摘要
      新鲜农产品在生食时可能会接触到具有临床重要性的抗微生物残留物、抗微生物耐药性细菌（ARB）和抗微生物耐药性基因（ARGs）。本综述旨在确定：（1）零售市场销售的新鲜农产品和生食农产品中抗菌药物残留、ARB和ARGs的存在和丰度；（2） 人类的相关健康风险；以及（3）新鲜农产品被ARB/ARGs污染的途径。我们搜索了Ovid Medline、Web of Science和Hinari数据库以及灰色文献，确定了40篇可供收录的文章。所有研究都调查了耐多药细菌的发生情况，10项研究集中在新鲜农产品中的ARGs，而没有一项研究调查抗菌药物残留。最常见的ARB是大肠杆菌（42.5%），其次是克雷伯菌（22.5%）和沙门氏菌（20%），主要在生菜上检测到。25篇文章提到了食用新鲜农产品对健康的风险，但没有一篇量化了风险。大约一半的文章称，农产品污染发生在收获前和收获后的过程中。我们的审查表明，食品生产和消费供应链上的所有利益相关者都需要良好的农业和制造业实践、行为改变沟通和提高认识计划，以防止通过生产接触ARB/ARG。
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Open AccessArticle
Contamination of Fresh Produce with Antibiotic-Resistant Bacteria and Associated Risks to Human Health: A Scoping Review
by Mahbubur Rahman 1,*ORCID,Mahbub-Ul Alam 1ORCID,Sharmin Khan Luies 1ORCID,Abul Kamal 1ORCID,Sharika Ferdous 1ORCID,Audrie Lin 2,Fazle Sharior 1ORCID,Rizwana Khan 1ORCID,Ziaur Rahman 1,Sarker Masud Parvez 1,3,Nuhu Amin 1,4ORCID,Rezaul Hasan 1,Birkneh Tilahun Tadesse 5,6ORCID,Neelam Taneja 7,Mohammad Aminul Islam 8 andAyse Ercumen 9
1
Environmental Interventions Unit, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Dhaka 1212, Bangladesh
2
Berkeley’s School of Public Health, University of California Berkeley, Berkeley, CA 94720, USA
3
Faculty of Medicine, The University of Queensland, Brisbane, QLD 4072, Australia
4
Institute for Sustainable Futures, University of Technology Sydney, 235 Jones St., Ultimo, NSW 2007, Australia
5
School of Medicine, Hawassa University, Shashemene, Awassa P.O. Box 5, Ethiopia
6
International Vaccine Institute, SNU Research Park, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Korea
7
Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
8
Allen Center, Paul G. Allen School for Global Health, Washington State University, 240 SE Ott Road, Pullman, WA 99164, USA
9
Department of Forestry and Environmental Resources, North Carolina State University, 2800 Faucette Drive, 3120 Jordan Hall, Raleigh, NC 27607, USA
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2022, 19(1), 360; https://doi.org/10.3390/ijerph19010360
Received: 30 September 2021 / Revised: 19 December 2021 / Accepted: 22 December 2021 / Published: 30 December 2021
(This article belongs to the Special Issue Assessment of Human Exposure Pathways to Antimicrobial Resistance in the Environment)
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Abstract
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 E. coli (42.5%) followed by Klebsiella spp. (22.5%), and Salmonella 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.

https://www.mdpi.com/1660-4601/19/1/360