Food Poisoning Outbreaks Research Articles

통영시 연안의 양식굴(Crassostrea gigas)에서 검출된 노로바이러스의 정량분석

Norovirus (NoV) is a major cause of food poisoning outbreaks in Korea. Most NoV outbreaks originate from environmental contamination, but bivalves such as oysters are also important vectors. Oyster Crassostrea gigas contamination by NoV has been reported in Korea, but no quantitative analyses of NoV have been performed. We investigated the NoV concentration in 21 oyster samples from a Korean commercial oyster-growing area with confirmed fecal contamination from January to December 2012, using real-time reverse transcription-polymerase chain reaction. Additionally, we assessed the NoV concentration after heating to investigate the effects of heat treatment on NoV-infected oysters. In NoV-positive samples, the cycle threshold (Ct) values were 37.43-39.41 and 36.77-39.30, while viral concentrations were and copies/g for genogroups I and II, respectively. After heat treatment, NoV genogroup I decreased by 83.4%, 88.0%, 89.4% and 100% at , , , and , respectively, for 15 min, while genogroup II respectively decreased by 67.3%, 76.3%, 80.1%, and 89.8% under the same conditions.

Molecular epidemiological characterization of Staphylococcus aureus isolates originating from food poisoning outbreaks that occurred in Tokyo, Japan.

Staphylococcal food poisoning (SFP), one of the commonest food-borne diseases, results from the ingestion of one or more staphylococcal enterotoxins (SEs) produced in foods by Staphylococcus aureus. In the present study, 203 S. aureus strains originating from 83 outbreaks that had occurred in Tokyo were examined for their coagulase type and genotype of SEs to analyze their molecular epidemiological characteristics. The representative subsets of the 83 S. aureus isolates were analyzed by multilocus sequence typing (MLST) and S. aureus pathogenicity island (SaPI) scanning. The isolates were integrated into eight specific clonal complexes (CC) s; CC81, CC8, CC6, CC5, CC508, CC59, CC20 and CC30. The profiles of the coagulase type, SE/SEl genotype and the suspected type of enterotoxin-encoding mobile genetic element (MGE) indicated a correlation with each CC. SaPI scanning showed fixed regularity between the distributions of genomic islands, including SaPIs, and the phylogenetic lineage based on MLST. These results indicate that the S. aureus isolates, which classified into eight CCs, have distinguishable properties concerning specific coagulase type, enterotoxin genotype and MGE type. Strains of S. aureus harboring these particular elements possess the potential to cause SFP.

WITHDRAWN: Staphylococcus aureus and understanding the factors that impact enterotoxin production in foods: A review

The staphylococci and their enterotoxins (SEs) are probably the most common cause of foodborne intoxication. There are numerous attributes that allow the major pathogen Staphylococcus aureus to act as an effective foodborne pathogen. This review will focus on the present knowledge of SEs and their production; examples of staphylococcal food poisoning outbreaks; nutritional factors affecting SE production; and select S. aureus-factors and -mechanisms that might be required for growth in food matrices.

Contribution of Lactococcus lactis reducing properties to the downregulation of a major virulence regulator in Staphylococcus aureus, the agr system.

Staphylococcus aureus is a major cause of food poisoning outbreaks associated with dairy products, because of the ingestion of preformed enterotoxins. The biocontrol of S. aureus using lactic acid bacteria (LAB) offers a promising opportunity to fight this pathogen while respecting the product ecosystem. We had previously established the ability of Lactococcus lactis, a lactic acid bacterium widely used in the dairy industry, to downregulate a major staphylococcal virulence regulator, the accessory gene regulator (agr) system, and, as a consequence, agr-controlled enterotoxins. In the present paper, we have shown that the oxygen-independent reducing properties of L. lactis contribute to agr downregulation. Neutralizing lactococcal reduction by adding potassium ferricyanide or maintaining the oxygen pressure constant at 50% released agr downregulation in the presence of L. lactis. This downregulation still occurred in an S. aureus srrA mutant, indicating that the staphylococcal respiratory response regulator SrrAB was not the only component in the signaling pathway. Therefore, this study clearly demonstrates the ability of L. lactis reducing properties to interfere with the expression of S. aureus virulence, thus highlighting this general property of LAB as a lever to control the virulence expression of this major pathogen in a food context and beyond.

Characterization of three Bacillus cereus strains involved in a major outbreak of food poisoning after consumption of fermented black beans (Douchi) in Yunan, China.

