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Source Attribution and Risk Assessment of Antimicrobial Resistance

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  • Authors: Sara M. Pires1, Ana Sofia Duarte2, Tine Hald3
  • Editors: Frank Møller Aarestrup4, Stefan Schwarz5, Jianzhong Shen6, Lina Cavaco7
  • VIEW AFFILIATIONS HIDE AFFILIATIONS
    Affiliations: 1: Risk Benefit Research Group, Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, 2800 Kgs. Lyngby; 2: Unit for Genomic Epidemiology, National Food Institute, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark; 3: Unit for Genomic Epidemiology, National Food Institute, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark; 4: Technical University of Denmark, Lyngby, Denmark; 5: Freie Universität Berlin, Berlin, Germany; 6: China Agricultural University, Beijing, China; 7: Statens Serum Institute, Copenhagen, Denmark
  • Source: microbiolspec June 2017 vol. 6 no. 3 doi:10.1128/microbiolspec.ARBA-0027-2017
  • Received 26 January 2018 Accepted 07 February 2018 Published 07 June 2017
  • Sara M. Pires, [email protected]
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  • Abstract:

    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.

  • Citation: Pires S, Duarte A, Hald T. 2017. Source Attribution and Risk Assessment of Antimicrobial Resistance. Microbiol Spectrum 6(3):ARBA-0027-2017. doi:10.1128/microbiolspec.ARBA-0027-2017.

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/content/journal/microbiolspec/10.1128/microbiolspec.ARBA-0027-2017
2017-06-07
2019-10-22

Abstract:

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.

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FIGURE 1

Routes of transmission of zoonotic pathogens and points of source attribution. Adapted from reference 7 .

Source: microbiolspec June 2017 vol. 6 no. 3 doi:10.1128/microbiolspec.ARBA-0027-2017
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TABLE 1

Definition, overview of methods and main challenges of source attribution and microbial risk assessment approaches

Source: microbiolspec June 2017 vol. 6 no. 3 doi:10.1128/microbiolspec.ARBA-0027-2017

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