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Antimicrobial Use and Resistance in Animals from a One Health Perspective

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Veterinary Sciences
Authors:
Mohamed Rhouma at Université de Montréal
Mohamed Rhouma
Marie Archambault at Université de Montréal
Marie Archambault
Patrick Butaye at City University of Hong Kong
Patrick Butaye
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Abstract

Among the many global health issues, antimicrobial resistance (AMR) is one that exemplifies the One Health approach, defined as a joint effort in which multiple disciplines collaborate to provide solutions for human, animal, and environmental health [...]
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Citation: Rhouma, M.; Archambault,
M.; Butaye, P. Antimicrobial Use and
Resistance in Animals from a One
Health Perspective. Vet. Sci. 2023,10,
319. https://doi.org/10.3390/
vetsci10050319
Received: 19 April 2023
Accepted: 25 April 2023
Published: 28 April 2023
Copyright: © 2023 by the authors.
Licensee MDPI, Basel, Switzerland.
This article is an open access article
distributed under the terms and
conditions of the Creative Commons
Attribution (CC BY) license (https://
creativecommons.org/licenses/by/
4.0/).
veterinary
sciences
Editorial
Antimicrobial Use and Resistance in Animals from a One
Health Perspective
Mohamed Rhouma 1,2,3,* , Marie Archambault 1,3 and Patrick Butaye 4
1Department of Pathology and Microbiology, Faculty of Veterinary Medicine, Universitéde Montréal,
3200 Rue Sicotte, Saint-Hyacinthe, QC J2S 2M2, Canada
2Groupe de Recherche et d’Enseignement en SalubritéAlimentaire (GRESA), Faculty of Veterinary Medicine,
Universitéde Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada
3Swine and Poultry Infectious Diseases Research Center, Faculty of Veterinary Medicine,
Universitéde Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada
4Department of Pathobiology, Pharmacology and Zoological Medicine, Faculty of Veterinary Medicine,
Ghent University, Salisburylaan 133, B9820 Merelbeke, Belgium
*Correspondence: mohamed.rhouma@umontreal.ca; Tel.: +1-450-773-8521 (ext. 52416)
Among the many global health issues, antimicrobial resistance (AMR) is one that
exemplifies the One Health approach, defined as a joint effort in which multiple disciplines
collaborate to provide solutions for human, animal, and environmental health [
1
]. Indeed,
AMR is predominantly the result of the irresponsible and excessive use of antimicrobials in
various sectors, such as human/veterinary medicine and agriculture (e.g., plant health).
Accordingly, solutions must be contributed by all relevant stakeholders to address this
global issue. The real dangers posed by the rapid loss of antimicrobial effectiveness, which
has been precipitated by the selection and spread of AMR bacteria, have prompted policy
makers to recognize this threat to health care systems and the economy while considering
it as a budgetary and regulatory priority [
2
]. Moreover, the COVID-19 pandemic has
generated powerful incentives and momentum with respect to raising awareness of the
importance of having effective drugs to treat microbial infections and the need to ensure
their efficacy over time [
3
]. As the number of brand-new antimicrobials available on the
market has drastically decreased since the 1990s [
4
], it is therefore crucial to implement all
possible strategies, in both human and veterinary medicine, to minimize the selection of
AMR bacteria while preserving the efficacy of the existing drugs and ensuring their optimal
longevity. Notably, the protection of the current antimicrobial arsenal is of particular
concern in veterinary medicine, where the possibility of acquiring new antimicrobials is
extremely limited and drug repurposing has been scarcely explored (unlike the trend in
human medicine) [4].
