Environmental Interventions Unit, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Dhaka 1212, Bangladesh.
Berkeley's School of Public Health, University of California Berkeley, Berkeley, CA 94720, USA.
Int J Environ Res Public Health. 2021 Dec 30;19(1):360. doi: 10.3390/ijerph19010360.
Fresh produce, when consumed raw, can be a source of exposure to antimicrobial residues, antimicrobial-resistant bacteria (ARB) and antimicrobial resistance genes (ARGs) of clinical importance. This review aims to determine: (1) the presence and abundance of antimicrobial residues, ARB and ARGs in fresh agricultural products sold in retail markets and consumed raw; (2) associated health risks in humans; and (3) pathways through which fresh produce becomes contaminated with ARB/ARGs. We searched the Ovid Medline, Web of Science and Hinari databases as well as grey literature, and identified 40 articles for inclusion. All studies investigated the occurrence of multidrug-resistant bacteria, and ten studies focused on ARGs in fresh produce, while none investigated antimicrobial residues. The most commonly observed ARB were (42.5%) followed by spp. (22.5%), and spp. (20%), mainly detected on lettuce. Twenty-five articles mentioned health risks from consuming fresh produce but none quantified the risk. About half of the articles stated produce contamination occurred during pre- and post-harvest processes. Our review indicates that good agricultural and manufacturing practices, behavioural change communication and awareness-raising programs are required for all stakeholders along the food production and consumption supply chain to prevent ARB/ARG exposure through produce.
新鲜农产品在零售市场上销售和生食时，可能会成为接触抗菌药物残留、具有临床重要意义的抗微生物药物耐药细菌（ARB）和抗微生物药物耐药基因（ARGs）的来源。本综述旨在确定：（1）在零售市场上销售和生食的新鲜农产品中存在和丰度的抗菌药物残留、ARB 和 ARGs；（2）人类相关的健康风险；以及（3）新鲜农产品被 ARB/ARGs 污染的途径。我们检索了 Ovid Medline、Web of Science 和 Hinari 数据库以及灰色文献，确定了 40 篇纳入的文章。所有研究均调查了多药耐药菌的发生情况，其中 10 项研究专注于新鲜农产品中的 ARGs，而没有研究调查抗菌药物残留。最常观察到的 ARB 是 （42.5%），其次是 spp.（22.5%）和 spp.（20%），主要在生菜上检测到。25 篇文章提到了食用新鲜农产品的健康风险，但没有定量风险。约一半的文章指出，在收获前后的过程中，农产品受到了污染。本综述表明，需要在食品生产和消费供应链的所有利益相关者中实施良好的农业和制造实践、行为改变沟通和提高认识方案，以防止通过农产品接触 ARB/ARG。
