Food Handlers Research Articles

Práticas higiênico-sanitárias em feiras de arte e gastronomia de Niterói/RJ, Brasil

Introduction: Street food is an important market segment with an impact on the generation of jobs, income, and appreciation of food culture. However, it poses a challenge for public health because it increases the risk of transmission of pathogens from foodborne disease. Objective: Evaluate the hygienic-sanitary practices of food handlers at fairs and the physical-functional conditions of gastronomy and arts fairs in the city of Niterói/RJ. Method: The descriptive methodology was applied, using a qualitative and quantitative approach. For data collection, two scripts were developed and applied to evaluate the functional conditions of the fairs and the hygienic-sanitary practices of the handlers during sales, and a questionnaire was administered to outline the socioeconomic profile of the workers. Results: 68.1% were women; average income of 3 minimum wages; 51.1% had completed higher education; 46.8% had never taken a Good Food Handling Practices course; 70.5% did not use hair protection; and 86.8% used adornments. In 40% of the fairs visited, there was the presence of animals/vectors, as well as the absence of toilet facilities for handlers. Conclusions: Thus, despite its socioeconomic importance, the street food trade represents a potential health risk. Therefore, it is necessary to expand the hygienic-sanitary training of handlers and improve the environmental conditions of fairs.

Living and learning in the retail sector: transactions of young adults’ life course experiences and workplace learning opportunities

This paper seeks to bridge the existing knowledge gap between workplace learning and life course studies by investigating how young adults in the retail industry identify, pursue, and actualise learning opportunities in their workplaces. It considers the elements from their life course that either facilitate or impede these learning opportunities. The study contributes to workplace learning and life course studies by constructing a nuanced understanding of young adults’ agency in navigating their learning and development within the work context. The research is based on an exploratory single case study of young adults working in the Danish retail sector, specifically in non-specialised food handling. Learning biography vignettes (LBV) serves as the empirical foundation for analysis. The findings highlight the complex interplay between personal life events, social support, work environments, and individual agency in shaping the learning and development trajectories of young adults. The research underscores the need for workplaces to be supportive and flexible, providing a range of learning opportunities. It is vital that these environments recognise individual agency and cater to both the personal and professional growth needs of young adults.

Investigation of the Antimicrobial Resistance of Important Pathogens Isolated from Poultry from 2015 to 2023 in the United States

Foodborne pathogens cause around 47.8 million illnesses in the U.S. annually, with antimicrobial misuse in food production, particularly in poultry processing, contributing significantly to this public health challenge. Misuse of antimicrobials can contribute to antimicrobial resistance (AMR) and make the treatment of pathogens increasingly difficult. This emphasizes the need to investigate antimicrobial resistance in U.S. poultry. This study analyzes data from the NCBI Pathogen Isolates Browser (2015–2023) to explore the relationships between antimicrobial-resistant pathogens, AMR genes, and antimicrobials detected with resistance in pathogens isolated from chicken and turkey. Using principal component analysis and hierarchical clustering, we mapped and profiled regional and temporal patterns of antimicrobial resistance. Salmonella enterica was the most prevalent antimicrobial-resistant pathogen across both chicken and turkey, with notable outbreaks, particularly in the Northeast. Antimicrobial-resistant Campylobacter jejuni was more prevalent in chicken, particularly in California and Georgia, while Escherichia coli and Shigella were more prominent in turkey, with concentrated antimicrobial resistance in Texas for pathogen samples isolated from chicken. Resistance to tetracycline and streptomycin was widespread, with distinct regional clusters: antimicrobial resistance was concentrated in states like Minnesota for pathogens isolated from chicken, while AMR found in pathogens isolated from turkey was more evenly distributed across the Midwest. Key AMR genes, such as tet(A), mdsA, and mdsB, also followed similar patterns, peaking in 2019 and significantly declining by 2022. The observed decline in AMR cases may be linked to improved biosecurity measures and disruptions in detection due to the COVID-19 pandemic. This comprehensive study of antimicrobial resistance in U.S. poultry provides valuable insights into resistance trends, which provide useful information to inform targeted interventions and policies to mitigate AMR threats in the poultry production industry. For consumers, these findings emphasize the importance of proper food handling and cooking practices to reduce the risk of exposure to resistant pathogens. Regulatory authorities should focus on enforcing stricter antimicrobial usage policies and enhancing surveillance systems to sustain the reduction in AMR cases.