Hence, the theme of this Special Issue is very topical and of particular interest to
the various stakeholders involved in the management of AMR in animals and at the
human–animal–environment interface. Indeed, several studies have shown that the misuse
and excessive use of antimicrobials in the human health care and livestock industries
are the main drivers of AMR [
5
–
7
]. How livestock contributes to the spread of AMR in
humans continues to be studied. The most recent studies do not quite indicate that there is
a large impact of AMR in animal bacteria on AMR in human bacteria, with the exception of
zoonotic bacteria [
7
–
9
]. However, it was recently shown that the effect of antimicrobial use
(AMU) on AMR have a bidirectional influences on AMR in human and animal bacteria on a
global scale [
10
]. These recent findings once again underscore the critical need to accelerate
the implementation of the One Health approach to address the global AMR crisis.
Among the possible solutions, research on alternatives to antibiotics for use in an-
imals seems necessary to contain the threat of AMR. For instance, it has been reported
that Romanian propolis ethanolic extracts present significant
in vitro
antibacterial activ-
ity against clinical strains of Staphylococcus aureus isolated from dog-derived superficial
Vet. Sci. 2023,10, 319. https://doi.org/10.3390/vetsci10050319 https://www.mdpi.com/journal/vetsci
Vet. Sci. 2023,10, 319 2 of 3
dermatitis samples and could, therefore, constitute a promising therapeutic option against
this potential skin infection [
11
]. Likewise, silver nanoparticles (AgNPs) present
in vitro
antibacterial activity against some bacterial pathogens (e.g., Staphylococcus pseudintermedius,
Staphylococcus aureus,Escherichia coli) and low toxicity to mammalian cells, suggesting that
AgNPs could be used as an alternative to antibiotics for the treatment of bacterial skin
infections, including infected wounds in animals [12].
The monitoring of AMR in animals and the characterization of the AMR patterns of
certain indicator bacterial strains are of crucial importance for the development of policies
that will ensure the responsible use of antimicrobials in animals. The development of
standardized AMR testing methods and harmonized interpretive criteria in veterinary
medicine are necessary to facilitate scientifically based stewardship and justified AMU in
animals [
13
]. It has also been shown that the susceptibility testing of bacteria, which are
not routinely investigated for AMR profiling, should sometimes be incorporated in AMR
surveillance systems alongside the consideration of the epidemiological and microbiological
data specific to certain countries [
14
] or to certain animal production sectors (e.g., the fish-
farming sector) [15].
Moreover, AMR in zoonotic bacteria (e.g., Salmonella) remains problematic in some
countries, with high rates of bacterial resistance to first- and second-line antimicrobials
being reported, thus urging various stakeholders in animal production to implement
effective policies to limit the spread of AMR [16].
Drug repurposing and repositioning, which consist of identifying new therapeutic
uses for existing molecules, have been scarcely investigated in veterinary medicine. In this
regard, it has been shown that the anti-inflammatory properties of doxycycline may be
useful for the long-term treatment of severe bronchiectasis in dogs [17].
Finally, in an overview of AMU in food-producing animals and of the current state of
knowledge regarding the role of farm animals in the spread of AMR in humans, actions
taken in the livestock industry were presented, from a sustainable animal production
perspective, in order to limit the spread of AMR bacteria and preserve the effectiveness of
antimicrobials [18].
Notably, the Guest Editors of this Special Issue have remarked that despite the growing
interest in veterinary antimicrobial stewardship (AMS), the optimization of the therapeutic
use of antimicrobials (with respect to dose, administration intervals, and treatment dura-
tions), which constitutes the key component of this concept, has not received the attention
it deserves in animals compared to that seen in human medicine, and this aspect must be
improved in future studies.
Author Contributions:
Conceptualization, M.R.; writing—original draft preparation, M.R.;
writing—review and editing, M.R., M.A. and P.B.; supervision, M.R. and P.B. All authors have
read and agreed to the published version of the manuscript.
Funding: This research received no external funding.
Acknowledgments:
We are grateful to all authors and reviewers who contributed to the success of
this Special Issue.
Conflicts of Interest: The authors declare no conflict of interest.
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... Public health and animal health authorities have recently focused on antimicrobial governance in companion animals (Rhouma et al., 2023). According to Allerton et al. (2021), European national guidelines on the use of antimicrobials in 2021 did not include companion animals, suggesting that this sector was still recently a blind spot in antimicrobial stewardship policies (Allerton et al., 2021). ...
