Chapter II

Review of Related Literature

In this chapter, focus is on various relevant literatures on
Food Safety, Related Studies on E. coli, Food Safety, S. aureus,
and Street Food.
E. coli
Escherichia coli typically colonizes the gastrointestinal
tract of human infants within a few hours after birth. Usually,
E. coli and its human host coexist in good health and with mutual
benefit for decades. These commensal E. coli strains rarely cause
disease except in immunocompromised hosts or where the normal
gastrointestinal barriers are breached as in peritonitis, for
example. The niche of commensal E. coli is the mucous layer of
the mammalian colon. The bacterium is a highly successful
competitor at this crowded site, comprising the most abundant
facultative anaerobe of the human intestinal microflora. Despite
the enormous body of literature on the genetics and physiology of
this species, the mechanisms whereby E. coli assures this
auspicious symbiosis in the colon are poorly characterized. One
interesting hypothesis suggests that E. coli might exploit its
ability to utilize gluconate in the colon more efficiently than
other resident species, thereby allowing it to occupy a highly
specific metabolic niche (Sweeney et al., 1996).

According to the World Health Organization (WHO, 1992) some

strains of E. coli can cause very serious - and in some cases
life-threatening - disease. One important group of these coli
bacteria is the group of Enterohaemorrhagic Escherichia coli
(EHEC). This type causes severe, often bloody diarrhoea,
accompanied by abdominal cramps. Healthy adults mostly (but not
always) recover completely from E. coli illness within a week.
However, in vulnerable people, especially young children and the
elderly, the illness can progress to Haemolytic Uraemic Syndrome
(HUS), a condition that can lead to serious kidney damage and
even death.
Food Safety
Food safety is about handling, storing and preparing food to
prevent infection and help to make sure that our food keeps
enough nutrients for us to have a healthy diet. Unsafe food and
water means that it has been exposed to dirt and germs, or may
even be rotten, which can cause infections or diseases (fao.org).
Foodborne diseases take a major toll on health. Millions of
people fall ill and many die as a result of eating unsafe food.
Food safety encompasses actions aimed at ensuring that all food
is as safe as possible. Food safety policies and actions need to
cover the entire food chain, from production to consumption (WHO,
1992).
Table 1

FDA Standards for Determining the Microbiological Quality of Precooked Breaded Fish Product.

S. aureus
Staphylococcus aureus is a Gram-positive spherical bacterium
approximately 1 m in diameter. Its cells form grape-like
clusters, since cell division takes place in more than one plane.
It is often found as a commensal associated with skin, skin
glands, and mucous membranes, particularly in the nose of healthy
individuals (Crossley & Archer, 1997). It has been estimated that
approx. 2030% of the general population are S. aureus carriers
(Heyman, 2004). On a rich medium, S. aureus forms medium size
golden colonies. On sheep blood agar plates, colonies of S.
aureus often cause -hemolysis (Ryan & Ray, 2004). The golden
pigmentation of S. aureus colonies is caused by the presence of

carotenoids and has been reported to be a virulence factor

protecting the pathogen against oxidants produced by the immune
system (Liu et al., 2005). Staphyloccoci are facultative
anaerobes capable of generating energy by aerobic respiration,
and by fermentation which yields mainly lactic acid.
Staphylococcus sp. is catalase-positive, a feature
differentiating them from Streptococcus sp., and they are
oxidase-negative and require complex nutrients, e.g., many amino
acids and vitamins B, for growth. S. aureus is very tolerant of
high concentrations of sodium chloride, up to 1.7 molar.
S. aureus is a commensal and a pathogen. The anterior nares
are the major site of colonization in humans. About 2030% of
individuals are persistent carriers of S. aureus, which means
they are always colonized by this bacterium, and 30% are
intermittent carriers (colonized transiently) (Wertheim et al.,
2005). Colonization significantly increases the risk of
infections since it provides a reservoir of the pathogen from
which bacteria are introduced when host defense is compromised
(Kluytmans et al., 1997). Patients with S. aureus infections are
usually infected with the same strain that they carry as a
commensal (Williams et al., 1959). S. aureus is one of the main
causes of hospital- and community-acquired infections which can
result in serious consequences (Diekema et al., 2001). Nosocomial
S. aureus infections affect the bloodstream, skin, soft tissues

and lower respiratory tracts. S. aureus can be a cause of central

venous catheter-associated bacteremia and ventilator-assisted
pneumonia. It also causes serious deep-seated infections, such as
endocarditis and osteomyelitis (Schito, 2006). In addition to the
infections listed above, S. aureus is often responsible for
toxin-mediated diseases, such as toxic shock syndrome, scalded
skin syndrome and staphylococcal foodborne diseases (SFD).
Hospitalized patients are particularly exposed to S. aureus
infections due to their compromised immune system and frequent
catheter insertions and injections (Lindsay & Holden, 2004). The
SENTRY Surveillance Program investigating worldwide S. aureus
infections during a two-year period has revealed that this
pathogen is the leading cause of bloodstream, lower respiratory
tract and skin/soft tissues infections in all regions surveyed
(Diekema et al., 2001). The importance of this human pathogen,
apart from its ability to cause life-threatening infections, is
its remarkable potential to develop antimicrobial resistance.
Street Food
Street food is exactly what the words conjure up: food
available in a public place, such as from a vendor on a street.
Typically, street food is tasty, ready-to-eat food or drink sold
on the street, in a market, fair, park or other public place. It
is sold by a hawker or vendor from a portable stall, cart or food
truck (Diekema et al., 2001). Some street foods are regional but

many are not, having spread beyond their place of origin and
enjoyed locally for their exotic or unusual ingredients and
flavors. Most street foods are considered both finger food and
fast food and are more reasonably priced than restaurant meals.
2.5 billion People worldwide eat street food every day, according
to a 2007 Food and Agriculture Organization study(FDA, 2007).
According to Ghosh et al. (2007), street foods are perceived
to be a major public health risk due to lack of basic
infrastructure and services, difficulty in controlling the large
numbers of street food vending operations because of their
diversity, mobility and temporary nature. A general lack of
factual knowledge about the epidemiological significance of many
street vended foods, poor knowledge of street vendors in basic
food safety measures and inadequate public awareness of hazards
posed by certain foods has severely hampered the deployment of a
precise scientific approach to this very serious issue of public
health and safety. Various studies have identified the sources of
food safety issues involved in street foods to be microorganism
belonging to the genus Bacillus, Staphylococcus, Clostridium,
Vibrio, Campylobacter Staphylococcus,
Clostridium, Vibrio, Campylobacter, Listeria, and Salmonella.