Three Bacillus cereus strains isolated from an outbreak of food poisoning caused by the consumption of fermented black beans (douchi) containing B. cereus is described. The outbreak involved 139 persons who had nausea, vomiting, and diarrhea. The strains were isolated from vomit and the unprepared douchi. Two of the strains produced the emetic toxin cereulide, as evidenced by polymerase chain reaction analysis for the presence of the nonribosomal synthetase cluster responsible for the synthesis of cereulide and by chemical analysis by high-performance liquid chromatography-mass spectrometry. These two strains belong to genetic group III of B. cereus, and multiple locus sequence typing revealed that the type was ST26, as a major part of B. cereus emetic strains. One of these strains produced significantly more cereulide at 37°C than the type cereulide producer (F4810/72), and it was also able to produce the toxin at 40°C and 42°C. The third strain belongs to genetic group IV, and it is a new multiple locus sequence type closely related to strains that are cytotoxic and enterotoxigenic. It possesses genes for hemolysin BL, nonhemolytic enterotoxin, and cytotoxin K2; however, it varies from the majority of strains possessing genes for hemolysin BL by not being hemolytic. Thus, two B. cereus strains producing the emetic toxin cereulide and a strain producing enterotoxins might have been involved in this food-poisoning incident caused by the consumption of a natural fermented food. The ability of one of the strains to produce cereulide at ≥37°C makes it possible that it is produced in the human gut in addition to occurring in the food.

Production of Staphylococcus aureus Enterotoxin A in Raw Milk at High Temperatures

Improper processing and storage of raw milk contaminated with Staphylococcus aureus at elevated temperatures can result in the production of staphylococcal enterotoxins, especially type A (SEA), which is most frequently associated with food poisoning outbreaks such as the large one in Osaka, Japan, in 2000. In this study, the characteristics of S. aureus growth and SEA production at various high temperatures in raw milk samples were studied using two raw milk samples naturally containing low and high levels of natural microflora. The optimal temperatures found for SEA production in the two milk types were as high as 40 and 44°C (range, 36 to 48°C), and SEA production was dependent on the initial dose of S. aureus. These high temperatures were close to that of the outbreak in Japan. Thus, it was concluded that temperature was critical for SEA production in raw milk. It was also observed that natural microflora in the milk samples considerably suppressed SEA production but not staphylococcal growth. On the other hand, the amount of toxin in most milk samples decreased after peaking during storage.

Cancer and non-cancer excess mortality resulting from mixed exposure to polychlorinated biphenyls and polychlorinated dibenzofurans from contaminated rice oil: "Yusho".

In 1968, rice oil contaminated with polychlorinated biphenyls and polychlorinated dibenzofurans caused a severe outbreak of food poisoning in Japan and was termed locally as "Yusho" (oil disease). In our previous study, we found that area-based standardized mortality ratios (SMRs) of some diseases were elevated shortly after the incident. This previous study, however, was unable to determine whether these elevated SMRs were a result of other area-specific factors. To overcome this limitation, we obtained mortality data from the 5 years before the incident and conducted an area-based study using vital statistics records dating from 1963 to 2002. The population of Nagasaki Prefecture was set as the reference population for calculating SMRs. We also included data on cause-specific mortality attributable to cancer and expanded the population to encompass two severely exposed areas where contaminated rice oil was distributed (namely Tamanoura and Naru). We also calculated SMRs in the remainder of the Shimo-Goto region, excluding the exposed area, which was used as a comparison area. Even after considering the time trends in mortality before the incident, mortality due to diabetes mellitus and heart disease, as well as all-cause mortality, was found to be elevated shortly afterward. Additionally, mortalities due to uterine cancer in Tamanoura and leukemia were also elevated at 30-34 and 10-59 years after the event in both exposed areas, respectively. SMRs for leukemia in Tamanoura were as high as 3.0 (95% confidence interval 1.4-6.2) and 2.4 (1.2-4.8) 10-19 years later. In this period, SMRs for leukemia in the comparison area were not elevated. Further epidemiological studies are needed regarding this rice-oil, "Yusho" outbreak, especially with regard to cancer and non-cancer mortality.

