Evidence of an association between use of anti-microbial agents in food animals and anti-microbial resistance among bacteria isolated from humans and the human health consequences of such resistance.
Several lines of evidence indicate that the use of anti-microbial agents in food animals is associated with anti-microbial resistance among bacteria isolated from humans. The use of anti-microbial agents in food animals is most clearly associated with anti-microbial resistance among Salmonella and Campylobacter isolated from humans, but also appears likely among enterococci, Escherichia coli and other bacteria. Evidence is also accumulating that the anti-microbial resistance among bacteria isolated from humans could be the result of using anti-microbial agents in food animals and is leading to human health consequences. These human health consequences include: (i) infections that would not have otherwise occurred and (ii) increased frequency of treatment failures and increased severity of infection. Increased severity of infection includes longer duration of illness, increased frequency of bloodstream infections, increased hospitalization and increased mortality. Continued work and research efforts will provide more evidence to explain the connection between the use of anti-microbial agents in food animals and anti-microbial-resistant infections in humans. One particular focus, which would solidify this connection, is to understand the factors that dictate spread of resistance determinants, especially resistant genes. With continued efforts on the part of the medical, veterinary and public health community, such research may contribute to more precise guidelines on the use of anti-microbials in food animals.
Angulo
F J
FJ
Foodborne and Diarrheal Diseases Branch, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. fangulo@cdc.gov
Nargund
V N
VN
Chiller
T C
TC
D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002167:Campylobacter / Q000187:drug effects; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D004363:Drug Utilization; D004926:Escherichia coli / Q000187:drug effects; D005516:Food Microbiology; D006801:Humans; D008460:Meat / Q000382:microbiology*; D012475:Salmonella / Q000187:drug effects; D019155:Veterinary Drugs
D000900:Anti-Bacterial Agents; D019155:Veterinary Drugs