... However, critically important and highly important antimicrobials in human medicine are frequently used in companion animal medicine, and various multi-drug-resistant bacteria have been isolated from dogs and cats Allerton et al., 2021). On the other hand, frequent interactions between humans and pets may also favor the interspecies transmission of resistant bacteria (Rhouma et al., 2023). Hence, the contribution of the companion animal sector to the problem of antimicrobial resistance must be considered in antimicrobial stewardship initiatives (Allerton et al., 2021;Tompson et al., 2021). ...
... However, these guidelines are not always followed. The determinants of antimicrobial use have recently been studied in the companion animal sector, and the current state of the problem suggests courses of action for better antimicrobial stewardship (Rhouma et al., 2023) including the development and update of prescription guidelines and continuing educational training programs Allerton et al., 2021). However, the current literature suggests that, depending on the context, continuing training is likely to have a limited impact on veterinarians' prescribing practices Walker et al., 2022). ...
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... Another challenge is that the use of antimicrobials against Mg and Ms needs to be further reduced in the future. Apart from the risk of treatment failures, extensive use of antimicrobials also contributes to the development of resistance in non-target organisms which can have a significant impact on human health (Velazquez-Meza et al., 2022;Rhouma et al., 2023). At the background of this development it is crucial to further optimize antimicrobial treatments, and to update knowledge on antimicrobial susceptibility profiles of Mg and Ms field isolates. ...
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... Indeed, zoonotic transmission of resistant bacteria has been demonstrated for several pathogens, such as E. coli, Salmonella, Campylobacter, and methicillin-resistant Staphylococcus aureus, although the general consensus is that the contribution of food producing animals in the spread of antibiotic resistance in human pathogens is still very low [3]. In any case, the health of animals and humans are fundamentally intertwined and should be ideally be considered with a onehealth perspective in mind [4]: decreasing antibiotic usage in animals will be beneficial for humans and vice versa. ...
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... Another challenge is that the use of antimicrobials against Mg and Ms needs to be further reduced in the future. Apart from the risk of treatment failures, extensive use of antimicrobials also contributes to the development of resistance in non-target organisms which can have a significant impact on human health (Velazquez-Meza et al., 2022;Rhouma et al., 2023). At the background of this development it is crucial to further optimize antimicrobial treatments, and to update knowledge on antimicrobial susceptibility profiles of Mg and Ms field isolates. ...
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Full-text available
  • Apr 2023
Background Antimicrobial resistance (AMR) is a pressing, holistic, and multisectoral challenge facing contemporary global health. In this study we assessed the associations between socioeconomic, anthropogenic, and environmental indicators and country-level rates of AMR in humans and food-producing animals. Methods In this modelling study, we obtained data on Carbapenem-resistant Acinetobacter baumanii and Pseudomonas aeruginosa, third generation cephalosporins-resistant Escherichia coli and Klebsiella pneumoniae, oxacillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus faecium AMR in humans and food-producing animals from publicly available sources, including WHO, World Bank, and Center for Disease Dynamics Economics and Policy. AMR in food-producing animals presented a combined prevalence of AMR exposure in cattle, pigs, and chickens. We used multivariable β regression models to determine the adjusted association between human and food-producing animal AMR rates and an array of ecological country-level indicators. Human AMR rates were classified according to the WHO priority pathogens list and antibiotic–bacterium pairs. Findings Significant associations were identified between animal antimicrobial consumption and AMR in food-producing animals (OR 1·05 [95% CI 1·01–1·10]; p=0·013), and between human antimicrobial consumption and AMR specifically in WHO critical priority (1·06 [1·00–1·12]; p=0·035) and high priority (1·22 [1·09–1·37]; p<0·0001) pathogens. Bidirectional associations were also found: animal antibiotic consumption was positively linked with resistance in critical priority human pathogens (1·07 [1·01–1·13]; p=0·020) and human antibiotic consumption was positively linked with animal AMR (1·05 [1·01–1·09]; p=0·010). Carbapenem-resistant Acinetobacter baumanii, third generation cephalosporins-resistant Escherichia coli, and oxacillin-resistant Staphylococcus aureus all had significant associations with animal antibiotic consumption. Analyses also suggested significant roles of socioeconomics, including governance on AMR rates in humans and animals. Interpretation Reduced rates of antibiotic consumption alone will not be sufficient to combat the rising worldwide prevalence of AMR. Control methods should focus on poverty reduction and aim to prevent AMR transmission across different One Health domains while accounting for domain-specific risk factors. The levelling up of livestock surveillance systems to better match those reporting on human AMR, and, strengthening all surveillance efforts, particularly in low-income and middle-income countries, are pressing priorities.
