Review of antibiotic resistance in China and its environment

Abstract

Antibiotic resistance is a global health crisis linked to increased, and often unrestricted, antibiotic use in humans and animals. As one of the world's largest producers and consumers of antibiotics, China is witness to some of the most acute symptoms of this crisis. Antibiotics and antibiotic resistance genes (ARGs) are widely distributed in surface water, sewage treatment plant effluent, soils and animal wastes. The emergence and increased prevalence of ARGs in the clinic/hospitals, especially carbapenem-resistant gram negative bacteria, has raised the concern of public health officials. It is important to understand the current state of antibiotic use in China and its relationship to ARG prevalence and diversity in the environment. Here we review these relationships and their relevance to antimicrobial resistance (AMR) trends witnessed in the clinical setting. This review highlights the issues of enrichment and dissemination of ARGs in the environment, and also future needs in mitigating the spread of antibiotic resistance in the environment, particularly under the 'planetary health' perspective, i.e., the systems that sustain or threaten human health.

Correlation of registered drug packs with Maastricht V/Florence Consensus Report and national treatment guidelines for management of Helicobacter pylori infection

“…Previous research indicates that leftover antibiotics may contribute to inappropriate antibiotic consumption hence further promoting antibiotic resistance . Drug waste may also contribute to antibiotic resistance and raise healthcare cost . Considering the prevalence of H pylori infection, arguments and the complexity for its treatment, poor accordance of registered drug packs or poor patient adherence to the treatment may contribute to antibiotic resistance and healthcare costs.…”

Synergistic China–US Ecological Research is Essential for Global Emerging Infectious Disease Preparedness

“…China is the largest producer and user of antibiotics in the world (Qiao et al 2018), increasing the likelihood of AMR pathogen development in food-borne illness. China was estimated to use 162,000 tons of antibiotics in 2013 (48% by humans and 52% by animals, respectively) which was 9 times that used in the USA in 2011-2012 (Zhang et al 2015).…”

Variations of antibiotic resistance profiles in chickens during administration of amoxicillin, chlortetracycline and florfenicol

“…This extensive use of antibiotics has also increased the stress on the agricultural environment since antibiotic resistant bacteria and ARGs are also frequently present in water, sediments, soils and animals (Qiao et al . ). For example, manure field applications or long‐term wastewater irrigation water generated from antibiotic‐treated animals significantly increase ARG abundance in farm soils (Zhou et al .…”