Human Health Risk Assessment (HHRA) for environmental development and transfer of antibiotic resistance.
Human Health Risk Assessment (HHRA) for environmental development and transfer of antibiotic resistance.
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DOI：
10.1289/ehp.1206316
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发表时间：
2013-09
影响因子：
10.4
通讯作者：
Topp E
中科院分区：
文献类型：
--
作者：
Ashbolt NJ;Amézquita A;Backhaus T;Borriello P;Brandt KK;Collignon P;Coors A;Finley R;Gaze WH;Heberer T;Lawrence JR;Larsson DG;McEwen SA;Ryan JJ;Schönfeld J;Silley P;Snape JR;Van den Eede C;Topp E
背景资料：直到最近，环境才明确涉及抗生素耐药性对临床结局的风险，但迄今为止，很少有记录在案的方法来正式评估这些风险。目的：我们研究了可能的方法，并试图确定研究需求，以实现人类健康风险评估（HHRA），重点关注环境在耐药病原体引起的抗生素治疗失败中的作用。研究方法：作者参加了2012年3月4日至8日在加拿大魁北克举行的研讨会，以确定耐药性对人类健康风险的环境评估的范围和目标。我们重点关注环境-抗性-发展“热点”、暴露评估（与食物无关）和剂量反应的关键要素，以表征可能改善抗药性管理方案的风险。讨论：确定了传统风险评估的各种新方面，以评估环境抗生素耐药性。这些措施包括：a）考虑到环境耐药基因组上增加的选择性压力，随着时间的推移，这种压力允许耐药细菌（AR B）的发展; B）识别和描述相关环境“热点”区室中的水平基因转移（HGT）速率;以及c）修改传统的剂量反应方法，以解决各种健康结果和途径的AR B剂量。结论：我们建议，环境方面的抗药性发展应包括在任何HHRA处理ARB的过程中。由于有限的可用数据，多准则决策分析方法将是一个有用的方式进行环境抗生素耐药性的HHRA，告知风险管理人员。引文：Ashbolt NJ，Amézquita A，巴克豪斯T，Borriello P，Brandt KK，Collignon P，Coors A，Finley R，Gaze WH，Heberer T，Lawrence JR，Larsson DG，麦克尤恩SA，Ryan JJ，Schönfeld J，Silley P，Snape JR，货货车den Eede C，Topp E. 2013.环境发展和抗生素耐药性转移的人类健康风险评估。环境健康展望121：993-1001; http://dx.doi.org/10.1289/ehp.1206316
Background: Only recently has the environment been clearly implicated in the risk of antibiotic resistance to clinical outcome, but to date there have been few documented approaches to formally assess these risks. Objective: We examined possible approaches and sought to identify research needs to enable human health risk assessments (HHRA) that focus on the role of the environment in the failure of antibiotic treatment caused by antibiotic-resistant pathogens. Methods: The authors participated in a workshop held 4–8 March 2012 in Québec, Canada, to define the scope and objectives of an environmental assessment of antibiotic-resistance risks to human health. We focused on key elements of environmental-resistance-development “hot spots,” exposure assessment (unrelated to food), and dose response to characterize risks that may improve antibiotic-resistance management options. Discussion: Various novel aspects to traditional risk assessments were identified to enable an assessment of environmental antibiotic resistance. These include a) accounting for an added selective pressure on the environmental resistome that, over time, allows for development of antibiotic-resistant bacteria (ARB); b) identifying and describing rates of horizontal gene transfer (HGT) in the relevant environmental “hot spot” compartments; and c) modifying traditional dose–response approaches to address doses of ARB for various health outcomes and pathways. Conclusions: We propose that environmental aspects of antibiotic-resistance development be included in the processes of any HHRA addressing ARB. Because of limited available data, a multicriteria decision analysis approach would be a useful way to undertake an HHRA of environmental antibiotic resistance that informs risk managers. Citation: Ashbolt NJ, Amézquita A, Backhaus T, Borriello P, Brandt KK, Collignon P, Coors A, Finley R, Gaze WH, Heberer T, Lawrence JR, Larsson DG, McEwen SA, Ryan JJ, Schönfeld J, Silley P, Snape JR, Van den Eede C, Topp E. 2013. Human health risk assessment (HHRA) for environmental development and transfer of antibiotic resistance. Environ Health Perspect 121:993–1001; http://dx.doi.org/10.1289/ehp.1206316
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影响因子：
11.4
作者：
Brandt, Kristian K.;Sjoholm, Ole R.;Nybroe, Ole
通讯作者：
Nybroe, Ole
影响因子：
11.4
作者：
Cummings, David E.;Archer, Karisa F.;Zuill, Douglas E.
通讯作者：
Zuill, Douglas E.
影响因子：
11.4
作者：
Berg, Jeanette;Thorsen, Maja K.;Brandt, Kristian K.
通讯作者：
Brandt, Kristian K.
影响因子：
4
作者：
Barkovskii, A. L.;Manoylov, K. M.;Bridges, C.
通讯作者：
Bridges, C.
DOI：
10.1080/09603120802449593
发表时间：
2009-01-01
影响因子：
3.2
作者：
Borjesson, Stefan;Dienues, Olaf;Lindgren, Per-Eric
通讯作者：
Lindgren, Per-Eric