Reducing the Risk of Transmission of Critical Antimicrobial Resistance Determinants From Contaminated Pork Products to Humans in South-East Asia

Abstract

Antimicrobial resistance (AMR) is a critical challenge worldwide as it impacts public health, especially via contamination in the food chain and in healthcare-associated infections. In relation to farming, the systems used, waste management on farms, and the production line process are all determinants reflecting the risk of AMR emergence and rate of contamination of foodstuffs. This review focuses on South East Asia (SEA), which contains diverse regions covering 11 countries, each having different levels of development, customs, laws, and regulations. Routinely, here as elsewhere antimicrobials are still used for three indications: therapy, prevention, and growth promotion, and these are the fundamental drivers of AMR development and persistence. The accuracy of detection of antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARG) depends on the laboratory standards applicable in the various institutes and countries, and this affects the consistency of regional data. Enterobacteriaceae such as Escherichia coli and Klebsiella pneumoniae are the standard proxy species used for indicating AMR-associated nosocomial infections and healthcare-associated infections. Pig feces and wastewater have been suspected as one of the hotspots for spread and circulation of ARB and ARG. As part of AMR surveillance in a One Health approach, clonal typing is used to identify bacterial clonal transmission from the production process to consumers and patients – although to date there have been few published definitive studies about this in SEA. Various alternatives to antibiotics are available to reduce antibiotic use on farms. Certain of these alternatives together with improved disease prevention methods are essential tools to reduce antimicrobial usage in swine farms and to support global policy. This review highlights evidence for potential transfer of resistant bacteria from food animals to humans, and awareness and understanding of AMR through a description of the occurrence of AMR in pig farm food chains under SEA management systems. The latter includes a description of standard pig farming practices, detection of AMR and clonal analysis of bacteria, and AMR in the food chain and associated environments. Finally, the possibility of using alternatives to antibiotics and improving policies for future strategies in combating AMR in a SEA context are outlined.

Farm Animal Veterinarians’ Knowledge and Attitudes toward Antimicrobial Resistance and Antimicrobial Use in the Republic of Serbia

“…Furthermore, a great majority of our respondents (77.3%) showed positive attitudes and openness to using antibiotic alternatives if proven to be successful in clinical practice. This is important since there is a global strategy [ 56 ] aimed at reducing AMR, which can be implemented by the development of new antibiotics [ 57 ], a seemingly difficult and slow task [ 58 ], or the application of safe and efficient alternatives to antibiotics [ 59 , 60 ].…”

A Review of Current Bacterial Resistance to Antibiotics in Food Animals

“…Animal manure and wastewater have been regarded as the hotspots for the transmission of ARB and ARG from animals to humans ( Sirichokchatchawan et al, 2021 ). A large amount of evidence has demonstrated that animal waste and slaughterhouses are a revisor of MDR bacteria, indicating an occupational risk to workers ( Aworh et al, 2021 ).…”

“…Some effective or commercially viable alternatives have been implemented by animal farmers or are under development; various alternatives (such as herbal plant extracts, probiotics, vaccines, enzymes, antimicrobial peptides, phages, etc.) to antibiotics are available to reduce antibiotic use in food animals in farms ( Figure 4 ; Cheng et al, 2014 ; Callaway et al, 2021 ; Sirichokchatchawan et al, 2021 ). Among them, some herbal plant extracts (such as tannins, saponins, essential oils, etc.)…”

“…Various exposure routes of ARB and ARGs originated in farms to humans, including direct or indirect contact with animals, manure or products, and inhalation of bioaerosol that harbors them, may be contributing to increased infections that are hardly treated with antibiotics ( He et al, 2020 ; Bai et al, 2021 ; Founou et al, 2021 ; Sirichokchatchawan et al, 2021 ). Some ARBs (such as Staphylococcus spp., Escherichia coli , Salmonella , etc.)…”

Metagenomic analysis of the gut microbiota in piglets either challenged or not with enterotoxigenic Escherichia coli reveals beneficial effects of probiotics on microbiome composition, resistome, digestive function and oxidative stress responses

“…Antibiotic usage has negative consequences that may affect public health, and, as a result many countries including Thailand have banned the use of antibiotics in livestock agriculture [6]. Consequently, the use of non-antibiotic alternatives for stimulating growth and altering the gut microbiome has received considerable attention in the livestock industries [10].…”