Background Antimicrobial resistance is an increasing challenge in low and middle-income countries as it is wide-spread in these countries and is linked to an increased mortality.Apart from human and environmental fact...Background Antimicrobial resistance is an increasing challenge in low and middle-income countries as it is wide-spread in these countries and is linked to an increased mortality.Apart from human and environmental factors,animal-related drivers of antimicrobial resistance in low-and middle-income countries have special features that differ from high-income countries.The aim of this narrative review is to address the zoonotic sources and the spread of antimicrobial resistance from the perspective of low-and middle-income countries.Main body Contamination with extended-spectrum beta-lactamase(ESBL)-producingEscherichia coli is highest in poultry(Africa:8.9–60%,Asia:53–93%)and there is a risk to import ESBL-producingE.coli through poultry meat in Africa.In aquacultures,the proportion of ESBL-producers amongE.coli can be high(27%)but the overall low quality of published studies limit the general conclusion on the impact of aquacultures on human health.ESBL-producingE.coli colonization of wildlife is 1–9%in bats or 2.5–63%birds.Since most of them are migratory animals,they can disperse antimicrobial resistant bacteria over large distances.So-called‘filth flies’are a relevant vector not only of enteric pathogens but also of antimicrobial resistant bacteria in settings where sanitary systems are poor.In Africa,up to 72.5%of‘filth flies’are colonized with ESBL-producingE.coli,mostly conferred by CTX-M(24.4–100%).While methicillin-resistantStaphylococcus aureus plays a minor role in livestock in Africa,it is frequently found in South America in poultry(27%)or pork(37.5–56.5%)but less common in Asia(poultry:3%,pork:1–16%).Conclusions Interventions to contain the spread of AMR should be tailored to the needs of low-and middle-income countries.These comprise capacity building of diagnostic facilities,surveillance,infection prevention and control in small-scale farming.展开更多
基金We acknowledge the open access fund of the University of Münster.
文摘Background Antimicrobial resistance is an increasing challenge in low and middle-income countries as it is wide-spread in these countries and is linked to an increased mortality.Apart from human and environmental factors,animal-related drivers of antimicrobial resistance in low-and middle-income countries have special features that differ from high-income countries.The aim of this narrative review is to address the zoonotic sources and the spread of antimicrobial resistance from the perspective of low-and middle-income countries.Main body Contamination with extended-spectrum beta-lactamase(ESBL)-producingEscherichia coli is highest in poultry(Africa:8.9–60%,Asia:53–93%)and there is a risk to import ESBL-producingE.coli through poultry meat in Africa.In aquacultures,the proportion of ESBL-producers amongE.coli can be high(27%)but the overall low quality of published studies limit the general conclusion on the impact of aquacultures on human health.ESBL-producingE.coli colonization of wildlife is 1–9%in bats or 2.5–63%birds.Since most of them are migratory animals,they can disperse antimicrobial resistant bacteria over large distances.So-called‘filth flies’are a relevant vector not only of enteric pathogens but also of antimicrobial resistant bacteria in settings where sanitary systems are poor.In Africa,up to 72.5%of‘filth flies’are colonized with ESBL-producingE.coli,mostly conferred by CTX-M(24.4–100%).While methicillin-resistantStaphylococcus aureus plays a minor role in livestock in Africa,it is frequently found in South America in poultry(27%)or pork(37.5–56.5%)but less common in Asia(poultry:3%,pork:1–16%).Conclusions Interventions to contain the spread of AMR should be tailored to the needs of low-and middle-income countries.These comprise capacity building of diagnostic facilities,surveillance,infection prevention and control in small-scale farming.
