Abstract
Aim: There is an ongoing debate as to what extent antimicrobial resistance (AMR) can be transmitted from dietary to humans via the consumption of food products. We investigated this association between dietary and global spreading carbapenem-resistant gene blaNDM Methods: We did a cross-sectional study to assess the risk factors for carrier of blaNDM in health community. Healthy adults were recruited from the residents attending Community Healthcare Service in Shenzhen City (Guangdong Province, China), through 1February 2018 to 31December 2019, and 718 pre-participants were included in this study. Questionnaire were obtained and the qualitative food frequency questionnaire (Q-FFQ) were used to assess dietary intake. qPCR was applied to confirm the carrier of blaNDM in participants’fecal samples. Multivariable logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (95% CI) of each outcome according to each dietary factor before and after prosperity score matching (PSM). Results: we showed that a high intake of coarse grain (OR 1.003; 95% CI 1.001–1.005, p < 0.01) and root and tuber crops (OR 1.003; 95% CI 1.001–1.004, p < 0.05) were independent risk factor for blaNDM carrier in health communities, suggesting a possible transfer of AMRbetweendietary andhumans. Surprisingly, we also showed an association between a higher intake of poultry as a protective, which may be explained by the beneficial effects on the gut microbiota. Conclusion: Dietary factors such as intake of coarse grain, root and tuber crops and poultry were associated with blaNDM carrier in health communities. The influence of dietary factorson blaNDM carrier in the present study provides insights for the tangible dietary advice with guidelines to the routine of people with the risk of blaNDM carrier. This demonstrates the role of dietary intake in the prevention of blaNDM carrier, since prevention is the best way to control modifiable risk factors. A lower carrier rate of blaNDM is helpful to reduce the possibility of transmission and pathogenicity. Further studies on food, microbiota and antimicrobial resistance are necessary to confirm this possible association and unravel underlying mechanisms.
Highlights
The emergence and spread of carbapenem-resistant Enterobacteriaceae (CRE) represents an emergent and serious threat to global public health systems [1]
We found 99 blaNDM positive samples through qPCR For analysis
In order to explore this topic, the present study aspired to investigate the association between blaNDM carrier and anthropometric, biochemical and dietary factors in health community participants living in Shenzhen, China
Summary
The emergence and spread of carbapenem-resistant Enterobacteriaceae (CRE) represents an emergent and serious threat to global public health systems [1]. The main mechanism for CRE is carbapenemases which belong to β-lactamases [2] and divided into three classes as follows: Class A (KPC, SME and so on); Class B (metallo-β-lactamases, including NDM, IMP and VIM); and Class D (OXA-like) [3]. Carbapenem antibiotics have never been licensed for veterinary use in any country worldwide. While a growing number of carbapenemases found from non-human sources have been reported [4,5,6,7]. Despite the expansion of the New Delhi metallo-β-lactamase (NDM-1) worldwide, recent years NDM has been frequently found from non-human sources such as food animals, vegetables and water in China [8,9,10,11,12,13,14,15].
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