抗微生物药物耐药性:对公共卫生系统的全球新出现的威胁。
Antimicrobial resistance: A global emerging threat to public health systems.
机构信息
a Veterinary Service, ASL Pescara , Pescara , Italy.
b Public Hospital , Pescara , Italy.
出版信息
Crit Rev Food Sci Nutr. 2017 Sep 2;57(13):2857-2876. doi: 10.1080/10408398.2015.1077192.
Antimicrobial resistance (AMR) became in the last two decades a global threat to public health systems in the world. Since the antibiotic era, with the discovery of the first antibiotics that provided consistent health benefits to human medicine, the misuse and abuse of antimicrobials in veterinary and human medicine have accelerated the growing worldwide phenomenon of AMR. This article presents an extensive overview of the epidemiology of AMR, with a focus on the link between food producing-animals and humans and on the legal framework and policies currently implemented at the EU level and globally. The ways of responding to the AMR challenges foresee an array of measures that include: designing more effective preventive measures at farm level to reduce the use of antimicrobials; development of novel antimicrobials; strengthening of AMR surveillance system in animal and human populations; better knowledge of the ecology of resistant bacteria and resistant genes; increased awareness of stakeholders on the prudent use of antibiotics in animal productions and clinical arena; and the public health and environmental consequences of AMR. Based on the global nature of AMR and considering that bacterial resistance does not recognize barriers and can spread to people and the environment, the article ends with specific recommendations structured around a holistic approach and targeted to different stakeholders.
抗菌药物耐药性(AMR)在过去二十年中已成为全球公共卫生系统的一大威胁。自抗生素时代以来,随着第一批抗生素的发现为人类医学带来了持续的健康益处,兽用和人用抗菌药物的滥用和误用加速了全球范围内 AMR 现象的不断增长。本文广泛概述了 AMR 的流行病学,重点介绍了食用动物与人类之间的联系,以及欧盟和全球目前实施的法律框架和政策。应对 AMR 挑战的方法包括采取一系列措施,其中包括:在农场层面设计更有效的预防措施,以减少抗生素的使用;开发新型抗生素;加强动物和人类群体中 AMR 的监测系统;更好地了解耐药细菌和耐药基因的生态;提高利益相关者对动物生产和临床领域合理使用抗生素的认识;以及 AMR 对公共卫生和环境的影响。鉴于 AMR 的全球性,以及细菌耐药性不承认障碍并且可以传播给人类和环境,本文最后提出了一些具体建议,这些建议围绕着整体方法和针对不同利益相关者的目标进行构建。