Anaphylaxis to beef in penicillin-allergic patient

Antibiotic Resistance and Food Safety: Perspectives on New Technologies and Molecules for Microbial Control in the Food Industry

Antibiotic resistance (ABR) has direct and indirect repercussions on public health and threatens to decrease the therapeutic effect of antibiotic treatments and lead to more infection-related deaths. There are several mechanisms by which ABR can be transferred from one microorganism to another. The risk of transfer is often related to environmental factors. The food supply chain offers conditions where ABR gene transfer can occur by multiple pathways, which generates concerns regarding food safety. This work reviews mechanisms involved in ABR gene transfer, potential transmission routes in the food supply chain, the prevalence of antibiotic residues in food and ABR organisms in processing lines and final products, and implications for public health. Finally, the paper will elaborate on the application of antimicrobial peptides as new alternatives to antibiotics that might countermeasure ABR and is compatible with current food trends.

The public health issue of antibiotic residues in food and feed: Causes, consequences, and potential solutions

Antibiotics are among the essential veterinary medicine compounds associated with animal feed and food animal production. The use of antibiotics for the treatment of bacterial infections is almost unavoidable, with less need to demonstrate their importance. Although banned as a growth factor for a few years, their use in animals can add residues in foodstuffs, presenting several environmental, technological, animal health, and consumer health risks. With regard to human health risks, antibiotic residues induce and accelerate antibiotic resistance development, promote the transfer of antibiotic-resistant bacteria to humans, cause allergies (penicillin), and induce other severe pathologies, such as cancers (sulfamethazine, oxytetracycline, and furazolidone), anaphylactic shock, nephropathy (gentamicin), bone marrow toxicity, mutagenic effects, and reproductive disorders (chloramphenicol). Antibiotic resistance, which has excessively increased over the years, is one of the adverse consequences of this phenomenon, constituting a severe public health issue, thus requiring the regulation of antibiotics in all areas, including animal breeding. This review discusses the common use of antibiotics in agriculture and antibiotic residues in food/feed. In-depth, we discussed the detection techniques of antibiotic residues, potential consequences on the environment and animal health, the technological transformation processes and impacts on consumer health, and recommendations to mitigate this situation.

Rational Pharmacotherapy in Infectious Diseases: Issues Related to Drug Residues in Edible Animal Tissues

Simple Summary

Drug use is essential to treat diseases in food-producing animals. The most widely used drugs are antiparasitics and antimicrobials. They contribute to guaranteeing good-quality food in sufficient quantity for human consumption. When using veterinary medicines, it is essential to follow the instructions on the package label. Administering the correct dose by the indicated route in the animal species for which the drug is labeled is critical. After a pharmacological treatment is administered to livestock, a period (indicated on the label) must often elapse before the tissues from the treated animals can be consumed by humans. Veterinary drug residues are controlled by taking food samples to verify that drug concentrations do not exceed the permitted limits. This allows authorities to know if the medicine use is correct or if suitable corrective measures should be taken. When label’s directions are not followed, drug residues may appear in food. The residues exceeding the permitted limits established by the authorities can produce unfavorable consequences, mainly on the consumer’s health. The food trade and even the environment can be affected by drug residues in animal tissues. Therefore, the correct use of drugs in livestock is critical, which includes respecting the rules to avoid residues in food for human consumption.

Abstract

Drugs are used in veterinary medicine to prevent or treat animal diseases. When rationally administered to livestock following Good Veterinary Practices (GVP), they greatly contribute to improving the production of food of animal origin. Since humans can be exposed chronically to veterinary drugs through the diet, residues in food are evaluated for effects following chronic exposures. Parameters such as an acceptable daily intake (ADI), the no-observed-adverse-effect level (NOAEL), maximum residue limits (MRLs), and the withdrawal periods (WPs) are determined for each drug used in livestock. Drug residues in food exceeding the MRLs usually appear when failing the GVP application. Different factors related either to the treated animal or to the type of drug administration, and even the type of cooking can affect the level of residues in edible tissues. Residues above the MRLs can have a diverse negative impact, mainly on the consumer’s health, and favor antimicrobial resistance (AMR). Drug residue monitoring programmes are crucial to ensure that prohibited or authorized substances do not exceed MRLs. This comprehensive review article addresses different aspects of drug residues in edible tissues produced as food for human consumption and provides relevant information contributing to rational pharmacotherapy in food-producing animals.

