Murphy C P, Fajt V R, Scott H M, Foster M J, Wickwire P, McEwen S A
Population Medicine,University of Guelph,Guelph,Ontario,Canada.
Department of Veterinary Physiology and Pharmacology,Texas A&M University,TX,USA.
Epidemiol Infect. 2016 Jan;144(1):1-18. doi: 10.1017/S0950268815000722. Epub 2015 Apr 23.
A scoping review was conducted to identify modifiable non-antimicrobial factors to reduce the occurrence of antimicrobial resistance in cattle populations. Searches were developed to retrieve peer-reviewed published studies in animal, human and in vitro microbial populations. Citations were retained when modifiable non-antimicrobial factors or interventions potentially associated with antimicrobial resistance were described. Studies described resistance in five bacterial genera, species or types, and 40 antimicrobials. Modifiable non-antimicrobial factors or interventions ranged widely in type, and the depth of evidence in animal populations was shallow. Specific associations between a factor or intervention with antimicrobial resistance in a population (e.g. associations between organic systems and tetracycline susceptibility in E. coli from cattle) were reported in a maximum of three studies. The identified non-antimicrobial factors or interventions were classified into 16 themes. Most reported associations between the non-antimicrobial modifiable factors or interventions and antimicrobial resistance were not statistically significant (P > 0·05 and a confidence interval including 1), but when significant, the results were not consistent in direction (increase or decrease in antimicrobial resistance) or magnitude. Research is needed to better understand the impacts of promising modifiable factors or interventions on the occurrence of antimicrobial resistance before any recommendations can be offered or adopted.
开展了一项范围综述,以确定可改变的非抗菌因素,以减少牛群中抗菌药物耐药性的发生。制定了检索策略,以检索动物、人类和体外微生物群体中经同行评审发表的研究。当描述了可能与抗菌药物耐药性相关的可改变的非抗菌因素或干预措施时,保留这些文献引用。研究描述了五个细菌属、种或类型以及40种抗菌药物的耐药情况。可改变的非抗菌因素或干预措施的类型范围广泛,动物群体中的证据深度较浅。关于某一因素或干预措施与群体中抗菌药物耐药性之间的具体关联(例如,有机系统与牛源大肠杆菌中四环素敏感性之间的关联),最多在三项研究中有所报道。所确定的非抗菌因素或干预措施被分为16个主题。大多数关于非抗菌可改变因素或干预措施与抗菌药物耐药性之间的关联报告无统计学意义(P>0·05且置信区间包含1),但当具有统计学意义时,结果在方向(抗菌药物耐药性的增加或减少)或幅度上并不一致。在能够提供或采纳任何建议之前,需要开展研究以更好地了解有前景的可改变因素或干预措施对抗菌药物耐药性发生的影响。