The Resistance Phenomenon in Microbes and Infectious Disease Vectors Implications for Human Health and Strategies for Containment: Workshop Summary (2003) / Chapter Skim
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Appendix A: Publc Health Consquences of Use of Antimicrobial Agents in Agriculture
Appendix A: Publc Health Consquences of Use of Antimicrobial Agents in Agriculture
Pages 231-243
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From page 231... ...
The agricultural use of antimicrobial agents that have a human analog increases the likelihood that human bacterial pathogens that have food animal reservoirs will develop cross-resistance to drugs approved for use in human medicine. The World Health Organization (WHO)
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From page 232... ...
While therapeutic usage of antimicrobial agents in food animals is important to promote animal health and provide an affordable supply of meat, milk, and eggs, it is vital that the long-term effectiveness of antimicrobial agents used in human medicine be preserved. This report presents current surveillance information on the frequency of resistant foodborne infections in the United States, reviews scientific evidence linking antimicrobial agent usage in agriculture to resistant foodborne infections in humans, and makes recommendations for measures to protect public health.
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From page 233... ...
Though more precise data on the quantity of antimicrobial agents used in food animals is needed, these initial estimates provide some perspective on the quantity. As in human medicine, the use of antimicrobial agents in agriculture creates a selective pressure for the emergence and dissemination of antimicrobial-resistant bacteria including animal pathogens, human pathogens which have food animal reservoirs, and other bacteria which are present in food animals (Cohen end Tauxe, 1986; Levy, 1997; van den Bogaard and Stobberingh, 1999~.
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From page 234... ...
The emergence of fluoroquinolone resistance among Campylobacter is an example of antimicrobial resistance resulting from the use of antimicrobial agents in food animals and the subsequent transfer via the food supply of resistant bacteria to humans. Fluoroquinolones were approved for human medicine in 1986.
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From page 235... ...
Furthermore, patients infected with Salmonella strains with a decreased susceptibility to fluoroquinolones may respond poorly to treatment with fluoroquinolones and have been associated with apparent treatment failures (Molbak et al., 1999; Angulo et al., 2000~. Third-generation cephalosporins, such as ceftriaxone, are commonly used for treatment of invasive Salmonella infections in children because of their pharmacodynamic properties and low prevalence of resistance to these agents.
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From page 236... ...
Commensal Bacteria Pathogenic bacteria, such as Campylobacter and Salmonella, are not the only concern when considering antimicrobial resistance in bacteria with food animal reservoirs. Commensal bacteria, which are naturally occurring host flora, constitute an enormous potential reservoir of resistance genes for pathogenic bacteria.
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From page 237... ...
As the reservoir of resistant commensal bacteria increases, the plasmid reservoir becomes larger and enables more frequent transfer of resistance to pathogenic bacteria including Salmonella and Shigella. Escherichia coli, which is the predominant isolate of aerobic fecal flora in humans and most animals, has demonstrated its ability to transfer resistance genes to other species, including pathogenic bacteria (ChaslusDancla et al., 1986; Humme!
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From page 238... ...
Clinical Implications Two human health consequences of increasing antimicrobial resistance in foodborne bacteria are an increase in foodborne illnesses and an increase in number of treatment failures. Increased human infections by resistant foodborne pathogens occur as the prevalence of resistance increases and as humans are exposed to antimicrobial agents.
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From page 239... ...
The widespread use of antimicrobial agents in food animals is associated with increasing antimicrobial resistance in foodborne pathogens, which subsequently may be transferred to humans. The transfer of these resistant bacteria or the genetic determinants for resistance causes adverse health consequences in humans by increasing the number of foodborne illnesses and increasing the potential for treatment failures.
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From page 240... ...
2001. Effect of abolishment of the use of antimicrobial agents for growth promotion on occurrence of antimicrobial resistance in fecal enterococci from food animals in Denmark.
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2001. The effect of discontinuing the use of antimicrobial growth promoters on the productivity in the Danish broiler production.
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1999. Committee on Drug Use in Food Animals, Panel on Animal Health, Food Safety, and Public Health, Board on Agriculture.
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1999. Use of antimicrobial growth promoters in food animals and Enterococcus faecium resistance to therapeutic antimicrobial drugs in Europe.
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