Occurrence of enterotoxin-encoding genes in Staphylococcus aureus causing mastitis in lactating goats

Staphylococcal enterotoxins are the leading cause of human food poisoning worldwide. Staphylococcus spp. are the main mastitis-causing agents in goats and frequently found in high counts in goat milk. This study aimed to investigate the occurrence of enterotoxin-encoding genes in Staphylococcus aureus associated with mastitis in lactating goats in Paraiba State, Brazil. Milk samples (n=2024) were collected from 393 farms. Staphylococcus aureus was isolated in 55 milk samples. Classical (sea, seb, sec, sed, see) and novel (seg, seh, sei) enterotoxin-encoding genes were investigated by means of polymerase chain reaction (PCR). From thirty-six tested isolates, enterotoxin-encoding genes were detected in 7 (19.5%) S. aureus. The gene encoding enterotoxin C (seC) was identified in six isolates, while seiwas observed in only one isolate. The genes sea, seb, sed, see, seg and seh were not observed amongst the S. aureus investigated in this study. In summary, S. aureus causing mastitis in goats can harbor enterotoxin-encoding genes and seC was the most frequent gene observed amongst the investigated isolates. This finding is important for surveillance purposes, since enterotoxin C should be investigated in human staphylococcal food poisoning outbreaks caused by consumption of goat milk and dairy products.

Prevalence of enterotoxins and toxin gene profiles of Staphylococcus aureus isolates recovered from a bakery involved in a second staphylococcal food poisoning occurrence.

The study objective was to characterize and analyse the distribution of enterotoxins and genes encoding enterotoxins in Staphylococcus aureus strains recovered from the 601 environment and ingredient samples obtained during multiple inspections of a bakery implicated in two separate staphylococcal food poisoning incidents. Staphylococcus aureus isolates were evaluated using serological assays for identification of classical staphylococcal enterotoxins (SEs) SEA-SEE and polymerase chain reaction for the detection of newly described SE and SE-like enterotoxin genes seg-seu. Pulsed field gel electrophoresis identified thirteen pattern types. During these investigations, a total of 585 environmental swabs and 16 raw ingredient samples were collected by investigators, 85 of which were confirmed to contain Staph. aureus; of those isolates, 95·3% (81/85) harboured enterotoxin genes and 4·7% (4/85) carried newly described SE and SE-like enterotoxin genes in the absence of classical enterotoxins. Our research demonstrates the prevalence and diversity of classical SEs and the probable underestimated impact of nonclassical SE and SE-like enterotoxins role in domestic staphylococcal food poisoning outbreaks. Given the abundance of SEs and SE-like toxins, these findings illustrate the utilization of PCR for enterotoxin gene identification and its significance in outbreak investigations.

Staphylococcus aureus food-poisoning outbreak associated with the consumption of ice-cream

In April 2013, a food poisoning outbreak caused by staphylococcal enterotoxins (SEs) in ice-cream occurred in Freiburg, Germany, among the 31 participants of a christening party. Of the 13 cases, seven were hospitalized or obtained ambulatory treatment. Different types of ice-cream, which was freshly produced at the hotel where the party took place, were found to contain SE and high amounts of coagulase positive staphylococci. Enterotoxigenic Staphylococcus aureus strains isolated from ice-cream and human cases were of the same spa-type (t127), harboured the sea gene and displayed identical phenotypic resistance-, Fourier transform infrared spectroscopy- (FT-IR) and microarray-profiles. Despite the strong microbiological and epidemiological evidence of ice-cream being the incriminated food vehicle of the outbreak, a common source of S. aureus from the ice-cream could not be deduced. As none of the employees carried the outbreak strain, either the equipment used for the production of the ice-cream or a contaminated ingredient is the most likely introduction source.

Occurrence and Characterization of Enterotoxigenic Potential of Staphylococcus Isolated from Dairy Products

AbstractStaphylococcus deserves our close attention because of its ability to produce a large amount of enterotoxins, which, if ingested, cause staphylococcal food poisoning. Cross‐contamination after milk pasteurization, caused especially by improper handling, is considered the most recurrent source of contamination of dairy products. Therefore, this research aimed to quantify and analyze the presence of coagulase‐positive and coagulase‐negative staphylococci from 104 dairy products samples to identify phenotypically the species and to evaluate the in vitro production of classical enterotoxins (SEA, SEB, SEC, SED and SEE) and the presence of possible coding genes of these enterotoxins. The average staphylococcal count values in different food groups ranged from 3.7 to 6.15 log colony‐forming units (cfu)/g. Among the staphylococcal strains, 74.3% (110/148) were coagulase‐negative Staphylococcus and 25.7% (38/148) were coagulase‐positive Staphylococcus, and 13 species were identified. From the 111 selected isolates, one (0.9%) strain produced enterotoxin, which was identified as S. aureus, coagulase positive, isolated from “Minas” half‐cured cheese, whose count was 6.28 log cfu/g. Contrary to expectations, no coding genes were present in the isolate analyzed. For this research, the analyzed samples showed high staphylococcal concentrations that do not exclude a possible risk of producing the already described enterotoxins. They also demonstrated poor hygiene during the production and commercialization of dairy products.Practical ApplicationsStaphylococcus aureus is one of the most common agents in bacterial food poisoning outbreaks. As milk is a major nutrient for infants, children, convalescents and old people, the presence of classical enterotoxins in milk and dairy products is a matter of concern. The information present in this research is important to alert about the inadequate quality of Brazilian milk products, and efforts from the government and the entire productive chain are required to attain consumer safety.

