Prack McCormick Barbara, Quiroga María P, Álvarez Verónica E, Centrón Daniela, Tittonell Pablo
Universidad Nacional de Lomas de Zamora, Facultad de Ciencias Agrarias, RP N˚4 km 2 (1836), Llavallol, Buenos Aires, Argentina.
Laboratorio de Investigaciones en Mecanismos de Resistencia a Antibióticos, Instituto de Investigaciones en Microbiología y Parasitología Médica, Facultad de Medicina, Universidad de Buenos Aires - Consejo Nacional de Investigaciones Científicas y Técnicas (IMPaM, UBA-CONICET), Paraguay 2157 (PC 1121), Ciudad Autónoma de Buenos Aires, Argentina.
Rev Argent Microbiol. 2023 Jan-Mar;55(1):25-42. doi: 10.1016/j.ram.2022.07.001. Epub 2022 Sep 19.
Abuse and misuse of antimicrobial agents has accelerated the spread of antimicrobial-resistant bacteria. The association between antimicrobial-resistant infections in humans and antimicrobial use in agriculture is complex, but well-documented. This study provides a systematic review and meta-analysis of the dissemination of antimicrobial resistance (AMR) to antimicrobials defined as critically important by the WHO, in swine, chicken, and cattle from intensive and extensive production systems in Argentina. We conducted searches in electronic databases (MEDLINE-PubMed, Web of Science, SciELO, the National System of Digital Repositories from Argentina) as well as in the gray literature. Inclusion criteria were epidemiological studies on AMR in the main food-transmitted bacteria, Salmonella spp., Campylobacter spp., Escherichia coli and Enterococcus spp., and mastitis-causing bacteria, isolated from swine, chicken, dairy and beef cattle from Argentina. This study gives evidence for supporting the hypothesis that AMR of common food-transmitted bacteria in Argentina is reaching alarming levels. Meta-analyses followed by subgroup analyses confirmed the association between the prevalence of AMR and (a) animal species (p<0.01) for streptomycin, ampicillin and tetracycline or (b) the animal production system (p<0.05) for streptomycin, cefotaxime, nalidixic acid, ampicillin and tetracycline. Moreover, swine (0.47 [0.29; 0.66]) and intensive production (0.62 [0.34; 0.83]) showed the highest pooled prevalence of multidrug resistance while dairy (0.056 [0.003; 0.524]) and extensive production (0.107 [0.043; 0.240]) showed the lowest. A research gap regarding beef-cattle from feedlot was identified. Finally, there is an urgent need for political measures meant to coordinate and harmonize AMR surveillance and regulate antimicrobial use in animal production.
抗菌药物的滥用和误用加速了抗菌药物耐药菌的传播。人类抗菌药物耐药性感染与农业中抗菌药物使用之间的关联很复杂,但有充分记录。本研究对阿根廷集约化和粗放式生产系统中猪、鸡和牛体内对世界卫生组织定义为极为重要的抗菌药物的抗菌药物耐药性(AMR)传播情况进行了系统评价和荟萃分析。我们在电子数据库(MEDLINE - PubMed、科学网、SciELO、阿根廷国家数字存储库系统)以及灰色文献中进行了检索。纳入标准为关于从阿根廷的猪、鸡、奶牛和肉牛中分离出的主要食源传播细菌(沙门氏菌属、弯曲杆菌属、大肠杆菌和肠球菌属)以及引起乳腺炎的细菌的AMR流行病学研究。本研究为支持阿根廷常见食源传播细菌的AMR达到令人担忧水平这一假设提供了证据。荟萃分析后进行的亚组分析证实了AMR流行率与(a)链霉素、氨苄青霉素和四环素的动物种类(p<0.01)或(b)链霉素、头孢噻肟、萘啶酸、氨苄青霉素和四环素的动物生产系统(p<0.05)之间的关联。此外,猪(0.47 [0.29; 0.66])和集约化生产(0.62 [0.34; 0.83])显示出最高的多重耐药合并流行率,而奶牛(0.056 [0.003; 0.524])和粗放式生产(0.107 [0.043; 0.240])显示出最低的多重耐药合并流行率。确定了关于饲养场肉牛的研究空白。最后,迫切需要采取政治措施来协调和统一AMR监测,并规范动物生产中的抗菌药物使用。