Human Colonization with Antibiotic-Resistant Bacteria from Nonoccupational Exposure to Domesticated Animals in Low- and Middle-Income Countries: A Critical Review

Abstract

Data on community-acquired antibiotic-resistant bacterial infections are particularly sparse in low-and middleincome 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.

One Health WASH: an AMR-smart integrative approach to preventing and controlling infection in farming communities

“…14 While the biological differences between humans and non-human animals mean that microorganisms can affect them differently, causing disease in humans but not in other animals and vice versa, the potential for acquiring and disseminating ARGs, supporting the perpetuation of AMR in both pathogenic and non-pathogenic bacteria is very high. 15 Furthermore, the lack of knowledge on the directionality of microbial spread between humans and animals and the potential for ARGs dissemination between animals and humans [16][17][18][19][20] highlights the importance of integrative approaches to AMR prevention and control, especially when most deaths associated with AMR in 2019 were linked to Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Streptococcus pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa, 21 which can be both pathogenic and opportunistic bacteria for both humans and animals.…”

Neglected Drivers of Antibiotic Resistance: Survival of Extended-Spectrum β-Lactamase-Producing Pathogenic Escherichia coli from Livestock Waste through Dormancy and Release of Transformable Extracellular Antibiotic Resistance Genes under Heat Treatment

“…In recent years, its global pandemic in clinical and even community infections have attracted much attention . At the same time, due to its high prevalence in livestock and poultry with an increasing trend, − it is further considered an emerging global threat, which manifests itself in the increased likelihood of the resistance transmission from animals to humans. − …”

Pickering emulsion technology based on the concept of “the combination of medicine and adjuvant” to enhance the oxidation stability of volatile oils in solid preparations—taking Lingzhu Pulvis as an example

“…The current applications of Pickering emulsions in Chinese herbal volatile oils are mainly to improve the dispersion of Chinese herbal volatile oils, antibacterial effects, stability, and other areas. 5,6 In Chinese medicine preparations, "the combination of medicine and adjuvant" is an important principle for the use of excipients and also a distinctive feature of Chinese medicine preparations different from chemical preparations. 7 In this hypothesis, from the therapeutic point of view, the powder acts as a stabilizer to improve the stability of the volatile oil, which in turn ensures the clinical efficacy and stability of the formulation, reecting the characteristics of "auxiliary medicine".…”

“…The current applications of Pickering emulsions in Chinese herbal volatile oils are mainly to improve the dispersion of Chinese herbal volatile oils, antibacterial effects, stability, and other areas. 5,6…”