Investigation of Shiga toxin-producing Escherichia coli and evaluation of the microbiological quality of raw vegetable sal-ads

Foodborne diseases (FBD) are a significant public health concern worldwide, affecting millions of people annually. Symptoms of FBD range from mild gastrointestinal discomfort to more severe conditions, which in some cases can lead to death. Raw vegetables, especially those consumed in ready-to-eat (RTE) salads, are particularly susceptible to microbial contamination. This study aimed to investigate the presence of Shiga toxin-producing Escherichia coli (STEC) and to evaluate the microbiological quality of 77 RTE raw vegetable salads from 20 restaurants in Niterói, RJ, Brazil. None samples presented STEC, nor the safety indicators (SI) Salmonella spp. and Listeria monocytogenes. However, 89.6% of the samples were considered unfit for human consumption, since they presented at least one hygiene indicator (HI) outside the established standards. The majority of samples (95.5%) were unsatisfactory for Enterobacteriaceae (EB), followed by total aerobic bacteria (TAB) (76.6%), thermotolerant coliforms (C45) (32.5%) and Escherichia coli (EC) (1.3%). The difference between the occurrences of hygiene indicators was not significant. Given the high percentage of inadequate samples found in the study, it is clear that there is a need for stricter surveillance and adequate hygiene practices in restaurants. To reduce the risks of microbial contamination in RTE raw vegetable salads, several approaches can be implemented. These include continuous training of food handlers, implementation of food safety management systems such as Hazard Analysis and Critical Control Points (HACCP), and regular inspections. In addition, consumers also play an important role by demanding safe food and following safe food handling and consumption practices at home.

A decision analysis of cancer patients and the consumption of ready-to-eat salad.

Listeria monocytogenes is a foodborne pathogen of concern for cancer patients, who face higher morbidity and mortality rates than the general population. The neutropenic diet (ND), which excludes fresh produce, is often utilized to mitigate this risk; however, an analysis weighing the theoretical listeriosis risk reduction of produce exclusion aspects of the ND and possible negative tradeoffs has never been conducted. Consequently, this work constructed decision analytic models using disability-adjusted life years (DALYs) to compare the impacts of the ND, such as increased neutropenic enterocolitis (NEC) likelihood, with three alternative dietary practices (safe food handling [SFH], surface blanching, and refrigeration only) across five age groups, for cancer patients who consume ready-to-eat salad. Less disruptive diets had fewer negative health impacts in all scenarios, with median alternative diet DALYs per person per chemotherapy cycle having lower values in terms of negative health outcomes (0.088-0.443) than the ND (0.619-3.102). DALYs were dominated by outcomes associated with NEC, which is more common in patients following the ND than in other diets. Switchover point analysis confirmed that, because of this discrepancy, there were no feasible values of other parameters that could justify the ND. Correspondingly, the sensitivity analysis indicated that NEC mortality rate and remaining life expectancy strongly affected DALYs, further illustrating the model's strong dependence on NEC outcomes. Given these findings, and the SFH's ease of implementation and high compliance rates, the SFH diet is recommended in place of the ND.

Hygienic practice during complementary feeding and associated factors among mothers of children aged 6-24 months in Borecha Woreda, southwestern Ethiopia: a community-based cross-sectional study.

