Antimicrobial use in aquaculture re-examined: its relevance to antimicrobial resistance and to animal and human health

The purpose of this review was to provide an updated overview on the use of antimicrobial agents in livestock, the associated problems for humans and current knowledge on the effects of reducing resistance in the livestock reservoir on both human health and animal production. There is still limiting data on both use of antimicrobial agents, occurrence and spread of resistance as well as impact on human health. However, in recent years, emerging issues related to methicillin-resistant Staphylococcus aureus , Clostridium difficile , Escherichia coli and horizontally transferred genes indicates that the livestock reservoir has a more significant impact on human health than was estimated 10 years ago, where the focus was mainly on resistance in Campylobacter and Salmonella . Studies have indicated that there might only be a marginal if any benefit from the regular use of antibiotics and have shown that it is possible to substantially reduce the use of antimicrobial agents in livestock production without compromising animal welfare or health or production. In some cases, this should be done in combination with other measures such as biosecurity and use of vaccines. To enable better studies on both the global burden and the effect of interventions, there is a need for global harmonized integrated and continuous surveillance of antimicrobial usage and antimicrobial resistance, preferably associated with data on production and animal diseases to determine the positive and negative impact of reducing antimicrobial use in livestock.

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Odgovornost in ukrepi zdravstvenih inštitucij v boju proti odpornim mikrobom

10.18690/978-961-286-478-1.16 ◽

2021 ◽

pp. 269-280

Author(s):

Lea Knez ◽

◽

Jelka Reberšek Gorišek ◽

Nina Gorišek Miksić ◽

◽

...

Keyword(s):

Antimicrobial Resistance ◽

Hand Hygiene ◽

Human Health ◽

Modern Medicine ◽

Antimicrobial Use ◽

Antimicrobial Treatments

Antimicrobial resistance is one of the significant threats to human health. To maintain the benefits of modern medicine, which hardly relies on antimicrobial treatments, all the stakeholders have to work together towards containing antimicrobial resistance. There are three fundamental strategies to tackle antimicrobial resistance: prudent and supervised antimicrobial use, improved hand hygiene, and improved cleaning of the patient environment.

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Antimicrobial use and resistance data in human and animal sectors in the Lao PDR: evidence to inform policy

BMJ Global Health ◽

10.1136/bmjgh-2021-007009 ◽

2021 ◽

Vol 6 (12) ◽

pp. e007009

Author(s):

Vilada Chansamouth ◽

Mayfong Mayxay ◽

David AB Dance ◽

Tamalee Roberts ◽

Rattanaxay Phetsouvanh ◽

...

Keyword(s):

Escherichia Coli ◽

Antimicrobial Resistance ◽

Human Health ◽

Scientific Evidence ◽

Animal Health ◽

Lao Pdr ◽

Blood Cultures ◽

Antimicrobial Use ◽

Self Medication ◽

Extended Spectrum Beta Lactamase

ObjectivesTo review the scientific evidence base on antimicrobial use (AMU) and antimicrobial resistance (AMR) in human and animal sectors in the Lao PDR (Laos).MethodsWe reviewed all publications from July 1994 (the first article describing AMR in Laos) to December 2020. Electronic searches were conducted using Google Scholar and PubMed with specific terms relating to AMR and AMU in Lao, French and English languages.FindingsWe screened 1,357 peer-reviewed and grey reports by title and abstract and then full articles/reports. Of 80 included, 66 (83%) related to human health, nine (11%) to animal health, four (5%) to both animal and human health and one (1%) to the environment. Sixty-two (78%) were on AMR and 18 (22%) on AMU. Extended spectrum beta lactamase-producing Escherichia coli was the greatest concern identified; the proportion of isolates increased fivefold from 2004 to 2016 (2/28 (7%) to 27/78 (35%)) from blood cultures submitted to the Microbiology Laboratory, Mahosot Hospital, Vientiane. Carbapenem resistant Escherichia coli was first identified in 2015. Methicillin-resistant Staphylococcus aureus (MRSA) was uncommon, with 15 cases of MRSA from blood cultures between its first identification in 2017 and December 2020. AMR patterns of global antimicrobial resistance surveillance system (GLASS) target pathogens from livestock were less well documented. There were few data on AMU in human health and none on AMU in livestock. The first hospital AMU survey in Laos showed that 70% (1,386/1,981) of in-patients in five hospitals from 2017 to 2018 received antimicrobial(s). Antibiotic self-medication was common.ConclusionAMR in Laos is occurring at relatively low proportions for some GLASS pathogens, giving the country a window of opportunity to act quickly to implement strategies to protect the population from a worsening situation. Urgent interventions to roll out new guidelines with enhanced one-health antibiotic stewardship, reduce antibiotic use without prescriptions, enhance surveillance and improve understanding of AMU and AMR are needed.

