One Health perspective for antimicrobial resistance

Abstract

Infectious diseases and other infections treatment is absolutely dependent on the use of antimicrobial agents. Nevertheless, in recent decades antimicrobial resistance (AMR) has become a growing threat for both human and animals. In 2014, a report of the Review on Antimicrobial Resistance estimated that antimicrobial resistance could cause 10 million deaths a year by 2050. Recently the emergence of colistin-resistant enterobacteria rendered infections caused by these bacteria as untreatable. These bacteria were designated Superbugs as they are resistant to all known antimicrobials. Commensal microbes that live on and in us are critical for our health, as this microbiome is like a filter between us and the world. Microbiome studies have clarified that microorganism exchange happens between people who cohabit certain spaces and even between animals and people living in the same environment. It is also well known that the consumption of food products of animal origin may provide access of microorganisms from the animal's microbiome to the consumer body. Bacteria may transmit resistance genes to each other through the conjugation process, one of the DNA transfer processes. Therefore, when acquiring resistant bacteria, both humans and animals, there may be transmission of resistance genes to other microorganisms that inhabit the own organism and, thus, the individual may develop antimicrobials resistant populations in his particular microbiome. Therefore, food products of animal origin may constitute a route of transmitting resistant bacteria and resistance genes from animals to people. Direct contact with animals or the animal environment may also be responsible for transmission. Fruits and vegetables contaminated by animal waste or contaminated water may similarly constitute a transmission route. Several multi drug resistance (MDR) pathogenic bacteria are shared between companion animals and humans. These organisms spread between animals and humans, although the direction of transfer is often difficult to prove. To control AMR a rational antimicrobial use must be followed. Antimicrobial stewardship refers to coordinated interventions designed to improve and measure the appropriate use of antimicrobials. But to face this serious problem, Antimicrobial Stewardship must have One Healt approach, and collaborative efforts between Medical and Veterinary doctors must be implemented to achieve global health.