associated with the expenditures borne by the Country budget and treated patients.
The data of the Central Statistical Office shows, that in recent years, the expenditures on health in households have been systematically increasing. In 2005, the average monthly expenditure per person amounted to 34,5 PLN, and 5 years later increased almost by 40%. In 2011 they amounted to 51 PLN. The costs of maintaining a patient infected with Staphylococcus are much higher and amount to an average of 500 PLN a day, but when it comes to blood infection caused by
Staphylococcus aureus the costs increase by almost 4 times [Summary 1].
Summary 1 The costs of hospitalization of a patient infected with Staphylococcus aureus
Food poisoning caused by
Staphylococcus aureus
Blood infections caused by
Staphylococcus aureus
Day in hospital Day in hospital in a separate room in the ICU
ward equipped with full monitoring, connected to respirators
Nursing and medical care Constantly present nurse in uniform (glasses,
mask, disposable apron) and the doctor
Unlicensed Assistive Personnel (UAP) UAP in uniform changing the bedding at least
Food poisoning caused by
Staphylococcus aureus
Blood infections caused by
Staphylococcus aureus
Board/catering: diet high in proteins, going back to oral nutrition, initially, preferably containing rice gruels and mousses
Parenteral nutrition with a drip (bag of nutrition containing vitamins and trace elements) – cost of about 200 PLN /16 h
Disposable equipment and devices (Application of peripheral venous catheter, syringes, needles, gloves), special apron
Disposable equipment and devices (Application of peripheral venous catheter, syringes, needles, gloves, drips)
Medicaments: replenishment of electrolytes deficiency, intravenous irrigation
(Gastrolith, Saltoral) sometimes antibiotics (Vancomycin or clindamycin)
Medicaments: meronem (1300 PLN – 10 ampoules applied every 6 h 1 amp.), tienam (500 PLN – 5 ampoules applied every 3-4 per 24 hours),
cardiac drugs, drugs supporting lungs and anitioedema, human albumin
(50 PLN – 15 ml), sandoglobulin
(1020 PLN – 6 g applied 0,4-1,0 g/kg m.c. for 1-4 days) research on aerobic and anaerobic organisms about 60 PLN.
TOTAL COST
About 500 PLN/24 hours About 1500–2000 PLN/24 hours
Source: own elaboration based on data collected from the branches of hospitals specializing in infections.
There is a possibility to limit the costs incurred due to staphylococcal food poisoning by the use of plant additives. Today, rising importance of plant products in health care has been observed, as substances of natural origin are usually more beneficial than those of chemical origin and they are generally considered to be healthy. Natural products may be sold as food, food additives or drugs. There are many interesting and biologically active plant ingredients containing inter alia: antioxidants, polyunsaturated fatty acids, anthocyanins, flavonols, proanthocyanidins, ellagic acid, anthraquinones, aceman, glycoproteins, which in addition to their antioxidant properties are characterized by antibacterial, anti-inflammatory, antiviral and immunostimulant activity. Among these plants is Aloe Vera, which due to its properties is used in the food industry by confectioners and in the dairy industry [6, 10]. A study carried out with the use of Aloe Vera in order to improve the microbiological quality of fermented milk products, confirmed the bacteriostatic effect of the applied additive in relation to relative anaerobes and fungi present in the tested products [14, 15, 17, 18]. Vuuren claims that for the antimicrobial properties of Aloe Vera are responsible mainly: aloe emodin, aloin and chrisofanol, because they exhibit the highest effectiveness against
Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Bacillus cereus and Bacillus subtilis [21]. Agarry et al. by making a comparison of the
antimicrobial activity of gel and the extract from the Aloe Vera leaves (Aloe
barbadensis Miller), showed that both forms have substantial biostatic properties
towards Staphylococcus aureus [1].
Thanks to its properties, Aloe Vera can effectively contribute to improving the microbiological quality of the products in which it is applied as an additional component. It would be beneficial to supplement fermented milk products with
Aloe Vera, all the more reason, that from year to year there has been a growing
trend in consumption of these products. In the years 2000-2011 production of maturing cheeses and curd cheeses increased in Poland, by almost 59% [4]. Finding the presence of staphylococci in milk products such as cottage cheese proves the need of optimization of these products, which can be done through the use of aloe pulp [15].
To minimize the household expenditures on medicines and pharmaceutical products, as well as the costs associated with hospitalization of people with staphylococcal poisoning, it would be worth to use biostatic properties of Aloe
Vera to fight Staphylococcus aureus. The condition is, however, that those
additives showed microbiological purity. Table 1 lists two methods of preservation of Aloe Vera, which as a result of carried research appeared to be the most optimal for both: to guarantee the microbiological purity of the tissue, as well as to preserve its biostatic properties [8, 9, 16]. The cost of preservation of 2 kg of Aloe Vera added to 10 kg of cottage cheese as an additive would ensure the health quality of dairy products [8, 9, 16] which is presented in table 1.
Table 1. The cost of preservation of 2 kg of Aloe Vera ensuring health quality of dairy products after it is added to milk products
Table 2. The costs of production associated with the preparation of one 150 g – packet of quark-rennet cheese with Aloe
Cost of producing of 10 kg of quark 50,00 PLN
Cost of purchasing of Aloe Vera leaves (2 kg) 40,00 PLN
Cost of preservation of Aloe Vera pulp by freezing in temp –10ºC 35,02 PLN
Total 125,02 PLN
Cost of 150 g of quark with aloe 1,87 PLN
The cost of purchasing Aloe Vera leaves 40,00 PLN
The cost of pulp preparation
Water consumption during the sterilization of water for rinsing the leaves 2,42 PLN
Power consumption during sterilization 3,05 PLN
Power consumption during homogenization of leaves 0,36 PLN
The costs of preservation of the Aloe Vera pulp
by applying The HHP method
The costs of preservation of the Aloe Vera pulp by freezing in temp. –10ºC Cost of high pressure processing 1200,00 PLN
Cost of storage in temp. 4ºC
for 6 months 28,56 PLN
Cost of storage in temp.
–10ºC for 6 months 29,19 PLN
The above confirms that from the financial point of view, it is more profitable to prepare food additives of biostatic nature and searching for effective methods of their fixation than treating patients having contact with contaminated food.
CONCLUSION
It seems reasonable to conduct studies that will contribute to improving the quality of fermented dairy products, and thus decrease the number of food poisonings.
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