English

This study examined the general hygiene and sanitary practices of street food venders in Nigeria. 110 random samples of street food venders were selected to represent 18% of street food venders in the study area. Data was collected using pre-test structured questionnaire and observation checklists. The relationships in the factors studied were determined. Food venders lacked basic training on hygiene and only 2.7% had formal training on food preparation. 63.6% acquired skills from parents while 33.7% acquired skills by self practice. 44.5% of vendors used their mouths to blow air into polythene bags to open, before using it to package foods for customers. 60.0% of the vendors prepared foods in unkempt environment with flies around the foods. The study indicated absence of evidence of relationship between venders’ education and vending location as well as between gender and personal hygiene. This study largely suggested non-compliance with the Codex Alimentarius Commission guidelines for street food control in Africa. The non regulation of street food vending business in Africa especially Nigeria portends danger of outbreak of food poisoning. Key words: Street foods, hygiene, sanitation, vendors, food safety, Kaduna-North Central Nigeria.

Characterization of enterohemorrhagic Escherichia coli O111 and O157 strains isolated from outbreak patients in Japan.

In April and May 2011, there was a serious food-poisoning outbreak in Japan caused by enterohemorrhagic Escherichia coli (EHEC) strains O111:H8 and O157:H7 from raw beef dishes at branches of a barbecue restaurant. This outbreak involved 181 infected patients, including 34 hemolytic-uremic syndrome (HUS) cases (19%). Among the 34 HUS patients, 21 developed acute encephalopathy (AE) and 5 died. Patient stool specimens yielded E. coli O111 and O157 strains. We also detected both EHEC O111 stx2 and stx-negative E. coli O111 strains in a stock of meat block from the restaurant. Pulsed-field gel electrophoresis (PFGE) and multilocus variable-number tandem-repeat analysis (MLVA) showed that the stx-negative E. coli O111 isolates were closely related to EHEC O111 stx2 isolates. Although the EHEC O157 strains had diverse stx gene profiles (stx1, stx2, and stx1 stx2), the PFGE and MLVA analyses indicated that these isolates originated from a single clone. Deletion of the Stx2-converting prophage from the EHEC O111 stx2 isolates was frequently observed during in vitro growth, suggesting that strain conversion from an EHEC O111 stx2 to an stx-negative strain may have occurred during infection.

Molecular epidemiology and identification of a Staphylococcus aureus clone causing food poisoning outbreaks in Japan.

Molecular characterization of isolates from staphylococcal food poisoning (SFP) outbreaks in Japan showed that the dominant lineage causing SFP outbreaks is clonal complex 81 (CC81), a single-locus variant of sequence type 1, coagulase type VII, positive for sea and/or seb, and positive for seh. Among various CC lineages producing staphylococcal enterotoxin A, CC81 showed the highest toxin productivity.