Antibiotic residues and antibiotic-resistant bacteria detected in milk marketed for human consumption in Kibera, Nairobi

The use of veterinary antibiotics is largely unregulated in low-income countries. Consequently, food producers rarely observe drug withdrawal periods, contributing to drug residues in food products. Drug residues in milk can cause immunogenic reactions in people, and selectively favor antibiotic-resistant bacteria in unpasteurized products. We quantified the prevalence of antibiotic residues in pasteurized and unpasteurized milk, and antibiotic-resistant bacteria from unpasteurized milk sold within Kibera, an informal settlement in Nairobi, Kenya. Ninety-five milk samples (74 pasteurized and 21 unpasteurized) were collected from shops, street vendors or vending machines, and tested for the presence of β-lactam and tetracycline residues using IDEXX SNAP kits. MacConkey agar without- and with antibiotics (ampicillin, 32 μg/ml; tetracycline, 16 μg/ml) was used to enumerate presumptive E. coli based on colony morphology (colony forming units per ml, CFU/ml). β-lactam and tetracycline residues were found in 7.4% and 3.2% of all milk samples, respectively. Residues were more likely to be present in unpasteurized milk samples (5/21, 23.8%) compared to pasteurized samples (5/75, 6.8%); P = 0.039. Two thirds of unpasteurized samples (14/21, 66.7%) contained detectable numbers of presumptive E. coli (mean 3.5 Log10 CFU/ml) and of these, 92.8% (13/14) were positive for ampicillin- (mean 3.2 Log10 CFU/ml) and 50% (7/14) for tetracycline-resistant E. coli (mean 3.1 Log10 CFU/ml). We found no relationship between the presence of antibiotic residues and the presence of antibiotic-resistant E. coli in unpasteurized milk sold within Kibera (P > 0.2).

An integrated experimental and physiologically based pharmacokinetic modeling study of penicillin G in heavy sows

Penicillin G is widely used in food-producing animals at extralabel doses and is one of the most frequently identified violative drug residues in animal-derived food products. In this study, the plasma pharmacokinetics and tissue residue depletion of penicillin G in heavy sows after repeated intramuscular administrations at label (6.5 mg/kg) and 5 × label (32.5 mg/kg) doses were determined. Plasma, urine, and environmental samples were tested as potential antemortem markers for penicillin G residues. The collected new data and other available data from the literature were used to develop a population physiologically based pharmacokinetic (PBPK) model for penicillin G in heavy sows. The results showed that antemortem testing of urine provided potential correlation with tissue residue levels. Based on the United States Department of Agriculture Food Safety and Inspection Service action limit of 25 ng/g, the model estimated a withdrawal interval of 38 days for penicillin G in heavy sows after 3 repeated intramuscular injections at 5 × label dose. This study improves our understanding of penicillin G pharmacokinetics and tissue residue depletion in heavy sows and provides a tool to predict proper withdrawal intervals after extralabel use of penicillin G in heavy sows, thereby helping safety assessment of sow-derived meat products.

Food safety impacts of antimicrobial use and their residues in aquaculture

BACKGROUND

Residues of antimicrobials in food have received much attention in recent years because of growing food safety and public health concerns. Their presence in food of animal origin constitutes socioeconomic challenges in international trade in animal and animal products. The major public health significances of antimicrobial residues include the development of antimicrobial drug resistance, hypersensitivity reaction, carcinogenicity, mutagenicity, teratogenicity, bone marrow depression, and disruption of normal intestinal flora. Indiscriminate use of antimicrobials in aquaculture resulting in occurrence of residues in aquaculture products and associated harmful health effects in humans requires control measures to ensure consumer protection.

MAIN BODY

This article focuses on factors contributing to the presence of antimicrobial residues in aquaculture products and their implications on consumers' safety. Regulatory actions aimed at prudent use of veterinary drugs in food-producing animals with emphasis on aquaculture for safe and wholesome food production are also reviewed.

CONCLUSION

Prudent use of antibiotics in aquaculture under veterinary supervision is critical in ensuring safety of aquaculture products. Good animal husbandry practices as well as the use of alternatives to antibiotics such as vaccination, probiotics, phage therapy, and essential oils are recommended panaceas to reducing the use of antimicrobial residues in aquaculture and consequent food safety effects.

Health concerns and management of select veterinary drug residues

The aim of this manuscript is to review the potential adverse health effects in humans if exposed to residues of selected veterinary drugs used in food-producing animals. Our other objectives are to briefly inform the reader of why many of these drugs are or were approved for use in livestock production and how drug residues can be mitigated for these drugs. The selected drugs include several antimicrobials, beta agonists, and phenylbutazone. The antimicrobials continue to be of regulatory concern not only because of their acute adverse effects but also because their use as growth promoters have been linked to antimicrobial resistance. Furthermore, nitroimidazoles and arsenicals are no longer approved for use in food animals in most jurisdictions. In recent years, the risk assessment and risk management of beta agonists, have been the focus of national and international agencies and this manuscript attempts to review the pharmacology of these drugs and regulatory challenges. Several of the drugs selected for this review can cause noncancer effects (e.g., penicillins) and others are potential carcinogens (e.g., nitroimidazoles). This review also focuses on how regulatory and independent organizations manage the risk of these veterinary drugs based on data from human health risk assessments.

Depletion of penicillin G residues in heavy sows after intramuscular injection. Part I: tissue residue depletion

Heavy sows (n = 126) were treated with penicillin G procaine at a 5× label dose (33 000 IU/kg) for 3 consecutive days by intramuscular (IM) injection using three patterns of drug administration. Treatments differed by injection pattern and injection volume. Sets of sows were slaughtered 5, 10, 15, 20, 25, 32, and 39 days after the last treatment; skeletal muscle, kidney, serum, and urine were collected for penicillin G analysis by LC-MS/MS. Penicillin G at withdrawal day 5 averaged 23.5 ± 10.5 and 3762 ± 1932 ng/g in muscle and kidney, respectively. After 15 days of withdrawal, muscle penicillin G residues were quantifiable in only one treated hog (3.4 ng/g) but averaged 119 ± 199 ng/g in kidneys. Using a hypothetical tolerance of 50 ng/g and a natural log-linear depletion model, the withdrawal period required for penicillin depletion to 50 ng/g was 11 days for skeletal muscle and 47 days for kidney.

