Abstract：
The emergence, persistence, and spread of antibiotic-resistant microbes is a tremendous public health threat that is considered nowadays a critical One Health issue. In Lebanon, the consumption of raw bovine milk has been recently reported as a result of the financial crisis. The objectives of the current study were (1) to evaluate raw bovine milk samples in a comprehensive manner for the types of antibiotics used and their residues, (2) to determine the presence of mesophilic bacteria, extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and methicillin-resistant Staphylococcus aureus (MRSA), and (3) to determine the associated human health risk caused by drinking raw milk with antibiotic residues among all age categories. LC-MS-MS was used to carry out the analysis. From 200 milk samples, 30 (15%) were found contaminated with four major antibiotics. The highest average concentration detected was for oxytetracyline 31.51 ± 13.23 μg/kg, followed by 5.5 ± 0.55 μg/kg for gentamicin, 4.56 ± 0.73 μg/kg for colistin, and 4.44 ± 0.89 μg/kg for tylosin. The mean contamination among most samples was below the maximum residue limits (MRLs). Upon comparison with the acceptable daily intake (ADI), the estimated daily intake (EDI) across all age groups was acceptable. The hazard quotient (HQ) was also below 1 across all age groups, signifying the absence of associated health risks for the Lebanese consumers. On the other hand, all milk samples were found exceeding the maximum tolerable value of mesophilic flora. Antibiotic-resistant bacteria (ARB) were detected and represented by ESBL-producing E. coli and MRSA isolates. Thus, the greatest threat of antibiotic use in Lebanon does not fall under antibiotic residues but rather the proliferation of antibiotic resistance in potentially pathogenic bacteria. In this study, the virulence profile of detected bacteria was not investigated; thus their pathogenicity remains unknown. Therefore, to mitigate this health threat in Lebanon, a \"One Health\" action plan against ABR is required. It will provide a framework for continued, more extensive action to reduce the emergence and spread of ABR in Lebanon.
摘要：
的出现,持久性,抗生素抗性微生物的传播是一个巨大的公共卫生威胁，现在被认为是一个至关重要的健康问题。在黎巴嫩,由于金融危机，最近有报道称原料牛乳的消费。本研究的目的是(1)综合评价原料牛乳样品中所用抗生素的种类及其残留,（2）确定嗜温细菌的存在，产超广谱β-内酰胺酶(ESBL)的大肠杆菌和耐甲氧西林金黄色葡萄球菌(MRSA),（3）确定在所有年龄类别中饮用含有抗生素残留的原料奶引起的相关人类健康风险。使用LC-MS-MS进行分析。从200份牛奶样本中，30（15％）被发现被四种主要抗生素污染。检测到的最高平均浓度为土霉素31.51±13.23μg/kg，其次是庆大霉素5.5±0.55μg/kg，粘菌素4.56±0.73μg/kg，泰乐菌素为4.44±0.89μg/kg。大多数样品中的平均污染低于最大残留限值(MRL)。与可接受的每日摄入量(ADI)相比，所有年龄组的估计日摄入量(EDI)均可接受.所有年龄组的风险商(HQ)也低于1，这表明黎巴嫩消费者没有相关的健康风险。另一方面,发现所有牛奶样品都超过了嗜温菌群的最大容许值。检测抗生素抗性细菌（ARB），并以产生ESBL的大肠杆菌和MRSA分离株为代表。因此，黎巴嫩使用抗生素的最大威胁不在于抗生素残留，而在于潜在致病菌的抗生素耐药性的扩散。在这项研究中,检测到的细菌的毒力谱没有被调查;因此它们的致病性仍然未知.因此,为了减轻黎巴嫩的健康威胁，需要针对ABR的“一个健康”行动计划。它将为继续提供一个框架，采取更广泛的行动，减少黎巴嫩ABR的出现和蔓延。
