Contact Time for Foods of Different Textures Leads to Differential Bacterial Growth: Testing the Five Second Rule

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International Journal of Applied Environmental Sciences ISSN 0973-6077 Volume 11, Number 6 (2016), pp. 1387-1396 Research India Publications http://www.ripublication.com Contact Time for Foods of Different Textures Leads to Differential Bacterial Growth: Testing the Five Second Rule Benjamin M. Lipschutz 1, Daniel Kagan 1, Lisa Steed 2, Evgenia Kagan 3, Joshua H. Lipschutz 3,4* 1 Addlestone Hebrew Academy, Charleston, SC, 29407, USA. 2 Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, 29425, USA. 3 Department of Medicine, Medical University of South Carolina, Charleston, SC, 29425, USA. 4 Department of Medicine, Ralph H. Johnson Veterans Affairs Medical Center, Charleston SC, 29425, USA. *Corresponding Author Abstract Food-borne illnesses result in significant morbidity and mortality. A major factor involved is bacterial cross-contamination from surface exposure. It is a commonly held belief that food dropped on the floor for five or less does not become contaminated by resident bacteria. We tested this belief in a real-world scenario using two distinct food types, that differed in texture and moisture content, in the kitchen of an average American five-person family without pets. The two foods tested were noodles, that had been sterilized by boiling, and Cheerios, from a newly opened box. The sample foods were dropped onto the kitchen floor from a height of three feet, and allowed to

1388 Benjamin M. Lipschutz et al remain on the kitchen floor for 5, 30, or 180. Two types of growth medium were used, MacConkey agar, designed to selectively isolate Gramnegative enteric bacilli, and blood agar, used to culture most microorganisms. Controls (in the case of noodles, samples taken with a sterile forceps directly from a pot of boiling water that had been allowed to cool to room temperature; and for Cheerios, samples taken directly from a newly-opened box with sterile forceps) included on each plate were all negative, with the exception of one Cheerio on a 5 second blood agar plate. The MacConkey plates were all negative, indicating no gram negative bacilli. Only two of the Cheerios blood agar plate samples were positive, with just 1 colony each, on the 30 and 180 second plates. Noodle samples were positive on blood agar plates at 5, 30, and 180, with more plates containing bacterial colonies seen on the 30 and 180 compared to the 5 second plates. The bacteria growing on the plates were then identified using matrix-assisted laser desorption/ionization (MALDI) mass spectrometry, and a variety of Gram-positive organisms were identified. We conclude that it is probably safe to eat dry/hard foods, such as Cheerios, that fall on a kitchen floor for 5, but not moist/sticky foods, such as noodles. Keywords: bacteria, contact, food. INTRODUCTION In the food services industry, it is standard operating procedure to discard food that has fallen to the ground. It is estimated that in the United States there are 9.4 million episodes of foodborne illness, 55,961 hospitalizations, and 1,351 deaths per year from various causes [1]. When data were analyzed from 1998 to 2013, 12% of all outbreaks reported to the Centers for Disease Control (CDC) were linked to surface cross-contamination. In fact, this was the 6th most common contributing factor (out of 32) [1, 2]. Nevertheless, there is a commonly held belief that food dropped on the floor for five or less does not have time to become contaminated by resident bacteria (the so-called 5 second rule ). Although, the 5 second rule has undergone testing on TV programs such as Mythbusters and the Discovery Science Channel, there have been only two peer-reviewed papers investigating this. The first, published in 2007, showed that longer contact times (5, 30 and 60 ) did indeed increase the transfer of Salmonella typhimurium from wood, tile or carpet to bologna or bread, but only after more than eight hours following surface inoculation [3]. The other recent study to explore this topic used four different surfaces (stainless steel, ceramic tile,