Cross-contamination of foods and implications for food allergic patients

Cross-contamination presents a risk of unknown magnitude for food allergic consumers. Published cases likely represent the tip of a rather large iceberg. Cross-contamination can occur in homes, restaurants, food manufacturing plants, and on farms. The frequency of cross-contamination as the cause of accidental exposures to allergenic foods is unknown. Food allergic individuals can react to ingestion of trace levels of the offending food, although a highly variable range of threshold doses exist among populations of food allergic individuals. The magnitude of the risk posed to food allergic consumers by cross-contamination is characterized by the frequency of exposure to cross-contaminated foods, the dose of exposure, and the individual's threshold dose. The food and food service industry (and food preparers in homes as well) have the responsibility to provide and prepare foods that are safe for food allergic consumers, but quality of life may be improved with the recognition that safe (though very low) thresholds do exist.

Detection of amoxicillin-diketopiperazine-2', 5' in wastewater samples

The short half-life of aminopenicillin antibiotics in the aquatic environment put to the challenge the detection of their degradation products among environmental hydro-chemists. In a quest to study the occurrence of a new emerging micro-pollutant in the aquatic environment we attempted this by analyzing samples from a wastewater treatment plant for a major degradation product of amoxicillin (i.e., amoxicillin-diketopiperazine-2', 5') using a high-performance liquid chromatography technique coupled with tandem mass spectrometry method. ADP was repeatedly detected in all wastewater and effluent samples (18) from which it was extracted. To the best of our knowledge, this is the first study that evidently proves the occurrence of the chemically stable form of AMX, its Diketopiperazine-2', 5', in wastewater and effluent samples. Furthermore, penicillins are known to cause most allergic drug reactions. There is a risk that residues of hypersensitivity-inducing drugs, such as penicillins and their degradation products, may elicit allergic reactions in human consumers of water and food of animal origin.

Tissue depletion of amoxicillin and its major metabolites in pigs: influence of the administration route and the simultaneous dosage of clavulanic acid

A residue depletion study of amoxicillin (AMO) and its major metabolites, amoxicilloic acid (AMA) and amoxicillin diketopiperazine-2',5'-dione, was performed after a single oral (p.o.) and intravenous (i.v.) administration of amoxicillin (20 mg kg (-1)) and amoxicillin/clavulanic acid (20 and 5 mg kg (-1)) to pigs. Animals were slaughtered 12, 36, 48, 60, 72, and 84 h after dosing. Tissue samples were analyzed using liquid chromatography-tandem mass spectrometry. Kidney samples contained high concentrations of amoxicilloic acid metabolite, which depleted much slower from tissues than amoxicillin, both after p.o. (t1/2AMO = 4.5 h vs t1/2AMA = 8 h) and i.v. (t1/2AMO = 4 h vs t1/2AMA = 8 h) administration. Moreover, after oral administration, significantly higher amoxicilloic acid concentrations were measured in liver and kidney than after i.v. administration. The coadministration of amoxicillin with clavulanic acid provoked no significant differences in amoxicilloic acid tissue concentrations as compared to an amoxicillin dosing. The prolonged presence of residues of amoxicilloic acid in edible tissues can play an important role in food safety, because the compound could give rise to a possible health risk, although it is not included in the maximum residue limit legislation.

Beef allergy: a review of 12 cases

BACKGROUND

Although beef allergy has long been considered a rare condition, the number of studies regarding the nature, epidemiology, and symptoms of beef allergy has been increasing. We aimed to describe the results of allergy work-up of 12 patients who have a convincing history of acute allergic symptoms following beef ingestion.

METHODS

Detailed histories of 10 children and two adult relatives were obtained and patients underwent skin prick tests with commercial beef extract, raw beef and cooked beef. Serum total and beef-specific IgE were measured. Labial, and in selected cases, open food challenges were undertaken.

RESULTS

Interestingly, the rate of family history of beef allergy was 67% (8/12). Three patients (two with commercial extract, and one with cooked beef) had positive skin test responses to beef. Ten (83%) patients had elevated serum IgE concentrations (median 316.5 kU/l, range 9-1321 kU/l) and the beef-specific IgE was positive in all patients (median 6.23 kUA/l, range 0.83-36.6 kUA/l). Labial food challenge was positive in four (30%) patients. Of the five patients who underwent open food challenges, three were positive and two tolerated the beef administered.

CONCLUSIONS

We conclude that skin prick tests do not accurately diagnose IgE-mediated sensitization to beef. Thus, patients with suspected beef allergy should be screened additionally for beef-specific IgE antibodies, and in selected cases oral food challenge should be carried out to verify the diagnosis.