摘要
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关于社区获得性抗生素耐药性细菌感染的数据在中低收入国家尤其稀少。对生产食品的动物使用抗生素的监测和监督有限，缺乏安全饮用水，LMIC的卫生和个人卫生基础设施不足，可能会加剧人畜共患抗生素耐药性传播的风险。这篇批评性综述汇编了LMIC家庭和后院农场内抗生素耐药性细菌（ARB）或抗生素耐药性基因（ARGs）人畜共患交换的证据，并评估了传播机制、风险因素和环境传播途径。总的来说，有大量证据表明驯养动物和接触过的人类之间存在抗生素耐药性的交换。人类和动物之间的全细菌传播和水平基因转移在家庭和后院农场内部和之间得到了证明。此外，我们确定水、土壤和动物食品是动物和人类之间ARB和ARGs交换的环境传播途径，尽管传播的方向性尚不清楚。在此，我们提出了研究设计、方法和主题考虑，以便优先纳入未来的“一个健康”研究，为有效干预和政策提供信息，以破坏低收入社区的人畜共患抗生素耐药性交流。
Abstract
Abstract Image
Data on community-acquired antibiotic-resistant bacterial infections are particularly sparse in low- and middle-income countries (LMICs). Limited surveillance and oversight of antibiotic use in food-producing animals, inadequate access to safe drinking water, and insufficient sanitation and hygiene infrastructure in LMICs could exacerbate the risk of zoonotic antibiotic resistance transmission. This critical review compiles evidence of zoonotic exchange of antibiotic-resistant bacteria (ARB) or antibiotic resistance genes (ARGs) within households and backyard farms in LMICs, as well as assesses transmission mechanisms, risk factors, and environmental transmission pathways. Overall, substantial evidence exists for exchange of antibiotic resistance between domesticated animals and in-contact humans. Whole bacteria transmission and horizontal gene transfer between humans and animals were demonstrated within and between households and backyard farms. Further, we identified water, soil, and animal food products as environmental transmission pathways for exchange of ARB and ARGs between animals and humans, although directionality of transmission is poorly understood. Herein we propose study designs, methods, and topical considerations for priority incorporation into future One Health research to inform effective interventions and policies to disrupt zoonotic antibiotic resistance exchange in low-income communities.

https://pubs.acs.org/doi/abs/10.1021/acs.est.2c01494