Nursing homes may want to step up their food safety vigilance to protect against Listeria bacterial infections, suggests a sweeping new report on healthcare-associated foodborne outbreaks.

Investigators combed through studies of healthcare facility outbreaks occurring in the United States and 37 other countries. They also analyzed German surveillance data and data from the European Food Safety Authority.

Among their findings on the causes and characteristics of these outbreaks: Long-term care facilities may be susceptible to the spread of listeriosis. These infections tend to be insidious, cropping up as single but severe cases over a prolonged time period, the authors said.

High-risk foods

The investigators traced these outbreaks to mixed foods, various fruits and vegetables, and meat and meat products. Some foods posed particular risk to the most vulnerable patients, they said.

Special care should be taken when offering berries, for example. Frozen berries should be heat-treated before being offered for consumption, and berries that have not been heated should not be served to vulnerable or immunocompromised patients, the authors cautioned. Fresh produce such as mung bean sprouts, raw celery and raw spinach is another key contamination risk factor for vulnerable patients, they wrote.

The takeaway? Some healthcare facilities may be more focused on nutritional risk and diet composition for vulnerable patients than microbial food safety and guidance. 

Beyond regulations

“Despite regulations to govern food safety and existing guidelines on food safety, there is still a need to raise awareness including regular food safety training programs for healthcare facility staff and to enforce adherence to safe food policies, especially regarding food for highly vulnerable or immunocompromised patients,” the authors wrote. 

“A diet should therefore be selected that is suitably nutritious and palatable without using high-risk foods,” they suggested. “Limited budgets of healthcare institutions may lead to minimizing catering costs, which may have an impact on the quality of the food served.” 

Surveillance of healthcare-associated infections should be integrated with surveillance of foodborne diseases to improve detection, they concluded.

Data came from countries that are members of the Organization for Economic Co-operation and Development. The study was published in the journal Eurosurveillance.