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Nohrborg S, Nguyen‐Thi T, Xuan HN, Hai YLT, Lindahl J, Boqvist S, Järhult JD, Magnusson U. Understanding veterinary drug shop workers' knowledge and practices to identify drivers of antibiotic use in Vietnamese livestock farms. Vet Med Sci 2024; 10:e1502. [PMID: 38853587 PMCID: PMC11163190 DOI: 10.1002/vms3.1502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 04/24/2024] [Accepted: 05/17/2024] [Indexed: 06/11/2024] Open
Abstract
BACKGROUND Antimicrobial resistance (AMR) is a One Health issue and a major threat to animal and human health. Antibiotic use (ABU) drives AMR development, and several hotspots for ABU, and AMR, in livestock have been identified in Southeast Asia, including Vietnam. There are often multiple drivers of ABU at farms, and to identify all of them there is a need to look beyond farm level. OBJECTIVES The overall aim of this study was to identify routines and/or competencies, related to antibiotic sales, among veterinary drug shop workers that may be improved in order to decrease the medically non-rational use of antibiotics in livestock production. METHODS A questionnaire-based survey was conducted at 50 veterinary drug shops in northern Vietnam. RESULTS Results showed high education and knowledge levels. According to the respondents, antibiotic treatment advice was almost always provided to the farmers, and the recommended treatment was most commonly based on recommendations for the specific disease. However, farmers had almost never had their animals properly diagnosed. Antibiotics were the most sold drug category, penicillins being the most common. Several broad-spectrum antibiotics were also quite frequently sold. Further, >50% of respondents recommended antibiotics for disease prevention. CONCLUSIONS Even though education and knowledge levels might be high, several challenges can prevent drug shop workers from contributing to more prudent ABU at farms, for example, lack of proper diagnosis, commercial interests and individual farmer motives, often in combination with poor compliance to regulations.
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Affiliation(s)
- Sandra Nohrborg
- Department of Clinical SciencesSwedish University of Agricultural SciencesUppsalaSweden
| | - Thinh Nguyen‐Thi
- International Livestock Research InstituteRegional Office for East and Southeast AsiaHanoiVietnam
| | - Huyen Nguyen Xuan
- Department of BacteriologyNational Institute of Veterinary ResearchHanoiVietnam
| | - Yen Luu Thi Hai
- Department of BacteriologyNational Institute of Veterinary ResearchHanoiVietnam
| | - Johanna Lindahl
- Department of Animal Health and Antimicrobial StrategiesSwedish Veterinary AgencyUppsalaSweden
| | - Sofia Boqvist
- Department of Animal BiosciencesSwedish University of Agricultural SciencesUppsalaSweden
| | - Josef D. Järhult
- Zoonosis Science Center, Department of Medical SciencesUppsala UniversityUppsalaSweden
| | - Ulf Magnusson
- Department of Clinical SciencesSwedish University of Agricultural SciencesUppsalaSweden
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Nohrborg S, Nguyen-Thi T, Xuan HN, Lindahl J, Boqvist S, Järhult JD, Magnusson U. Understanding Vietnamese chicken farmers' knowledge and practices related to antimicrobial resistance using an item response theory approach. Front Vet Sci 2024; 11:1319933. [PMID: 38645642 PMCID: PMC11027563 DOI: 10.3389/fvets.2024.1319933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 03/21/2024] [Indexed: 04/23/2024] Open
Abstract
Introduction Antimicrobial resistance (AMR) poses a threat to animal and human health, as well as food security and nutrition. Development of AMR is accelerated by over- and misuse of antimicrobials as seen in many livestock systems, including poultry production. In Vietnam, high AMR levels have been reported previously within poultry production, a sector which is dominated by small-scale farming, even though it is intensifying. This study focuses on understanding small- and medium-scale chicken farmers' knowledge and practices related to AMR by applying an item response theory (IRT) approach, which has several advantages over simpler statistical methods. Methods Farmers representing 305 farms in Thai Nguyen province were interviewed from November 2021 to January 2022, using a structured questionnaire. Results generated with IRT were used in regression models to find associations between farm characteristics, and knowledge and practice levels. Results Descriptive results showed that almost all farmers could buy veterinary drugs without prescription in the local community, that only one third of the farmers received veterinary professional advice or services, and that the majority of farmers gave antibiotics as a disease preventive measure. Regression analysis showed that multiple farm characteristics were significantly associated to farmers' knowledge and practice scores. Conclusion The study highlights the complexity when tailoring interventions to move towards more medically rational antibiotic use at farms in a setting with high access to over-the-counter veterinary drugs and low access to veterinary services, since many on-farm factors relevant for the specific context need to be considered.
