Understanding the veterinary antibiotics supply chain to address antimicrobial resistance in Lao PDR: Roles and interactions of involved stakeholders

Poupaud, Mariline; Putthana, V.; Patriarchi, Alessandro; Caro, D; Agunos, Agnes; Tansakul, Natthasit; Goutard, Flavie

doi:10.1016/j.actatropica.2021.105943

Cited by 21 publications

(29 citation statements)

References 20 publications

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“…As the country lacks provincial veterinary diagnostic laboratories, most infectious disease treatments in animals are empirical. 78 A recent article on the antibiotic supply chain in the animal sector in Laos, but outside this review period, 21 found that of 96 chicken farms and 96 pig farms, 49% and 60%, respectively, claimed that they gave antibiotics to their animals. Of 29 chicken farms with antibiotics found during the survey, tetracycline was the most commonly found, in 10/29 (34%) of chicken farms.…”

Section: Resultsmentioning

confidence: 99%

“…Amoxicillin was the most common in pig farms at 17/73 (23%). 21 There have not been reports or data on AMU in aquaculture, nor on AMR among fish bacterial pathogens in Laos.…”

Section: Resultsmentioning

confidence: 99%

“…20 Although colistin is not available for human use in Laos, it is used for livestock. 21 Eleven (6%) colistin resistant K. pneumoniae isolates were reported from 190 stool samples of healthy Lao individuals. Among these 11 isolates, nine different STs were reported and seven (64%) had mgrB genes without mutations.…”

Section: Bmj Global Healthmentioning

confidence: 99%

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Antimicrobial use and resistance data in human and animal sectors in the Lao PDR: evidence to inform policy

et al. 2021

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ObjectivesTo review the scientific evidence base on antimicrobial use (AMU) and antimicrobial resistance (AMR) in human and animal sectors in the Lao PDR (Laos).MethodsWe reviewed all publications from July 1994 (the first article describing AMR in Laos) to December 2020. Electronic searches were conducted using Google Scholar and PubMed with specific terms relating to AMR and AMU in Lao, French and English languages.FindingsWe screened 1,357 peer-reviewed and grey reports by title and abstract and then full articles/reports. Of 80 included, 66 (83%) related to human health, nine (11%) to animal health, four (5%) to both animal and human health and one (1%) to the environment. Sixty-two (78%) were on AMR and 18 (22%) on AMU. Extended spectrum beta lactamase-producing Escherichia coli was the greatest concern identified; the proportion of isolates increased fivefold from 2004 to 2016 (2/28 (7%) to 27/78 (35%)) from blood cultures submitted to the Microbiology Laboratory, Mahosot Hospital, Vientiane. Carbapenem resistant Escherichia coli was first identified in 2015. Methicillin-resistant Staphylococcus aureus (MRSA) was uncommon, with 15 cases of MRSA from blood cultures between its first identification in 2017 and December 2020. AMR patterns of global antimicrobial resistance surveillance system (GLASS) target pathogens from livestock were less well documented. There were few data on AMU in human health and none on AMU in livestock. The first hospital AMU survey in Laos showed that 70% (1,386/1,981) of in-patients in five hospitals from 2017 to 2018 received antimicrobial(s). Antibiotic self-medication was common.ConclusionAMR in Laos is occurring at relatively low proportions for some GLASS pathogens, giving the country a window of opportunity to act quickly to implement strategies to protect the population from a worsening situation. Urgent interventions to roll out new guidelines with enhanced one-health antibiotic stewardship, reduce antibiotic use without prescriptions, enhance surveillance and improve understanding of AMU and AMR are needed.

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Section: Resultsmentioning

confidence: 99%

“…Amoxicillin was the most common in pig farms at 17/73 (23%). 21 There have not been reports or data on AMU in aquaculture, nor on AMR among fish bacterial pathogens in Laos.…”

Section: Resultsmentioning

confidence: 99%

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Antimicrobial use and resistance data in human and animal sectors in the Lao PDR: evidence to inform policy

et al. 2021

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“…Low-level resistance to azithromycin—a semi-synthetic macrolide—was detected, which was more pronounced in E. coli and Salmonella from pigs than from chickens. Other surveillance systems, such as the US NARMS [ 33 ], reported occasional detection of azithromycin-resistant Salmonella isolates from food animal species, whereas the EFSA reported resistance levels that varied from rare to moderate depending on the country [ 34 ]. Without detailed AMU information (i.e., the use of natural macrolides such as erythromycin) and characterization of macrolide resistance determinants from the isolates, it is unclear how resistance to azithromycin emerged in the Lao PDR’s animal populations.…”

Section: Discussionmentioning

confidence: 99%

“…is a phenomenon that has been observed in countries where chloramphenicol has not been used for decades. Although this is a finding commonly reported by several surveillance systems across the world [ 29 , 33 , 34 , 35 , 36 , 37 ], it is important to investigate whether chloramphenicol has been completely banned from animal production, according to the FAO’s plea to all countries to discontinue the use of chloramphenicol in animal production [ 38 ]. The roles of other antimicrobials belonging to the phenicols class of antimicrobials (e.g., thiamphenicol) [ 32 ] also need to be investigated.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Resistance Surveillance of Pigs and Chickens in the Lao People’s Democratic Republic, 2018–2021

et al. 2022

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The use of antimicrobials in the livestock sector has been identified as a driver for the emergence of antimicrobial resistance (AMR), and AMR has become a growing public health and economic threat in the Lao PDR. We conducted surveillance for AMR in five provinces of the Lao PDR, in order to determine the antimicrobial susceptibility of Escherichia coli and Salmonella spp. isolated from caecal samples from slaughtered pigs at slaughterhouses and from slaughtered chickens at markets during two different time periods: 2018/2019 and 2020/2021. Antimicrobial susceptibility was determined using a panel of 14 antimicrobials using the broth microdilution technique. E. coli and Salmonella from chickens (62% and 33%, respectively) and pigs (88% and 81%, respectively) exhibited resistance to ≥3 classes of antimicrobials. Of important public health concern was the detection of Salmonella resistant to cefotaxime/ceftazidime, ciprofloxacin, and colistin, deemed as critically important antimicrobials in human medicine. This study aimed to evaluate a national sampling strategy at slaughterhouses and wet markets, and to pilot the laboratory methodologies for bacterial recovery and AMR testing. Experiences from this study will inform capacity development for a national AMR surveillance program, and these early data could serve as reference points for monitoring the impact of the Lao PDR’s national action plan to contain AMR.

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A One-Health Sampling Strategy to Explore the Dissemination and Relationship Between Colistin Resistance in Human, Animal, and Environmental Sectors in Laos

et al. 2022

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Understanding the veterinary antibiotics supply chain to address antimicrobial resistance in Lao PDR: Roles and interactions of involved stakeholders

Cited by 21 publications

References 20 publications

Antimicrobial use and resistance data in human and animal sectors in the Lao PDR: evidence to inform policy

Antimicrobial use and resistance data in human and animal sectors in the Lao PDR: evidence to inform policy

Antimicrobial Resistance Surveillance of Pigs and Chickens in the Lao People’s Democratic Republic, 2018–2021

A One-Health Sampling Strategy to Explore the Dissemination and Relationship Between Colistin Resistance in Human, Animal, and Environmental Sectors in Laos

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