一个值得高度关注的问题——动物源细菌耐药性

由于动物源细菌耐药性关乎到人类健康,使得畜禽疾病防控和公共卫生安全日益受到全世界的普遍关注。本文就动物源细菌耐药性的危害、我国动物源细菌的耐药性状况、发展趋势及应对策略进行了综述,以期对我国开展动物源细菌耐药性检测和制定预防对策提供参考。     

2020年动物源细菌耐药性监测工作总结会在京召开

近日,中国兽医药品监察所在北京召开2020年动物源细菌耐药性监测工作总结会。中国兽医药品监察所副所长高光、农业农村部畜牧兽医局药政药械处副处长冯华兵及相关专家出席会议。会议总结了2020年全国动物源细菌耐药性监测工作情况,全面分析了我国动物源细菌耐药性变化趋势,讨论了耐药性监测工作中存在的问题及改进措施,研究制定了2021年动物源细菌耐药性监测计划。     

国家动物源细菌耐药性监测工作的探讨和建议

介绍了国外动物源细菌耐药性监测工作的情况及目标,对我国的动物源细菌耐药性监测工作需考虑的许多因素进行了介绍和讨论,包括动物品种、食品、采样方法、样本的收集、细菌品种、抗菌药物、标准药敏试验法、质控、结果记录和数据库设计、报告和结果分析等,并对今后的动物源细菌耐药性监测工作提出了建议。     

我国动物源细菌耐药性监测系统简介

本文介绍了我国动物源细菌耐药性监测网络的组成和主要内容,详细阐述了其过程控制,包括采样、细菌分离鉴定和耐药性检测、耐药性检测结果汇总分析等,并介绍了我国取得的成就,如建立了动物源细菌耐药性监测技术平台和耐药性细菌资源库、创建了具有自主知识产权的动物源细菌耐药性数据库、摸清了我国动物源细菌的耐药性状况等。针对我国动物源细菌的耐药现状,提出了应对措施,包括规范我国兽用抗菌药物饲料添加剂的使用、加强动物处方药的管理并建立治疗用抗菌药物的分级管理制度、持续开展畜禽细菌耐药性动态监测等。     

农业部印发通知要求加强动物源细菌耐药性监测工作

正为贯彻落实《遏制细菌耐药性国家行动计划(2016年~2020年)》,进一步加强动物源细菌耐药性监测工作,保证动物源性食品安全和公共卫生安全,农业部近日发布了关于印发《2017年动物源细菌耐药性监测计划》的通知。通知对动物源细菌耐药性监测工作任务分工作了规定。农业部负责组织全国动物源细菌耐药性监测工作。各省(自治区、直辖市)兽医行政管理部门负责选定连续定点监测养殖场(猪场、肉鸡场、蛋鸡场或奶牛场各1个,共3个),     

动物源细菌耐药性监测与流行病学研究

全面分析了开展动物源细菌耐药性监测与流行病学研究的必要性和紧迫性,介绍了动物源细菌耐药性监测与流行病学研究的国外概况和国内现状,指出当前我国在该领域内存在的问题,提出6点建议以期做好动物源细菌耐药性的防控工作。     

我国动物源细菌耐药性监测及预警的研究进展

利用调查和数据统计报道我国近年来的兽用抗生素使用、养殖业用药背景、抗菌药物耐药、动物源细菌耐药性监测、动物源细菌耐药监测数据库研究及国家制定的相关政策等现状,并针对我国动物源细菌的耐药和监测现状,提出了我国政府与各地区相关部门应科学评估分析动物源细菌耐药性监测数据及变化趋势;借鉴发达国家的经验和方法,完善我国动物源细菌耐药性监测网络和监测体系;加强教育和宣传等应对措施,为解决全球动物源细菌耐药性问题作出贡献。     

要闻

农业部印发《2013年动物源细菌耐药性监测计划》根据《兽药管理条例》规定,为做好2013年度动物源细菌耐药性监测工作,进一步提高我国细菌耐药性监测能力,农业部特制定《2013年动物源细菌耐药性监测计划》。各监测任务承担单位的采样、细菌分离和鉴定、耐药性检测和结果上报等活动要按照《动物源细菌耐药性检测采样、检测技术要点》;样品应从畜禽养殖场、屠宰     

