Abstract
Antibacterial resistance is one of the 2019 World Health Organization’s top ten threats to public health worldwide. Hence, the emergence of β-lactam and colistin resistance among Gram-negative bacteria has become a serious concern. The reservoirs for such bacteria are increasing not only in hospital settings but in several other sources, including vegetables and fruit. In recent years, fresh produce gained important attention due to its consumption in healthy diets combined with a low energy density. However, since fresh produce is often consumed raw, it may also be a source of foodborne disease and a reservoir for antibiotic resistant Gram-negative bacteria including those producing extended-spectrum β-lactamase, cephalosporinase and carbapenemase enzymes, as well as those harboring the plasmid-mediated colistin resistance (mcr) gene. This review aims to provide an overview of the currently available scientific literature on the presence of extended-spectrum β-lactamases, cephalosporinase, carbapenemase and mcr genes in Gram-negative bacteria in vegetables and fruit with a focus on the possible contamination pathways in fresh produce.
Highlights
Fresh produce is considered a good source of minerals, vitamins, phytonutrients and dietary fiber
Fresh produce represents a route of human exposure to antibiotic-resistant bacteria and has often served as a reservoir of antibiotic resistance genes, representing a major public health threat [3,4]
The electrostatic interaction between the cationic region of colistin, which is from the diamino-butyric acid (Dab) residues, and the negatively charged phosphate groups of lipid A, replace the magnesium and calcium ions previously united with the phosphate group
Summary
Fresh produce is considered a good source of minerals, vitamins, phytonutrients and dietary fiber. Various β-lactamases have been identified worldwide, including penicillinases, extended-spectrum β-lactamases (ESBLs), cephalosporinases (AmpC), and carbapenemases [7]. Given these circumstances, the approved alternative is colistin, but its re-use in clinical practice has led to the appearance of colistin-resistant bacteria, through horizontal transfer (mcr) [8]. Extendedspectrum β-lactamase, cephalosporinase and carbapenemase producers as well as mcr gene-producing Gram-negative bacteria isolated from fresh vegetables and fruit have been reported in several countries around the world [3,4,10,11]. The aim of this review is to highlight the current situation of the worldwide dissemination of ESBL, cephalosporinase, carbapenemase and mcr gene-producing Gramnegative bacteria from fresh vegetables and fruit, their genetic characteristics, and possible contamination pathways. Enterobacteriaceae, class D carbapenemases are mainly represented by the OXA-48-like enzymes [24]
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