Risk Benefit Research Group, Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, 2800 Kgs. Lyngby.
Unit for Genomic Epidemiology, National Food Institute, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark.
Microbiol Spectr. 2018 May;6(3). doi: 10.1128/microbiolspec.ARBA-0027-2017.
Source attribution and microbial risk assessment methods have been widely applied for the control of several foodborne pathogens worldwide by identifying (i) the most important pathogen sources and (ii) the risk represented by specific foods and the critical points in these foods' production chains for microbial control. Such evidence has proved crucial for risk managers to identify and prioritize effective food safety and public health strategies. In the context of antimicrobial resistance (AMR) from livestock and pets, the utility of these methods is recognized, but a number of challenges have largely prevented their application and routine use. One key challenge has been to define the hazard in question: Is it the antimicrobial drug use in animals, the antimicrobial-resistant bacteria in animals and foods, or the antimicrobial resistance genes that can be transferred between commensal and pathogenic bacteria in the animal or human gut or in the environment? Other important limitations include the lack of occurrence and transmission data and the lack of evidence to inform dose-response relationships. We present the main principles, available methods, strengths, and weaknesses of source attribution and risk assessment methods, discuss their utility to identify sources and estimate risks of AMR from livestock and pets, and provide an overview of conducted studies. In addition, we discuss remaining challenges and current and future opportunities to improve methods and knowledge of the sources and transmission routes of AMR from animals through food, direct contact, or the environment, including improvements in surveillance and developments in genotypic typing methods.
源归因和微生物风险评估方法已被广泛应用于控制世界范围内的几种食源性致病菌，方法是识别 (i) 最重要的病原体来源和 (ii) 特定食品所代表的风险以及这些食品生产链中的微生物控制关键点。这些证据对于风险管理者确定和优先考虑有效的食品安全和公共卫生策略至关重要。在来自牲畜和宠物的抗微生物药物耐药性 (AMR) 的背景下，这些方法的实用性已得到认可，但许多挑战在很大程度上阻止了它们的应用和常规使用。一个关键挑战是定义相关危害：是动物中使用的抗菌药物、动物和食品中的抗微生物耐药细菌，还是可以在动物或人类肠道或环境中的共生菌和病原菌之间转移的抗微生物耐药基因？其他重要限制包括缺乏发生和传播数据以及缺乏信息来告知剂量反应关系。我们介绍了源归因和风险评估方法的主要原则、可用方法、优势和劣势，讨论了它们在识别牲畜和宠物的 AMR 来源和估计风险方面的实用性，并概述了已进行的研究。此外，我们还讨论了剩余的挑战以及当前和未来的机会，以改进通过食物、直接接触或环境从动物传播 AMR 的来源和传播途径的方法和知识，包括改进监测和发展基因分型方法。
