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Risk assessments evaluating foodborne antimicrobial resistance in humans: A scoping review
Microbial Risk Analysis ( IF 3.0 ) Pub Date : 2018-08-17 , DOI: 10.1016/j.mran.2018.08.002
N Caffrey , J Invik , C L Waldner , D Ramsay , S L Checkley

Risk assessments are utilized to understand the risks associated with bacterial foodborne pathogens with increased antimicrobial resistance (AMR). This review aimed at identifying and describing the literature on risk assessments for the study of antimicrobial resistance of foodborne bacteria in humans, with focus only on products intended for the treatment of bacterial infections. The definition of what constituted a risk assessment from a methodological perspective is based on the Codex Guidelines for Risk Analysis of Foodborne Antimicrobial Resistance. Thirty-eight articles produced between 1989–2018 were identified following a comprehensive search strategy. Most articles (25/38) were quantitative risk assessments. The most frequently identified hazard of concern was the consumption of retail meat. Knowledge gaps were evident throughout the four components of the risk assessments, particularly in the hazard characterization component. There appears to be a lack of evidence available to inform risk assessments regarding the additional effects of disease with an AMR organism. The adverse health effects attributable to AMR were addressed in less than half of the articles identified. Additionally, vulnerable populations were not generally included in the risk assessment. There is the potential for risk assessments to consider a broader scope for sources of information to identify and characterize the hazard of concern. Codex guidelines provide a structured framework by which to conduct a risk assessment relating to the microbiological hazards and AMR and should be addressed in every risk assessment on these topics.



中文翻译:

评估人类食源性抗菌素耐药性的风险评估:范围回顾

风险评估用于了解与抗菌素耐药性(AMR)增加有关的细菌性食源性病原体相关的风险。这篇综述旨在鉴定和描述有关人类食源性细菌的抗菌素耐药性研究风险评估的文献,重点仅在于旨在治疗细菌感染的产品。从方法学角度出发,构成风险评估的定义是基于《食典抗菌素耐药性风险分析法典指南》。根据全面的搜索策略,确定了1989年至2018年之间产生的38篇文章。大多数文章(25/38)是定量风险评估。最常见的令人担忧的危害是零售肉类的消费。在整个风险评估的四个组成部分中,尤其是在危害描述组成部分中,知识差距明显。似乎缺乏可用的证据来告知有关AMR生物对疾病的其他影响的风险评估。不到一半的已查明文章归因于抗菌药物耐药对健康的不利影响。此外,风险评估通常不包括脆弱人群。风险评估有可能考虑更广泛的信息来源范围,以识别和表征所关注的危害。食品法典指南提供了一个结构化的框架,通过该框架可以进行与微生物危害和AMR相关的风险评估,并且在有关这些主题的每次风险评估中都应加以处理。

更新日期:2018-08-17
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