Managing of the outbreak of staphylococcal food poisoning in primary school

Izvleček Izhodišče: Oktobra 2010 smo imeli na Gorenjskem v eni izmed osnovnih šol z vrtcem izbruh stafilokokne zastrupitve s hrano. Metode: Izvedli smo retrospektivno kohortno epidemiološko raziskavo in izračunali stopnjo obolevnosti v izbruhu ter relativno tveganje (RT) za vsako živilo. Pri obolelih smo kultivirali blato in izbruhanino. Opravili smo terenski ogled z odvzemom vzorca hrane, brisov delovnih površin na snažnost in brisa rok zaposlenih v kuhinji. V okviru usmerjenega pregleda smo trem zaposlenim v kuhinji odvzeli kužnine za mikrobiološke preiskave. Izolatom bakterije Staphylococcus aureus smo določili enterotoksine s testom aglutinacije SET RPLA (Oxoid). Za primerjavo sorodnosti bakterije S. aureus iz živila in humanih vzorcev smo opravili tipizacijo izolatov s pulzno elektroforezo (PFGE). Rezultati: Obolelo je 73 oseb od 374 izpostavljenih. Stopnja obolevnosti je bila 19,5-odstotna. Najpogostejši bolezenski znaki so bili: bruhanje (87,7 %), bolečine v trebuhu (75,3 %), driska (64,2 %) in slabost (59,3 %). Največje relativno tveganje (RT) za zastrupitev je bilo povezano z uživanjem mesnega sira (RT= 24,2 (95 % CI 12,1-48,5; p<0,001) in krompirjeve solate (RT= 19,4 (95 % CI 10,7-35,2; p<0,001). S kože rok osebe, zaposlene v kuhinji, iz vzorca hrane in kužnin obolelih otrok smo izolirali bakterijo S. aureus, ki je izločala enterotoksina A; po občutljivosti za antibiotike se ni razlikovala od drugih; z metodo PFGE se je pokazala 96,3-odstotna sorodnost med sevi. Zaključki: Opisana raziskava je vzorčen primer dela in ukrepanja področnega epidemiologa in mikrobiologa ob pojavu izbruha. V izbruhu smo dokazali epidemiološko povezane izolate in opredelili pomen posameznih preiskav.

Real-time RT-PCR을 이용한 Feline Calicivirus 불활성화의 정량적 분석

Norovirus causes acute gastroenteritis in all age groups and its food poisoning outbreaks are rap- idly increasing in Korea. Reverse transcription-polymerase chain reaction (RT-PCR) is most widely used for the rapid detection of foodborne viruses due to high sensitivity. However, the false positive results of RT-PCR obtained against already inactivated viruses could be a serious drawbacks in food safety area. In this study, we investigated a method to yield true positive RT-PCR results only with alive viruses. To decompose the RNA genes from dead viruses, the enzymatic treatments composed of proteinse K and Ribonuclease A were applied to the sanitized and inactivated virus particles. Another aim of this study was to quantify the efficiencies of several major sanitizing treatments using real- time RT-PCR. Feline calicivirus (FCV) that belongs to the same Caliciviridae family with norovirus was used as a surrogate model for norovirus. The initial level of virus in control suspension was approximately 10 4 PFU/mL. Most of inactivated viruses treated with the enzymatic treatment for 30 min at 37 o C were not detected in RT-PCR, Quanti- fication results to verify the inactivation efficiencies of sanitizing treatments using real-time RT-PCR showed no false positive in most cases. We could successfully develope a numerical quantification process for the inactivated viruses after major sanitizing treatments using real-time RT-PCR. The results obtained in this study could provide a novel basis of rapid virus quantification in food safety area.

Serodiagnosis Using Microagglutination Assay during the Food-Poisoning Outbreak in Japan Caused by Consumption of Raw Beef Contaminated with Enterohemorrhagic Escherichia coli O111 and O157

A microagglutination (MA) assay to identify antibodies to Escherichia coli O111 and O157 was conducted in sera collected from 60 patients during a food-poisoning outbreak affecting 181 patients in Japan which was caused by the consumption of contaminated raw beef. Enterohemorrhagic E. coli (EHEC) O111:H8 and/or O157:H7 was isolated from the stools of some of the patients, but the total rate of positivity for antibodies to O111 (45/60, 75.0%) was significantly higher than that for antibodies to O157 (10/60, 16.7%). The MA titers of antibodies to O111 measured in patients with hemolytic-uremic syndrome and bloody diarrhea were higher than those measured in patients with only diarrhea. In patients from whose stool no isolates of E. coli O111 and O157 were obtained, the positive antibody detection rates were 12/19 (63.2%) for O111 and 2/19 (10.5%) for O157, and the MA titers of antibodies to O111 measured were higher than those to O157. Similarly, the MA titers of antibodies to O111 were significantly higher than those to O157, regardless of the other groups, including groups O111, O111 and O157, and O157. These serodiagnosis results suggest that EHEC O111:H8 stx2 played a primary role in the pathogenesis of this outbreak. Furthermore, our findings suggest that the isolates from the patients' stool specimens were not always the major causative pathogen in patients with multiple EHEC infections, because the sera from patients from whose stools only O157 was isolated were positive for antibodies to O111. Measuring antibodies to E. coli O antigen is helpful especially in cases with multiple EHEC infections, even with a non-O157 serotype.

