Abstract
Use, overuse, and misuse of antimicrobials contributes to selection and dissemination of bacterial resistance determinants that may be transferred to humans and constitute a global public health concern. Because of the continued emergence and expansion of antimicrobial resistance, combined with the lack of novel antimicrobial agents, efforts are underway to preserve the efficacy of current available life-saving antimicrobials in humans. As a result, uses of medically important antimicrobials in food animal production have generated debate and led to calls to reduce both antimicrobial use and the need for use. This manuscript, commissioned by the World Health Organization (WHO) to help inform the development of the WHO guidelines on the use of medically important antimicrobials in food animals, includes three illustrations of antimicrobial use in food animal production that has contributed to the selection-and subsequent transfer-of resistance determinants from food animals to humans. Herein, antimicrobial use and the epidemiology of bacterial resistance are described for streptothricins, glycopeptides, and colistin. Taken together, these historical and current narratives reinforce the need for actions that will preserve the efficacy of antimicrobials.
Highlights
Use, overuse, and misuse of antimicrobials contributes to selection and dissemination of bacterial resistance determinants that may be transferred to humans and constitute a global public health concern
In this review, we have focused on three illustrative examples of selection— and subsequent transfer of antimicrobial resistance determinants from food animals to humans
The use of antimicrobials in food animal production contributes to the selection and dissemination of antimicrobial resistance determinants that may reach human populations
Summary
Our general knowledge on antimicrobial resistance among bacteria is ever evolving; in particular, the story of colistin resistance is rapidly unfolding. The genetic characterization of the VanA gene cluster provides an illustrative example of the dissemination of glycopeptide resistance from animals to humans following selection, due to use of avoparcin for growth promotion. Evaluation of the VanA gene cluster variants provides an illustrative example of the emergence and selection of a genetic resistance determinant as a consequence of antimicrobial use in food animals, and subsequent dissemination of the resistant bacteria to humans. Since this report was prepared, a number of other mcr variants have been reported, some of which appear to have been disseminating globally prior to characterization[233,234,235] While some of these genes may contribute towards evidencing selection—and subsequent dissemination—of the colistin resistance determinant from food animals to humans, the focus of this report was the initial epidemiology of colistin resistance (i.e. mcr-1). Antimicrobial use in food animals, and subsequent transfer of bacteria harboring that resistant gene to humans
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