食品中耐药细菌风险评估的研究进展
|
摘要
近年来抗生素的使用和滥用是普遍存在的问题,食品中耐药细菌和耐药基因引起的人类疾病威胁已成为全球性关注的热点。因此,全面开展从农场到餐桌耐药细菌的风险评估研究具有十分重要的意义。本文根据国际食品法典委员会拟定的微生物风险评估原则和指导方针,从危害识别、释放评估、暴露评估、剂量-反应关系评估、风险评估5个步骤进行阐述。通过分析国内外抗生素耐药细菌风险评估案例,综述了食品中耐药细菌风险评估的研究进展及其预防控制措施,以期为未来耐药细菌风险评估提供理论依据。
In recent years, the misuse and abuse of antibiotics have become a widespread problem. Antibiotic-resistant bacteria and antibiotic-resistant genes in foods are a global concern because diseases caused by them pose a threat to human health. Therefore, it is of signi?cant importance to conduct a comprehensive risk assessment of antibiotic-resistant bacteria from the farm to the table. This paper describes the five steps of hazard identification, release assessment,exposure assessment, dose-response relationship assessment, and risk assessment based on the principles and guidelines for microbiological risk assessment developed by the Codex Alimentarius Commission. We analyze cases of risk assessment of antibiotic-resistant bacteria. Furthermore, we review recent progress in risk assessment of antibiotic-resistant bacteria in foods and prevention and control measures against them, in order to provide a theoretical basis for risk assessment of antibiotic-resistant bacteria in the future.
In recent years, the misuse and abuse of antibiotics have become a widespread problem. Antibiotic-resistant bacteria and antibiotic-resistant genes in foods are a global concern because diseases caused by them pose a threat to human health. Therefore, it is of signi?cant importance to conduct a comprehensive risk assessment of antibiotic-resistant bacteria from the farm to the table. This paper describes the five steps of hazard identification, release assessment,exposure assessment, dose-response relationship assessment, and risk assessment based on the principles and guidelines for microbiological risk assessment developed by the Codex Alimentarius Commission. We analyze cases of risk assessment of antibiotic-resistant bacteria. Furthermore, we review recent progress in risk assessment of antibiotic-resistant bacteria in foods and prevention and control measures against them, in order to provide a theoretical basis for risk assessment of antibiotic-resistant bacteria in the future.
引文
[1]GOTHWAL R,SHASHIDHAR T.Antibiotic pollution in the environment:a review[J].Clean-Soil,Air,Water,2015,43(4):479-489.DOI:10.1002/clen.201300989.
[2]YUAN X,ZHANG T,KAWAKAMI K,et al.Molecular characterization of multidrug-and extensively drug-resistant Mycobacterium tuberculosis strains in Jiangxi,China[J].Journal of Clinical Microbiology,2012,50(7):2404-2413.DOI:10.1128/JCM.06860-11.
[3]ZHANG W,LUO Y,LI J,et al.Wide dissemination of multidrugresistant Shigella isolates in China[J].Journal of Antimicrobial Chemotherapy,2011,66(11):2527-2535.DOI:10.1093/jac/dkr341.
[4]罗永乾.动物源大肠杆菌、沙门氏菌和金黄色葡萄球菌耐药表型与氯霉素类抗菌药物耐药基因型的研究[D].重庆:西南大学,2017:1-2.
[5]BEDIE E A,MICHEL T,JULIUS A,et al.Relationship between multiple drug resistance and biofilm formation in Staphylococcus aureus isolated from medical and non-medical personnel in Yaounde,Cameroon[J].Pan African Medical Journal,2014,17:185-187.DOI:10.11604/pamj.2014.17.186.2363.
[6]陈春林,翟少钦,付利芝.细菌耐药现状、危害及应对措施[J].畜禽业,2018,29(4):47-48.DOI:10.19567/j.cnki.1008-0414.2018.04.030.
[7]ALLEN H K,DONATO J,WANG H H,et al.Call of the wild:antibiotic resistance genes in natural environments[J].Nature Reviews Microbiology,2010,8(4):251-259.DOI:10.1038/nrmicro2312.
[8]马苏,宋立,梁耀峰,等.食源性抗菌药耐药性风险分析指南介绍[J].中国兽药杂志,2013,47(3):44-47.
