Redmond Elizabeth, Griffith Christopher J
Food Research and Consultancy Unit Cardiff School of Health Sciences University of Wales Institute, Cardiff, UK.
J Fam Health Care. 2009;19(1):26-31.
Infant susceptibility and the risks posed by infections associated with bottle-fed powdered infant formula (PIF) have received increased attention in recent years. Intrinsic contamination of PIF with pathogens has been reported and extrinsic contamination can be introduced from the handler or the environment during reconstitution. Recommended disinfection advice and bottle decontamination have changed in recent years and the aim of this study was to validate the efficacy of four current disinfection methods using bottles that had contained reconstituted PIF spiked with either a representative mixed bacterial culture or specific pathogens. Initially, bottles (n = 6) of reconstituted formula were spiked with 10(5) cfu/ml representative mixed culture. For subsequent experiments, reconstituted formula was spiked with either 10(2) and 10(4) cfu/ml of Enterobacter sakazakii (Cronobacter), Bacillus cereus and Staphylococcus aureus. Before disinfection, bottles were cleaned according to recommended guidelines. Disinfection procedures tested included a hypochlorite-based chemical solution and three heat-based methods. Bottles were sampled in four sites. Before cleaning and disinfection, the inner screw cap and inner-teat were the most heavily contaminated sites with 1.6-7.4 x 10(3) cfu/per-area-sampled; the bottle interior was more contaminated overall with 1.2 x 10(4) cfu/per-area-sampled. After disinfection, adherence to recommended procedures (combined with good hygiene) enabled effective decontamination to be achieved using all methods. Small differences in disinfection ability were not significant (p > 0.05). Cumulatively, 800 sites were sampled and no B. cereus or E. sakazakii were isolated. S. aureus was isolated from 0.1% of sites with one site exceeding 1 cfu/ml. Findings indicate the potential for bottle contamination and that strict adherence to four currently used methods allowed effective decontamination. This highlights the importance of effective consumer education by health care professionals.
近年来，婴儿易感性以及与瓶装婴儿配方奶粉（PIF）相关感染所带来的风险受到了更多关注。已有报道称PIF存在病原体的内在污染，并且在冲调过程中可能会因操作人员或环境引入外在污染。近年来，推荐的消毒建议和奶瓶去污方法有所变化，本研究的目的是使用含有添加了代表性混合细菌培养物或特定病原体的冲调后PIF的奶瓶，验证四种当前消毒方法的有效性。最初，将6个装有冲调配方奶粉的奶瓶添加10⁵ cfu/ml的代表性混合培养物。在后续实验中，冲调后的配方奶粉添加10²和10⁴ cfu/ml的阪崎肠杆菌（克罗诺杆菌属）、蜡样芽孢杆菌和金黄色葡萄球菌。在消毒前，按照推荐指南对奶瓶进行清洗。测试的消毒程序包括一种基于次氯酸盐的化学溶液和三种基于加热的方法。在四个部位对奶瓶进行采样。在清洗和消毒前，内螺帽和奶嘴内部是污染最严重的部位，每采样面积有1.6 - 7.4×10³ cfu；奶瓶内部总体污染更严重，每采样面积有1.2×10⁴ cfu。消毒后，严格按照推荐程序（结合良好的卫生习惯）使用所有方法都能实现有效的去污。消毒能力的微小差异不显著（p > 0.05）。累计采样800个部位，未分离出蜡样芽孢杆菌或阪崎肠杆菌。从0.1%的部位分离出金黄色葡萄球菌，其中一个部位超过1 cfu/ml。研究结果表明奶瓶存在污染的可能性，并且严格遵循目前使用的四种方法可实现有效的去污。这凸显了医疗保健专业人员对消费者进行有效教育的重要性。
