Apostolakos Ilias, Piccirillo Alessandra
a Department of Comparative Biomedicine and Food Science , University of Padua , Legnaro , Italy.
Avian Pathol. 2018 Dec;47(6):546-558. doi: 10.1080/03079457.2018.1524573. Epub 2018 Oct 2.
Colistin has been re-assessed as a critically important antimicrobial in humans due to its efficacy against multi-drug resistant Gram-negative bacteria, in particular P. aeruginosa, A. baumannii, and K. pneumoniae. The recent discovery of mobile colistin resistance (mcr) determinants in humans and animals has brought concerns regarding the future of this antimicrobial. In this paper, we aim to highlight the current challenges with colistin resistant bacteria and to summarize reliable global data on colistin resistance in poultry production. In addition, we present and compare data from a screening for colistin resistance carried out on a collection of clinical Escherichia coli isolated from poultry in Italy. In Europe, resistance rates for Salmonella and E. coli are in general low with sporadic incidence of high colistin resistance levels. Absence of resistance or very low rates have been recorded in countries where colistin is either not employed (e.g. Norway) or used in minimal amounts (e.g. Denmark) in food-producing animals. In large poultry meat producing countries, such as China and Brazil, the widespread use of colistin has resulted in the dissemination of resistance determinants in diverse bacterial species. Worryingly, these bacteria are often co-resistant to other critically important antimicrobials, such as extended-spectrum cephalosporins. The data gap for many countries and for zoonotic bacteria, the role of the "phantom resistome" and the circulation of mcr-carriers expressing resistance phenotypes close or below the current ECOFF values, should be considered in future investigations. The importance of poultry as a cheap protein source and the global effort to mitigate colistin resistance and preserve this essential antimicrobial require a thorough re-assessment of colistin use in poultry.
由于黏菌素对多重耐药革兰氏阴性菌，特别是铜绿假单胞菌、鲍曼不动杆菌和肺炎克雷伯菌具有疗效，因此它被重新评估为对人类至关重要的抗菌药物。最近在人和动物中发现了可移动的黏菌素耐药性（mcr）决定因素，这引发了人们对这种抗菌药物未来的担忧。在本文中，我们旨在强调耐黏菌素细菌当前面临的挑战，并总结家禽生产中耐黏菌素的可靠全球数据。此外，我们展示并比较了对从意大利家禽中分离出的临床大肠杆菌进行黏菌素耐药性筛查的数据。在欧洲，沙门氏菌和大肠杆菌的耐药率总体较低，高黏菌素耐药水平的发生率呈散发性。在未使用黏菌素（如挪威）或在产食用动物中使用量极少（如丹麦）的国家，未记录到耐药情况或耐药率极低。在大型家禽肉类生产国，如中国和巴西，黏菌素的广泛使用导致耐药决定因素在多种细菌物种中传播。令人担忧的是，这些细菌通常对其他至关重要的抗菌药物也具有共同耐药性，如广谱头孢菌素。在未来的调查中，应考虑许多国家和人畜共患病细菌的数据缺口、“幽灵耐药基因组”的作用以及表达接近或低于当前流行病学临界值的耐药表型的mcr携带者的传播情况。家禽作为廉价蛋白质来源的重要性以及全球为减轻黏菌素耐药性和保留这种重要抗菌药物所做的努力，需要对家禽中黏菌素的使用进行全面重新评估。