我国动物源细菌耐药性数据库的建立与应用

为加强全国动物源细菌耐药性监测数据统一管理,实时掌握我国动物源细菌耐药性的流行动态,中国兽医药品监察所联合多家国内细菌耐药性监测单位,开发了我国的动物源细菌耐药性监测数据库。该数据库为B/S架构,全国不同地区动物源细菌耐药性监测实验室均可通过网页浏览器连接服务器,实现了监测数据即时储存、统计分析和上报,为我国兽医临床细菌耐药性监测提供了重要的技术支持。     

兽药

正农业部印发《2017年动物源细菌耐药性监测计划》2月9日,农业部印发《2017年动物源细菌耐药性监测计划》(以下简称《监测计划》),至此动物源细菌耐药性监测工作正式展开。此次公布的动物源细菌耐药性监测计划中就要求各地兽医行政管理部门对辖区内动物肠道菌群血清     

Monitoring of antimicrobial resistance among food animals: principles and limitations

Large amounts of antimicrobial agents are in the production of food animals used for therapy and prophylactics of bacterial infections and in feed to promote growth. The use of antimicrobial agents causes problems in the therapy of infections through the selection for resistance among bacteria pathogenic for animals or humans. Current knowledge regarding the occurrence of antimicrobial resistance in food animals, the quantitative impact of the use of different antimicrobial agents on selection for resistance and the most appropriate treatment regimes to limit the development of resistance is incomplete. Programmes monitoring the occurrence and development of resistance are essential to determine the most important areas for intervention and to monitor the effects of interventions. When designing a monitoring programme it is important to decide on the purpose of the programme. Thus, there are major differences between programmes designed to detect changes in a national population, individual herds or groups of animals. In addition, programmes have to be designed differently according to whether the aim is to determine changes in resistance for all antimicrobial agents or only the antimicrobial agents considered most important in relation to treatment of humans. In 1995 a continuous surveillance for antimicrobial resistance among bacteria isolated from food animals was established in Denmark. Three categories of bacteria, indicator bacteria, zoonotic bacteria and animal pathogens are continuously isolated from broilers, cattle and pigs and tested for susceptibility to antimicrobial agents used for therapy and growth promotion by disc diffusion or minimal inhibitory concentration determinations. This programme will only detect changes on a national level. However, isolating the bacteria and testing for several antimicrobial agents will enable us to determine the effect of linkage of resistance. Since 1995 major differences in the consumption pattern of different antimicrobial agents have occurred in Denmark. The Danish monitoring programme has enabled us to determine the effect of these changes on the occurrence of resistance. The Danish monitoring is, however, not suited to determine changes on a herd level or to detect emergence of new types of resistance only occurring at a low level.     

Development of an antibiotic resistance monitoring system in Hungary

Because of the rapid development and spread of antimicrobial resistance it is important that a system be established to monitor antimicrobial resistance in pathogenic zoonotic and commensal bacteria of animal origin. Susceptibility testing of bacteria from carcasses and different samples of animal origin has been carried out in veterinary institutes for a long time but by an inconsistent methodology. The disc diffusion method proposed by the National Committee for Clinical Laboratory Standards (NCCLS) was introduced in all institutes in 1997. In order to obtain a coherent view of the antimicrobial resistance of bacteria a computer system was consulted, consisting of a central computer to store all data and some local computers attached to it through the network. At these local measuring stations computers are connected to a video camera, which displays the picture of Petri dishes on the monitor, and inhibition zone diameters of bacteria can be drawn with the mouse by the inspector. The software measures the diameters, evaluates whether or not the bacteria are sensitive, and stores the data. The evaluation is based upon the data of the NCCLS. The central computer can be connected to as many local computers with measuring stations as we wish, so it is suitable for an integrated system for monitoring trends in antimicrobial resistance of bacteria from animals, food and humans, facilitating comparison of the occurrence of resistance for each circumstance in the chain. It depends on the examiners which antibiotics they want to examine. Thirty-two different antibiotic panels were compiled, taking into consideration the active ingredients of medicinal products permitted for veterinary use in Hungary, natural resistance and cross-resistance, the mechanism of resistance and the animal species, i.e. which drugs were recommended for treatment in the given animal species, and the recommendations of the OIE Expert Group on Antimicrobial Resistance. The members of the panels can be changed any time, even during the measuring process. In addition to the inhibition zone diameters of bacteria the database also includes information about bacterial and animal species, the age of animals and the sample or organ where the bacteria are from. Since January 2001 the antibiotic susceptibility of E. coli, Salmonella, Campylobacter and Enterococcus strains isolated from the colons of slaughter cows, pigs and broiler chickens has also been examined. Each of the 19 counties of Hungary submits to the laboratory three tied colon samples from a herd of the above-mentioned animals every month.     

