Journal Article

Zoonotic sources and the spread of antimicrobial resistance from the perspective of low and middle-income countries

Walther, Birgit, Olaru, Ioana D., Schaumburg, Frieder

2023

Overview

Background Antimicrobial resistance is an increasing challenge in low and middle-income countries as it is widespread in these countries and is linked to an increased mortality. Apart from human and environmental factors, animal-related drivers of antimicrobial resistance in low- and middle-income countries have special features that differ from high-income countries. The aim of this narrative review is to address the zoonotic sources and the spread of antimicrobial resistance from the perspective of low- and middle-income countries. Main body Contamination with extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli is highest in poultry (Africa: 8.9–60%, Asia: 53–93%) and there is a risk to import ESBL-producing E. coli through poultry meat in Africa. In aquacultures, the proportion of ESBL-producers among E. coli can be high (27%) but the overall low quality of published studies limit the general conclusion on the impact of aquacultures on human health. ESBL-producing E. coli colonization of wildlife is 1–9% in bats or 2.5–63% birds. Since most of them are migratory animals, they can disperse antimicrobial resistant bacteria over large distances. So-called ‘filth flies’ are a relevant vector not only of enteric pathogens but also of antimicrobial resistant bacteria in settings where sanitary systems are poor. In Africa, up to 72.5% of ‘filth flies’ are colonized with ESBL-producing E. coli , mostly conferred by CTX-M (24.4–100%). While methicillin-resistant Staphylococcus aureus plays a minor role in livestock in Africa, it is frequently found in South America in poultry (27%) or pork (37.5–56.5%) but less common in Asia (poultry: 3%, pork: 1–16%). Conclusions Interventions to contain the spread of AMR should be tailored to the needs of low- and middle-income countries. These comprise capacity building of diagnostic facilities, surveillance, infection prevention and control in small-scale farming. Graphical abstract

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Animals / Antimicrobial agents / Antimicrobial resistance / Aquaculture / Aquaculture industry / Bacteria / Beta lactamases / Capacity development / Cloning / Commentary / Disease control / Drug resistance / Drug resistance in microorganisms / E coli / Environmental factors / Extended-spectrum Beta-lactamase / Food contamination & poisoning / Geography and infectious diseases: Role of human mobility / Health aspects / Health surveillance / Income / Infectious Diseases / International economic relations / Livestock / Medicine / Medicine & Public Health / Methicillin / Methicillin-resistant Staphylococcus aureus / Pathogens / Plasmids / Pork / Poultry / Public Health / Small farms / Small-scale farming / Staphylococcus infections / translocation and access to healthcare / Tropical Medicine / Wildlife / Zoonoses