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Affiliation(s)
- Sandra Nohrborg
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Thinh Nguyen-Thi
- International Livestock Research Institute, Regional Office for East and Southeast Asia, Hanoi, Vietnam
| | - Huyen Nguyen Xuan
- Department of Bacteriology, National Institute of Veterinary Research, Hanoi, Vietnam
| | - Johanna Lindahl
- Department of Animal Health and Antimicrobial Strategies, National Veterinary Institute, Uppsala, Sweden
| | - Sofia Boqvist
- Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Josef D. Järhult
- Department of Medical Sciences, Zoonosis Science Center, Uppsala University, Uppsala, Sweden
| | - Ulf Magnusson
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
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3
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Brizuela J, Kajeekul R, Roodsant TJ, Riwload A, Boueroy P, Pattanapongpaibool A, Thaipadungpanit J, Jenjaroenpun P, Wongsurawat T, Batty EM, van der Putten BCL, Schultsz C, Kerdsin A. Streptococcus suis outbreak caused by an emerging zoonotic strain with acquired multi-drug resistance in Thailand. Microb Genom 2023; 9:mgen000952. [PMID: 36790403 PMCID: PMC9997742 DOI: 10.1099/mgen.0.000952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
Streptococcus suis is an emerging zoonotic swine pathogen which can cause severe infections in humans. In March 2021, an outbreak of S. suis infections with 19 confirmed cases of septicemia and meningitis leading to two deaths, occurred in Nakhon Ratchasima province, Thailand. We characterized the outbreak through an epidemiological investigation combined with Illumina and Nanopore whole genome sequencing (WGS). The source of the outbreak was traced back to a raw pork dish prepared from a single pig during a Buddhist ceremony attended by 241 people. WGS analysis revealed that a single S. suis serotype 2 strain belonging to a novel sequence type (ST) of the emergent Thai zoonotic clade CC233/379, was responsible for the infections. The outbreak clone grouped together with other Thai zoonotic strains from CC233/379 and CC104 in a global S. suis phylogeny and capsule switching events between serotype 2 zoonotic strains and serotype 7 porcine strains were identified. The outbreak strain showed reduced susceptibility to penicillin corresponding with mutations in key residues in the penicillin binding proteins (PBPs). Furthermore, the outbreak strain was resistant to tetracycline, erythromycin, clindamycin, linezolid and chloramphenicol, having acquired an integrative and conjugative element (ICE) carrying resistance genes tetO and ermB, as well as a transposon from the IS1216 family carrying optrA and ermA. This investigation demonstrates that multi-drug resistant zoonotic lineages of S. suis which pose a threat to human health continue to emerge.