An outbreak of staphylococcal food poisoning in a nursing hostel, Mysore, Karnataka

Objectives: To know the clinical profile of the students affected due to food poisoning, the possible source of infection and the causative agent for food poisoning. Background: Food-borne diseases due to microbial contamination of food, represent serious threat to the health of millions of people henceforth, we investigated into the outbreak of food poisoning in a nursing hostel of urban Mysore. Materials and Methods: A descriptive study was conducted using semi-structured questionnaire to gather information on regarding time and type of food item consumed, onset of symptoms, presenting symptoms, medical care provided and time taken for recovery. A case for the outbreak was defined as any person who had consumed lunch on 9/12/12 from the implicated kitchen and had experienced vomiting or diarrhea or pain abdomen or all the three symptoms within 24 hours of eating lunch. Results: Out of 171 inmates,46 people suffered from food poisoning within a period of 3 days,thus leading to the attack rate of 26.9%.Commonest symptom reported among the students was pain abdomen (26.9%) followed by diarrhea. Highest risk of food poisoning was associated with consumption of Kerala matta rice This association was statistically significant with relative risk of 31.49 (95% CI 10.82-95.6). Samples of 'Kerala matta rice was subjected to bacteriological analysis, which showed colonies of coagulase-positive Staphylococcus aureus . Conclusions: In the present outbreak, the results of investigation revealed that 'Kerala matta rice' was the food item responsible for occurrence of food poisoning due to Staphylococcus . Environmental factors that could have played an important role in bacterial proliferation and enterotoxin production are manual handling of cooked rice by the food handlers and storage of the rice at room temperature for a long duration between time of preparation and consumption.

The Crystal Structure of Shiga Toxin Type 2 with Bound Disaccharide Guides the Design of a Heterobifunctional Toxin Inhibitor

Shiga toxin type 2 (Stx2a) is clinically most closely associated with enterohemorrhagic E. coli O157:H7-mediated hemorrhagic colitis that sometimes progresses to hemolytic-uremic syndrome. The ability to express the toxin has been acquired by other Escherichia coli strains, and outbreaks of food poisoning have caused significant mortality rates as, for example, in the 2011 outbreak in northern Germany. Stx2a, an AB5 toxin, gains entry into human cells via the glycosphingolipid receptor Gb3. We have determined the first crystal structure of a disaccharide analog of Gb3 bound to the B5 pentamer of Stx2a holotoxin. In this Gb3 analog,-GalNAc replaces the terminal-Gal residue. This co-crystal structure confirms previous inferences that two of the primary binding sites identified in theB5 pentamer of Stx1 are also functional in Stx2a. This knowledge provides a rationale for the synthesis and evaluation of heterobifunctional antagonists for E. coli toxins that target Stx2a. Incorporation of GalNAc Gb3 trisaccharide in a heterobifunctional ligand with an attached pyruvate acetal, a ligand for human amyloid P component, and conjugation to poly[acrylamide-co-(3-azidopropylmethacrylamide)] produced a polymer that neutralized Stx2a in a mouse model of Shigatoxemia.

IMPLANTAÇÃO DOS PROCEDIMENTOS OPERACIONAIS PADRONIZADOS (POPs) DE HIGIENIZAÇÃO E DESINFECÇÃO DOS EQUIPAMENTOS E UTENSÍLIOS EM UMA UNIDADE DE ALIMENTAÇÃO E NUTRIÇÃO HOSPITALAR

In a hospital UFNs, an outbreak of food poisoning can have disastrous consequences and aggregate risk of death for patients. Thus, the training of food handlers is critical to ensuring the quality of the food that is produced. The aim of this study was to implement the SOPs related to sanitation and disinfection of equipment and utensils, by means of a training, containing illustrative figures and everyday issues on the subject; and evaluate the daily practice of sanitation and disinfection activities before and after the intervention with employees of UFN. We developed and implemented a guidefor inspection of best practices in sanitation of equipment and utensils at two different times, before and after the intervention with the food handlers. The results showed a significant improvement in the situation of this unit in terms of practice, frequency and fulfillment of stages related to sanitation and disinfection of equipment and utensils. We concluded that the implementation of SOPs for sanitation and disinfection was carried out successfully, and that empowering employees with dynamic and interactive training allows them a greater understanding of the importance of hygiene practices in the daily routine of UFN.