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Current Insights Regarding the Role of Farm Animals in the Spread of Antimicrobial Resistance from a One Health Perspective
Article
Full-text available
  • Sep 2022
Antimicrobial resistance (AMR) represents a global threat to both human and animal health and has received increasing attention over the years from different stakeholders. Certain AMR bacteria circulate between humans, animals, and the environment, while AMR genes can be found in all ecosystems. The aim of the present review was to provide an overview of antimicrobial use in food-producing animals and to document the current status of the role of farm animals in the spread of AMR to humans. The available body of scientific evidence supported the notion that restricted use of antimicrobials in farm animals was effective in reducing AMR in livestock and, in some cases, in humans. However, most recent studies have reported that livestock have little contribution to the acquisition of AMR bacteria and/or AMR genes by humans. Overall, strategies applied on farms that target the reduction of all antimicrobials are recommended, as these are apparently associated with notable reduction in AMR (avoiding co-resistance between antimicrobials). The interconnection between human and animal health as well as the environment requires the acceleration of the implementation of the ‘One Health’ approach to effectively fight AMR while preserving the effectiveness of antimicrobials.
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Antibacterial Activity of Romanian Propolis against Staphylococcus aureus Isolated from Dogs with Superficial Pyoderma: In Vitro Test
Article
Full-text available
  • Jun 2022
Staphylococcal infection treatment in dogs is frequently associated with adverse side effects, high costs, prolonged treatment, and resistant strain selection. Staphylococcus aureus is the most frequently isolated staphylococci in cases of canine superficial pyoderma. The number of Staphylococcus strains to exhibit primary resistance to various drugs in vitro is increasing. Propolis has a diverse chemical composition and well-known therapeutic properties against bacterial infections. The current investigation evaluated in vitro the antimicrobial activity of the commercial allopathic antimicrobials, Romanian propolis ethanolic extracts, against clinical Staphylococcus aureus strains isolated from superficial dermatitis clinical samples in dogs and two reference strains: Staphylococcus aureus ATCC 25923 and Staphylococcus aureus ATCC 43300, as the MSSA and MRSA positive controls, respectively, in western Romania. We used the microdilution broth technique to evaluate the susceptibility profile of the bacteria. The minimum inhibitory concentration (MIC) of the Romanian propolis ethanolic extract ranged from 6 to 10 µg/mL for all isolates, determined by the broth microdilution method. The MICs of ethanolic Romanian propolis extracts had a pronounced antibacterial activity. These results indicate that propolis can potentially be used and recommended for in vivo experiments as a promising therapeutic agent against Staphylococcus aureus infections in superficial dermatitis of dogs.