[9]FLOREZ-CUADRADO D,MORENO M A,UGARTE-RUíZ M,et al.Antimicrobial resistance in the food chain in the European Union[J].Advances in Food&Nutrition Research,2018,86:117-120.DOI:10.1016/bs.afnr.2018.04.004.
[10]DAUBIN V,SZOLLOSI G J.Horizontal gene transfer and the history of life[J].Cold Spring Harbr Perspectives in Biology,2016,8(4):3-5.DOI:10.1101/cshperspect.a018036.
[11]段昕妤,肖蘅,陈善元.动物类群中水平基因转移的研究进展[J].生命科学研究,2017,21(4):360-364.DOI:10.16605/j.cnki.1007-7847.2017.04.014.
[12]蓝惠华,张玲,王厚照.水平基因转移介导抗菌素耐药性传播机制的研究进展[J].微生物学杂志,2017,37(4):93-97.DOI:10.3969/j.issn.1005-7021.2017.04.014.
[13]AARESTRUP F M.Veterinary drug usage and antimicrobial resistance in bacteria of animal origin[J].Basic&Clinical Pharmacology&Toxicology,2005,96(4):271-281.DOI:10.1111/j.1742-7843.2005.pto960401.x.
[14]BENNETT P M.Plasmid encoded antibiotic resistance:acquisition and transfer of antibiotic resistance genes in bacteria[J].British Journal of Pharmacology,2010,153(Suppl 1):S347-S357.DOI:10.1038/sj.bjp.0707607.
[15]SALYERS A A,MOON K,SCHLESSINGER D.The human intestinal tract:a hotbed of resistance gene transfer?part II 1[J].Clinical Microbiology Newsletter,2007,29(4):25-30.DOI:10.1016/j.clinmicnews.2007.02.001.
[16]VERRAES C,VAN BOXSTALE S,VAN MEERVENNE E,et al.Antimicrobial resistance in the food chain:a review[J].International Journal of Environmental Research and Public Health,2013,10(7):2643-2669.DOI:10.3390/ijerph10072643.
[17]FANG Hua,HAN Lingxi,ZHANG Houpu,et al.Dissemination of antibiotic resistance genes and human pathogenic bacteria from a pig feedlot to the surrounding stream and agricultural soils[J].Journal of Hazardous Materials,2018,357:53-62.DOI:10.1016/j.jhazmat.2018.05.066.
[18]APATA D F.Antibiotic resistance in poultry[J].International Journal of Poultry Science,2009,8(4):404-408.DOI:10.3923/ijps.2009.404.408.
[19]HOLMES A H,MOORE L S,SUNDSFJORD A,et al.Understanding the mechanisms and drivers of antimicrobial resistance[J].Lancet,2015,387:176-187.DOI:10.1016/S0140-6736(15)00473-0.
[20]CLAYCAMP H G,HOOBERMAN B H.Antimicrobial resistance risk assessment in food safety[J].Journal of Food Protection,2004,67(9):2063-2071.DOI:10.4315/0362-028X-67.9.2063.
[21]EMA,CVMP,AWP.Guideline on the assessment of the risk to public health from antimicrobial resistance due to the use of an antimicrobial veterinary medicinal product in food-producing animals[EB/OL].(2015-02-12)[2018-07-10].https://www.ema.europa.eu/documents/scientific-guideline/draft-guideline-assessment-risk-public-healthantimicrobial-resistance-due-use-antimicrobial_en.pdf.
[22]ALBAN L,ELLISIVERSEN J,ANDREASEN M,et al.Assessment of the risk to public health due to use of antimicrobials in pigs:an example of pleuromutilins in denmark[J].Frontiers in Veterinary Science,2017,4:73-75.DOI:10.3389/fvets.2017.00074.
[23]LAXMINARAYAN R,DUSE A,WATTAL C,et al.Antibiotic resistance:the need for global solutions[J].The Lancet Infectious Diseases,2013,13(12):1057-1098.DOI:10.1016/S1473-3099(13)70318-9.
[24]ECONOMOU V,GOUSIA P.Agriculture and food animals as a source of antimicrobial-resistant bacteria[J].Infection&Drug Resistance,2015,2015:49-61.DOI:10.2147/IDR.S55778.
[25]WOOLHOUSE M,WARD M,VAN B B,et al.Antimicrobial resistance in humans,livestock and the wider environment[J].Philosophical Transactions of the Royal Society B Biological Sciences,2015,370:2-5.DOI:10.1098/rstb.2014.0083.
