title: Public health risk of antimicrobial resistance transfer from companion animals.
abstract: Antimicrobials are important tools for the therapy of infectious bacterial diseases in companion animals. Loss of efficacy of antimicrobial substances can seriously compromise animal health and welfare. A need for the development of new antimicrobials for the therapy of multiresistant infections, particularly those caused by Gram-negative bacteria, has been acknowledged in human medicine and a future corresponding need in veterinary medicine is expected. A unique aspect related to antimicrobial resistance and risk of resistance transfer in companion animals is their close contact with humans. This creates opportunities for interspecies transmission of resistant bacteria. Yet, the current knowledge of this field is limited and no risk assessment is performed when approving new veterinary antimicrobials. The objective of this review is to summarize the current knowledge on the use and indications for antimicrobials in companion animals, drug-resistant bacteria of concern among companion animals, risk factors for colonization of companion animals with resistant bacteria and transmission of antimicrobial resistance (bacteria and/or resistance determinants) between animals and humans. The major antimicrobial resistance microbiological hazards originating from companion animals that directly or indirectly may cause adverse health effects in humans are MRSA, methicillin-resistant Staphylococcus pseudintermedius, VRE, ESBL- or carbapenemase-producing Enterobacteriaceae and Gram-negative bacteria. In the face of the previously recognized microbiological hazards, a risk assessment tool could be applied in applications for marketing authorization for medicinal products for companion animals. This would allow the approval of new veterinary medicinal antimicrobials for which risk levels are estimated as acceptable for public health.
authors.affiliation: Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal.
authors.forename: Constança
authors.initials: C
authors.lastname: Pomba
authors.affiliation: Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.
authors.forename: Merja
authors.initials: M
authors.lastname: Rantala
authors.affiliation: National Veterinary Institute, Uppsala, Sweden.
authors.forename: Christina
authors.initials: C
authors.lastname: Greko
authors.affiliation: Danish Health and Medicines Authority, Copenhagen, Denmark.
authors.forename: Keith Edward
authors.initials: KE
authors.lastname: Baptiste
authors.affiliation: Scientific Institute of Public Health, Brussels, Belgium.
authors.forename: Boudewijn
authors.initials: B
authors.lastname: Catry
authors.affiliation: National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
authors.forename: Engeline
authors.initials: E
authors.lastname: van Duijkeren
authors.affiliation: Royal Veterinary College, University of London, London, UK.
authors.forename: Ana
authors.initials: A
authors.lastname: Mateus
authors.affiliation: Faculty of Veterinary Medicine, Complutense University, Madrid, Spain.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Moreno
authors.affiliation: Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.
authors.forename: Satu
authors.initials: S
authors.lastname: Pyörälä
authors.affiliation: Veterinary Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Modestas
authors.initials: M
authors.lastname: Ružauskas
authors.affiliation: Agence Nationale de Sécurité Sanitaire (ANSES), Fougères, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Sanders
authors.affiliation: Veterinary Laboratories Agency, New Haw, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Teale
authors.affiliation: Health Protection Agency, London, UK.
authors.forename: E John
authors.initials: EJ
authors.lastname: Threlfall
authors.affiliation: European Medicines Agency, London, UK.
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Kunsagi
authors.affiliation: European Medicines Agency, London, UK.|Facultat de Veterinària, UAB, Cerdanyola del Vallès, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Torren-Edo
authors.affiliation: Veterinary Medicines Directorate, Addlestone, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Jukes
authors.affiliation: Läkemedelsverket, Uppsala, Sweden.
authors.forename: Karolina
authors.initials: K
authors.lastname: Törneke
mesh_terms: D000818:Animals; D001419:Bacteria / Q000187:drug effects*; D001424:Bacterial Infections / Q000382:microbiology / Q000635:transmission / Q000662:veterinary*; D018562:Disease Transmission, Infectious; D024881:Drug Resistance, Bacterial; D006801:Humans; D057805:Pets; D018570:Risk Assessment; D015047:Zoonoses / Q000382:microbiology* / Q000635:transmission*