Contamination of Fresh Produce with Antibiotic-Resistant Bacteria and Associated Risks to Human Health: A Scoping Review

Mahbubur Rahman, Mahbub-Ul Alam, Sharmin Khan Luies, Abul Kamal, Sharika Ferdous, Audrie Lin, Fazle Sharior, Rizwana Khan, Ziaur Rahman, Sarker Masud Parvez, Nuhu Amin, Rezaul Hasan, Birkneh Tilahun Tadesse, Neelam Taneja, Mohammad Aminul Islam and Ayse Ercumen
Additional contact information
Mahbubur Rahman: Environmental Interventions Unit, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Dhaka 1212, Bangladesh
Mahbub-Ul Alam: Environmental Interventions Unit, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Dhaka 1212, Bangladesh
Sharmin Khan Luies: Environmental Interventions Unit, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Dhaka 1212, Bangladesh
Abul Kamal: Environmental Interventions Unit, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Dhaka 1212, Bangladesh
Sharika Ferdous: Environmental Interventions Unit, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Dhaka 1212, Bangladesh
Audrie Lin: Berkeley’s School of Public Health, University of California Berkeley, Berkeley, CA 94720, USA
Fazle Sharior: Environmental Interventions Unit, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Dhaka 1212, Bangladesh
Rizwana Khan: Environmental Interventions Unit, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Dhaka 1212, Bangladesh
Ziaur Rahman: Environmental Interventions Unit, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Dhaka 1212, Bangladesh
Sarker Masud Parvez: Environmental Interventions Unit, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Dhaka 1212, Bangladesh
Nuhu Amin: Environmental Interventions Unit, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Dhaka 1212, Bangladesh
Rezaul Hasan: Environmental Interventions Unit, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Dhaka 1212, Bangladesh
Birkneh Tilahun Tadesse: School of Medicine, Hawassa University, Shashemene, Awassa P.O. Box 5, Ethiopia
Neelam Taneja: Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
Mohammad Aminul Islam: Allen Center, Paul G. Allen School for Global Health, Washington State University, 240 SE Ott Road, Pullman, WA 99164, USA
Ayse Ercumen: Department of Forestry and Environmental Resources, North Carolina State University, 2800 Faucette Drive, 3120 Jordan Hall, Raleigh, NC 27607, USA

IJERPH, 2021, vol. 19, issue 1, 1-15

Abstract: Fresh produce, when consumed raw, can be a source of exposure to antimicrobial residues, antimicrobial-resistant bacteria (ARB) and antimicrobial resistance genes (ARGs) of clinical importance. This review aims to determine: (1) the presence and abundance of antimicrobial residues, ARB and ARGs in fresh agricultural products sold in retail markets and consumed raw; (2) associated health risks in humans; and (3) pathways through which fresh produce becomes contaminated with ARB/ARGs. We searched the Ovid Medline, Web of Science and Hinari databases as well as grey literature, and identified 40 articles for inclusion. All studies investigated the occurrence of multidrug-resistant bacteria, and ten studies focused on ARGs in fresh produce, while none investigated antimicrobial residues. The most commonly observed ARB were E. coli (42.5%) followed by Klebsiella spp. (22.5%), and Salmonella spp. (20%), mainly detected on lettuce. Twenty-five articles mentioned health risks from consuming fresh produce but none quantified the risk. About half of the articles stated produce contamination occurred during pre- and post-harvest processes. Our review indicates that good agricultural and manufacturing practices, behavioural change communication and awareness-raising programs are required for all stakeholders along the food production and consumption supply chain to prevent ARB/ARG exposure through produce.

Keywords: antimicrobial resistance; antibiotic-resistant bacteria; antibiotic resistance genes; agriculture; fresh agriculture products; vegetables; fruits; leafy greens; retail markets; health risks (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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