[26]TEZEL U,PAVLOSTATHIS S G.Role of quaternary ammonium compounds on antimicrobial resistance in the environment[M]//KEENP L,MONTFORTS M H M M.Antimicrobial resistance in the environment.New Jersey:John Wiley&Sons,Inc.,2011:349-387.DOI:10.1002/9781118156247.ch20.
[27]WAND M E,BOCK L J,BONNEY L C,et al.Mechanisms of increased resistance to chlorhexidine and cross-resistance to colistin following exposure of Klebsiella pneumoniae clinical isolates to chlorhexidine[J].Antimicrob Agents Chemother,2017,61(1):AAC.01162-16.DOI:10.1128/AAC.01162-16.
[28]赵勇,李欢,张昭寰,等.食源性致病菌耐药机制研究进展[J].生物加工过程,2018,16(2):1-10.DOI:10.3969/j.issn.1672-3678.
[29]FOUNOU L L,FOUNOU R C,ESSACK S Y.Antibiotic resistance in the food chain:a developing country-perspective[J].Frontiers in Microbiology,2016,7:8-10.DOI:10.3389/fmicb.2016.01881.
[30]SINGER R S,RUEGG P L,BAUMAN D E.Quantitative risk assessment of antimicrobial-resistant foodborne infections in humans due to recombinant bovine somatotropin usage in dairy cows[J].Journal of Food Protection,2017,80(7):1099-1116.DOI:10.4315/0362-028X.JFP-16-404.
[31]OLIVEIRA L,HULLAND C,RUEGG P L.Characterization of clinical mastitis occurring in cows on 50 large dairy herds in Wisconsin[J].Journal of Dairy Science,2013,96(12):7538-7549.DOI:10.3168/jds.2012-6078.
[32]ANDERSON S A,WOO R W Y,CRAWFORD L M.Risk assessment of the impact on human health of resistant Campylobacter jejuni from fluoroquinolone use in beef cattle[J].Food Control,2001,12(1):13-25.DOI:10.1016/S0956-7135(00)00014-1.
[33]HAPTER C.Risk assessment for antimicrobial resistance arising from the use of antimicrobials in animals[M].Paris:Scientific Publication,2017:5-7.
[34]MARSHALL B M,LEVY S B.Food animals and antimicrobials:impacts on human health[J].Clinical Microbiology Reviews,2011,24(4):718-733.DOI:10.1128/CMR.00002-11.
[35]PRICE L B,STEGGER M,HASMAN H,et al.Staphylococcus aureus CC398:host adaptation and emergence of methicillin resistance in livestock[J].mBio,2013,4(1):e00520-12.DOI:10.1128/mBio.00305-11.
[36]COETZEE J,CORCORAN C,PRENTICE E,et al.Clinical alert:emergence of plasmid-mediated colistin resistance(MCR-1)among Escherichia coli isolated from South African patients:in practice[J].South African Medical Journal,2016,106(5):449-450.DOI:10.7196/SAMJ.2016.v106i5.10710.
[37]LIU Y Y,WANG Y,WALSH T R,et al.Emergence of plasmidmediated colistin resistance mechanism MCR-1 in animals and human beings in China:a microbiological and molecular biological study[J].The Lancet Infectious Diseases,2016,16(2):161-168.
[38]FLORENCE C,ANGELES A M,WANNES V,et al.Transmission dynamics of methicillin-resistantstaphylococcus aureusin pigs[J].Front Microbiol,2013,4(4):56-58.DOI:10.3389/fmicb.2013.00057.
[39]KUNDU A,WUERTZ S,SMITH W A.Quantitative microbial risk assessment to estimate the risk of diarrheal diseases from fresh produce consumption in India[J].Food Microbiology,2018,75:74-76.DOI:10.1016/j.fm.2018.01.017.
[40]王耀华.流行病学中剂量反应关系的建模及其趋势类型的统计推断[D].长春:东北师范大学,2011:1-2.
[41]NICHOLAS J A,AMéZQUITA A,THOMAS B,等.抗生素耐药性环境中产生和转移的人类健康风险评估(HHRA)[J].环境与职业医学,2014,31(2):151-157.DOI:10.1289/ehp.1206316.
[42]STELLA P,BELOEIL P A,GUERRA B,et al.The role of the European Food Safety Authority(EFSA)in the fight against antimicrobial resistance(AMR)[J].Food Protection Trends,2018,38(1):72-80.