Complementary feeding is a critical transitional phase in the life of an infant, and complementary foods should be prepared, stored, and fed hygienically, with clean hands, dishes, and utensils to prevent diseases. However, the prevalence and risk factors associated with hygienic complementary feeding practice have not been well addressed in Ethiopia, especially in the study area. This study aimed to assess hygienic practices and associated factors during complementary feeding among mothers with children aged 6-24 months in Borecha Woreda, Buno Bedele Zone, southwestern Ethiopia, in 2022. A community-based cross-sectional study was conducted using a multistage sampling technique. The study was conducted on 536 mothers of children aged 6-24 months in Borecha Woreda from 1 March to 1 April 2022. Data were collected using an interviewer-administered questionnaire. The data were coded, cleaned, edited, and entered into Epi-Data version 4.6 and then exported to SPSS version 20.0 for further analysis. Both bivariate and multivariable logistic regression models were fitted. Moreover, crude (for bivariate) and adjusted (multivariable) odds ratios (AORs) with 95% confidence intervals (CIs) were computed to assess the association between independent factors and outcome variables. A p-value of <0.05 was considered statistically significant. Out of 536 respondents, 350 (65.3%) exhibited poor hygienic practices during complementary feeding. The risk of poor hygienic practices was about two times higher among women over 30 than those under 25 (AOR: 1.8; 95% CI: 1.11-2.90). Mothers whose husbands had primary education or higher had a 50% reduced risk (AOR: 0.50; 95% CI 0.31-0.83) of poor hygienic care practices during complementary feeding compared to their counterparts. The odds of poor hygiene practice among mothers with poor knowledge of hygienic care were 2.71 times higher than those with good knowledge (AOR: 2.71; 95% CI: 1.60-4.61). The prevalence of poor hygienic practices during the preparation and handling of complementary foods among mothers in Borecha Woreda is high compared to other studies. Therefore, improving hygiene practices during complementary food preparation requires the involvement and responsibility of policymakers, the community, and families.

Complementary feeding and food handling practices among caregivers in a semi-urban setting in Northern Uganda

Background: Complementary feeding practices influence the nutritional status and health of children, especially in developing countries where sub-optimal infant feeding practices are the major cause of childhood undernutrition, morbidity, and mortality. This study sought to characterize the adequacy of complimentary feeding and food handling practices among caregivers of children aged 6-23 months in a semi-urban setting. Methods: Exploratory cross-sectional study was conducted in Adyel division, Lira district in Northern Uganda among 127 child-caregiver pairs randomly selected from three villages. Caregivers were interviewed about their child-feeding practices, complementary foods used, and common practices in handling and preparation of foods used as complementary feeds. Results: Overall, children’s feeding patterns met the recommended dietary intake when assessed using the child feeding index (CFI) whereby children aged 6-8, 9-11, and 12-23 months scored 8.03, 9.17, and 7.59, respectively. However, most children were complemented with foods from the household meals and dietary diversity was limited by frequent use of food leftover from the previous meals. Conclusions: Inappropriate meal patterns and food handling practices identified are likely to compromise child nutrition and health. Nutrition education is needed to improve the caregivers’ child-feeding and food handling practices within their socio-economic and cultural context. Keywords: Complementary feeding practices; food handling; diet quality; food safety; children; Uganda.

Food Safety Handling Knowledge, Attitude, Practice and Associated Factors Among the Food Handlers in Restaurants: The Case of Gode Town, Somali Region, Ethiopia

Food Safety Handling Knowledge, Attitude, Practice and Associated Factors Among the Food Handlers in Restaurants: The Case of Gode Town, Somali Region, Ethiopia

Investigation of a collective food poisoning in the province of Kenitra - Morocco from 2019 to 2023: A study to determine the epidemiological profile and the effectiveness of the management measures implemented

