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    Vergelijkende humane blootstellingsschatting van ESBL-producerende Escherichia coli via consumptie van vlees

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    Authors
    Evers EG
    van Duijkeren E
    Series/Report no.
    RIVM rapport 2016-0160
    Type
    Report
    Language
    nl
    
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    Title
    Vergelijkende humane blootstellingsschatting van ESBL-producerende Escherichia coli via consumptie van vlees
    Translated Title
    Exposure of consumers to ESBL-producing Escherichia coli by eating meat
    Publiekssamenvatting
    Mensen kunnen op verschillende manieren blootgesteld worden aan bacteriën. Dit kunnen ook bacteriën zijn die resistent zijn tegen antibiotica, zoals de ESBL-producerende E. coli-bacteriën. Een van de mogelijke blootstellingsbronnen hiervan is vlees. Het RIVM heeft berekend in welke mate verschillende vleessoorten bijdragen aan de blootstelling van de mens aan ESBL-producerende bacteriën. Volgens deze schattingen is rundvlees een veel belangrijkere bron dan kippenvlees. Vlees van varken, kalf of schaap is minder relevant voor de totale blootstelling door het eten van vlees.

    Van de onderzochte vleessoorten is rundvlees verantwoordelijk voor circa 78 procent van de totale blootstelling via het eten van vlees. Dat komt vooral doordat sommige rundvleesproducten rauw worden gegeten, zoals filet americain. Op rauw kippenvlees komen de meeste ESBL-producerende bacteriën voor. Doordat het meestal goed wordt verhit voordat het wordt gegeten, is de blootstelling via kippenvlees veel lager (18 procent). Mensen kunnen wel door rauw kippenvlees besmet raken via kruisbesmetting in de keuken, bijvoorbeeld door kip en groente met hetzelfde mes of op dezelfde snijplank te snijden.

    In de berekeningen is rekening gehouden met de invloed van diverse factoren die de aanwezigheid van bacteriën op vlees beïnvloeden: soorten voorbewerking (verhitten, zouten, drogen/fermenteren), bewaarcondities (kamertemperatuur, koelkast, vriezer), en de bereiding in de keuken (rauw, goed doorbakken, half doorbakken, de mate van kruisbesmetting et cetera). Er zijn geen metingen verricht.

    Het gaat in dit onderzoek om het verschil tussen soorten vlees. Het is onduidelijk wat het aandeel van vlees is in de totale blootstelling aan ESBL-producerende bacteriën, omdat mensen ook via andere bronnen dan vlees daaraan worden blootgesteld. Voorbeelden zijn contacten met dieren, contacten tussen mensen, andere soorten voedsel zoals rauwe groenten en fruit en via het milieu, zoals door zwemmen in oppervlaktewater. Ook is niet duidelijk in welke mate mensen door de blootstelling via vlees daadwerkelijk drager worden van deze bacterie. Bovendien wordt niet iedere drager ziek van een resistente bacterie.
    People can be exposed to bacteria in various ways. These can be bacteria that are resistant to antibiotics, such as ESBL-producing E. coli-bacteria. One of the possible sources of exposure for this is meat. RIVM (National Institute for Public Health and the Environment) has calculated to what degree different types of meat contribute to the exposure of humans to ESBL-producing bacteria. According to these estimates, beef is a much more important source than chicken meat. Meat from pigs, calves, or sheep is less relevant for the total exposure that results from eating meat.

    Of the types of meat investigated, beef is responsible for approximately 78% of the total exposure resulting from the eating of meat. This is due primarily to the fact that some beef products are eaten raw, such as steak tartare. ESBL-producing bacteria are found most often on raw chicken meat. As it is usually cooked quite well before being eaten, the exposure via chicken meat is much lower (18%). However, persons can become contaminated via raw chicken meat as a result of cross contamination in the kitchen, for example by cutting chicken and vegetables with the same knife on the same cutting board.

    The calculations take into account the influence of various factors that affect the presence of bacteria on meat: types of pre-processing (heating, salting, drying/fermenting), storage conditions (room temperature, refrigerator, freezer), and the method of preparation in the kitchen (raw, thoroughly cooked, half cooked, the degree of cross contamination, et cetera). No measurements were carried out.

    The focus of this study was on the difference between types of meat. It is not clear how large the contribution of meat is to the total exposure to ESBL-producing bacteria, as people are also exposed to these bacteria via sources other than meat. Examples of other sources of exposure include contacts with animals, contacts between persons, other types of food such as raw vegetables and fruit, and via the environment, for example by swimming in surface waters. It is also not clear to what degree people can actually become carriers of these bacteria by exposure via meat. In addition, not every carrier becomes sick from resistant bacteria
    Publisher
    Rijksinstituut voor Volksgezondheid en Milieu RIVM
    Sponsors
    Ministerie van VWS
    URI
    http://hdl.handle.net/10029/620829
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    RIVM official reports

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