[43]COLLIINEAU L,CARMO L P,ENDIMIANI A,et al.Risk ranking of antimicrobial-resistant hazards found in meat in Switzerland[J].Risk Analysis,2018,38(5):1070-1084.DOI:10.1111/risa.12901.
[44]PAPADOPOULOS P,PAPADOPOULOS T,ANGELIDIS A S,et al.Prevalence of Staphylococcus aureus and of methicillin-resistant S.aureus(MRSA)along the production chain of dairy products in north-western Greece[J].Food Microbiology,2018,69:43-50.DOI:10.1016/j.fm.2017.07.016.
[45]SRUJANA G,KRISHNA R V.Occurrence of antibiotic resistant bacteria in raw and pasteurized milk samples of Warangal City,Telangan State[J].International.Journal of Current Microbiology and Applied.Sciences,2016,5(7):337-342.
[46]HARBRATH S,BALKHY H H,GOOSSENS H,et al.Antimicrobial resistance:one world,one fight![J].Antimicrobial Resistance and Infection Control,2015,4(1):47-49.DOI:10.1186/s13756-015-0091-2.
[47]TEAM E E.WHO member states adopt global action plan on antimicrobial resistance[J].European Communicable Disease Bulletin,2015,20(21):1-2.
[2]YUAN X,ZHANG T,KAWAKAMI K,et al.Molecular characterization of multidrug-and extensively drug-resistant Mycobacterium tuberculosis strains in Jiangxi,China[J].Journal of Clinical Microbiology,2012,50(7):2404-2413.DOI:10.1128/JCM.06860-11.
[3]ZHANG W,LUO Y,LI J,et al.Wide dissemination of multidrugresistant Shigella isolates in China[J].Journal of Antimicrobial Chemotherapy,2011,66(11):2527-2535.DOI:10.1093/jac/dkr341.
[4]罗永乾.动物源大肠杆菌、沙门氏菌和金黄色葡萄球菌耐药表型与氯霉素类抗菌药物耐药基因型的研究[D].重庆:西南大学,2017:1-2.
[5]BEDIE E A,MICHEL T,JULIUS A,et al.Relationship between multiple drug resistance and biofilm formation in Staphylococcus aureus isolated from medical and non-medical personnel in Yaounde,Cameroon[J].Pan African Medical Journal,2014,17:185-187.DOI:10.11604/pamj.2014.17.186.2363.
[6]陈春林,翟少钦,付利芝.细菌耐药现状、危害及应对措施[J].畜禽业,2018,29(4):47-48.DOI:10.19567/j.cnki.1008-0414.2018.04.030.
[7]ALLEN H K,DONATO J,WANG H H,et al.Call of the wild:antibiotic resistance genes in natural environments[J].Nature Reviews Microbiology,2010,8(4):251-259.DOI:10.1038/nrmicro2312.
[8]马苏,宋立,梁耀峰,等.食源性抗菌药耐药性风险分析指南介绍[J].中国兽药杂志,2013,47(3):44-47.
[9]FLOREZ-CUADRADO D,MORENO M A,UGARTE-RUíZ M,et al.Antimicrobial resistance in the food chain in the European Union[J].Advances in Food&Nutrition Research,2018,86:117-120.DOI:10.1016/bs.afnr.2018.04.004.
[10]DAUBIN V,SZOLLOSI G J.Horizontal gene transfer and the history of life[J].Cold Spring Harbr Perspectives in Biology,2016,8(4):3-5.DOI:10.1101/cshperspect.a018036.
[11]段昕妤,肖蘅,陈善元.动物类群中水平基因转移的研究进展[J].生命科学研究,2017,21(4):360-364.DOI:10.16605/j.cnki.1007-7847.2017.04.014.
[12]蓝惠华,张玲,王厚照.水平基因转移介导抗菌素耐药性传播机制的研究进展[J].微生物学杂志,2017,37(4):93-97.DOI:10.3969/j.issn.1005-7021.2017.04.014.
[13]AARESTRUP F M.Veterinary drug usage and antimicrobial resistance in bacteria of animal origin[J].Basic&Clinical Pharmacology&Toxicology,2005,96(4):271-281.DOI:10.1111/j.1742-7843.2005.pto960401.x.
[14]BENNETT P M.Plasmid encoded antibiotic resistance:acquisition and transfer of antibiotic resistance genes in bacteria[J].British Journal of Pharmacology,2010,153(Suppl 1):S347-S357.DOI:10.1038/sj.bjp.0707607.
