Department of Population Medicine, University of Guelph, Guelph, Canada N1G 2W1.
Infectious Diseases and Microbiology, Canberra Hospital, Canberra, Australia and Medical School, Australian National University, Acton, Australia.
Microbiol Spectr. 2018 Mar;6(2). doi: 10.1128/microbiolspec.ARBA-0009-2017.
One Health is the collaborative effort of multiple health science professions to attain optimal health for people, domestic animals, wildlife, plants, and our environment. The drivers of antimicrobial resistance include antimicrobial use and abuse in human, animal, and environmental sectors and the spread of resistant bacteria and resistance determinants within and between these sectors and around the globe. Most of the classes of antimicrobials used to treat bacterial infections in humans are also used in animals. Given the important and interdependent human, animal, and environmental dimensions of antimicrobial resistance, it is logical to take a One Health approach when addressing this problem. This includes taking steps to preserve the continued effectiveness of existing antimicrobials by eliminating their inappropriate use and by limiting the spread of infection. Major concerns in the animal health and agriculture sectors are mass medication of animals with antimicrobials that are critically important for humans, such as third-generation cephalosporins and fluoroquinolones, and the long-term, in-feed use of medically important antimicrobials, such as colistin, tetracyclines, and macrolides, for growth promotion. In the human sector it is essential to prevent infections, reduce over-prescribing of antimicrobials, improve sanitation, and improve hygiene and infection control. Pollution from inadequate treatment of industrial, residential, and farm waste is expanding the resistome in the environment. Numerous countries and several international agencies have included a One Health approach within their action plans to address antimicrobial resistance. Necessary actions include improvements in antimicrobial use regulation and policy, surveillance, stewardship, infection control, sanitation, animal husbandry, and alternatives to antimicrobials. WHO recently has launched new guidelines on the use of medically important antimicrobials in food-producing animals, recommending that farmers and the food industry stop using antimicrobials routinely to promote growth and prevent disease in healthy animals. These guidelines aim to help preserve the effectiveness of antimicrobials that are important for human medicine by reducing their use in animals.
One Health 是多个健康科学专业合作的结果，旨在实现人类、家畜、野生动物、植物和环境的最佳健康状态。抗生素耐药性的驱动因素包括人类、动物和环境部门中抗生素的使用和滥用，以及耐药细菌和耐药决定因素在这些部门以及全球范围内的传播。用于治疗人类细菌感染的大多数抗生素类别也用于动物。鉴于抗生素耐药性在人类、动物和环境方面的重要性和相互依存性，在解决这一问题时采取 One Health 方法是合理的。这包括通过消除抗生素的不当使用和限制感染的传播来采取措施，以保持现有抗生素的持续有效性。动物健康和农业部门的主要关注点是大规模使用对人类至关重要的抗生素（如第三代头孢菌素和氟喹诺酮类药物）对动物进行药物治疗，以及长期、饲料中使用重要的抗生素（如粘菌素、四环素和大环内酯类药物）来促进生长。在人类部门，必须预防感染、减少对抗生素的过度处方、改善卫生条件以及加强卫生和感染控制。工业、住宅和农场废物处理不当导致的污染正在扩大环境中的耐药组。许多国家和几个国际机构已将 One Health 方法纳入其解决抗生素耐药性的行动计划中。必要的行动包括改善抗生素使用监管和政策、监测、管理、感染控制、卫生、畜牧业以及抗生素替代品的使用。世界卫生组织最近发布了关于在食用动物中使用重要医学抗生素的新指南，建议农民和食品行业停止常规使用抗生素来促进健康动物的生长和预防疾病。这些指南旨在通过减少动物中抗生素的使用来帮助保留对人类医学重要的抗生素的有效性。