Aim The objective of this study is to examine collective foodborne illnesses (TIAC) reported in the province of Kenitra from 2019 to 2023, with the aim of determining the epidemiological profile and evaluating the effectiveness of the management measures implemented. On August 5, 2019, the survey therefore highlighted 9 cases (response rate of 75%), with an average age of 29 years and 75.5% women. Nausea, abdominal pain, diarrhea and vomiting were the main symptoms. The study revealed a significant correlation between the consumption of fish (75% attack rate), fries (90%) and soda (80%). Likewise, the study conducted on February 1, 2022 revealed a significant correlation between intoxication and consumption of soup (RR=1.4), chicken (RR=2.4), salad (RR= 1.62) and bread (RR=2.4). Rice presents a higher risk (RR=5.1, p=0.05). Levels of staphylococcus aureus were detected during microbiological analyses, exceeding acceptable thresholds. Faced with these findings, monitoring of food safety practices seems necessary. Preventing these outbreaks in the future would be most effective by improving food handling, storage and preparation methods. Bangladesh Journal of Medical Science Vol. 23 No. 04 October’24 Page : 1020-1029

Observation of Food Handlers’ Hand Hygiene Behavior During Production at a Sandwich-making Factory

Effective hand hygiene is essential during food production to reduce the risk of microbiological contamination. Improper hand hygiene by food handlers can be a major contributing factor in the spread of foodborne illnesses. Self-reported behavior does not equate to actual behavior as it has the limitation of biases. Therefore, observational data are more effective at assessing the actual behavior of food handlers. Covert observation utilizing closed-circuit television (CCTV) cameras can yield reliable data. This study utilized covert observation to assess hand hygiene compliance from CCTV footage of food handlers in a sandwich-making facility. An electronic observation checklist, based upon the company’s hand-hygiene protocol, was used to capture observed hand hygiene practices. A total of 588 occasions that required hand hygiene practices by food handlers (n = 12) were observed during the production of ready-to-eat (RTE) sandwiches over 16 h during two shifts. Food handlers did not wash their hands on 32% of occasions which required food hygiene practices. Of those occasions where there was an attempt to implement hand hygiene practices (n = 401), only 1% of behaviors were compliant with the company hand hygiene protocol. Observations indicated that 95% of attempts did not adhere to the recommended handwashing duration (≥20 s). Soap was not used in 4% of attempts, and hands were not wetted prior to applying soap in 16% of attempts. Additionally, 62% of attempts did not use hand sanitizer after handwashing and drying. Food handlers were observed attempting hand hygiene practices significantly more frequently (p < 0.001) when entering (89% of occasions) than exiting (8% of occasions) the production area. Findings indicate that appropriate interventions are needed to improve hand hygiene compliance of food handlers to ensure food is produced safely within the food manufacturing sector.

Assessment and Association of the World Health Organization’s Five Keys to Food Safety Among Selected Food Truck Operators Demographic in Jeddah City

The World Health Organization (WHO) reports that food handlers play a significant role in the maintenance of food safety from food production to storage. This study aims to assess the implementation of WHO five keys to safer food in the food trucks in Jeddah city. This study was an observational study. A total of 103 registered and licensed food trucks in Jeddah were selected using the opportunity sampling method. The WHO’s five keys to safer food questionnaire was used by the researchers to inspect and evaluate the hygiene status of food trucks. A chi-square test was used to assess the association between the demographic characteristics of food truck handlers and the implementation of the variables used to evaluate WHO’s five keys to safer food in their food trucks. P value < 0.05 was considered significant. The participation rate was 64.4% (103/160). Most food truck handlers were older than 30 years (55.3%), were men (81.6%), had secondary-level education (40.8%), and were Saudi nationals (69.9%). More than 50% of food truck handlers had less than three years of experience in business, and 67% of food truck handlers had undergone training in food handling. The researchers found good implementation of Key 5c. – “Water from cans/bottles used for cooking” (93.2%), followed by Key 1a. “Cleaning and disinfecting done periodically” (78.6%), and poor implementation for Key 3a. – “Calibrated thermometers are used to check temperatures” (30.1%) in the food trucks. The overall implementation score of WHO’s five keys to safer food was found to be good (score ≥ 8) in 57.3% of food trucks. Food handlers’ age, gender, and training in food handling indicated a significant association with the implementation of WHO’s five keys to safer food. The exposure of food handlers to food handling training indicated a significant association with good implementation of all five keys to safer food.