[15]SALYERS A A,MOON K,SCHLESSINGER D.The human intestinal tract:a hotbed of resistance gene transfer?part II 1[J].Clinical Microbiology Newsletter,2007,29(4):25-30.DOI:10.1016/j.clinmicnews.2007.02.001.
[16]VERRAES C,VAN BOXSTALE S,VAN MEERVENNE E,et al.Antimicrobial resistance in the food chain:a review[J].International Journal of Environmental Research and Public Health,2013,10(7):2643-2669.DOI:10.3390/ijerph10072643.
[17]FANG Hua,HAN Lingxi,ZHANG Houpu,et al.Dissemination of antibiotic resistance genes and human pathogenic bacteria from a pig feedlot to the surrounding stream and agricultural soils[J].Journal of Hazardous Materials,2018,357:53-62.DOI:10.1016/j.jhazmat.2018.05.066.
[18]APATA D F.Antibiotic resistance in poultry[J].International Journal of Poultry Science,2009,8(4):404-408.DOI:10.3923/ijps.2009.404.408.
[19]HOLMES A H,MOORE L S,SUNDSFJORD A,et al.Understanding the mechanisms and drivers of antimicrobial resistance[J].Lancet,2015,387:176-187.DOI:10.1016/S0140-6736(15)00473-0.
[20]CLAYCAMP H G,HOOBERMAN B H.Antimicrobial resistance risk assessment in food safety[J].Journal of Food Protection,2004,67(9):2063-2071.DOI:10.4315/0362-028X-67.9.2063.
[21]EMA,CVMP,AWP.Guideline on the assessment of the risk to public health from antimicrobial resistance due to the use of an antimicrobial veterinary medicinal product in food-producing animals[EB/OL].(2015-02-12)[2018-07-10].https://www.ema.europa.eu/documents/scientific-guideline/draft-guideline-assessment-risk-public-healthantimicrobial-resistance-due-use-antimicrobial_en.pdf.
[22]ALBAN L,ELLISIVERSEN J,ANDREASEN M,et al.Assessment of the risk to public health due to use of antimicrobials in pigs:an example of pleuromutilins in denmark[J].Frontiers in Veterinary Science,2017,4:73-75.DOI:10.3389/fvets.2017.00074.
[23]LAXMINARAYAN R,DUSE A,WATTAL C,et al.Antibiotic resistance:the need for global solutions[J].The Lancet Infectious Diseases,2013,13(12):1057-1098.DOI:10.1016/S1473-3099(13)70318-9.
[24]ECONOMOU V,GOUSIA P.Agriculture and food animals as a source of antimicrobial-resistant bacteria[J].Infection&Drug Resistance,2015,2015:49-61.DOI:10.2147/IDR.S55778.
[25]WOOLHOUSE M,WARD M,VAN B B,et al.Antimicrobial resistance in humans,livestock and the wider environment[J].Philosophical Transactions of the Royal Society B Biological Sciences,2015,370:2-5.DOI:10.1098/rstb.2014.0083.
[26]TEZEL U,PAVLOSTATHIS S G.Role of quaternary ammonium compounds on antimicrobial resistance in the environment[M]//KEENP L,MONTFORTS M H M M.Antimicrobial resistance in the environment.New Jersey:John Wiley&Sons,Inc.,2011:349-387.DOI:10.1002/9781118156247.ch20.
[27]WAND M E,BOCK L J,BONNEY L C,et al.Mechanisms of increased resistance to chlorhexidine and cross-resistance to colistin following exposure of Klebsiella pneumoniae clinical isolates to chlorhexidine[J].Antimicrob Agents Chemother,2017,61(1):AAC.01162-16.DOI:10.1128/AAC.01162-16.
[28]赵勇,李欢,张昭寰,等.食源性致病菌耐药机制研究进展[J].生物加工过程,2018,16(2):1-10.DOI:10.3969/j.issn.1672-3678.
[29]FOUNOU L L,FOUNOU R C,ESSACK S Y.Antibiotic resistance in the food chain:a developing country-perspective[J].Frontiers in Microbiology,2016,7:8-10.DOI:10.3389/fmicb.2016.01881.