动物源细菌耐药性评估在兽用抗菌药使用减量化行动中的应用

动物源细菌耐药性已引起广泛关注,全国正在逐步推进兽用抗菌药物使用减量化行动。为更好地推动减量化行动的实施,浙江省在耐药性的评估及应用方面进行探索。研究分析了耐药性评估在减量化行动中的作用,建立了耐药系数评估模型与应用方法,研判了目前耐药性监测可能存在的问题,以期更好地推进兽用抗菌药物使用减量化行动。     

The management of risk arising from the use of antimicrobial agents in veterinary medicine in EU/EEA countries – a review

Antimicrobials are essential medicines for the treatment of many microbial infections in humans and animals. Only a small number of antimicrobial agents with new mechanisms of action have been authorized in recent years for use in either humans or animals. Antimicrobial resistance (AMR) arising from the use of antimicrobial agents in veterinary medicine is a concern for public health due to the detection of increasing levels of resistance in foodborne zoonotic bacteria, particularly gram‐negative bacteria, and due to the detection of determinants of resistance such as Extended‐spectrum beta‐lactamases (ESBL) in bacteria from animals and in foodstuffs of animal origin. The importance and the extent of the emergence and spread of AMR from animals to humans has yet to be quantified. Likewise, the relative contribution that the use of antimicrobial agents in animals makes to the overall risk to human from AMR is currently a subject of debate that can only be resolved through further research. Nevertheless, risk managers have agreed that the impact on public health of the use of antimicrobials in animals should be minimized as far as possible and a variety of measures have been introduced by different authorities in the EU to achieve this objective. This article reviews a range of measures that have been implemented within European countries to reduce the occurrence and the risk of transmission of AMR to humans following the use of antimicrobial agents in animals and briefly describes some of the alternatives to the use of antimicrobial agents that are being developed.     

Public health and policy

Antimicrobial agent usage data are essential for focusing efforts to reduce misuse and overuse of antimicrobial agents in food producing animals because these practices may select for resistance in bacteria of animals. Transfer of resistant bacteria from animals to humans can lead to human infection caused by resistant pathogens. Resistant infections can lead to treatment failures, resulting in prolonged or more severe illness. Multiple World Health Organization (WHO) reports have concluded that both antimicrobial resistance and antimicrobial usage should be monitored on the national level. The system for collecting antimicrobial usage data should be clear and transparent to facilitate trend analysis and comparison within and among countries. Therapeutic, prophylactic and growth promotion use should be recorded, along with route of administration and animal species and/or production class treated. The usage data should be compared to resistance data, and the comparison should be made available in a timely manner. In the United States, surveillance of antimicrobial resistance in foodborne bacteria is performed by the National Antimicrobial Resistance Monitoring System (NARMS) for enteric bacteria, however, the United States still lacks a mechanism for collecting antimicrobial usage data. Combined with antimicrobial resistance information from NARMS, antimicrobial usage data will help to direct education efforts and policy decisions, minimizing the risk that people will develop antimicrobial resistant infections as a result of eating food of animal origin. Ultimately mitigation strategies guided by usage data will be more effective in maintaining antimicrobial drugs for appropriate veterinary use and in protecting human health.     

