Antimicrobial resistance dynamics and the one-health strategy: a review

Abstract

Antimicrobial resistance is a global threat that kills at least 75,000 people every year worldwide and causes extended hospital stays. In coming 10 years, it is projected to have huge health and economic burden on countries and the scarcity of available antibiotics further worsens the situation. It is a result of many confounding factors that ranges from indiscriminate antibiotic usage in humans, animals and agriculture and the rapid rate of emergence and dissemination of the resistant pathogens. This menace is challenging and urgent attention at many fronts such as antibiotic stewardship, strict regulations over antibiotics usage, large-scale surveillance and responsible public behavior. This demands international cooperation and integrated efforts under 'One-health' approach to effectively mitigate the issue of antimicrobial resistance.Here, we review the multifaceted nature of antimicrobial resistance and usefulness of the 'One-Health' approach to curb the origin and spread of antimicrobial resistance. The role of antibiotics and antimicrobial resistance has been discussed with examples citing the historical mistake of using antibiotics common between animal and humans. This generated resistance against last-resort antibiotics and multiplier effects against related classes of antibiotics. We highlight the effectiveness of hygiene in livestock rearing, careful antibiotic usage and large-scale surveillance of animals, humans and environment domains for understanding the emergence and spread of antimicrobial resistance.Further, we focus on the steps taken for mitigation of antimicrobial resistance that includes public awareness led successful ban of triclosan and the significant decrease in resistant pathogens due to strict antibiotic stewardship. We emphasize the positive role of inter-continental partnership such as Global Antibiotic Resistance Partnership and international collaboration for high-throughput surveillance and continuous data exchange for effective regulation of antimicrobial resistance. The last section underscores the need for bringing all the mitigation steps proposed in the earlier sections under an integrated approach called as One-health. 'One-Health' is a holistic and integrative approach that can help in effective participation of stakeholders from public, health care professionals and government to mitigate antimicrobial resistance. This is essential for effective control and structured framework to tackle the issue of antimicrobial resistance.

Review and Comparison of Antimicrobial Resistance Gene Databases

“…The emergence of resistant microbes will not only cause untreatable primer infections, but the safe performance of routine medical procedures (such as surgeries or chemotherapy treatment of oncological patients) will become impossible due to the inability of a successful antibiotic prophylaxis [1,2,4]. Even though one usually associates AMR with hospitals and the misuse/overuse of antibiotics by medical professionals, the influence of agriculture and the environment is no less important [1,2,[4][5][6]. Therefore, to tackle this global challenge the investigation of the spread of AMR between different environments is required.…”

Is One Health a Viable Strategy in Animal Health Litigation: Evidence from Civil Lawsuits in China

“…Though researchers are trying to define the scope of One Health and then use this term, there is still no consensus on what constitutes One Health precisely up to now. However, the absence of a precise definition does not undermine the strategic value of One Health since researchers have achieved one common understanding that One Health is a universal strategy or initiative aimed at increasing multidisciplinary collaboration and communication across all facets of human, animal, and environmental health [19,77,78].…”

Review and Comparison of Antimicrobial Resistance Gene Databases

“…The emergence of resistant microbes will not only cause untreatable primer infections, but the safe performance of routine medical procedures (such as surgeries or chemotherapic treatment of oncological patients) will become impossible due to the inability of a successful antibiotic profilaxis [1,2,4]. Even though one usually associates AMR with hospitals and the misuse/overuse of antibiotics by medical professionals, the influence of agriculture and the environment is no less important [1,2,[4][5][6]. Therefore to tackle this global challenge the investigation of the spread of AMR between different environments is required.…”

“…genes coding enzymes that degrade the antibiotic compounds or open alternative metabolic pathways for evading the effects of the antibiotic) through horizontal gene transfer (HGT) [7,8]. It is believed that the majority of antimicrobial resistance genes (ARG) transmitted between bacteria is not the novel product of widespread antibiotic usage by humans, but evolved previously for a variety of functions and enriched with the extensive usage of antibiotics since the mid 20th century [9][10][11].As environmental microbes have a significant role in the spread of resistance genes, the global surveillance of ARGs in various environments is critical for understanding and combating AMR [6,11]. As bacterial AMR is currently the most important form of resistance in microbes, we will refer it to when we mention AMR throughout this review.…”