Human, animal and environmental contributors to antibiotic resistance in low-resource settings: integrating behavioural, epidemiological and One Health approaches

Abstract

Antibiotic resistance (ABR) is recognized as a One Health challenge because of the rapid emergence and dissemination of resistant bacteria and genes among humans, animals and the environment on a global scale. However, there is a paucity of research assessing ABR contemporaneously in humans, animals and the environment in low-resource settings. This critical review seeks to identify the extent of One Health research on ABR in low- and middle-income countries (LMICs). Existing research has highlighted hotspots for environmental contamination; food-animal production systems that are likely to harbour reservoirs or promote transmission of ABR as well as high and increasing human rates of colonization with ABR commensal bacteria such as However, very few studies have integrated all three components of the One Health spectrum to understand the dynamics of transmission and the prevalence of community-acquired resistance in humans and animals. Microbiological, epidemiological and social science research is needed at community and population levels across the One Health spectrum in order to fill the large gaps in knowledge of ABR in low-resource settings.

Antibiotic resistance in bacterial isolates from freshwater samples in Fildes Peninsula, King George Island, Antarctica

“…On the other hand, we observed important differences www.nature.com/scientificreports www.nature.com/scientificreports/ in the antibiotic susceptibility patterns and in the bacterial richness and diversity of the ARGs detected among zones under human (zone A) and animal (Zone B) influence, in comparison with the more remote area (zone C). These differences could be due to the important influence of animals and humans that could be generating a selective pressure on the local microbiota 12 . It is also important to remark that the ARI indices, according to Krumperman 24 showed differences between the zones, reflecting that the dissemination of the ARGs in the Antarctic environment could be influenced by the presence of both humans and animals.…”

Antibiotic use in chicken farms in northwestern China

“…Moreover, only one-third of the farmers knew about the potential for antibiotic resistance transmission from animals to humans. This is also the case for farmers in other developing countries such as Cambodia [14,35]. In contrast farmers from developed countries such as Germany have a higher level of awareness of the possible transmission between animals and humans [42].…”

“…The pattern of use and misuse of antibiotics in food animals can highlight the implications of the emergence of different types of antibiotic resistant bacteria and their dissemination among animals, humans and the environment. The situation has been reported in many previous studies from multiple countries, which have initiated the One Health approach for better understanding and addressing health issues around the world [30,[35][36][37].…”

Antibiotic-Resistant Escherichia coli and Class 1 Integrons in Humans, Domestic Animals, and Wild Primates in Rural Uganda

“…Additional factors, such as unregulated use and counterfeit antibiotics, may compound the development and maintenance of resistance in such settings (14,15). Moreover, studies that consider both animals and humans as contributors to antibiotic resistance in low-resource settings are rare but needed (16).…”