Hygiene Analysis of Food Handlers at Malahayati Islamic Hospital

ABSTRACT Hospital food management is a series of activities starting from menu planning to distributing food to patients. Providing food in hospitals is an activity that is under the responsibility of the Nutrition Installation. In carrying out his duties, a food handler in a nutrition installation must always maintain personal hygiene so that the cleanliness and quality of the food served to patients is maintained. This study aims to determine the description of the hygiene of food handlers at the Malahayati Islamic Hospital. The method used in this research is qualitative with a description method. The informants in this research were 10 people, cooks and waiters at Malahayati Islamic Hospital. Based on the results obtained, it was found that the implementation of food handler hygiene at RSI Malahayati Medan was included in the good category, with a percentage of 93%. However, in practice, there are still food handlers who do not use PPE (Personal Protective Equipment) when serving food. The implementation of food handler hygiene at the Malahayati Islamic Hospital does not fully meet the standards of the Regulation of the Minister of Health of the Republic of Indonesia Number 1096/Menkes/Per/VI/2011. Keywords: Food Handler, Hospital Food Management ,Hygiene

Knowledge, attitudes, and practices towards poultry handling and Salmonella risk among households in Beirut, Lebanon

Food-Borne Disease (FBD) is defined as an illness resulting from consuming foods contaminated with bacteria, their toxins, viruses, or parasites. Food poisoning due to improper food handling is a major global public health problem. In Lebanon, numerous challenges affect safe food consumption, with poultry being a common vehicle for many pathogens, such as Salmonella spp. This bacterium can cause serious illnesses, including gastroenteritis, characterized by abdominal pain, vomiting, diarrhea, and fever. This study aimed to examine the Knowledge, Attitudes, and Practices (KAPs) towards poultry handling among households in Beirut, Lebanon, and identify factors influencing KAP levels. A cross-sectional study was conducted through face-to-face interviews with 125 households in different areas of Beirut. The interview was divided into four main parts: sociodemographic characteristics, knowledge, attitudes, and practices. The results showed that consumers’ knowledge and practices were inadequate, though their attitude was positive. Participants aged 43-55 had higher odds of having a good knowledge level than those aged 18-29 (OR = 3.889, p = 0.02). Additionally, those with a college education were 7.442 times more likely to have a positive attitude towards food safety compared to those with no formal education (p = 0.005). Most participants (91.2%) do not regularly check their refrigerator and freezer temperatures. Furthermore, significant associations (p < 0.001) existed between the different KAP levels. This study aimed to raise public awareness regarding the handling of chicken to minimize food-borne illnesses by evaluating food handlers’ knowledge and behaviors. Insights from this study can used in campaigns to raise awareness about Salmonella and transmission risks among households. Moreover, findings may guide policymakers to create regulations for safe handling of poultry.

Food safety within the household: a cross-sectional study among domestic food handlers in Italy

Food safety within the household: a cross-sectional study among domestic food handlers in Italy

Assessing foodborne outbreak risks in Chinese households: A national survey analysis of pork handling practices

ObjectiveThis study aimed to assess the risk of foodborne outbreaks associated with household food handling practices in China and identify the consumer groups that are at higher risk for foodborne outbreaks. MethodsA national survey of household pork handling practices was conducted in China. The risk of foodborne outbreaks stemming from consumers’ improper handling practices was assessed utilizing the Weighted Harmonic Outbreak Prevention Index (WHOPI). The index categorized these practices into three levels of good hygienic practice (GHP): low (WHOPI≤0.35), medium (WHOPI: 0.36–0.70), and high (WHOPI>0.7). Logistic regression analyses were used to identify groups at higher risk for foodborne outbreaks. ResultsA total of 2730 households from seven provinces in mainland China were analyzed. Based on WHOPI, only 0.4 % of households demonstrated a high level of GHP, while 55.4 % showed a low level of GHP. The primary non-conforming stage was separation practices, followed by cooking and purchasing practices. Nearly two-thirds of households (64.8 %) didn’t have a separate cutting board for raw meat, and 44.9 % of them claimed to use the same board to handle ready-to-eats afterward. Logistic regression indicated more attention is required for those living in southern and rural areas, working in non-public institutions, possessing lower levels of education, and being single or widowed. ConclusionThe household food handling practices of Chinese consumers involve serious food safety risks. Education programs and interventions concerning safe handling practices in households are urgently needed.

