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动物抗生素的使用:对细菌耐药性和公众健康的影响。

Antibiotic usage in animals: impact on bacterial resistance and public health.

作者信息

van den Bogaard A E, Stobberingh E E

机构信息

Department of Medical Microbiology, University Maastricht, The Netherlands.

出版信息

Drugs. 1999 Oct;58(4):589-607. doi: 10.2165/00003495-199958040-00002.

Abstract

Antibiotic use whether for therapy or prevention of bacterial diseases, or as performance enhancers will result in antibiotic resistant micro-organisms, not only among pathogens but also among bacteria of the endogenous microflora of animals. The extent to which antibiotic use in animals will contribute to the antibiotic resistance in humans is still under much debate. In addition to the veterinary use of antibiotics, the use of these agents as antimicrobial growth promoters (AGP) greatly influences the prevalence of resistance in animal bacteria and a poses risk factor for the emergence of antibiotic resistance in human pathogens. Antibiotic resistant bacteria such as Escherichia coli, Salmonella spp., Campylobacter spp. and enterococci from animals can colonise or infect the human population via contact (occupational exposure) or via the food chain. Moreover, resistance genes can be transferred from bacteria of animals to human pathogens in the intestinal flora of humans. In humans, the control of resistance is based on hygienic measures: prevention of cross contamination and a decrease in the usage of antibiotics. In food animals housed closely together, hygienic measures, such as prevention of oral-faecal contact, are not feasible. Therefore, diminishing the need for antibiotics is the only possible way of controlling resistance in large groups of animals. This can be achieved by improvement of animal husbandry systems, feed composition and eradication of or vaccination against infectious diseases. Moreover, abolishing the use of antibiotics as feed additives for growth promotion in animals bred as a food source for humans would decrease the use of antibiotics in animals on a worldwide scale by nearly 50%. This would not only diminish the public health risk of dissemination of resistant bacteria or resistant genes from animals to humans, but would also be of major importance in maintaining the efficacy of antibiotics in veterinary medicine.

摘要

抗生素的使用,无论是用于治疗或预防细菌性疾病,还是作为性能增强剂,都会导致产生抗生素耐药微生物,不仅在病原体中如此,在动物内源性微生物群的细菌中也是如此。动物使用抗生素对人类抗生素耐药性的影响程度仍存在诸多争议。除了在兽医领域使用抗生素外,将这些药物用作抗菌生长促进剂(AGP)极大地影响了动物细菌中耐药性的流行,并且是人类病原体中出现抗生素耐药性的一个风险因素。来自动物的抗生素耐药细菌,如大肠杆菌、沙门氏菌属、弯曲杆菌属和肠球菌,可通过接触(职业暴露)或食物链在人群中定植或感染。此外,耐药基因可从动物细菌转移至人类肠道菌群中的人类病原体。在人类中,耐药性的控制基于卫生措施:防止交叉污染和减少抗生素的使用。在饲养密度大的食用动物中,诸如防止口粪接触等卫生措施并不可行。因此,减少对抗生素的需求是控制大量动物耐药性的唯一可行方法。这可以通过改进畜牧系统、饲料成分以及根除传染病或进行疫苗接种来实现。此外,取消将抗生素用作人类食用动物生长促进的饲料添加剂,将在全球范围内使动物抗生素使用量减少近50%。这不仅会降低耐药细菌或耐药基因从动物传播至人类的公共卫生风险,而且对于维持抗生素在兽医学中的疗效也至关重要。

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