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Affiliation(s)
- Jaime Brizuela
- Amsterdam UMC location University of Amsterdam, Department of Global Health, Amsterdam Institute for Global Health and Development, Paasheuvelweg 25, Amsterdam, The Netherlands.,Amsterdam UMC location University of Amsterdam, Department of Medical Microbiology and Infection Prevention, Meibergdreef 9, Amsterdam, The Netherlands
| | - Rattagan Kajeekul
- Department of Medicine, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand
| | - Thomas J Roodsant
- Amsterdam UMC location University of Amsterdam, Department of Global Health, Amsterdam Institute for Global Health and Development, Paasheuvelweg 25, Amsterdam, The Netherlands.,Amsterdam UMC location University of Amsterdam, Department of Medical Microbiology and Infection Prevention, Meibergdreef 9, Amsterdam, The Netherlands
| | - Athita Riwload
- Clinical Microbiology Laboratory, Department of Medical Technology, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand
| | - Parichart Boueroy
- Faculty of Public Health, Kasetsart University Chalermphrakiat Sakon Nakhon Province Campus, Sakon Nakhon, Thailand
| | | | - Janjira Thaipadungpanit
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Piroon Jenjaroenpun
- Division of Bioinformatics and Data Management for Research, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Thidathip Wongsurawat
- Division of Bioinformatics and Data Management for Research, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Elizabeth M Batty
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Boas C L van der Putten
- Amsterdam UMC location University of Amsterdam, Department of Global Health, Amsterdam Institute for Global Health and Development, Paasheuvelweg 25, Amsterdam, The Netherlands.,Amsterdam UMC location University of Amsterdam, Department of Medical Microbiology and Infection Prevention, Meibergdreef 9, Amsterdam, The Netherlands
| | - Constance Schultsz
- Amsterdam UMC location University of Amsterdam, Department of Global Health, Amsterdam Institute for Global Health and Development, Paasheuvelweg 25, Amsterdam, The Netherlands.,Amsterdam UMC location University of Amsterdam, Department of Medical Microbiology and Infection Prevention, Meibergdreef 9, Amsterdam, The Netherlands
| | - Anusak Kerdsin
- Faculty of Public Health, Kasetsart University Chalermphrakiat Sakon Nakhon Province Campus, Sakon Nakhon, Thailand
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Malijan GM, Howteerakul N, Ali N, Siri S, Kengganpanich M, Nascimento R, Booton RD, Turner KM, Cooper BS, Meeyai A. A scoping review of antibiotic use practices and drivers of inappropriate antibiotic use in animal farms in WHO Southeast Asia region. One Health 2022; 15:100412. [PMID: 36277092 PMCID: PMC9582544 DOI: 10.1016/j.onehlt.2022.100412] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/13/2022] [Accepted: 06/23/2022] [Indexed: 11/29/2022] Open
Abstract
Antibiotic use (ABU) plays an important role in the proliferation of antimicrobial resistance (AMR). Global antimicrobial consumption in food production is projected to rise by 67% from 2010 to 2030, but available estimates are limited by the scarcity of ABU data and absence of global surveillance systems. The WHO South-East Asia (WHO SEA) region is at high risk of emergence of AMR, likely driven by intensifying farm operations and worsening ABU hotspots. However, little is known about farm-level ABU practices in the region. To summarize emerging evidence and research gaps, we conducted a scoping review of ABU practices following the Arksey and O'Malley methodological framework. We included studies published between 2010 and 2021 on farm-level ABU/AMR in the 11 WHO SEA member states, and databases were last searched on 31 October 2021. Our search strategy identified 184 unique articles, and 25 publications underwent full-text eligibility assessment. Seventeen studies, reported in 18 publications, were included in the scoping review. We found heterogeneity in the categorizations, definitions, and ABU characterization methods used across studies and farm types. Most studies involved poultry, pig, and cattle farms, and only one study examined aquaculture. Most studies evaluated ABU prevalence by asking respondents about the presence or absence of ABU in the farm. Only two studies quantified antibiotic consumption, and sampling bias and lack of standardized data collection methods were identified as key limitations. Emerging evidence that farm workers had difficulty differentiating antibiotics from other substances contributed to the uncertainty about the reliability of self-reported data without other validation techniques. ABU for growth promotion and treatment were prevalent. We found a large overlap in the critically important antibiotics used in farm animals and humans. The ease of access to antibiotics compounded by the difficulties in accessing quality veterinary care and preventive services likely drive inappropriate ABU in complex ways. The methods used to characterize antibiotic use in farm animals are heterogenous. Studies characterizing antibiotic use are limited in number and validity. The antibiotics used in farm animals are critically important to human medicine. Easy antibiotic access and limited veterinary care likely drive inappropriate use.
