Geographically targeted surveillance of livestock could help prioritize intervention against antimicrobial resistance in China

Abstract

ntimicrobials are used in agriculture as disease treatments, prophylactically to prevent infections in healthy animals and to increase productivity 1 . However, the routine use of antimicrobials as surrogates for good hygiene practices on farms 2,3 is driving a rise in antimicrobial resistance (AMR), with increasingly serious consequences for animal health 1,4 and potentially for human health 5,6 .Globally, 73% of antimicrobials are used in animals 7 , with China being the largest consumer of antimicrobials in absolute terms (41,967 t in 2017) and the second largest consumer in relative terms with 200 mg kg −1 (ref. 8 ) (Supplementary Fig. 1a,b). In comparison, Denmark and the Netherlands use respectively 39 and 56 mg kg −1 (ref. 9 ), while maintaining a productive livestock sector. Multiple factors may contribute to antimicrobial overuse in China. Meat production has grown by 560% since 1979 (FAOSTAT, http://www. fao.org/faostat/en/#data/QL), which could have made farmers reliant on antimicrobials to prevent infections. Veterinary antimicrobials are reportedly accessible without prescriptions 10 and are sold at low prices in comparison to other countries 11 . As in many other low-and middle-income countries (LMICs) 12,13 , farmers predominantly obtain antimicrobials from local drug stores where vendors also provide medical advice without veterinary training 10,14 . Additionally, enforcing the existing regulations 10 on the compounds authorized in animals, or the recently announced ban on growth promoters 15 , remains a formidable challenge in a country where 360 million people are active in agriculture (World Bank, https:// data.worldbank.org/indicator/SL.AGR.EMPL.ZS). In the last 5 yr, China has reported multiple first emergence of resistance genes to last-resort antimicrobials such as colistin and tigecycline 16,17 and a recent global analysis suggested that China may have become one of the largest hotspots of resistance among LMICs 4 , ranking eighth in relative terms, and first in absolute terms, for the animal-associated burden of AMR amongst LMICs (Supplementary Fig. 1d,e).

Modelling the impact of antimicrobial use and external introductions on commensal E. coli colistin resistance in small‐scale chicken farms of the Mekong delta of Vietnam

“…Our study confirms the importance of considering the landscape scale when investigating the determinants of AMR (Singer et al., 2006 ; Zhao et al., 2021 ). Here, we could interpret our results in terms of sources and sinks of resistance.…”

The temporal dynamics of antimicrobial-resistant Salmonella enterica and predominant serovars in China

“…Moreover, we also found the AMR rate of most antimicrobials of human origin isolates decreased in 2012, which was probably influenced by the policy for antimicrobial management ( http://www.gov.cn/flfg/2012–05/08/content_2132174.htm ). A recent study reported that the prevalence of resistance in Salmonella showed an increased trend after 2010 in penicillin in chicken, and in sulfonamide, penicillins, and tetracycline in pigs [ 22 ]. A similar landscape was also observed in other countries, for example, the prevalence of MDR was generally low ranging from 3.4% in 1984 to a high of 9.7% in 2013 in Australia [ 7 ].…”

Predictive Mapping of Antimicrobial Resistance for Escherichia coli, Salmonella, and Campylobacter in Food-Producing Animals, Europe, 2000–2021

“…However, recent works have shown that resistance levels in humans and animals can vary at a fine spatial scale, and accumulation of resistance genes in those areas may create geographic hotspots for AMR (2,9). Identifying geographic hotspots of AMR within countries could help with targeting interventions against AMR, such as improved farm biosecurity and targeted surveillance, where they might have the greatest benefits (10)(11)(12).…”