HYGIENE AND SANITATION PRACTICES ON CUSTOMER SATISFACTION IN ETHNICAL RESTAURANTS FOUND IN NAIROBI COUNTY

Hygiene is no new concept to humanity, more so where the hotel industry is involved. The world is becoming a busy globe and meals that were once shared at home are now being provided more and more in eating establishments. People in this case have to trust third parties to handle the preparation of their food and the question about how that food is handled is brought up. This is the same question posed as far as hotel establishments are concerned in Kenya. Can one really trust the people handling their food in hotel? What role does hygiene and sanitation, especially of the food play in convincing individuals to eat in a particular hotel establishment. To be able to answer this question, the study embarked on a study that sampled prominent ethical restaurant within Nairobi City County and interacted with 120 sampled respondents through stratification. The respondents participated in the study by answering a series of questions outlined in a structured questionnaire. The respondents were drawn from various ranks in the establishment ranging from the managers and owners of the restaurants. Data collected was analyzed by use of descriptive statistics with the aid of statistical packages for social sciences and presented in the form of tables, charts and graphs. The study findings showed that restaurants had clear policies for health and safety, though compliance was found to be a challenge leading to unhygienic handling of food and customer dissatisfaction. Structurally, health measures were ineffective in some restaurants, leading to customer discomfort and low frequency of visits. Customers expect a restaurant with good health on first instinct and determined preference. The study however established that the management responded to customer complaints and implemented hygiene changes. As such, it can be concluded that health measures, customer expectations and perceptions had an effect on customer satisfaction and the performance of the restaurants. The study recommends regular capacity building of staff on health and sanitation policies and standards. Also recommended were regular reviews of the restaurant buildings to ensure conducive environment for dining should be undertaken. Training of staff on food handling as well as effective supervision would enhance customer experience at the restaurants. The study recommends further studies in evaluate the effect of staff skills on customer satisfaction in restaurants and assessment of the effect of ethnic cuisines on the performance of restaurants.

PREVALENCE AND MOLECULAR CHARACTERIZATION OF ROTAVIRUS IN MEAT CUTS, AND MEAT HANDLERS IN SELECTED ABATTOIRS IN NAIROBI, KENYA

In Kenya, food screening exercises mostly applies to bacterial and parasitic agents, with enteric viral detection neglected. This study aimed to determine the prevalence and molecular characterization of rotavirus in beef/pork cuts and beef/pork handlers in 4 selected abattoirs in Nairobi. Rotavirus was preferred because of its high prevalence rates and its ability to cause pathophysiologic infective gastroenteritis in humans. It has diverse strains characterized as P and G genotypes based on the VP7 and VP4 proteins, respectively. This cross-section study involved the collection of a total of 467, (165) beef/pork cuts and (302) handlers fecal samples. Collected samples wereprepared before rotavirus identification. Prepared meat and stool suspensions were subjected to direct RNA extraction and EIA detection respectively. All the stool suspensionsand RNA extracted meat suspensions subjected to EIA and Two step RT-PCR were all non-reactive respectively. Therefore, there was no VP4 and VP7 genotyping for characterizationpurposes on confirmed primary PCR products. Eppicollect5 was also used to collect and store the descriptive data of study participants, and the analysis conducted using Power BI statistical software application. The studys findings, indicating no human rotaviral infections in meat cuts, enhance public health by reassuring consumers, guiding regulatory policies, emphasizing the need for ongoing surveillance, directing resources to pressing concerns, supporting safe food handling campaigns, establishing baseline data for future assessments, and encouraging best practices in both formal and informal markets.