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Antimicrobial Resistance of Clinical and Commensal Escherichia coli Canine Isolates: Profile Characterization and Comparison of Antimicrobial Susceptibility Results According to Different Guidelines
Article
Full-text available
  • Jun 2022
Background: Pyometra is a diestrual chronic disease frequently associated with Escherichia coli. Initial pyometra treatment involves empiric antimicrobial therapy whose suitability should be confirmed by antimicrobial susceptibility testing. Antimicrobial resistance is a major health issue for veterinary medicine, rendering surveillance studies essential. Our goal was to determine the susceptibility profile of E. coli isolates obtained from healthy and pyometra-presenting dogs and to compare the application of different antimicrobial susceptibility guidelines. Methods: The antimicrobial susceptibility profile (ASP) of 74 E. coli isolates was determined by disk diffusion, using six antimicrobials commonly used in veterinary medicine. Profiles were assessed by CLSI VET01S, CLSI M100 and EUCAST guidelines. β-lactamases-encoding genes blaTEM, blaSHV and blaOXA were detected by multiplex PCR. Biofilm production ability was evaluated by pellicle formation assays in Luria-Bertani medium. Results: Variations in the resistance frequency were observed for amoxicillin/clavulanic acid, cephalexin and cefotaxime (29.7-54.1%, 10.8-16.2% and 1.4-4.1%, respectively). Results varied slightly between clinical and commensal isolates, as well as their biofilm-forming ability. Genes blaTEM, blaSHV and blaOXA were detected in 25.5%, 11.8% and 9.8% of isolates, respectively. Conclusions: Results show the importance of ASP determination in veterinary isolates and the need for using standardized and validated testing methods and harmonized interpretive criteria.
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Genetic Diversity, Biofilm Formation, and Antibiotic Resistance of Pseudomonas aeruginosa Isolated from Cow, Camel, and Mare with Clinical Endometritis
Article
Full-text available
  • May 2022
Pseudomonas aeruginosa is a ubiquitous opportunistic bacterium that causes diseases in animals and humans. This study aimed to investigate the genetic diversity, antimicrobial resistance, biofilm formation, and virulence and antibiotic resistance genes of P. aeruginosa isolated from the uterus of cow, camel, and mare with clinical endometritis and their drinking water. Among the 180 uterine swabs and 90 drinking water samples analysed, 54 (20%) P. aeruginosa isolates were recovered. Isolates were identified biochemically to the genus level by the automated Vitek 2 system and genetically by the amplification of the gyrB gene and the sequencing of the 16S rRNA gene. Multi-locus sequence typing identified ten different sequence types for the P. aeruginosa isolates. The identification of ST2012 was significantly (p ≤ 0.05) higher than that of ST296, ST308, ST111, and ST241. The isolates exhibited significantly (p ≤ 0.05) increased resistance to piperacillin (77.8%), ciproflox-acin (59.3%), gentamicin (50%), and ceftazidime (38.9%). Eight (14.8%) isolates showed resistance to imipenem; however, none of the isolates showed resistance to colistin. Multidrug resistance (MDR) was observed in 24 isolates (44.4%) with a multiple antibiotic resistance index ranging from 0.44 to 0.77. MDR was identified in 30 (33.3%) isolates. Furthermore, 38.8% and 9.2% of the isolates exhibited a positive extended-spectrum-β-lactamase (ESBL) and metallo-β-lactamase (MBL) phenotype, respectively. The most prevalent β-lactamase encoding genes were blaTEM and blaCTX-M, however, the blaIPM gene was not detected in any of the isolates. Biofilm formation was observed in 49 (90.7%) isolates classified as: 11.1% weak biofilm producers; 38.9% moderate biofilm producers; 40.7% strong biofilm producers. A positive correlation was observed between the MAR index and biofilm formation. In conclusion, the results highlighted that farm animals with clinical endometritis could act as a reservoir for MDR and virulent P. aeruginosa. The emergence of ESBLs and MBLs producing P. aeruginosa in different farm animals is a public health concern. Therefore, surveillance programs to monitor and control MDR P. aeruginosa in animals are required. Citation: Mahmoud, S.F.; Fayez, M.; Swelum, A.A.; Alswat, A.S.; Alkafafy, M.; Alzahrani, O.M.; Alsunaini, S.J.; Almuslem, A.; Al Amer, A.S.; Yusuf, S. Genetic Diversity, Biofilm Formation, and Antibiotic Resistance of Pseudomonas aeruginosa Isolated from Cow, Camel, and Mare with Clinical Endometritis. Vet. Sci. 2022, 9, 239.
