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Food Safety Focus (136th Issue, November 2017) – Food Safety Platform

Five Keys to Food Safety and Antimicrobial Resistance

Reported by Dr. Fiona FONG, Research Officer,
Risk Communication Section,
Centre for Food Safety

As mentioned in the last article, antimicrobial resistance (AMR) is the ability of microbes to resist the effects of drugs and AMR microbes may exist in people, animals, the environment and foods. The World Health Organization (WHO) states that inappropriate food handling encourages the spread of AMR. With regard to the already existence of AMR bacteria in foods, it is important to prevent humans
from infected with these bacteria. The Centre for Food Safety (CFS) has all along been promoting the importance of good personal and environmental hygiene during all food preparation and handling processes. In connection with the education and publicity on AMR in food, the CFS promotes the Five Keys to Food Safety.

What are the Five Keys to Food Safety? 

The Five Keys to Food Safety were primarily developed by the WHO. In Hong Kong, they are adopted as (1) “Choose” (choose safe raw materials), (2) “Clean” (keep hands and utensils clean), (3) “Separate” (separate raw and cooked food), (4) “Cook” (cook thoroughly), and (5) “Safe temperature” (keep food at safe temperature). They are simple health messages based on scientific evidence that each individual should know and practise in order to prevent foodborne diseases, regardless of whether the pathogens are AMR or non-AMR.

Prevention of foodborne diseases by "Five Keys to Food Safety".
Prevention of foodborne diseases by "Five Keys to Food Safety".

(1) “Choose” (Choose Safe Raw Materials)

Consumers should patronise reliable shops with good hygiene conditions and choose fresh and wholesome foods as damaged food products may contain harmful microorganisms including AMR bacteria.

In addition, consumers and traders should not purchase raw materials of animal origin from illegal or questionable sources because the use of antimicrobials in these food animals is unlikely under official control and the misuse of antimicrobials can accelerate the development and spread of AMR.

(2) “Clean” (Keep Hands and Utensils Clean)

Food handlers should keep hands clean as dirty hands may transmit bacteria including AMR bacteria. They should wash hands thoroughly with warm water and soap, especially before handling foods and after visiting toilet.

Besides, foods can become contaminated with AMR bacteria through unhygienic food preparation environment. Research studies showed that AMR bacteria (e.g. methicillin-resistant Staphylococcus aureus) were found on different surfaces in kitchen such as countertops, faucet handle and dish towel. Kitchen (including utensils) should therefore be kept clean. 

(3) “Separate” (Separate Raw and Cooked Food)

According to overseas reports, AMR bacteria were isolated from raw meats such as chicken and pork. These bacteria can be transmitted to cooked foods by cross-contamination. They can be transmitted directly (e.g. when a food item or its juice comes into contact with another food item) or indirectly (e.g. through hands, cutting boards, towels, etc.).

To minimise cross-contamination, raw foods should be separated from cooked foods. Separate utensils (including cutting boards and knives) marked with labels of different colours can be used to handle raw foods and ready-to-eat cooked foods.

(4) “Cook” (Cook Thoroughly)

Raw foods contain bacteria in general; however, thorough cooking can normally destroy most bacteria, including AMR bacteria. Foods should be cooked to a core temperature of at least 75°C. The cooked meat and its juices should not be red. Soups and stews should be brought to a boil and continue to boil for at least one minute.

(5) “Safe Temperature” (Keep Food at Safe Temperature)

Pathogenic bacteria, including AMR bacteria, may be introduced into the ready-to-eat cooked foods if there are subsequent lapses in food safety practices after cooking. They can multiply rapidly in foods as a result of time and temperature abuse to a level that can cause foodborne illness in consumers. It is therefore advisable to consume foods immediately after cooking and not to leave the cooked foods at room temperature for more than two hours. If the cooked foods have been held at room temperature for more than four hours, they should be discarded. For cooked foods that are not intended for immediate consumption but will be served hot, they should be kept at above 60°C prior to serving. On the other hand, leftovers and perishable foods should be refrigerated at or below 4°C promptly.

In gist, it is important to prevent humans from infection with AMR bacteria. Generally speaking, principles adopted to the prevention and control of spread of bacteria via foods are also applicable to the prevention and control of spread of AMR bacteria. Thorough cooking, good hygienic practices during food handling as well as maintaining good personal and environmental hygiene are all important to prevent foodborne diseases, including those caused by AMR pathogens.