Improving household food safety through combining nudge strategies with knowledge-based intervention: The effectiveness and mechanism

The role of household settings is vital in the global challenge of foodborne diseases, serving as key areas for outbreaks. Despite significant efforts by governmental and research institutions to promote safe food handling, traditional knowledge-based interventions often are short in boosting motivation. Our study addressed this issue by integrating motivational nudge strategies with declarative and procedural knowledge-based interventions, targeting 914 primary household food handlers. Through randomized controlled trials, the impact of these interventions was rigorously evaluated. We found that a combination of mindful nudging and declarative knowledge-based intervention significantly improved compliance with food safety guidelines. Additionally, our analysis highlighted the critical mediating role of attitudes in this process. This research may present practical multidisciplinary intervention strategies for promoting safe food-handling behaviors.

Effectiveness of self-instructional module on food hygiene among the food handlers working in fast food centres of Gangtok, Sikkim

Background: Food hygiene refers to the cleanliness of all sorts of foods during their manufacturing, handling, distribution, and service. According to WHO, an estimated 600 million individuals- nearly one out of every ten people- become unwell each year after consuming contaminated food, leading to 420,000 deaths and the loss of 33 million healthy lives per year. The objective of the study was to compare the pre-test and post-test knowledge on food hygiene among the fast-food handlers of Gangtok, Sikkim. Methods: A pre-experimental, one-group pre-test-post-test design was adopted to conduct this study among 70 food handlers working in fast food centres of Gangtok, Sikkim. Simple random sampling technique was used to select the participants. The data was collected by using demographic proforma and semi-structured knowledge questionnaire. A self-instructional module was provided to the participants after pre-test and post-test was conducted after 7 days. Statistical analysis was performed in SPSS. Results: The result of the present study for the knowledge on food hygiene showed that majority (87.1%) of the fast-food handlers had average knowledge in pre-test and majority (77.1%) had good knowledge in post-test with a mean score difference of 5. Significant association was found between the pre-test knowledge on food hygiene with educational qualification (p=0.014). Conclusions: The study findings revealed that the self-instructional module was effective in improving knowledge of the fast-food handlers and it helped to know the current scenario regarding food hygiene among the fast-food handlers working in Gangtok, Sikkim.

Isolation and characterization of pathogenic Klebsiella pneumoniae strains from lettuce: a potential source of antibiotic resistance and development of a mathematical model for ANOVA results.

This study aimed to evaluate the prevalence of Klebsiella pneumoniae contamination in raw lettuce from Risalpur, Pakistan, and to analyze the antibiotic susceptibility profiles of the isolated strains. The presence of foodborne pathogens such as K. pneumoniae poses significant public health risks, particularly in regions with suboptimal hygiene practices and improper food handling. Lettuce samples were collected from various sources in Risalpur and screened for K. pneumoniae. Antimicrobial susceptibility testing was performed to evaluate the effectiveness of various antibiotics against the isolated strains. Statistical analyses, including ANOVA and linear regression, were conducted to assess differences in inhibition zones and to predict antibiotic effectiveness based on concentration. The results revealed a significant prevalence of K. pneumoniae in the lettuce samples, highlighting the risks associated with poor hygiene, transportation, storage, and contaminated irrigation water. The isolated strains exhibited high susceptibility to gentamicin but demonstrated notable resistance to doxycycline, vancomycin, and ticarcillin. Multidrug-resistant (MDR) strains were identified. ANOVA showed significant differences in inhibition zones, and the linear regression model predicted a Zone of Inhibition based on antibiotic concentration (β0 = 10.6667, β1 = 0.4556). The identification of MDR strains of K. pneumoniae underscores the urgent need for enhanced antibiotic stewardship and food safety protocols to manage foodborne pathogens. Improved hygiene practices throughout the food production and supply chain are critical to mitigate health risks and address the challenge of growing antibiotic resistance.