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Affiliation(s)
- Greco Mark Malijan
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX1 3SY, United Kingdom
| | - Nopporn Howteerakul
- Department of Epidemiology, Faculty of Public Health, Mahidol University, 420/1 Ratchawithi Rd., Ratchathewi District, Bangkok 10400, Thailand
| | - Natasha Ali
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX1 3SY, United Kingdom
| | - Sukhontha Siri
- Department of Epidemiology, Faculty of Public Health, Mahidol University, 420/1 Ratchawithi Rd., Ratchathewi District, Bangkok 10400, Thailand
| | - Mondha Kengganpanich
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, 420/1 Ratchawithi Rd., Ratchathewi District, Bangkok 10400, Thailand
| | | | - Roger Nascimento
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX1 3SY, United Kingdom
| | - Ross D. Booton
- UK Health Security Agency, 133-155 Waterloo Road, London, SE1 8UG, United Kingdom
| | | | - Ben S. Cooper
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX1 3SY, United Kingdom
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Thailand
| | - Aronrag Meeyai
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX1 3SY, United Kingdom
- Department of Epidemiology, Faculty of Public Health, Mahidol University, 420/1 Ratchawithi Rd., Ratchathewi District, Bangkok 10400, Thailand
- Corresponding author at: Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX1 3SY, United Kingdom.
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Swarthout JM, Chan EMG, Garcia D, Nadimpalli ML, Pickering AJ. Human Colonization with Antibiotic-Resistant Bacteria from Nonoccupational Exposure to Domesticated Animals in Low- and Middle-Income Countries: A Critical Review. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:14875-14890. [PMID: 35947446 DOI: 10.1021/acs.est.2c01494] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Data on community-acquired antibiotic-resistant bacterial infections are particularly sparse in low- and middle-income countries (LMICs). Limited surveillance and oversight of antibiotic use in food-producing animals, inadequate access to safe drinking water, and insufficient sanitation and hygiene infrastructure in LMICs could exacerbate the risk of zoonotic antibiotic resistance transmission. This critical review compiles evidence of zoonotic exchange of antibiotic-resistant bacteria (ARB) or antibiotic resistance genes (ARGs) within households and backyard farms in LMICs, as well as assesses transmission mechanisms, risk factors, and environmental transmission pathways. Overall, substantial evidence exists for exchange of antibiotic resistance between domesticated animals and in-contact humans. Whole bacteria transmission and horizontal gene transfer between humans and animals were demonstrated within and between households and backyard farms. Further, we identified water, soil, and animal food products as environmental transmission pathways for exchange of ARB and ARGs between animals and humans, although directionality of transmission is poorly understood. Herein we propose study designs, methods, and topical considerations for priority incorporation into future One Health research to inform effective interventions and policies to disrupt zoonotic antibiotic resistance exchange in low-income communities.
