Ramon Pardo Pilar, Sati Hatim, Galas Marcelo
Pan American Health Organization (PAHO). Washington, DC, EE. UU.
Rev Peru Med Exp Salud Publica. 2018 Jan-Mar;35(1):103-109. doi: 10.17843/rpmesp.2018.351.3605.
Antimicrobial resistance is a complex epidemiology problem worldwide which calls for a wide and integrated approach such as "One Health." Resistant organisms are present in humans, animals, food, and the environment, and the main impeller of this resistance is the use of antimicrobial agents. The occurrence and propagation of antimicrobial resistance continue incessantly in the world, leaving devastating economic and health consequences behind. In 2015, the WHO, in collaboration with key partners such as the FAO and the OIE, developed the World Action Plan in Antimicrobial Resistance, under the perspective of "One Health." This Plan was endorsed by several countries and seeks collaboration for the prevention and control of antimicrobial resistance. This article aims at explaining the scope of the "One Health" approach within the context of antimicrobial resistance, the reason behind its adoption and what is expected from it. One of the main conclusions is the significant lack of knowledge on the selection and propagation of resistant organisms in the environment, with an emphasis on the threats and risks that this represents to human and animal health. Efforts need to be strengthened in order to better define the risks, design interventions, and measure its impact on antimicrobial resistance.
抗菌药物耐药性是一个全球性的复杂流行病学问题，需要采取广泛且综合的方法，如“同一健康”理念。耐药生物存在于人类、动物、食物和环境中，而这种耐药性的主要推动因素是抗菌药物的使用。抗菌药物耐药性在全球持续不断地出现和传播，带来了毁灭性的经济和健康后果。2015年，世界卫生组织与联合国粮食及农业组织、世界动物卫生组织等主要伙伴合作，从“同一健康”角度制定了《抗菌药物耐药性全球行动计划》。该计划得到了多个国家的认可，并寻求各方合作以预防和控制抗菌药物耐药性。本文旨在解释“同一健康”方法在抗菌药物耐药性背景下的范围、采用该方法的原因以及期望达成的目标。主要结论之一是，目前对于环境中耐药生物的选择和传播缺乏足够了解，尤其强调这对人类和动物健康构成的威胁和风险。需要加大力度，以便更好地界定风险、设计干预措施并衡量其对抗菌药物耐药性的影响。
