Quantitative Microbial Risk Assessment of Klebsiella pneumoniae to Ciprofloxacin from Pork in Bangkok

Abstract

Risk estimates are evaluated by using quantitative microbial risk assessment (QMRA) which is a scientific tool. The methodology can be applied to model of human adverse health effect associated with K. pneumoniae and ciprofloxacin-resistant K. pneumoniae (CRKP) from pork consumption in Bangkok. This study had four phases which were 1) sample collection, 2) bacterial isolation and enumeration, 3) antimicrobial susceptibility test and 4) risk assessment. A total of 378 pork samples from fresh markets were collected from six Bangkok areas which contained Central Bangkok, Eastern Bangkok, Northern Bangkok, Southern Bangkok, Upper Thonburi and Lower Thonburi. The mean prevalence of K. pneumonaie and CRKP from retail pork in Bangkok was approximatedly 89.95% and 7.65%, respectively. Likewise, the mean concentration of K. pneumonaie and CRKP was 6.56 and 5.89 log cfu/g, respectively. The highest K. pneumoniae concentration was in Lower Thonburi which was significantly higher than that of any Bangkok areas (p value < 0.05). The CRKP concentrations across all Bangkok areas were not significantly different (p value > 0.05). Daily risk estimates from K. pneumoniae and CRKP were 4.94 x 10-4 and 8.57 x 10-7. These were equivalent to annual risk of 18,067 and 33 cases per 100,000 Bangkok residents from K. pneumoniae and CRKP, respectively. Interestingly, the risk estimate from CRKP was atleat 500 times lower than that of K. pneumoniae. This means that the concern of AMR risk from CRKP was negligible. Hygiene and sanitary measure in the entire pork production chain can affect reduce microbial growth and contamination. Additionally, proper cook can also reduce the amount of microbial load by the point of consumption. The accurate risk estimates from K. pneumoniae and CRKP shall be achieved when the models of K. pneumoniae and CRKP are available in the further studies.