Journal of Food Hygiene and Safety (한국식품위생안전성학회지)

The Korean Society of Food Hygiene and Safety (한국식품위생안전성학회)
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Classification of Critically Important Antimicrobials and their Use in Food Safety

중요 항생제의 분류와 식품안전분야에서 활용

  • Hyo-Sun Kwak (Department of Food Science and Biotechnology, Kyung Hee University) ;
  • Jun-Hyeok Ham (Department of Food Science and Biotechnology, Kyung Hee University) ;
  • Eiseul Kim (Department of Food Science and Biotechnology, Kyung Hee University) ;
  • Yinhua Cai (Department of Food Science and Biotechnology, Kyung Hee University) ;
  • Sang-Hee Jeong (Department of Biomedical Science, Hoseo University) ;
  • Hae-Yeong Kim (Department of Food Science and Biotechnology, Kyung Hee University)
  • 곽효선 (경희대학교 식품생명공학과) ;
  • 함준혁 (경희대학교 식품생명공학과) ;
  • 김이슬 (경희대학교 식품생명공학과) ;
  • 채은화 (경희대학교 식품생명공학과) ;
  • 정상희 (호서대학교 임상병리학과) ;
  • 김해영 (경희대학교 식품생명공학과)
  • Received : 2023.06.05
  • Accepted : 2023.07.15
  • Published : 2023.08.31
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Abstract

Antimicrobials in human medicine are classified by The World Health Organization (WHO) into three groups: critically important antimicrobials (CIA), highly important antimicrobials (HIA), and important antimicrobials (IA). CIA are antibiotic classes that satisfy two main criteria: that they are the sole or the only available limited therapeutic option to effectively treat severe bacterial infections in humans (Criterion 1), and infections where bacteria are transmitted to humans from non-human sources or have the potential to acquire resistance genes from non-human sources (Criterion 2). WHO emphasizes the need for cautious and responsible use of the CIA to mitigate risk and safeguard human health. Specific antimicrobials within the CIA with a high priority for management are reclassified as "highest priority critically important antimicrobials (HP-CIA)" and include the 3rd generation of cephalosporins and the next generation of macrolides, quinolones, glycopeptides, and polymyxins. The CIA list is the scientific basis for risk assessment and risk management policies that warrant using antimicrobials to reduce antimicrobial resistance in several countries. In addition, the CIA list ensures food safety in the food industry, including for the popular food chain companies McDonald's and KFC. The continuous update of the CIA list reflects the advancement in research and emerging future challenges. Thus, active and deliberate evaluation of antimicrobial resistance and the construction of a list that reflects the specific circumstances of a country are essential to safeguarding food security.

WHO에서는 항생제 사용으로 인한 위해를 줄이고 사람의 건강을 지키기 위한 목적으로, 더욱 신중하게 사용해야 하는 항생제를 '중요 항생제'로 분류하였다. 중요 항생제 선정은 2가지 기준으로 분류하였는데, 기준 1은 사람에서 심각한 세균 감염을 치료하기 위하여 유일한 또는 치료제가 제한적인 항생제 계열, 기준 2는 세균이 비인체 유래로부터 사람으로 감염된 경우 또는 세균이 비인체로부터 내성유전자를 획득할 가능성이 있는 경우이다. 그 결과 '매우 중요한 항생제(Critically important antimicrobials, CIA)', '중요도 높은 항생제(Highly important antimicrobials, HIA)', '중요항생제(Important antimicrobials, IA)' 등 3개 그룹으로 분류되었다. 특히, 매우 중요한 항생제 중에서도 관리의 우선순위가 높은 항생제를 '최우선 중요 항생제(Highest priority critically important antimicrobials, HPCIA)'로 재분류하였는데, 여기에는 3세대 이상 Cephalosporins, Macrolides, Quinolones, Glycopeptides 및 Polymyxins가 속하였다. 중요 항생제 목록은 많은 국가에서 항생제의 올바른 사용과 내성 감소를 위한 위해평가 및 위해관리 정책 등 다양한 분야에 과학적 근거를 제공하며, McDonalds, KFC 등 식품산업 분야에서도 식품안전을 위하여 중요 항생제 목록이 활용되고 있다. 중요 항생제 목록(CIA list)는 앞으로도 새로운 연구 결과를 반영하여 지속적으로 보완될 것이다. 국내에서도 우리의 항생제 내성에 대한 조사결과 등을 신중하고 면밀하게 검토하여 우리 실정에 적합한 목록을 개발함으로써 식품안전성을 확보해 나가는 것이 필요할 것으로 생각된다.

Keywords

Acknowledgement

본 연구는 식품의약품안전처의 지원으로 수행되었습니다(과제번호: 23192기획농311).

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