Food Protection Trends - September/October 2017 - 356
This is not an isolated standard. It is intended to be
used in conjunction with Codex Guidelines on national
regulatory programs associated with the use of veterinary
drugs in food-producing animals (4). Subsequently, in
2011, Codex adopted "Guidelines for risk analysis of
foodborne antimicrobial resistance" (5). This highlighted
the importance that the international food regulatory
community placed on having a structured and harmonized
framework for AMR risk analysis. The guidelines also give
a perspective on the complexity of the issue and the related
challenges in addressing AMR within the food chain. Codex
recently undertook work to review the extent to which
countries are adopting and applying the existing Codex
guidance and to identify major capacity development
gaps and any other challenges countries face in adopting
and applying these standards (6). This review, as well
as developments in the area over the past 10 years, were
considered by the Codex Alimentarius Commission in July
2016 in its decision to update some of the existing Codex
texts and develop new texts on AMR. A new Codex task
force on AMR was established, which will meet for the first
time in 2017. However, given the importance of this issue
and the need to provide countries with updated guidance in
a timely manner, work has already begun with a first Codex
working group on AMR, which was convened at the end of
2016. That group's tasks included detailed definition of the
standard setting work to be undertaken by Codex as well
as identification of the need for scientific advice related to
AMR in the food chain, including risk management options
for the containment of AMR, to support the standard
setting process. In this context, the discussions on AMR in
the food chain will continue within this international food
safety forum in the coming years.
AMR IN FOOD CHAIN ECOSYSTEMS
Food chain ecosystems harbor foodborne pathogens,
commensals and bacteria that together with bacteriophages provide a pool of genomes, or a microbiome, that
may include genes encoding resistance to antimicrobials,
or a resistome (10, 37, 43). The food chain microbiome
is dynamic and can be the result of a co-mingling of
those from domestic and wild animals, food, environmental systems and human systems. The diversity and
level of AMR genes making up the resistome will be
related to the bacterial flora typical of an ecosystem;
the point in the food chain; the collective impact of
food chain processes, practices and inputs; and the local
environment, which varies among countries and regions.
Bacteria present in the food chain can be intrinsically
resistant strains and can be enriched or selected in a
bacterial population following exposure to antimicrobials, possibly also sanitizers and biocides. Resistance may
result from gene mutation or horizontal transfer of genes
originating from the vast pool of resistance genes present
in the entire food chain resistome (10, 37, 43).
356
Food Protection Trends September/October
It is well documented that antimicrobials used, appropriately or inappropriately, during primary production
in agricultural systems have the potential to promote the
emergence of AMR in foodborne pathogens, with the
subsequent deleterious consequence of failed antimicrobial
therapy for those foodborne illnesses for which antibiotic
treatment is required for patients (8, 35, 37, 43). There is
accumulating evidence that food may also be a source of
extra-intestinal AMR infections, for example, as a source
of urinary tract infections caused by common etiological
agents such as extra-intestinal pathogenic Escherichia coli,
where failure in clinical therapy is a public health issue
(28). The consequences of exposure of consumers and food
chain workers to AMR bacteria other than pathogens in
food and to the food chain resistome generally is even more
complex (43). Resistant microorganisms and AMR genes
are ubiquitous in the environment around livestock production systems (45), in animal feeds (8) and in fertilized soils
(32). Moreover, waterways and oceans are reservoirs for
AMR genes (18), and there is evidence of recent exchange
of antibiotic resistance genes between soil bacteria and
clinical pathogens (16) and the jump of resistant organisms
from human to livestock and from livestock to human (43).
Co-mingling of various microbial ecosystems and resistomes occurs along the food chain, but the consequences
of this cross-contamination and the risk of transmission of
AMR via this means to the consumer is more speculative
(10, 37, 43). An ecological and holistic approach is best
suited to allow us to understand the risk of AMR emergence and transmission as well as the effectiveness of risk
mitigations throughout the food chain from production to
consumption. This will involve taking into consideration
the overall resistome, the relationships of pathogens and
commensals, and the quantitative effects of the environment, food processing and food handling on the risk (10,
25, 34, 37, 43, 45).
The food chain - a favorable niche for AMR transmission
Food ecosystems can provide ideal niches and conditions
under which a food microbiome can be exposed to
additional genetic material through interactions among
animals, humans and the environment, and where bacterial
genes can be mobilized. Transfer of AMR genes among food
bacteria, including pathogens, has been demonstrated in
vitro and in vivo, e.g., among lactic acid bacteria, between
Enterococcus and Listeria monocytogenes, between Salmonella
and E. coli, among E. coli and between isolates of species of
animal and human origins (10, 37).
The food chain and food can provide ideal environments
for the persistence and amplification of bacteria, and knowledge is accumulating of niches and scenarios that may favor
AMR evolution and transmission. For example, bacteria
usually do not reside in the ecosystem of a food or food environment as planktonic cells; rather they form assemblages
or biofilms, free-floating or attached to surfaces, where
Table of Contents for the Digital Edition of Food Protection Trends - September/October 2017
Contents
Food Protection Trends - September/October 2017 - Cover1
Food Protection Trends - September/October 2017 - Cover2
Food Protection Trends - September/October 2017 - Contents
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Food Protection Trends - September/October 2017 - Cover3
Food Protection Trends - September/October 2017 - Cover4
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