Abstract
Antimicrobial resistance is a global threat that kills at least 75,000 people every year worldwide and causes extended hospital stays. In the coming 10 years, antimicrobial resistance is projected to have huge health and economic burden on countries, and the scarcity of available antibiotics further worsens the situation. Antimicrobial resistance results mainly from indiscriminate antibiotic usage in humans, animals and agriculture, and from the rapid emergence and dissemination of resistant pathogens. This issue is challenging for antibiotic stewardship, strict regulations on antibiotics usage, large-scale surveillance and responsible public behavior. This demands international cooperation and integrated efforts under the ‘one-health’ strategy. Here, we review antimicrobial resistance and the one-health strategy. We discuss the historical issue of using antibiotics. We highlight the effectiveness of hygiene in livestock rearing, careful antibiotic usage and large-scale surveillance of animals, humans and environment domains. We present strategies for mitigation of antimicrobial resistance, exemplified by the successful ban of triclosan which induced a significant decline of resistant pathogens. We emphasize the benefits of the global antibiotic resistance partnership and of the one-health participation of stakeholders from public, healthcare professionals and government to mitigate antimicrobial resistance.
Highlights
There have been many stages of discovery and development in the knowledge and status of antibiotics usage and menace of antimicrobial resistance
Regulatory constraints, long development phase, accruing financial inputs dampened the pharmaceutical interest into new antibiotics and fewer antibiotics were developed after the mid-1980s (Spellberg and Gilbert 2014)
High antibiotic concentration is linked to antimicrobial resistance often through horizontal gene transfer of antibiotic resistance determinants such as genes, transposons, integrons in deadly pathogens such as Acinetobacter baumannii (Gillings 2013), (Rodgers et al 2019)
Summary
There have been many stages of discovery and development in the knowledge and status of antibiotics usage and menace of antimicrobial resistance. The interconnections and microbial exchange between ecological niches involving humans, animals and poultry, agriculture, environment and wastewater (sewage) cannot be neglected This is frequently underscored by recognition of animal carriers and zoonotic sources during disease outbreaks (He et al 2021). The underlying principles of ‘one health’ help to achieve long-term sustainability by strengthening human-animal bonds, providing safe food and water, sustainable agricultural practices, surveillance of disease, antimicrobial resistance and environment, alignment of government policies and regulations for efficient communication and global outreach. Direct outcomes of this ‘one-health’ approach would be interdisciplinary solutions emanating from strategic education, training, prevention, diagnosis and novel therapies against antimicrobial resistance (Fig. 1). The issue of antimicrobial resistance can only be dealt through knowledge and multi-thronged mitigation approaches, and we discuss the overlapping landscape of antimicrobial resistance and stakeholders in
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