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The objective was to investigate the food safety and hygienic status ina hospital food service unit (FSU) serving low microbial diets (LMDs)to immune-compromised patients, by means of an audit (questionnaire)and bacterial samples to validate the audit findings. The primaryresearch was done in a FSU of a 350-bed hospital in Gauteng, SouthAfrica. One audit was done in ten areas (for receiving, storage,preparation, serving/distribution, customer, premises and equipmenthygiene, staff dress code, staff premises and rest areas, and qualityassurance/records procedures) of the FSU using a pre-tested form basedon Hazard Analysis Critical Control Points (HACCP)principles/standards. The audit form consisted of a set number ofquestions for each one of the ten areas, with a possible maximum scoreof two (2) for each question. A set of five (5) questions for the staffpremises was set, with a possible maximum score of 10. If a score ofonly two (2) were then reached, a % was calculated to score the area,in this case 20%. In addition to the audit, four surface swabs (patientfood serving tray, chef′s gloved hands, chopping board for saladsand sandwiches, microwave oven door handle) and four food samples(green beans and potatoes, chicken gravy, cold meat cuts, quiche) wererandomly taken during the survey. The samples were tested to assess themicrobiological safety of the foods prepared for Total aerobic platecount (TAPC), Escherichia coli, total Coliforms, Staphylococcus aureusand Salmonella spp. The results of the audit, surface and food sampleswere used to evaluate possible food and safety risks in the FSUaccording to internationally approved HACCP standards. All ten areasaudited were below the set standard (> 80% value) with an averagescore of 41.1%. The service and distribution area had the highest score(69.4%), while the quality procedures and records division had thelowest score (5.6%). The microbiological tests showed relatively highmicrobial counts for a number of samples. The results of this studysuggests, that even though so called safety procedures were in place,they were not followed, which could have severe health implications forthe critically ill. The results of the study support the important roleof food and safety protocols in FSUs to lower food safety risks whenproviding food that is safe for immune-compromised patient use.

Food safety risk factors in a hospital food service unit serving low microbial diets to immune-compromised patients.