Global trends in antimicrobial resistance in animals in low- and middle-income countries

作者：Thomas P. Van Boeckel, João Pires, R. Silvester, Cheng Zhao, Jin Su Song, Nicola G. Criscuolo, Marius Gilbert, Sebastian Bonhoeffer, Ramanan Laxminarayan · 发表于：International Journal of Infectious Diseases · 年份：2020 · DOI：10.1016/j.ijid.2020.09.086 · 被引用次数：31 · 研究领域：Pharmaceutical and Antibiotic Environmental Impacts、Microbial infections and disease research、Salmonella and Campylobacter epidemiology

Background: Since the 1950s, the global increase in demand for meat and dairy has driven the use of antimicrobial drugs in agriculture. This practice has led to the development of antimicrobial resistance in animals and food products, with potentially harmful consequence for agricultural productivity, and human health. In low- and middle-income countries (LMICs), trends in AMR are poorly documented, and surveillance network are at best nascent. Thus far, expert opinion has prevailed over an evidence-based assessment of the AMR status of LMICs. In this context, point prevalence surveys can be used as surrogates to systematic surveillance to provide a baseline of AMR levels, and guide interventions in LMICs. Methods and materials: We extracted twelve thousand resistance rates from point prevalence surveys conducted in LMICs on common foodborne pathogens. Data on AMR was identified for Escherichia coli, non-Typhoidal Salmonella, Campylobacter spp., and Staphylococcus aureus. Resistance rates were manually extracted and curated across all the studies in a public database named RESBANK. We accounted for potential differences in accuracy of antimicrobial susceptibility testing between regions using the WHO External Quality Control System, as well as for temporal revisions of the breakpoints used for susceptibility testing. For each study, we calculated the proportion of drugs tested with resistance levels higher than 50% (P50), and used ensemble geospatial modelling (stacked genera...