VPHJ
“AntiMicrobial Resistance”
Event Report
SEAOHUN 2018 International Conference in Vietnam OIE Junior Ambassadors: “The Rinderpest Game”
INTERVIEW
Prof. Dr. Wayan Tunas A, DVM Project Report
Speakers on Webinar Series “One Health Day” Greetings
by SCOH Team 2018/2019
December
#13
EVENT
REPORTS
Event Reports The OIE RINDERPEST GAME: HIGHLIGHTS OF THE MONTH Nabeelah - IVSA South Africa Interviewed a professor of veterinary infectious diseases on rinderpest, why it is still relevant, and what he thinks of the Rinderpest Game! •Posted the interview from IVSA south Africa's public Facebook page •234 views!
Ivana and Bajram - Macedonia and Kosovo (respectively) Presented the OIE Rinderpest Campaign together whilst on exchange with Macedonian and Polish students. They received support from a farm animal disease professor •30 students from Poland, Macedonia and Kosovo present •Encouraged them to play the game!
Event Reports - VPHJ #13
4
Event Reports Lucia - Czech Republic Held a presentation on the OIE and its campaigns during an IVSA Meeting. •Over 100 students attended Met with Czech OIE Delegate, MVDr. Zbyněk Semerád, to discuss the OIE and her role as an OIE Junior Ambassador. “we had long conversation about the main goals of my role and his one and future communication and cooperation between two of us. (…) Meeting was very successful.”
Patrycja Ambrochowiz - Poland Created a website for polish students on the OIE campaigns.
5
Event Reports - VPHJ #13
Event Reports Hyunju - South Korea published an article on the Rinderpest Game on DAILY VET, a local veterinary magazine.
These are just a few examples of many great projects and activities that you have done throughout the month. Feel free to take inspiration, continue to be creative and keep up the good work!
Event Reports - VPHJ #13
6
Articles
Antimicrobial ResisTance
Articles - AMR Review article: Antimicrobial resistance By: Nadeen Mohamed, Nurhan Hanafy, Kholoud Khaled, Mohamed tarek (Egypt - IVSA Cairo)
Infections and diseases may be
rheumatoid arthritis; or who have had
caused by different types of organisms
complex
like bacteria, fungi and virus etc., in
transplants, joint replacements, or cardiac
humans and animals. The drug used to
surgery
prevent
to
the
pathogenicity
of
surgeries
such
as
organ
(1-4)
. Antibiotics have also helped
extend
expected
life
spans
by
microorganism is called an antimicrobial
changing
agent.
organism
infections(4,5). In 1920, people in the U.S.
to resist the actions of the class of drugs
were expected to live to be only 56.4
that destroys or inhibits the growth of
years old; now, however, the average
The ability of
an
disease-causing microbes
defined
as
the
outcome
of
bacterial
U.S. life span is nearly 80 years
(6)
.
antimicrobial resistance.
Antibiotics have had similar beneficial
Antibiotics:
effects
worldwide.
In
developing
Antibiotics are effective against
countries where sanitation is still poor,
bacterial, fungal and parasitic infections,
antibiotics decrease the morbidity and
but they are not helpful against viral
mortality caused by food-borne and other
infections. Antibiotics have not only
poverty-relate infections
(4)
.
saved patients’ lives, they have played a
The management of microbial
vital role in achieving major advances in
infections in ancient Egypt, Greece, and
medicine and surgery
(1).
They have
China
is
well-documented
(2)
.
The
treated
modern era of antibiotics started with the
infections that can occur in patien ts who
discovery of penicillin by Sir Alexander
are receiving chemotherapy treatments;
Fleming
who have chronic diseases such as
antibiotics have transformed mode rn
diabetes, end-stage renal disease, or
medicine and saved millions of lives.
successfully
7
prevented
or
in
Articles - AMR - VPHJ #13
1950s
(2,5)
,
since
then, (7,8)
.
Articles - AMR Antibiotics were first prescribed to treat serious infections
(8)
However, cases of vancomycin
. Penicillin
resistance were reported in coagulase -
was successful in controlling bacterial
negative staphylococci in 1979 and 1983
infections among World War II soldiers
(8)
(2)
1980s,
. However, shortly thereaft er, penicillin
. From the late 1960s through the early the
pharmaceutical
industry
resistance became a substantial clinical
introduced many new antibiotics to solve
problem, so that, by the 1950s, many of
the resistance problem, but after that the
the advances of the prior decade were
antibiotic pipeline began to dry up and
threatened lactam
. In response, new beta -
antibiotics
developed, confidence of
(5)
and (2,6)
were
discovered,
deployed,
restoring
. However, the first case
methicillin-resistant Staphylococcus
fewer new drugs were introduced first
patients
antibiotics,
were
bacterial
same decade, in the United Kingdom in
antibiotic effect:
.
Unfortunately,
resistance
has
treated
with
infections
have
(5)
again become a threat Bacterial
(2,8)
.As a
result, in 2015, many decades after the
aureus (MRSA) was identified during that 1962 and in the United States in 1968
(5)
strategies
. to
resist
the
(9,10,11)
1. Modifications of the antibiotic molecule:
eventually been seen to nearly all
The bacteria produce enzymes
(8)
that inactivate the drug by adding
antibiotics that have been developed
.