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Beyond Antimicrobial Use: A Framework for Prioritizing Antimicrobial Resistance Interventions

Annual Review of Animal Biosciences ◽

10.1146/annurev-animal-072020-080638 ◽

2021 ◽

Vol 9 (1) ◽

pp. 313-332

Author(s):

Noelle R. Noyes ◽

Ilya B. Slizovskiy ◽

Randall S. Singer

Keyword(s):

Antimicrobial Resistance ◽

Human Health ◽

Antimicrobial Stewardship ◽

Focal Point ◽

Livestock Production ◽

Microbial Interactions ◽

Antimicrobial Use ◽

Environmental Systems ◽

The Many ◽

The Impact

Antimicrobial resistance (AMR) is a threat to animal and human health. Antimicrobial use has been identified as a major driver of AMR, and reductions in use are a focal point of interventions to reduce resistance. Accordingly, stakeholders in human health and livestock production have implemented antimicrobial stewardship programs aimed at reducing use. Thus far, these efforts have yielded variable impacts on AMR. Furthermore, scientific advances are prompting an expansion and more nuanced appreciation of the many nonantibiotic factors that drive AMR, as well as how these factors vary across systems, geographies, and contexts. Given these trends, we propose a framework to prioritize AMR interventions. We use this framework to evaluate the impact of interventions that focus on antimicrobial use. We conclude by suggesting that priorities be expanded to include greater consideration of host–microbial interactions that dictate AMR, as well as anthropogenic and environmental systems that promote dissemination of AMR.

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Recent Review on Subclass B1 Metallo-β-lactamases Inhibitors: Sword for Antimicrobial Resistance

Current Drug Targets ◽

10.2174/1389450120666181217101812 ◽

2019 ◽

Vol 20 (7) ◽

pp. 756-762 ◽

Cited By ~ 2

Author(s):

Aditi Kaushik ◽

Manish Kaushik ◽

Viney Lather ◽

J.S. Dua

Keyword(s):

Antibiotic Resistance ◽

Multidrug Resistance ◽

Antimicrobial Resistance ◽

Global Health ◽

Human Health ◽

Microbial Pathogens ◽

Present Review ◽

Drug Molecules ◽

Global Threat ◽

Powerful Strategy

An emerging crisis of antibiotic resistance for microbial pathogens is alarming all the nations, posing a global threat to human health. The production of the metallo-β-lactamase enzyme is the most powerful strategy of bacteria to produce resistance. An efficient way to combat this global health threat is the development of broad/non-specific type of metallo-β-lactamase inhibitors, which can inhibit the different isoforms of the enzyme. Till date, there are no clinically active drugs against metallo- β-lactamase. The lack of efficient drug molecules against MBLs carrying bacteria requires continuous research efforts to overcome the problem of multidrug-resistance bacteria. The present review will discuss the clinically potent molecules against different variants of B1 metallo-β-lactamase.

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Knowledge, Attitude, and Practices on Antimicrobial Use and Antimicrobial Resistance among Poultry Drug and Feed Sellers in Bangladesh

Veterinary Sciences ◽

10.3390/vetsci8060111 ◽

2021 ◽

Vol 8 (6) ◽

pp. 111

Author(s):

Md. Abul Kalam ◽

Md. Abdul Alim ◽

Shahanaj Shano ◽

Md. Raihan Khan Nayem ◽

Md. Rahim Badsha ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Current Knowledge ◽

Rank Order ◽

Antimicrobial Use ◽

Poultry Production ◽

Attitudes And Practices ◽

12Th Grade ◽

Study Results ◽

Knowledge Attitudes And Practices ◽

Drug Sellers

Poultry production has boomed in Bangladesh in recent years. The poultry sector has contributed significantly to meet the increased demand for animal source proteins in the country. However, increased use of antimicrobials and antibiotics appeared to be a significant threat to food safety in the poultry sector. The poultry drug and feed sellers are at the frontline position involving selecting and delivering the antimicrobials to the poultry farmers. Studies assessing the poultry drug and feed sellers’ knowledge, attitudes, and practices (KAPs) are limited. The current study aimed to assess the community poultry drug and feed sellers’ KAPs of antimicrobial use (AMU) and antimicrobial resistance (AMR) in some selected areas of Bangladesh. We determined the respondents’ (drug and the feed sellers) KAPs of AMU and AMR using a tested and paper-based questionnaire. The study demonstrated that most respondents have insufficient knowledge, less positive attitudes, and inappropriate practices regarding AMU and AMR. The factor score analysis further showed that the type of respondents and their years of experience, level of education, and training on the drug were the significant factors impacting the current knowledge, attitudes, and practices of AMU and AMR. The adjusted logistic regression analysis revealed that the drug sellers who completed their education up to 12th grade and had training on the drug had adequate knowledge of AMU and AMR. The data also showed that the drug sellers belong to the age group 31–35 and 36–40 years and who completed 12th grade had good attitudes on the same. Likewise, the analysis further determined that drug sellers belonging the age category 18–25 and 26–30 years, and interestingly, the respondents who completed education up to 12th grade, had better practices. Spearman’s rank-order correlation revealed a positive association between each pair of the KAPs scores for the respondents. The correlation was fair between knowledge–attitudes, knowledge–practices, and attitudes–practices. Based on the current study results, we recommend educational interventions and appropriate training for the poultry drug and feed sellers to raise awareness and to upgrade their current knowledge on the appropriate use of antimicrobials. This will ultimately lead to reducing the chances of developing AMR in the poultry sectors of the country.