Contact time for foods of different textures leads to differential bacterial growth 1389 wood and carpet), four different foods (watermelon, bread, bread with butter and gummy candy), four different contact times (<1, 5, 30 and 300 ), and two bacterial preparation methods. Although they showed that longer contact times resulted in more transfer, they also showed that other factors including the nature of the food and the surface were of equal or greater importance. Some transfer did take place instantaneously (i.e. at times <1 second), indicating that the five-second rule, at least in certain cases, was incorrect [4]. What these studies had in common is that they measured transfer of known bacteria from an artificially inoculated surface. We report here the results of a real-world study to investigate the degree of transfer, and the type of bacteria transferred, to two foods of differing moisture content dropped on the kitchen floor of a typical American five-person family (three children all over the age of eight, and two adults) without pets. METHODS Food types Two foods of differing texture and moisture content were chosen to be tested: pasta noodles and Cheerios. The noodles were sterilized (and cooked) in typical fashion in a boiling pot for ten minutes, and were allowed to cool to room temperature over thirty minutes, prior to being removed with sterile forceps, for use as either s or test samples dropped onto the floor. The Cheerios were removed using sterile forceps from a newly opened box, for use as either s or test samples dropped onto the floor. Agar Two types of agar plates were used: MacConkey agar, which is designed to selectively isolate Gram-negative and enteric bacilli based on lactose fermentation, and blood agar, used to culture almost all microorganisms. Mass spectrometry The colonies growing on the plates were sampled with a wire loop, and matrixassisted laser desorption/ionization (MALDI) mass spectrometry was used to identify the different microorganisms (MALDI PM Microflex LT, Bruker Daltonics Inc., Billerica, MA).

1390 Benjamin M. Lipschutz et al Statistics Pearson s chi-squared testing was performed to compare bacterial growth of the noodles and Cheerios that were in contact with the kitchen floor over the different time points studied (5, 30, and 180 ). RESULTS Bacterial transfer from contact of food with the kitchen floor Two foods of differing texture and moisture content were chosen for sampling: pasta noodles and Cheerios. The noodles were sterilized (and cooked) in typical fashion in a boiling pot for ten minutes, and were allowed to cool to room temperature over 30 minutes, prior to being removed with sterile forceps, for use as either s or samples dropped onto the floor. Cheerios were removed with sterile forceps from a newly opened box, for use as either s or test samples dropped onto the floor. The samples were dropped from a height of three feet (counter level) and allowed to remain on the floor for 5, 30, or 180. The samples were then placed on MacConkey and blood agar plates using sterile forceps. At the same time that the samples were placed onto each agar plate, s (either sterile noodles from the pot, or Cheerios from the box) were placed on the other half of the plate. The bottom and top of the plastic petri dishes containing the agar were labeled with a permanent marker so that the samples and s would not be misidentified. Following placement of the samples and s onto the agar plates, the plates were placed in a 37 o C incubator for 48 hours. After 48 hours, the number of colonies surrounding the samples and s was determined (Table 1). Table 1: Bacterial colonies growing on each plate per replicate. Noodles 5 5 30 30 180 180 Replicate 1 Replicate 2 0 0 4 0 2 0 0 0 12 0 4 0

Contact time for foods of different textures leads to differential bacterial growth 1391 Replicate 3 Replicate 4 0 0 9 0 24 0 9 0 2 0 3 0 Cheerios 5 5 30 30 180 180 Replicate 1 Replicate 2 Replicate 3 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 The samples were first analyzed using chi-square testing for differences between the presence versus absence of bacterial growth in the samples compared to s for each plate. Overall, the difference between the samples compared to their respective s was significant for the noodles (p=0.018), but not for the Cheerios (p=0.223). When comparing 5 of contact time with the kitchen floor versus 30, there was a significant difference for the noodles (p=0.028), but not for the Cheerios (p=0.273) (Figures 1A,B). There was also a significant difference comparing 5 of contact time versus 180 for the noodles (p=0.028), but not for the Cheerios (p=0.083). Similarly, there was a difference for 5 versus 30 & 180 of contact time for the noodles (p=0.005), but not for the Cheerios (p=0.134). There was not, however, a difference between 30 versus 180 of contact time for either the noodles or the Cheerios. When the number of colonies was compared between the different time points, there was also an increase in colony counts per plate as the duration of contract increased (Figures 2A,B), though it did not reach statistical significance for either the noodles (p=0.235) or the Cheerios (p=0.076).

1392 Benjamin M. Lipschutz et al The foods were then removed from the blood agar plates, and the plates were incubated for 48 hours in a 37 o C incubator, before being placed in a 4 o C refrigerator until the colonies could be counted, photographed (Figure 3), and identified. Figure 1: Analysis of the difference between replicates. Bacterial colonies were determined to be present or absent on the blood agar plates for the noodle and Cheerio samples and s at 5, 30, and 180 following dropping of the samples on the kitchen floor and growing the plates for 48 hours in a 37 o C incubator.

