Antimicrobial resistance in humans, livestock and the wider environment.
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.
Centre for Immunity, Infection and Evolution, University of Edinburgh, Ashworth Laboratories, Kings Buildings, Charlotte Auerbach Road, Edinburgh EH9 3FL, UK mark.woolhouse@ed.ac.uk.
Mark
M
Woolhouse
Centre for Immunity, Infection and Evolution, University of Edinburgh, Ashworth Laboratories, Kings Buildings, Charlotte Auerbach Road, Edinburgh EH9 3FL, UK.
Melissa
M
Ward
Centre for Immunity, Infection and Evolution, University of Edinburgh, Ashworth Laboratories, Kings Buildings, Charlotte Auerbach Road, Edinburgh EH9 3FL, UK.
Bram
B
van Bunnik
Wellcome Trust, Gibbs Building, 215 Euston Road, London NW1 2BE, UK.
Jeremy
J
Farrar
D000818:Animals; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D005075:Biological Evolution; D004352:Drug Resistance, Microbial / Q000235:genetics*; D004777:Environment; D022761:Gene Transfer, Horizontal / Q000235:genetics*; D006801:Humans; D058751:Livestock; D055624:Methicillin-Resistant Staphylococcus aureus / Q000235:genetics*
D000890:Anti-Infective Agents
Intergovernmental Panel on Climate Change; biota; governance; phylogenetics; reservoirs; sequencing