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Antimicrobial resistance: One Health approach
Article
Full-text available
  • Mar 2022
  • Vet. World
In this research, a review of antimicrobial resistance (AMR) is conducted as part of the One Health approach. A review of publications, which included "antimicrobial resistance" and "One Health," was conducted. Among the global health problems, AMR is the one that most clearly illustrates the One Health approach. AMR is a critical global problem affecting humans, the environment, and animals. This is related to each of these three components due to the irresponsible and excessive use of antimicrobials in various sectors (agriculture, livestock, and human medicine). Improper management of antimicrobials, inadequate control of infections, agricultural debris, pollutants in the environment, and migration of people and animals infected with resistant bacteria facilitate the spread of resistance. The study aimed to analyze the problem of AMR from a health perspective to analyze the different actors involved in One Health.
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Antimicrobial Susceptibility Profiles of Bacteria Commonly Isolated from Farmed Salmonids in Atlantic Canada (2000–2021)
Article
Full-text available
  • Mar 2022
Bacterial infection and antimicrobial resistance are important constraints in the production and sustainability of farmed salmonids. This retrospective study aimed to describe the frequency of bacterial isolates and antimicrobial resistance profiles in salmonid aquaculture in Atlantic Canada. Bacterial isolates and antimicrobial susceptibility testing (AST) results assessed by disk diffusion testing were summarized for 18,776 Atlantic salmon (Salmo salar) and rainbow trout (Oncorhynchus mykiss) samples from 2291 unique cases submitted to the Atlantic Veterinary College, Aquatic Diagnostic Services Bacteriology Laboratory from 2000 to 2021. Kidney was the most commonly submitted tissue (60.29%, n = 11,320), and these specimens were mostly submitted as swabs (63.68%, n = 11,957). The most prevalent pathogens detected in these cases were Yersinia ruckeri type 1 (5.54%, n = 127), Renibacterium salmoninarum (2.10%, n = 48), Aeromonas salmonicida (atypical) (1.66%, n = 38), and Pseudomonas fluorescens (1.22%, n = 28). Most bacterial isolates tested (n = 918) showed resistance to florfenicol, oxytetracycline, ormetoprim-sulfadimethoxine, and trimethoprim-sulfamethoxazole, but not to enrofloxacin. This report provides baseline data for antimicrobial surveillance programs that investigate emerging antimicrobial resistance trends in salmonid aquaculture in Atlantic Canada.
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Sub-Antimicrobial Dosage Scheme of Doxycycline for the Chronic Treatment of Bronchiectasis in a Dog
Article
Full-text available
  • Mar 2022
A 9-month-old German shepherd dog was examined because of a chronic cough, exercise intolerance and labored breathing, as well as recurrent episodes of lethargy with anorexia. Multifocal severe bronchiectasis and neutrophilic bronchitis was found with thoracic computed tomography and cytology of bronchoalveolar lavage fluid, respectively. While oral azithromycin was administered, clinical signs were absent. However, stopping azithromycin lead repeatedly to presumed bacterial pneumonia within 1–2 months. With sub-antimicrobial dosed oral doxycycline (initially 1.5 mg/kg once daily for 3 months, then 0.7–0.5 mg/kg once daily for 6 months), the dog remained free from clinical signs. Bronchiectasis is characterized by marked irreversible bronchial dilation. Accumulation of intraluminal mucopurulent material and neutrophilic inflammation cause chronic cough and recurrent bacterial pneumonia. For therapy, life-long oral antibiotics are recommended. Chronic antibiotic administration, however, can select resistant bacterial strains. Though both azithromycin and doxycycline possess anti-inflammatory effects, doxycycline has these off-target properties at a sub-antimicrobial dose. In this report, a chronic sub-antimicrobial dose of doxycycline resulted in the resolution of chronic cough, exercise intolerance and labored breathing, and prevented recurrence of suspected bacterial pneumonia in the long-term in a dog with severe bronchiectasis. Beneficial effect of doxycycline is probably related to its anti-inflammatory effects rather than its antimicrobial properties.
