Rhouma Mohamed, Fairbrother John Morris, Beaudry Francis, Letellier Ann
Department of Pathology and Microbiology, Faculty of Veterinary Medicine, University of Montreal, 3200 Sicotte Street, Saint-Hyacinthe, QC, J2S 2M2, Canada.
Department of Veterinary Biomedicine, Faculty of Veterinary Medicine, University of Montreal, 3200 Sicotte Street, Saint-Hyacinthe, QC, J2S 2M2, Canada.
Acta Vet Scand. 2017 May 19;59(1):31. doi: 10.1186/s13028-017-0299-7.
Post-weaning diarrhea (PWD) is one of the most serious threats for the swine industry worldwide. It is commonly associated with the proliferation of enterotoxigenic Escherichia coli in the pig intestine. Colistin, a cationic antibiotic, is widely used in swine for the oral treatment of intestinal infections caused by E. coli, and particularly of PWD. However, despite the effectiveness of this antibiotic in the treatment of PWD, several studies have reported high rates of colistin resistant E. coli in swine. Furthermore, this antibiotic is considered of very high importance in humans, being used for the treatment of infections due to multidrug-resistant (MDR) Gram-negative bacteria (GNB). Moreover, the recent discovery of the mcr-1 gene encoding for colistin resistance in Enterobacteriaceae on a conjugative stable plasmid has raised great concern about the possible loss of colistin effectiveness for the treatment of MDR-GNB in humans. Consequently, it has been proposed that the use of colistin in animal production should be considered as a last resort treatment only. Thus, to overcome the economic losses, which would result from the restriction of use of colistin, especially for prophylactic purposes in PWD control, we believe that an understanding of the factors contributing to the development of this disease and the putting in place of practical alternative strategies for the control of PWD in swine is crucial. Such alternatives should improve animal gut health and reduce economic losses in pigs without promoting bacterial resistance. The present review begins with an overview of risk factors of PWD and an update of colistin use in PWD control worldwide in terms of quantities and microbiological outcomes. Subsequently, alternative strategies to the use of colistin for the control of this disease are described and discussed. Finally, a practical approach for the control of PWD in its various phases is proposed.
断奶后腹泻（PWD）是全球养猪业面临的最严重威胁之一。它通常与产肠毒素大肠杆菌在猪肠道内的增殖有关。黏菌素是一种阳离子抗生素，广泛用于猪，用于口服治疗由大肠杆菌引起的肠道感染，尤其是断奶后腹泻。然而，尽管这种抗生素在治疗断奶后腹泻方面有效，但多项研究报告称猪体内对黏菌素有抗性的大肠杆菌比例很高。此外，这种抗生素在人类中被认为非常重要，用于治疗多重耐药（MDR）革兰氏阴性菌（GNB）引起的感染。此外，最近在接合稳定质粒上发现了编码肠杆菌科黏菌素抗性的mcr-1基因，这引起了人们对黏菌素治疗人类多重耐药革兰氏阴性菌有效性可能丧失的极大关注。因此，有人提议仅应将黏菌素在动物生产中的使用视为最后的治疗手段。因此，为了克服因限制使用黏菌素，特别是在控制断奶后腹泻的预防目的方面使用黏菌素而导致的经济损失，我们认为了解导致这种疾病发生的因素并制定切实可行的替代策略来控制猪的断奶后腹泻至关重要。这些替代方法应改善动物肠道健康，减少猪的经济损失，同时不会促进细菌耐药性。本综述首先概述断奶后腹泻的风险因素，并更新全球在控制断奶后腹泻中使用黏菌素的数量和微生物学结果。随后，描述并讨论了替代黏菌素用于控制这种疾病的策略。最后，提出了在断奶后腹泻各个阶段进行控制的实用方法。
