投稿分類 感控監測

主委發表種類: 口頭

投稿標題(中): 利用質譜分析儀增進醫院內的食物安全監測效能

投稿標題(英): Improving the Performance of Food Safety in Hospital by MALDI-TOF

投稿摘要: Background
The quality of meals provided in hospitals is essential to patients. The nosocomial food contamination can cause various food-borne illnesses of patients. The Ministry of Health and Welfare (MOHW) abrogated and amended the Sanitation Standard for Microorganisms in Foods in 2021. We examined whether combination of the Standard and MALDI-TOF are enough to routinely monitor the food safety base on our experience about non-conformity in 2023.
Methods &Materials
The surveillance in foods routinely was performed in our hospital based on the various Standards “Methods of Test for Food Microorganisms” promulgated by Food and Drug Administration in Taiwan. All suspected pathogens were analyzed on the Bruker MALDI Biotyper® system in ISO15189-certified medical laboratories.
Results
Five nonconformities could be observed from 137 examined meals in 2023. At first, Staphylococcus aureus, Listeria monocytogenes and Salmonella species were not detected in the tested meal. The results were eligible for the Standard about ready-to-eat foods from MOHW. However, the suspected pathogens such as Klebsiella pneumonia and Enterobacter cloacae were isolated from same meal through further identification by MALDI-TOF. Thus, the infection control team-driven intervention was activated immediately to correct the porcess of meal serving supplied by subcontractor. Finally, we demostrated the contaminated meal was resulted from inadequate cleaning of kitchenware and improved abnormal procedure. The routine surveillance was continued to confirm the served meal meet the requirements established by our hospital.
Conclusions
In summary, all suspected pathogens from foods should be identified by cost saving and timely MALDI-TOF to aviod the potential risk. Although the five served meal meet the Standard about ready-to-eat foods from MOHW, but the potential pathogens could cause disease in the patients with a weaker immune system. We suggested that MALDI-TOF should be implemented for routine surveillance in hospitals to improve the performance of food safety.

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