The relationship between antibiotic use in humans and poultry and antibiotic resistance prevalence in humans: an ecological regression study of Campylobacter in the UK
The relationship between antibiotic use in humans and poultry and antibiotic resistance prevalence in humans: an ecological regression study of Campylobacter in the UK
复制标题
人类和家禽抗生素使用与人类抗生素耐药性流行之间的关系：英国弯曲杆菌的生态回归研究
DOI：
10.1101/2024.01.10.24301092
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发表时间：
2024
期刊：
影响因子：
--
通讯作者：
Emes E
中科院分区：
文献类型：
--
作者：
Emes E
抗生素耐药性（ABR）是细菌病原体在抗生素存在下生存的能力，是全球人类健康日益紧迫的问题。抗生素（ABU）在人类和家畜中的使用被认为是全球ABR流行率上升的主要驱动力，但这种关系在人群水平上的形状和大小仍然不确定。在英国，细菌病原体弯曲杆菌是食源性感染的主要原因，大多数感染归因于家禽。这是一个强有力的案例研究，以调查抗生素使用与人类和动物耐药性之间的生态关系。尽管在过去的十年中，人类和家禽的ABU显著减少，但英国弯曲杆菌感染的ABR率仍然相对较高。我们汇编了2011年至2022年英国弯曲杆菌感染和初级保健，二级保健和家禽健康中抗生素使用的数据（人类数据仅来自英格兰）。采用混合普通最小二乘回归方法，我们研究了弯曲菌感染的ABR率与这三个部门中ABU数量之间的关系。我们还使用不同的规格探索了这种关系的形状和大小。我们的结果表明，在英国，人类弯曲杆菌感染的抗生素耐药率与人类抗生素的使用呈正相关，一些证据表明，它也与家禽抗生素的使用有关。然而，抗生素的使用只能解释相对较小部分的耐药性变化。对于人类健康，我们发现的证据表明（抗生素）使用和耐药性之间的关系随着时间的推移而减弱，随着耐药性在人群中的建立，支持耐药阈值的想法，超过该阈值，耐药菌株成为地方病，减少使用变得不那么有效。我们的研究结果表明，单独减少使用可能不足以使弯曲杆菌的ABR水平下降到理想的水平。虽然抗生素管理仍然是必不可少的，但未来的政策和弯曲杆菌研究应专注于传播因素，保护人类的新抗生素，以及家禽感染的替代和补充疗法，如疫苗接种和噬菌体。
Antibiotic resistance (ABR), the capacity of bacterial pathogens to survive in the presence of antibiotics, is an increasingly pressing issue for human health worldwide. The use of antibiotics (ABU) in humans and livestock animals, is considered the main driver of the global increase in ABR prevalence, but the shape and size of this relationship at the population level is still uncertain.In the UK, the bacterial pathogenCampylobacteris a major cause of foodborne infection, with most infections attributed to poultry. It is a strong case study to investigate the ecological relationship between antibiotic use and resistance across humans and animals. Despite significant reductions in ABU in humans and poultry over the last decade, the rate of ABR inCampylobacterinfections in the UK has remained relatively high.We compiled data onCampylobacterinfections and the use of antibiotics in primary care, secondary care, and poultry health in the UK from 2011 to 2022 (human data were from England only). Using pooled ordinary least squares regression, we investigated the relationship between the rate of ABR inCampylobacterinfections and the quantity of ABU in each of these three sectors. We also explored the shape and size of this relationship using different specifications.Our results suggest that the rate of antibiotic resistance in humanCampylobacterinfections in the UK was positively linked with use of antibiotics in humans, with some evidence that it was also linked to antibiotic use in poultry. However, antibiotic use explained only a relatively small portion of the changes in resistance. For human health, we found evidence that the relationship between (antibiotic) use and resistance weakens over time as resistance builds up in the human population, supporting the idea of a resistance threshold beyond which resistant strains become endemic and reductions in use become less effective.Our results suggest that reducing use alone may not be sufficient to bring the level of ABR inCampylobacterdown to desirable levels. While antibiotic stewardship remains essential, future policy and research onCampylobactershould dedicate focus to transmission factors, safeguarding new antibiotics in people, and alternative and complementary therapies for poultry infection such as vaccination and bacteriophages.
影响因子：
5.6
作者：
Zhang, Dandan;Cui, Youwen;Zhang, Xinping
通讯作者：
Zhang, Xinping
影响因子：
5.2
作者：
Rahman, Sakib;Hollis, Aidan
通讯作者：
Hollis, Aidan