Contact time for foods of different textures leads to differential bacterial growth 1393 Significant differences, using chi-square analysis, were seen from 5 compared to 30 and 180 for the noodles, but not the Cheerios. Figure 2: Analysis of the number of colonies per plate. The number of bacterial colonies were counted on the blood agar plates for the noodle and Cheerio samples and s at 5, 30, and 180 following the dropping of samples on the

1394 Benjamin M. Lipschutz et al kitchen floor and growing the plates for 48 hours in a 37 o C incubator. Significant differences, using chi-square analysis, from 5 compared to 30 and 180 were not seen for either the noodles or the Cheerios. Figure 3: Colonies grown on blood agar plates. For each plate, sterile noodles were used as s, as seen in the top arrow pointing to the indentation from the noodle, or dropped as samples from three feet unto the kitchen floor using sterile forceps (bottom arrow). Colonies surrounding the indentation were then counted (arrowheads) after 48 hours of growth in a 37 o C incubator. This plate was the fourth replicate of noodles dropped for 30 onto the kitchen floor.

Contact time for foods of different textures leads to differential bacterial growth 1395 Identification of bacteria that were transferred following contact with the kitchen floor MacConkey agar is a selective and differential culture medium for bacteria designed to selectively isolate Gram-negative and enteric bacteria. There were no colonies that grew in the and sample sections of any MacConkey agar plate. The blood agar plates had variable numbers of colonies as shown in Table 1. The bacterial colonies were identified by MALDI mass spectrometry according to the manufacturer s instructions. The bacteria that we identified were: Staphylococcus pasteuri, Staphylococcus caprae, Staphylococcus epidermidis, Staphylococcus aureus, Staphylococcus saprophyticus, Staphylococcus cohnii, Staphylococcus saprophyticus, Brevibacterium iodinum, Streptococcus mitis (the alpha strep), Lysinibacillus sp., and Corynebacterium afermentans. DISCUSSION We report two principal findings here, both of which are quite interesting. First, we show that bacterial transfer is dependent on the type and texture of the food. Second, we show that for a moist/adhesive food, bacterial transfer is dependent on contact time. Our study had several advantages, including: it was a real-world study in the kitchen of an average American five-person family without very young children or pets, and our study determined the type of bacteria that were transferred in a nonbiased screen using state-of-the-art mass spectrometry. The two other peer-reviewed studies that tested the 5-second rule [3, 4], investigated the transfer of a known bacteria that had been placed on a surface, and, therefore, did not examine the type of bacteria that are transferred in a real-world setting. The lack of Gram-negative and enteric bacilli on the kitchen floor of a household with no pets or very young children was anticipated as fecal material would, hopefully, not be found on the kitchen floor. The Cheerios were hard and dry and bacteria that were transferred following contact time on the kitchen floor were rare. Only one colony was seen at 30 and two at 180, which was similar to the number of bacterial colonies transferred in the Cheerios (one at 5 ). The noodles were sticky and moist, and moisture is known to facilitate bacterial transfer [5]. Indeed, nine colonies of bacteria were seen with 5 of contact time, 27 colonies were seen following 30 of contact, and 33 colonies following 180, though the increase in colony counts did not reach statistical significance, most likely due to the relatively small number of plates sampled. For the noodles, all the samples were negative for bacterial growth.

1396 Benjamin M. Lipschutz et al MALDI mass spectrometry identified 11 different types of Gram-positive bacteria, and represent the expected cohort of resident bacteria on the kitchen floor of a fiveperson American family without very young children or pets. We conclude that it is probably safe to eat hard foods, such as Cheerios, that fall on the kitchen floor for 5, but not "sticky" foods such as noodles. ACKNOWLEDGEMENTS We would like to thank Amy Wahlquist of the South Carolina Clinical and Translational Research (SCTR) Institute for her assistance with the statistical analysis of our data set. REFERENCES [1] Scallan, E., et al., Foodborne illness acquired in the United States--major pathogens. Emerg Infect Dis, 2011. 17(1): p. 7-15. [2] Gould, L.H., et al., Surveillance for foodborne disease outbreaks - United States, 1998-2008. MMWR Surveill Summ, 2013. 62(2): p. 1-34. [3] Dawson, P., et al., Residence time and food contact time effects on transfer of Salmonella Typhimurium from tile, wood and carpet: testing the five-second rule. J Appl Microbiol, 2007. 102(4): p. 945-53. [4] Miranda, R.C. and D.W. Schaffner, Longer Contact Times Increase Cross- Contamination of Enterobacter aerogenes from Surfaces to Food. Appl Environ Microbiol, 2016. [5] Perez-Rodriguez, F., et al., Understanding and modelling bacterial transfer to foods: a review. Trend Food Sci Tech, 2008. 19: p. 131-144.