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Affiliation(s)
- Jenna M Swarthout
- Department of Civil and Environmental Engineering, Tufts University, Medford, Massachusetts 02155, United States
| | - Elana M G Chan
- Department of Civil and Environmental Engineering, Tufts University, Medford, Massachusetts 02155, United States
| | - Denise Garcia
- Department of Civil and Environmental Engineering, University of California, Berkeley, Berkeley, California 94720, United States
| | - Maya L Nadimpalli
- Department of Civil and Environmental Engineering, Tufts University, Medford, Massachusetts 02155, United States
- Stuart B. Levy Center for Integrated Management of Antimicrobial Resistance, Tufts University, Boston, Massachusetts 02111, United States
| | - Amy J Pickering
- Department of Civil and Environmental Engineering, Tufts University, Medford, Massachusetts 02155, United States
- Department of Civil and Environmental Engineering, University of California, Berkeley, Berkeley, California 94720, United States
- Stuart B. Levy Center for Integrated Management of Antimicrobial Resistance, Tufts University, Boston, Massachusetts 02111, United States
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6
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Genome-associations of extended-spectrum ß-lactamase producing (ESBL) or AmpC producing E. coli in small and medium pig farms from Khon Kaen province, Thailand. BMC Microbiol 2022; 22:253. [PMID: 36266637 PMCID: PMC9585832 DOI: 10.1186/s12866-022-02646-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 09/09/2022] [Indexed: 11/30/2022] Open
Abstract
Thailand is undergoing rapid intensification of livestock production where small subsistence farms and medium sized commercial farms coexist. In medium farms, antimicrobials are prescribed by a veterinarian, whereas in small farms antimicrobial use remains largely unsupervised. The impact of these differences as well as other farming practices on the emergence and composition of antimicrobial resistance genes (ARGs) remains largely unknown. We analyzed 363 genomes of extended-spectrum ß-lactamase producing (ESBL) and/or AmpC producing Escherichia coli recovered from humans and pigs at small and medium farms from the Khon Kaen province, Thailand. We tested for genome-wide associations to identify links between ARGs, host, and farm size. Pig isolates from small farms were associated with mcr and qnr genes conferring resistance to colistin and fluoroquinolones, respectively. In contrast, pig isolates from medium farms were associated with ARGs conferring resistance to drugs commonly used on medium farms (i.e., streptomycin). ESBL plasmids from small farms co-carried ARGs conferring resistance to critically important antimicrobials more frequently compared to plasmid from medium farms. Frequent ARG combinations included blaCTX-M-55 + qnrS1 (29.8% vs 17.5% in small and medium farms, respectively), blaCTX-M-55 + qnrS1 + mcr-3.19 (5% vs 0%), blaCTX-M-14 + qnrS1 (9.3% vs 6.2%), and blaCTX-M-14 + qnrS1 + mcr-1.1 (3.1% vs 0%). The co-location on plasmids of ARGs conferring resistance to critically important antimicrobials as defined by the World Health Organization is concerning, and actions to curb their spread are urgently needed. Legislation on limiting antimicrobial sales and initiatives to better inform farmers and veterinarians on appropriate antimicrobial usage and farm biosecurity could help reduce antimicrobial use on farms.
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Bastard J, Nhung NT, Hien VB, Kiet BT, Temime L, Opatowski L, Carrique‐Mas J, Choisy M. Modelling the impact of antimicrobial use and external introductions on commensal E. coli colistin resistance in small-scale chicken farms of the Mekong delta of Vietnam. Transbound Emerg Dis 2022; 69:e2185-e2194. [PMID: 35419995 PMCID: PMC9790599 DOI: 10.1111/tbed.14558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 03/13/2022] [Accepted: 04/08/2022] [Indexed: 12/31/2022]
Abstract
Colistin is a critically important antimicrobial for human medicine, and colistin-resistant Escherichia coli are commonly found in poultry and poultry products in Southeast Asia. Here, we aim at disentangling the within-farm and outside-farm drivers of colistin resistance in small-scale chicken farms of the Mekong delta of Vietnam. Nineteen Vietnamese chicken farms were followed up along a whole production cycle, during which weekly antimicrobial use data were recorded. At the beginning, middle and end of each production cycle, commensal E. coli samples from birds were collected, pooled and tested for colistin resistance. Twelve models were fitted to the data using an expectation-maximization algorithm and compared. We further tested the spatial clustering of the occurrence of resistance importations from external sources using the local Moran's I statistic. In the best model, colistin resistance in E. coli from chickens was found to be mostly affected by importations of resistance, and, to a lesser extent, by the use of antimicrobials in the last 1.73 weeks [0.00; 2.90], but not by the use of antimicrobials in day-olds, nor their colistin resistance carriage from hatchery. The occurrence of external source importations proved to be sometimes spatially clustered, suggesting a role of local environmental sources of colistin resistance.