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Antimicrobial Use Control Measures to Prevent and Control Antimicrobial Resistance in US Hospitals

Infection Control and Hospital Epidemiology ◽

10.1086/507963 ◽

2006 ◽

Vol 27 (10) ◽

pp. 1088-1095 ◽

Cited By ~ 33

Author(s):

Alan J. Zillich ◽

Jason M. Sutherland ◽

Stephen J. Wilson ◽

Daniel J. Diekema ◽

Erika J. Ernst ◽

...

Keyword(s):

Clinical Practice ◽

Antimicrobial Resistance ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Veterans Affairs ◽

Control Measures ◽

Antimicrobial Use ◽

Cross Sectional ◽

Term Care ◽

Recommended Practices

Objective.Clinical practice guidelines and recommended practices to control use of antibiotics have been published, but the effect of these practices on antimicrobial resistance (AMR) rates in hospitals is unknown. The objective of this study was to examine relationships between antimicrobial use control strategies and AMR rates in a national sample of US hospitals.Design.Cross-sectional, stratified study of a nationally representative sample of US hospitals.Methods.A survey instrument was sent to the person responsible for infection control at a sample of 670 US hospitals. The outcome was current prevalences of 4 epidemiologically important, drug-resistant pathogens, considered concurrently: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci, ceftazidime-resistant Klebsiella species, and quinolone (ciprofloxacin)-resistant Escherichia coli Five independent variables regarding hospital practices were selected from the survey: the extent to which hospitals (1) implement practices recommended in clinical practice guidelines and ensure best practices for antimicrobial use, (2) disseminate information on clinical practice guidelines for antimicrobial use, (3) use antimicrobial-related information technology, (4) use decision support tools, and (5) communicate to prescribers about antimicrobial use. Control variables included the hospitals' number of beds, teaching status, Veterans Affairs status, geographic region, and number of long-term care beds; and the presence of an intensive care unit, a burn unit, or transplant services. A generalized estimating equation modeled all resistance rates simultaneously to identify overall predictors of AMR levels at the facility.Results.Completed survey instruments were returned by 448 hospitals (67%). Four antimicrobial control measures were associated with higher prevalence of AMR. Implementation of recommended practices for antimicrobial use (P< .01) and optimization of the duration of empirical antibiotic prophylaxis (P<.01) were associated with a lower prevalence of AMR. Use of restrictive formularies (P = .05) and dissemination of clinical practice guideline information (P<.01) were associated with higher prevalence of AMR. Number of beds and Veterans Affairs status were also associated with higher AMR rates overall.Conclusions.Implementation of guideline-recommended practices to control antimicrobial use and optimize the duration of empirical therapy appears to help control AMR rates in US hospitals. A longitudinal study would confirm the results of this cross-sectional study. These results highlight the need for systems interventions and reengineering to ensure more-consistent application of guideline-recommended measures for antimicrobial use.

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Salmon aquaculture, Piscirickettsia salmonis virulence, and One Health: Dealing with harmful synergies between heavy antimicrobial use and piscine and human health comment on Avendaño-Herrera (2021)

Aquaculture ◽

10.1016/j.aquaculture.2021.736520 ◽

2021 ◽

Vol 537 ◽

pp. 736520

Author(s):

Felipe C. Cabello ◽

Henry P. Godfrey

Keyword(s):

Human Health ◽

One Health ◽

Antimicrobial Use ◽

Salmon Aquaculture ◽

Piscirickettsia Salmonis

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Antimicrobial Use, Residues, Resistance and Governance in the Food and Agriculture Sectors, Tanzania

Antibiotics ◽

10.3390/antibiotics10040454 ◽

2021 ◽

Vol 10 (4) ◽

pp. 454

Author(s):

Robinson H. Mdegela ◽

Elibariki R. Mwakapeje ◽

Bachana Rubegwa ◽

Daniel T. Gebeyehu ◽

Solange Niyigena ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Antimicrobial Resistance ◽

