Working across sectors: a public health approach to antimicrobial resistance
1. Working across sectors:
a public health approach to
to antimicrobial resistance
December 2014 1
2. AAnnttiibbiioottiicc uussee:: uussee iinn ppllaannttss,, ffiisshh
aanndd aanniimmaallss
US: OVER-USE OF ANTIBIOTICS THREATENS HUMANS
by Danielle Knight
Washington,11 Oct. (IPS) –
More than half of the antibiotics used in the United States are
estimated to be used in animal feed for poultry, hogs, and
cattle. In 80 percent of cases, the drugs are used to fatten the
animals faster.
Between 40,000 and 50,000 pounds of tetracycline and
streptomycin - both used to treat infections in humans - are
sprayed to control bacterial disease among fruit trees.
In the United States nearly 150 pounds of antibiotic are
applied per acre of salmon
Source: Inter Press Service
December 2014 2
4. Primary effects sought from
antibiotic growth promoters
• increased growth
• improved feed efficiency
• lower incidence of certain diseases
Source. Doyle E, Food Research Institute, University of Wisconsin
December 2014 4
9. EEssttiimmaatteedd aannttiimmiiccrroobbiiaall uussee ttoo pprroodduuccee
oonn kkiillooggrraamm ooff mmeeaatt
Source: Grave K, Torren-Edo J, Mackay D. Comparison of the sales of veterinary antibacterial agents between 10 European countries. Journal of Antimicrobial Chemotherapy, 2010, 65(9):2037-40.
December 2014 9
12. MMaaccrroolliiddee uussee aanndd eenntteerrooccooccccaall
rreessiissttaannccee iinn ppiiggss,, DDeennmmaarrkk
Source: Statens Serum Institut, Danish Veterinary and Food Administration, Danish Medicines Agency, NationalVeterinary Institute and National Food Institute, Technical University of Denmark.
1December 2014 2
13. CCeepphhaalloossppoorriinn rreessiissttaannccee aafftteerr ssttooppppiinngg
uussee iinn ppoouullttrryy,, QQuueebbeecc,, CCaannaaddaa
Source: Dutil L et al. Ceftiofur resistance in Salmonella enterica serovar Heidelberg from chicken meat and humans, Canada. Emerging Infectious Diseases, 2010, 16(1):48-54.
1December 2014 3
26. PPoossssiibbllee aalltteerrnnaattiivveess ttoo ggrroowwtthh pprroommootteerrss
• Alternative husbandry practices leading to cleaner agriculture
• Probiotics (e.g. lactic acid bacteria) and competitive exclusion of other
organisms
• Organic acids (Acidifers) to acidify feed and encourage growth of
lactobacilli – PH monitoring/rumen chip technology
• Gastrointestinal enzymes to increase digestability of feed
• Immune modulators to enhance resistance to infection
• Feed supplements (vitamins, protein supplements and minerals)
• Nitric Oxide and respiratory disease - stressed animals
Source. Doyle E. Food Research Institute, University of Wisconsin
2December 2014 6
27. Putting it all together: antimicrobial
resistance in animals, plants and fish
• Increased public awareness
• Clean agriculture
• Use existing vaccines
• Work across sectors
• Regulation with enforcement
• Monitoring effectiveness of above and other interventions
• Research and development - newer technologies, point of care
diagnostics, vaccines
• Select/hybridise/engineer microbial-resistant plants
• Consider an international treaty
• Do the bottom line mathematics
December 2014 27
28. TThhee bboottttoomm lliinnee:: ddoo tthhee mmaatthhss
Human + antibiotic = saved life
Food animal, fish and plant + antibiotic = saved life
+ rapid growth, and equal or increased profit
2December 2014 8
29. LLeeaaddiinngg iinnffeeccttiioouuss ccaauusseess ooff mmoorrttaalliittyy,,
22000088 eessttiimmaatteess,, wwiitthh ssmmaallllppooxx 11996677
3.5
3.0
2.5
2.0
1.5
1.0
0.5
Smallpox 1967
2December 2014 9
Deaths (millions)
< 5 years old > 5 years old
0
ARI Diarrhoea AIDS TB Malaria Measles