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Affiliation(s)
- Jonathan Bastard
- Université Paris‐Saclay, UVSQ, Univ. Paris‐Sud, Inserm, CESP, Anti‐Infective Evasion and Pharmacoepidemiology TeamMontigny‐le‐BretonneuxFrance
- Institut PasteurEpidemiology and Modelling of Antibiotic Evasion UnitParisFrance
- MESuRS laboratoryConservatoire national des arts et métiersParisFrance
- PACRI unitInstitut PasteurConservatoire national des arts et métiersParisFrance
| | | | - Vo Be Hien
- Sub‐Department of Animal Health and Production, Dong ThapVietnam
| | - Bach Tuan Kiet
- Sub‐Department of Animal Health and Production, Dong ThapVietnam
| | - Laura Temime
- MESuRS laboratoryConservatoire national des arts et métiersParisFrance
- PACRI unitInstitut PasteurConservatoire national des arts et métiersParisFrance
| | - Lulla Opatowski
- Université Paris‐Saclay, UVSQ, Univ. Paris‐Sud, Inserm, CESP, Anti‐Infective Evasion and Pharmacoepidemiology TeamMontigny‐le‐BretonneuxFrance
- Institut PasteurEpidemiology and Modelling of Antibiotic Evasion UnitParisFrance
| | - Juan Carrique‐Mas
- Oxford University Clinical Research UnitHo Chi MinhVietnam
- Centre for Tropical Medicine and Global HealthOxford UniversityOxfordUK
| | - Marc Choisy
- Oxford University Clinical Research UnitHo Chi MinhVietnam
- Centre for Tropical Medicine and Global HealthOxford UniversityOxfordUK
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Zhao C, Wang Y, Tiseo K, Pires J, Criscuolo NG, Van Boeckel TP. Geographically targeted surveillance of livestock could help prioritize intervention against antimicrobial resistance in China. NATURE FOOD 2021; 2:596-602. [PMID: 37118162 DOI: 10.1038/s43016-021-00320-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 06/15/2021] [Indexed: 04/30/2023]
Abstract
The rise of antimicrobial resistance (AMR) in animals is being fuelled by the widespread use of veterinary antimicrobials. China is the largest global consumer of veterinary antimicrobials, and improving AMR surveillance strategies in this region could help prioritize intervention and preserve antimicrobial efficacy. Here we mapped AMR rates in pigs, chickens and cattle in China using 446 surveys of event-based surveillance between 2000 and 2019 for foodborne bacteria, in combination with geospatial models to identify locations where conducting new surveys could have the highest benefits. Using maps of uncertainty, we show that eastern China currently has the highest AMR rates, and southwestern and northeastern China would benefit the most from additional surveillance efforts. Instead of distributing new surveys evenly across administrative divisions, using geographically targeted surveillance could reduce AMR prediction uncertainty by two-fold. In a context of competing disease control priorities, our findings present a feasible option for optimizing surveillance efforts-and slowing the spread of AMR.
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Affiliation(s)
- Cheng Zhao
- Institute for Environmental Decisions, ETH Zurich, Zurich, Switzerland
| | - Yu Wang
- Institute for Environmental Decisions, ETH Zurich, Zurich, Switzerland
| | - Katie Tiseo
- Institute for Environmental Decisions, ETH Zurich, Zurich, Switzerland
| | - João Pires
- Institute for Environmental Decisions, ETH Zurich, Zurich, Switzerland
| | | | - Thomas P Van Boeckel
- Institute for Environmental Decisions, ETH Zurich, Zurich, Switzerland.
- Center for Disease Dynamics, Economics & Policy, Washington DC, USA.
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