屠宰前鸡、猪源大肠杆菌耐药性调查

本试验旨在了解屠宰前鸡、猪源食品动物体内大肠杆菌耐药情况,分析潜在的食品安全问题。从广州市畜禽交易市场随机采集待屠宰鸡和猪的粪便样品,分离鉴定大肠杆菌,并采用琼脂稀释法检测大肠杆菌对15种抗菌药物的敏感性。结果显示,从658份猪源样品和133份鸡源样品中共分离鉴定出731株大肠杆菌,其中猪源606株,鸡源125株。药敏试验结果显示,731株大肠杆菌均表现出不同程度的耐药,耐药谱广且多重耐药现象严重。对复方新诺明和四环素的耐药率为90.0%以上,仅对头孢西丁、黏菌素和阿米卡星较敏感(耐药率均低于3%)。鸡源大肠杆菌对头孢噻肟、头孢曲松、新霉素、阿米卡星、萘啶酸和环丙沙星的耐药率显著高于猪源大肠杆菌(P＜0.05)。鸡源大肠杆菌中3耐及3耐以上的菌株占97.60%,猪源大肠杆菌占94.72%。结果表明,屠宰前畜禽体内大肠杆菌对临床常用抗菌药物的耐药性非常严重,以多重耐药为主,且耐药谱丰富多样。提示屠宰前畜禽携带的耐药菌对食品安全和人类健康存在较大的安全隐患。     

细菌的获得性耐药机制研究进展

抗菌药物的广泛使用,导致细菌耐药性日益严重,耐药菌所致的感染给人类健康及畜禽生产带来巨大威胁。细菌耐药可由多种机制所介导,研究细菌的耐药机制对防止或延缓耐药性的产生具有重要意义。近年来,影响药物与作用靶位结合及作用靶位结构变化等机制介导的耐药受到人们的关注。论文将对作用靶位变化导致细菌耐药问题的最新研究进展进行综述,以期为防止和延缓细菌耐药性的产生提供理论依据。     

Pilot study of antimicrobial-resistant Escherichia coli in herring gulls (Larus argentatus) and wastewater in the northeastern United States

Wildlife may be an important reservoir of antibiotic-resistant bacteria and resistance genes. In this pilot study, the prevalence and patterns of antimicrobial resistance in Escherichia coli cultured from wild herring gull (Larus argentatus) feces and human wastewater at Cape Cod, Massachusetts, USA, was compared. Antimicrobial susceptibility was tested using Kirby-Bauer disk diffusion with seven antimicrobial agents. A high proportion of antimicrobial agent-resistant E. coli isolates (59.2%) were detected in wastewater samples compared with a lower prevalence of 17.5% in gull feces. In addition, there was a large proportion of isolates with intermediate susceptibility (93.0%) in gull feces. Although similar resistance patterns and shared resistance genes suggest possible wastewater contamination of the local environment, the relatively low frequency of resistance and high prevalence of intermediate susceptibility detected in E. coli cultured from gull feces depict a complex model of antimicrobial resistance among E. coli strains of wildlife origin.     

Antimicrobial resistance in bacteria from horses: Epidemiology of antimicrobial resistance

Antimicrobial resistance poses a significant threat to the continued successful use of antimicrobial agents for the treatment of bacterial infections. While the epidemiology of antimicrobial resistance in bacteria from man has been studied extensively, less work has been undertaken in companion animals, particularly horses. Methicillin‐resistant Staphylococcus aureus has been identified as a cause of infections, with a low prevalence of nasal carriage by horses in the community but higher for hospitalised horses. Molecular characterisation has shown methicillin‐resistant Staphylococcus aureus strains either to be predominantly of types associated with horses or of sequence type ST398. Antimicrobial‐resistant Escherichia coli (including multidrug‐resistant and extended spectrum β‐lactamase‐producing isolates) have caused infections and been documented in faecal carriage by horses, with many significant resistance mechanisms identified. More sporadic reports and molecular characterisation exist for resistance in other bacteria such as enterococci, Salmonella, Acinetobacter and Pseudomonas species. Limited work has been undertaken evaluating risk factors and much of the epidemiology of antimicrobial resistance in bacteria from horses remains to be determined.