Hygienic conditions and microbiological status of chilled Ready-To-Eat products served in Southern Spanish hospitals

Chilled Ready-To-Eat (RTE) foods are of concern in hospital foodservices because they can support microbial growth when subjecting to time/temperature abuses during processing and distribution together with poor handling practices. This study was conducted in five different hospitals (A–E) of Southern Spain during 2008–2009 to perform an evaluation of their sanitary conditions and microbiological quality of two RTE meals: lettuce salads and cooked ham. A checklist based on hygiene principles embedded in Food European legislation was developed and applied in each hospital. In parallel, microbiological analysis of food contact surfaces, air quality and time/temperature measurements along the distribution chain were carried out. RTE samples (n = 150) were examined for mesophilic aerobic bacteria (MAB), total coliforms, coagulase-positive Staphylococci (CPS), Escherichia coli, Listeria spp. and Salmonella spp. Differences were found between hospitals regarding handling practices and cleanliness of working surfaces. Cooked ham samples presented lower counts of MAB and total coliforms (<103 and <10 cfu/g respectively) than lettuce salads (104 to 105 and 10 to 104 cfu/g respectively), although concentration of CPS was higher in cooked ham samples reaching maximum levels close to 103 cfu/g. Neither Listeria spp. nor Salmonella spp. were detected in any food sample. Prevalence of E. coli was low (3%). Surface counts and air quality presented high variability among the different hospitals evaluated. It was concluded that good manufacturing practices and HACCP principles should be followed together with special training of food handlers. This study can help risk managers to better define the control measures to be adopted in healthcare settings in order to prevent foodborne infections.