[30]SINGER R S,RUEGG P L,BAUMAN D E.Quantitative risk assessment of antimicrobial-resistant foodborne infections in humans due to recombinant bovine somatotropin usage in dairy cows[J].Journal of Food Protection,2017,80(7):1099-1116.DOI:10.4315/0362-028X.JFP-16-404.
[31]OLIVEIRA L,HULLAND C,RUEGG P L.Characterization of clinical mastitis occurring in cows on 50 large dairy herds in Wisconsin[J].Journal of Dairy Science,2013,96(12):7538-7549.DOI:10.3168/jds.2012-6078.
[32]ANDERSON S A,WOO R W Y,CRAWFORD L M.Risk assessment of the impact on human health of resistant Campylobacter jejuni from fluoroquinolone use in beef cattle[J].Food Control,2001,12(1):13-25.DOI:10.1016/S0956-7135(00)00014-1.
[33]HAPTER C.Risk assessment for antimicrobial resistance arising from the use of antimicrobials in animals[M].Paris:Scientific Publication,2017:5-7.
[34]MARSHALL B M,LEVY S B.Food animals and antimicrobials:impacts on human health[J].Clinical Microbiology Reviews,2011,24(4):718-733.DOI:10.1128/CMR.00002-11.
[35]PRICE L B,STEGGER M,HASMAN H,et al.Staphylococcus aureus CC398:host adaptation and emergence of methicillin resistance in livestock[J].mBio,2013,4(1):e00520-12.DOI:10.1128/mBio.00305-11.
[36]COETZEE J,CORCORAN C,PRENTICE E,et al.Clinical alert:emergence of plasmid-mediated colistin resistance(MCR-1)among Escherichia coli isolated from South African patients:in practice[J].South African Medical Journal,2016,106(5):449-450.DOI:10.7196/SAMJ.2016.v106i5.10710.
[37]LIU Y Y,WANG Y,WALSH T R,et al.Emergence of plasmidmediated colistin resistance mechanism MCR-1 in animals and human beings in China:a microbiological and molecular biological study[J].The Lancet Infectious Diseases,2016,16(2):161-168.
[38]FLORENCE C,ANGELES A M,WANNES V,et al.Transmission dynamics of methicillin-resistantstaphylococcus aureusin pigs[J].Front Microbiol,2013,4(4):56-58.DOI:10.3389/fmicb.2013.00057.
[39]KUNDU A,WUERTZ S,SMITH W A.Quantitative microbial risk assessment to estimate the risk of diarrheal diseases from fresh produce consumption in India[J].Food Microbiology,2018,75:74-76.DOI:10.1016/j.fm.2018.01.017.
[40]王耀华.流行病学中剂量反应关系的建模及其趋势类型的统计推断[D].长春:东北师范大学,2011:1-2.
[41]NICHOLAS J A,AMéZQUITA A,THOMAS B,等.抗生素耐药性环境中产生和转移的人类健康风险评估(HHRA)[J].环境与职业医学,2014,31(2):151-157.DOI:10.1289/ehp.1206316.
[42]STELLA P,BELOEIL P A,GUERRA B,et al.The role of the European Food Safety Authority(EFSA)in the fight against antimicrobial resistance(AMR)[J].Food Protection Trends,2018,38(1):72-80.
[43]COLLIINEAU L,CARMO L P,ENDIMIANI A,et al.Risk ranking of antimicrobial-resistant hazards found in meat in Switzerland[J].Risk Analysis,2018,38(5):1070-1084.DOI:10.1111/risa.12901.
[44]PAPADOPOULOS P,PAPADOPOULOS T,ANGELIDIS A S,et al.Prevalence of Staphylococcus aureus and of methicillin-resistant S.aureus(MRSA)along the production chain of dairy products in north-western Greece[J].Food Microbiology,2018,69:43-50.DOI:10.1016/j.fm.2017.07.016.
[45]SRUJANA G,KRISHNA R V.Occurrence of antibiotic resistant bacteria in raw and pasteurized milk samples of Warangal City,Telangan State[J].International.Journal of Current Microbiology and Applied.Sciences,2016,5(7):337-342.
[46]HARBRATH S,BALKHY H H,GOOSSENS H,et al.Antimicrobial resistance:one world,one fight![J].Antimicrobial Resistance and Infection Control,2015,4(1):47-49.DOI:10.1186/s13756-015-0091-2.
[47]TEAM E E.WHO member states adopt global action plan on antimicrobial resistance[J].European Communicable Disease Bulletin,2015,20(21):1-2.