Crop Production ◽

Growth Promotion ◽

Penicillin G ◽

Animal Origin ◽

Antimicrobial Use ◽

Food And Agriculture ◽

Food Of Animal Origin ◽

Food Animals

All infections are potentially curable as long as the etiological agents are susceptible to antimicrobials. The increased rate at which antimicrobials are becoming ineffective is a global health risk of increasing concern that threatens withdrawal of beneficial antimicrobials for disease control. The increased demand for food of animal origin, in particular eggs, meat and milk has led to intensification and commercial production systems where excessive use and misuse of antimicrobials may prevail. Antimicrobials, handled and used by farmers and animal attendants with no formal education, may be predisposed to incorrect dosages, misuse, incorrect applications and non-adherence to withdrawal periods. This study was conducted to assess the regulatory roles and governance of antimicrobials, establish the pattern and extent of their use, evaluate the antimicrobial residues and resistance in the food animals and crop agriculture value chains, and relate these findings to existing strategies in place for combating the emergence of antimicrobial resistance in Tanzania. A multimethod approach (desk review, field study and interviews) was used. Relevant establishments were also visited. High levels of resistance to penicillin G, chloramphenicol, streptomycin and oxytetracycline have been reported, especially for Actinobacter pyogenes, Staphylococcus hyicus, Staphylococcus intermedius and Staphylococcus aureus from dairy cattle with mastitis and in humans. Similar trends were found in poultry where eggs and meat are contaminated with Escherichia coli strains resistant to amoxicillin + clavulanate, sulphamethoxazole and neomycin. An increasing trend of emerging multidrug resistant E. coli, Klebsiella pneumoniae, Staphylococcus aureus and Salmonella was also found in food animals. An increase in methicillin resistant Staphlococcus aureus (MRSA) and extended-spectrum beta-lactamase (ESBL) in the livestock sector in Tanzania have been reported. The pathogens isolated in animals were resistant to ampicillin, augmentin, gentamicin, co-trimoxazole, tetracycline, amoxicillin, streptomycin, nalidixic acid, azithromycin, chloramphenicol, tylosin, erythromycin, cefuroxime, norfloxacin and ciprofloxacin. An increased usage of antimicrobials for prophylaxis, and therapeutics against pathogens and for growth promotion in livestock, aquaculture and crop production were observed. A One Health strategic approach is advocated to combat antimicrobial resistance (AMR) in the food and agriculture sectors in Tanzania. Practical recommendations include (a) legislation review and implementation; (b) antimicrobial use (AMU), AMR and antimicrobial residue (AR) awareness and advocacy among stakeholders along the value chain; (c) strengthening of surveillance and monitoring programs for AMU, AMR and AR; (d) enhanced development and use of rapid and innovative diagnostic tests and the promotion of biosecurity principles; and (e) good husbandry practices. The utilization of this information to improve public health policies and reduce the burden of AMR will be beneficial.

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Association between antimicrobial usage and resistance in Salmonella from poultry farms in Nigeria

BMC Veterinary Research ◽

10.1186/s12917-021-02938-2 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Abdurrahman Hassan Jibril ◽

Iruka N. Okeke ◽

Anders Dalsgaard ◽

John Elmerdahl Olsen

Keyword(s):

Treatment Outcome ◽

Antimicrobial Resistance ◽

Global Health ◽

Human Medicine ◽

Antimicrobial Use ◽

Resistance Development ◽

Use Patterns ◽

Antimicrobial Usage ◽

Poultry Farms ◽

Reduction Strategies

Abstract Background Antimicrobial resistance (AMR) is a global health threat affecting treatment outcome in animals and humans. A pre-requisite for development of AMR reduction strategies is knowledge of antimicrobial use patterns, and how these affect resistance development. The aim of this study was to determine antimicrobial usage (AMU) and whether such usage was associated with AMR in Salmonella from poultry farms in Northwest Nigeria. Results Fifteen (37%) of antimicrobial products observed contained compounds that are of highest priority and critically important for human medicine. Broilers chicken consumed higher (28 ± 14 mg/kg active ingredients) amounts of antimicrobials compared to layers (13 ± 8 mg/kg) per week (p = 0.0009). Surprisingly, chickens raised under backyard system consumed higher amounts of antimicrobials (34 ± 7 mg/kg) than poultry in other systems (p = 0.02). High levels of resistance to tetracycline (58%), sulphonamides (65%), ciprofloxacin (46%) and gentamicin (42%) correlated with high farm level usage of these antimicrobials, and there was a strong correlation (r = 0.9) between farm usage and resistance of isolates to the same antimicrobials (p = 0.03). Conclusion High AMU, including use of highest priority critically important antimicrobials was observed at poultry farms in Northwest Nigeria. AMU correlated with high levels of resistance. Communication of prudent use of antimicrobials to farmers and regulation to obtain reduction in AMU should be a priority.

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