PDF(Pubmed)
Abstract：
The current society consists of an increasing number of people vulnerable to infections. For certain people with severe immunodeficiency, a neutropenic or low-microbial diet is being prescribed, which substitutes high-risk foods that are more likely to contain human (opportunistic) pathogens with lower-risk alternatives. These neutropenic dietary guidelines are typically set up from a clinical and nutritional perspective, rather than from a food processing and food preservation perspective. In this study, the current guidelines in use by the Ghent University Hospital were evaluated based on the current knowledge of food processing and preservation technologies and the scientific evidence on microbiological quality, safety, and hygiene of processed foods. Three criteria are identified to be important: (1) the microbial contamination level and composition; (2) the potential presence of established foodborne pathogens such as Salmonella spp. (to which a zero-tolerance policy is recommended); and (3) an increased vigilance for L. monocytogenes as an opportunistic foodborne pathogen with a high mortality rate in immunocompromised individuals (to which a zero-tolerance policy should apply). A combination of these three criteria was used as a framework for the evaluation of the suitability of foodstuffs to be included in a low-microbial diet. Differences in processing technologies, initial contamination of products, etc., however, lead to a high degree of variability in microbial contamination and make it difficult to unambiguously accept or reject a certain type of foodstuff without prior knowledge of the ingredients and the processing and preservation technologies applied during manufacturing and subsequent storage conditions. A restricted screening on a selection of (minimally processed) plant-based foodstuffs on the retail market in Flanders, Belgium supported decision-making on the inclusion of these food types in a low-microbial diet. Still, when determining the suitability of a foodstuff to be included in a low-microbial diet, not only the microbiological status but also nutritional and sensorial properties should be assessed, which requires multidisciplinary communication and collaboration.
摘要：
当前的社会包括越来越多的人容易感染。对于某些患有严重免疫缺陷的人，正在规定中性粒细胞减少或低微生物饮食，用风险较低的替代品替代更可能含有人类（机会性）病原体的高风险食品。这些中性粒细胞减少症饮食指南通常是从临床和营养角度出发的，而不是从食品加工和食品保存的角度来看。在这项研究中,根特大学医院目前使用的指南是根据食品加工和保存技术的现有知识以及微生物质量的科学证据进行评估的，安全,和加工食品的卫生。确定了三个重要标准：（1）微生物污染水平和组成；（2）潜在存在已确定的食源性病原体，例如沙门氏菌。（建议采取零容忍政策）；（3）提高对单核细胞增生李斯特菌作为机会性食源性病原体的警惕，在免疫功能低下的个体中死亡率很高（应采取零容忍政策）。这三个标准的组合被用作评估食品是否适合纳入低微生物饮食的框架。加工技术的差异，产品的初始污染，等。,然而,导致微生物污染的高度可变性,并且使得在没有在制造和随后的储存条件期间应用的成分和加工和保存技术的先验知识的情况下难以明确地接受或拒绝某种类型的食品。对佛兰德零售市场上的一些(最低限度加工的)植物性食品进行限制性筛选，比利时支持将这些食物类型纳入低微生物饮食的决策。尽管如此，当确定低微生物饮食中包含的食品的适宜性时，不仅要评估微生物学状态，还要评估营养和感官特性，这需要多学科的沟通和协作。
