Probing popular and political discourse on antimicrobial resistance in China

Drivers of global media attention and representations for antimicrobial resistance risk: an analysis of online English and Chinese news media data, 2015-2018

BACKGROUND

How antimicrobial resistance (AMR) risk is communicated in news media can shape public understanding and the engagement of different sectors with AMR. This study examined online news media attention for AMR risk and analyzed how AMR risk was communicated using a global sample of English and Chinese news articles.

METHODS

A total of 16,265 and 8335 English and Chinese news relevant to AMR risk, respectively, published in 2015-2018 were retrieved from a professional media-monitoring platform, to examine media attention for AMR and its drivers, of which, 788 articles from six main English-speaking countries and three main Chinese-speaking territories were drawn using constructed-week sampling for content analysis.

RESULTS

Media attention mainly fluctuated around official reports or scientific discovery of AMR risks or solutions but seldom around reports of inappropriate antimicrobial use (AMU), and not consistently increased in response to World Antimicrobial Awareness Week. The content analysis found that (1) heterogeneous medical terminologies and the 'superbug' frame were most commonly used to define AMR or AMR risk; (2) a temporal increase in communicating microbial evolution as a process of AMR was identified but communication about inappropriate AMU in general consumers as the cause of AMR remained inadequate; and (3) the multifaceted consequences of AMR and individual actions that can be taken to tackle AMR were inadequately communicated.

CONCLUSIONS

The media should be encouraged or reoriented to communicate more about actions that can be taken by general consumers to enable collective actions and the multifaceted conseuqences of AMR to encourage one-health approach for tackling AMR.

Comparison of China's and the European Union's Approaches to Antimicrobial Stewardship in the Pork Industry

Antimicrobial resistance (AMR) is a recognized global public health concern. Although the link between antimicrobial usage in food animals and AMR in humans is established, the detailed interactions are unclear. Antimicrobial stewardship (AMS) in livestock was first implemented in Europe with Sweden as the pioneer in 1986. Despite this head start, AMR is still an ongoing challenge for Europe. The European Union (EU) is an established agriculture producer, the second largest pork producer globally, and one of the largest markets for organic food. China is the global leader in both production and consumption of pork. China's rise in prosperity has led to an increase in its pork demand. Chinese producers commonly use antimicrobials during production for disease treatment and prevention to meet this increased demand. China's rising prosperity together with recent publicized food safety scandals, disease outbreaks in domestic livestock products, and increased AMR awareness have resulted in an increased willingness to pay and demand for organic food by Chinese consumers. Responding to the growing concerns of AMR by consumers and the World Health Organization (WHO), the Chinese government introduced a national pilot program in 2016 to reduce unnecessary antimicrobial use. Compared with China, the EU is a different entity as it is a political union comprising diverse countries and although it may have more experience in AMS, both entities face similar issues with AMR and increasing demand for organic food. Increased interest in organic food has arisen due to concerns about AMR, food safety, outbreaks of bacterial food contamination, and animal welfare. This article aims to compare the different AMS strategies employed by each entity, China and the EU, and how the increased demand for organic produce globally also influences the effort to reduce antimicrobial use in these entities' pork industries.

Farm Animal Welfare Science in China-A Bibliometric Review of Chinese Literature

Simple Summary

For animal welfare scientists and advocates who operate in English, it may be assumed that animal welfare is not an area that receives attention within China; coupled with an awareness that China has not yet opted to enact animal welfare legislation, the reason for this assumption may also be in part due to the perceived lack of animal welfare literature coming from the country. Operating under the hypothesis that animal welfare literature emanating from China may have instead been published in Chinese, rather than English, this study reports the finding of a systematic search of Chinese animal welfare literature on Chinese databases. We searched for articles and research publications released in a recent 10-year period, specifically related to the welfare of the two most commonly farmed land-based animals in China; pigs and chickens, and identified 854 academic publications. In order to facilitate an understanding of Chinese scientific priorities in the field, we further categorised the identified literature into broader approximate categories of welfare freedoms (e.g., freedom from hunger and thirst, freedom to express natural behavior). The identification of a significant animal welfare literature represents an opportunity to increase collaboration with Chinese partners by identifying areas of mutual interest, and to share mutually beneficial knowledge more readily. This could be sustained by increasing the accessibility of Chinese literature to English speakers, and to English literature to Chinese speakers.

Abstract

Farm animal welfare in the People’s Republic of China (henceforth, China) is not well represented in the international scientific literature. This may lead researchers, advocates and those with agricultural partnerships in China to assume that animal welfare is not a field of interest there. This study reports a literature review of published pig and poultry welfare research in China using Chinese scientific databases. We aimed to determine which areas of welfare research have recently received academic attention in China. From an understanding of areas being studied, current and emerging priority areas for research could be determined. This study identified 854 academic publications citing pig or chicken welfare in China published between 2008 and 2018. Within these publications, two broader areas of significant attention were addressed in the context of animal welfare; yield and product quality, such as feeding, biosecurity and antimicrobial resistance, including immunity and second, the relationship of animal welfare with the Chinese philosophy of ‘ecological agriculture.’ Holistic systems were advocated to maximize sustainability and maintain a healthy environment, such as the creation of fermented bedding for pigs. Environmental enrichment was also a focus of attention, demonstrating an interest in animals’ mental welfare, which was usually conjectured from their behavior. Few of the articles were translated into English or other languages and therefore most were largely unavailable to the English-speaking global scientific community. This presents an opportunity to provide relevant animal welfare knowledge, which could improve animal welfare globally. China is a global animal trade leader and the home of the largest agricultural industries in the world. An increase in collaboration on animal welfare research and understanding of the advancements that have been made in China, as reviewed in this manuscript, could advance farm animal welfare from a global perspective.

Direct medical burden of antimicrobial-resistant healthcare-associated infections: empirical evidence from China

BACKGROUND

Antimicrobial resistance (AMR) and healthcare-associated infections (HAIs) are among the biggest global public health challenges, and overlap widely. These infections cause significant morbidity and mortality, put pressure on health systems, and incur rising direct and indirect costs.

AIM

This study analysed the direct medical burden attributable to AMR-HAIs in Chinese public tertiary hospitals, and aimed to inform both the medical regulators and hospital managers for better control of HAIs and containment of AMR.

METHODS

The propensity score matching method (γ= 0.25σ, nearest neighbor 1:1 matching) was applied to conduct a retrospective cohort study in five public tertiary hospitals in the Hubei province of China during 2013-2015. Descriptive analysis, Pearson's chi-squared test, Mann-Whitney U-test, Wilcoxon signed-rank test and paired/independent Z/T test were conducted. The statistically significant level was set at P<0.05.

FINDINGS

From 2013 to 2015 overall, the additional total medical expenditure per HAI-AMR inpatient was US$15,557.25 compared with that of the non-HAIs, and the additional length of per hospital stay of the HAI-AMR inpatient was 41 days compared with that of the non-HAIs (P<0.001).

CONCLUSIONS

In combination with AMR, HAIs caused significant additional medical expenses and affected the turnover rate of hospital beds. Most of the increased medical costs fell to patients and their families. These findings call for more effective control of HAIs and containment of AMR. A national study is needed to estimate the medical, social and economic burden of HAIs in combination with AMR.