Department of Civil and Environmental Engineering, Tufts University, Medford, Massachusetts 02155, United States.
Department of Civil and Environmental Engineering, University of California, Berkeley, Berkeley, California 94720, United States.
Environ Sci Technol. 2022 Nov 1;56(21):14875-14890. doi: 10.1021/acs.est.2c01494. Epub 2022 Aug 10.
Data on community-acquired antibiotic-resistant bacterial infections are particularly sparse in low- and middle-income countries (LMICs). Limited surveillance and oversight of antibiotic use in food-producing animals, inadequate access to safe drinking water, and insufficient sanitation and hygiene infrastructure in LMICs could exacerbate the risk of zoonotic antibiotic resistance transmission. This critical review compiles evidence of zoonotic exchange of antibiotic-resistant bacteria (ARB) or antibiotic resistance genes (ARGs) within households and backyard farms in LMICs, as well as assesses transmission mechanisms, risk factors, and environmental transmission pathways. Overall, substantial evidence exists for exchange of antibiotic resistance between domesticated animals and in-contact humans. Whole bacteria transmission and horizontal gene transfer between humans and animals were demonstrated within and between households and backyard farms. Further, we identified water, soil, and animal food products as environmental transmission pathways for exchange of ARB and ARGs between animals and humans, although directionality of transmission is poorly understood. Herein we propose study designs, methods, and topical considerations for priority incorporation into future One Health research to inform effective interventions and policies to disrupt zoonotic antibiotic resistance exchange in low-income communities.
关于社区获得性抗生素耐药细菌感染的数据在中低收入国家（LMICs）尤为稀缺。在这些国家，对食用动物抗生素使用的监测和监督有限，安全饮用水的获取不足，以及卫生和环境卫生基础设施不足，可能会加剧人畜共患抗生素耐药性传播的风险。本综述综述了在中低收入国家的家庭和后院农场中，人畜共患抗生素耐药细菌（ARB）或抗生素耐药基因（ARGs）交换的证据，并评估了传播机制、危险因素和环境传播途径。总的来说，大量证据表明家养动物和接触者之间存在抗生素耐药性的交换。在家庭和后院农场中，已经证明了人与人之间以及动物之间的全细菌传播和水平基因转移。此外，我们还确定了水、土壤和动物食品是动物和人类之间 ARB 和 ARGs 交换的环境传播途径，尽管对传播的方向了解甚少。在此，我们提出了研究设计、方法和专题考虑因素，以供未来纳入“同一健康”研究，以提供有效的干预措施和政策，以阻断低收入社区的人畜共患抗生素耐药性传播。
