Khan Yasir R, Hernandez Jorge A, Kariyawasam Subhashinie, Butcher Gary, Czyz Daniel M, Pellissery Abraham J, Denagamage Thomas
Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
Department of Comparative, Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
J Glob Antimicrob Resist. 2024 Dec;39:212-223. doi: 10.1016/j.jgar.2024.09.010. Epub 2024 Oct 25.
This systematic review aimed to (i) determine the risk of antimicrobial resistance (AMR) development associated with antimicrobial use (AMU) and other exposure factors in broilers, and (ii) identify best management practices to mitigate preharvest AMR development of enteric bacteria alongside broiler production.
Study selection criteria comprised the population, exposure or intervention, comparator, and outcome framework and included broiler (population), AMU or other management practices (exposure or intervention), organic or antibiotic-free production (comparator), and the presence of AMR-enteric bacteria/genes (outcome). Peer-reviewed primary research studies were searched in PubMed on 19 December 2022, and AGRICOLA, Embase, Scopus, and Web of Science on 10 February 2023. The risk of bias in studies was assessed using the modified ROBIS-E risk of bias assessment tool. The results were synthesised and presented narratively according to PRISMA 2020 guidelines.
In total, 205/2699 studies were subjected to full-text review, with 15 included in the final synthesis. Enteric bacteria Escherichia coli, Salmonella and Campylobacter exhibited AMR and multidrug resistance against several critically important antimicrobials (aminoglycoside, cephalosporin, chloramphenicol, macrolide, penicillin, quinolone, tetracycline, and sulfonamide) for human health. The risk of AMR development in bacteria was shown to be potentially higher with AMU in broiler production. Substandard farm management practices, poor biosecurity measures, and conventional production systems have also been associated with the dissemination of AMR in bacteria.
Our findings indicate that AMU exposure is associated with considerably higher risk of AMR development in enteric bacteria. Antimicrobial stewardship, organic/antibiotic-free broiler production, good farm management practices, and high-level biosecurity measures are able to substantially mitigate preharvest AMR development in enteric bacteria. However, most of studies were cross-sectional, and therefore causal inference cannot be established.
本系统评价旨在（i）确定肉鸡中与抗菌药物使用（AMU）及其他暴露因素相关的抗菌药物耐药性（AMR）发展风险，以及（ii）确定在肉鸡生产过程中减轻肠道细菌收获前AMR发展的最佳管理措施。
研究选择标准包括人群、暴露或干预、对照和结果框架，涵盖肉鸡（人群）、AMU或其他管理措施（暴露或干预）、有机或无抗生素生产（对照）以及AMR肠道细菌/基因的存在情况（结果）。于2022年12月19日在PubMed以及2023年2月10日在AGRICOLA、Embase、Scopus和科学网中检索同行评审的原始研究。使用改良的ROBIS-E偏倚风险评估工具评估研究中的偏倚风险。根据PRISMA 2020指南对结果进行综合并以叙述形式呈现。
总共205/2699项研究接受了全文审查，最终综合纳入15项。肠道细菌大肠杆菌、沙门氏菌和弯曲杆菌对几种对人类健康至关重要的抗菌药物（氨基糖苷类、头孢菌素类、氯霉素、大环内酯类、青霉素类、喹诺酮类、四环素类和磺胺类）表现出AMR和多重耐药性。肉鸡生产中AMU会使细菌产生AMR的风险可能更高。不合格的农场管理措施、较差的生物安全措施以及传统生产系统也与细菌中AMR的传播有关。
我们的研究结果表明，AMU暴露与肠道细菌AMR发展的风险显著更高有关。抗菌药物管理、有机/无抗生素肉鸡生产、良好的农场管理措施和高水平的生物安全措施能够大幅减轻肠道细菌收获前的AMR发展。然而，大多数研究为横断面研究，因此无法建立因果推断。
