Abstract
Codex published the 'Guidelines for Risk Analysis of Foodborne Antimicrobial Resistance' to standardise the approach for evaluating risk posed by foodborne antimicrobial-resistant bacteria. One of the first steps in the guidelines is to compile a risk profile, which provides the current state of knowledge regarding a food safety issue, describes risk management options and recommends next steps. In Canada, ceftiofur/ceftriaxone-resistant Salmonella enterica subsp. enterica serovar Heidelberg from poultry was identified as an antimicrobial resistance (AMR) food safety issue. The first objective of this article was to contextualise this food safety issue, using the risk profile format of the Codex Guidelines. A second objective was to evaluate the applicability of the Codex Guidelines. This risk profile indicated that ceftiofur/ceftriaxone-resistant S. Heidelberg (CSH) was commonly isolated from poultry and was associated with severe disease in humans. Ceftiofur use in poultry hatcheries temporally mirrored the prevalence of CSH from poultry meat at retail and from people with salmonellosis. The evidence was sufficient to indicate the need for risk management options, such as restricting the use of ceftiofur in poultry. The Codex Guidelines provided a useful approach to summarise data for decision-makers to evaluate an AMR food safety issue.
Highlights
Antimicrobial resistance (AMR) is a worldwide health threat, as demonstrated by global AMR surveillance data [1]
The results demonstrated that changes in the incidence of ceftriaxoneresistant S. Heidelberg (CSH) in people paralleled the changes in antimicrobial use (AMU) practices in the poultry industry, in line with a previous finding of a significant temporal correlation between ceftiofur resistance in S
The information presented in this article, with the levels of concern and data quality ascribed to appropriate sections, suggest that CSH is not just a hazard, but an AMR risk
Summary
Antimicrobial resistance (AMR) is a worldwide health threat, as demonstrated by global AMR surveillance data [1]. Quantification of the association between AMR arising through the food chain on adverse human health impacts has proven to be challenging and has been the subject of debate for decades. This is due in part to the complexity of multiple foodborne AMR transmission pathways, the exchange of resistance determinants between bacterial species and the lack of standardised methods to conduct an evaluation of the risk. Based on the findings of a risk profile, subsequent steps in risk analysis are either to make an immediate (and/or provisional) decision for risk management, launch a full qualitative or quantitative risk assessment, maintain status quo or gather more data before making a preliminary decision [7]
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