Antimicrobial resistance (AMR) in humans is inter-linked with AMR in
other populations, especially farm animals, and in the wider
environment. The relatively few bacterial species that cause disease in
humans, and are the targets of antibiotic treatment, constitute a tiny
subset of the overall diversity of bacteria that includes the gut
microbiota and vast numbers in the soil. However, resistance can pass
between these different populations; and homologous resistance genes
have been found in pathogens, normal flora and soil bacteria. Farm
animals are an important component of this complex system: they are
exposed to enormous quantities of antibiotics (despite attempts at
reduction) and act as another reservoir of resistance genes. Whole
genome sequencing is revealing and beginning to quantify the two-way
traffic of AMR bacteria between the farm and the clinic. Surveillance of
bacterial disease, drug usage and resistance in livestock is still
relatively poor, though improving, but achieving better antimicrobial
stewardship on the farm is challenging: antibiotics are an integral part
of industrial agriculture and there are very few alternatives. Human
production and use of antibiotics either on the farm or in the clinic is
but a recent addition to the natural and ancient process of antibiotic
production and resistance evolution that occurs on a global scale in the
soil. Viewed in this way, AMR is somewhat analogous to climate change,
and that suggests that an intergovernmental panel, akin to the
Intergovernmental Panel on Climate Change, could be an appropriate
vehicle to actively address the problem.
full text (free download):
http://rstb.royalsocietypublishing.org/content/370/1670/20140083
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