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Prevalence, Risk Factors, Antimicrobial Resistance and Molecular Characterization of Salmonella in Northeast Tunisia Broiler Flocks
Article
Full-text available
  • Dec 2021
This study was conducted in northeastern Tunisia to estimate both the prevalence and the risk factors of Salmonella in broiler flocks as well as to characterize the isolated multidrug-resistant (MDR) Salmonella strains. In the present study, a total number of 124 farms were sampled; Salmonella isolates were identified by the alternative technique VIDAS Easy Salmonella. The susceptibility of Salmonella isolates was assessed against 21 antimicrobials using the disk diffusion method on Mueller–Hinton agar using antimicrobial discs. Some antimicrobial resistance genes were identified using PCR. The prevalence rate of Salmonella infection, in the sampled farms, was estimated at 19.9% (64/322). Moreover, a total number of 13 different serotypes were identified. High rate of resistance was identified against nalidixic acid (82.85%), amoxicillin (81.25%), streptomycin (75%), and ciprofloxacin (75%). Alarming level of resistance to ertapenem (12.5%) was noticed. A total of 87.5% (56/64) of isolated strains were recognized as MDR. Three MDR strains were extended-spectrum β-lactamases (ESBL)-producers and three MDR strains were cephalosporinase-producers. The blaCTX-M gene was amplified in all the three ESBL strains. The qnrB gene was not amplified in fluoroquinolones-resistant strains. The tetA and tetB genes were amplified in 5% (2/40) and 2.5% (1/40) of tetracycline-resistant strains, respectively. The dfrA1 gene was amplified in five of the 20 trimethoprim-resistant strains. The mcr-1, mcr-2, mcr-3, mcr-4, and mcr-5 genes were not amplified in any of the phenotypically colistin-resistant strains. In terms of integrase genes int1 and int2, only gene class 2 was amplified in 11% (7/64) of analyzed strains. Risk factors, such as the poor level of cleaning and disinfection, the lack of antimicrobial treatment at the start of the breeding, and a crawl space duration lower than 15 days, were associated with high Salmonella infection in birds. These data should be considered when preparing salmonellosis control programs in Tunisian broiler flocks.
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Colistin: From the shadows to a One Health approach for addressing antimicrobial resistance
Article
  • Jan 2023
  • INT J ANTIMICROB AG
Antimicrobial resistance (AMR) poses a serious threat to human, animal, and environmental health worldwide. Colistin has regained importance as a last-resort treatment against multidrug-resistant Gram-negative bacteria. However, colistin resistance has been reported in various Enterobacteriaceae species isolated from several sources. The 2015 discovery of the plasmid-mediated mcr-1 (mobile colistin resistance) gene conferring resistance to colistin was a major concern within the scientific community worldwide. The global spread of this plasmid - as well as the subsequent identification of 10 MCR-family genes and their variants that catalyse the addition of phosphoethanolamine to the phosphate group of lipid A - underscore the urgent need to regulate colistin use, particularly in animal production. This review traces the history of colistin resistance and mcr-like gene identification and examines the impact of policy changes regarding colistin use on the prevalence of mcr-1-positive E. coli and colistin-resistant E. coli from a One Health perspective. The withdrawal of colistin as a livestock growth promoter in several countries reduced the prevalence of colistin-resistant bacteria and its resistance determinants (e.g., mcr-1 gene) in farm animals, humans, and the environment. This reduction was certainly favored by the significant fitness cost associated with the acquisition and expression of mcr-1 gene in enterobacterial species. The success of this One Health intervention could be used to accelerate regulation of other important antimicrobials, especially those associated with bacterial resistance mechanisms linked to high fitness cost. The development of global collaborations and the implementation of sustainable solutions like the One Health approach are essential for managing AMR.
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