Vancomycin was introduced into clinical
specific
practice in 1972 for the treatment of
compound or that destroy the molecule
methicillin resistance in both aureus and
itself, rendering the antibiotic unable to
coagulase-negative staphylococci
(3,8)
.
interact
It had been so difficult to induce vancomycin
resistance
that
it
was
chemical
with
alterations
of
production
of
moieties
its the
target.
to
Chemical
antibiotic
enzyme s
the
via
capable
of
believed unlikely to occur in a clini cal
introducing chemical changes to the
setting (2).
antimicrobial molecule is a well -known
Articles - AMR - VPHJ #13
8
Articles - AMR mechanism
of
acquired
antibiotic
are
usually
found
in
MDR
resistance in both gram -negative and
bacteria. This mechanism of resistance
gram-positive
affects a wide range of antimicrobial
bacteria.
Interestingly,
most of the antibiotics affected by these
classes
enzymatic
their
inhibitors, fluoroquinolones, β-lactams,
inhibiting
carbapenems and polymyxins. The genes
protein synthesis at the ribosome level .
encoding efflux pumps can be located in
One of the best examples of resistance
MGEs (as initially described for the TET
via modification of the drug is the
gene)
presence of aminoglycoside modifying
Importantly,
enzymes (AMEs) that covalently modify
pumps
the hydroxyl or amino groups of the
resistance of some bacterial species to a
aminoglycoside molecule , multiple AMEs
particular antibiotic (e.g. E. faecalis
have been described to date and they
intrinsic resistance to streptogramin A .
have
There are major families of efflux pumps,
mechanism
modific ations of
action
become
the
exert by
predominant
mechanism of aminoglycoside resistance worldwide.
Production
of
complex
bacterial
machineries capable to extrude a toxic compound out of the cell can also result in antimicrobial resistance. These systems may be substrate-specific (for a particular antibiotic such as TET determinants for tetracycline
including
or can
in
protein
the
synthesis
chromosome.
chromosomally explain
the
encoded inherent
including MFS, MATE and RND. 2. Changes in target sites:
1. Efflux Pumps:
and
m ef
genes
for
macrolides in pneumococci) or with broad substrate specificity,
9
which
i. Target protection: Although
some
of
the
genetic
determinants coding for proteins that mediate target protection have been found in the bacterial chromosome, most of the clinically relevant genes involved in this mechanism of resistance are carried by MGEs. Examples of drugs affected by this mechanism include tetracycline (Tet[M] and Tet[O]),
Articles - AMR - VPHJ #13
Articles - AMR fluoroquinolones (Qnr) and fusidic acid
ii. B) Enzymatic alteration of the
(FusB and FusC). One of the classic and
target site:
best-studied examples of the target
As the methylation of the ribosome
protection mechanism is the tetracycline
catalysed by an enzyme encoded by the
resistance determinants Tet(M) .
erythromycin
i. A) Modification of the target sit e:
(erm) genes which results in macrolide
These target changes may consist of :
resistance.
i) point mutations in the genes encoding
methylation
iii. Resistance due to global cell adaptations:
the target site, ii) enzymatic alterations of the binding site (e.g. addition of methyl groups),
Through
long
periods
of
advancement, microscopic organisms have created complex components to
and/or iii) replacement or bypass of the original
adapt to natural stressors and weights with the end goal to endure the most
target. As mentioned, regardless of the type of change, the final effec t is always the same, a decrease in the affinity of the antibiotic for the target site. One of the most classical examples of mutational resistance is the development of rifampin (RIF) resistance.
ribosomal
threatening conditions, including the human body. Microorganisms need to seek supplements and dodge the assault of particles delivered by other adversary creatures with the end goal to pick up the "high ground". Inside a specific host, bacterial creatures are continually
Articles - AMR - VPHJ #13
10
Articles - AMR assaulted by the host's insusceptible
factors (possibly with "anti-evolution"
framework and all together build up
drugs)-
themselves
unexplored route toward fighting the
specifically
organic
specifically,
Mfd-giving
an
specialties, it is vital that they adjust and
AMR crisis.
adapt to these distressing circumstances.
References
Along these lines, bacterial pathogens
(1) Wright, G. D. (2014). Something old, something new: revisiting
have formulated exceptionally co mplex
microbiology, 60(3), 147-154.
instruments to stay away from the
natural products in antibiotic drug discovery. Canadian journal of (2) Sengupta, S., Chattopadhyay, M. K., & Grossart, H. P. (2013). The multifaceted
roles
of
antibiotics
and
antibiotic
disturbance of significant cell process, for
nature. Frontiers in microbiology , 4, 47.
example, cell divider amalgamation and
and threats. Pharmacy and Therapeutics , 40(4), 277.
film
homeostasis.
Improvement
of
resistance
in
(3) Ventola, C. L. (2015). The antibiotic resistanc e crisis: part 1: causes
(4) Rossolini, G. M., Arena, F., Pecile, P., & Pollini, S. (2014). Update on the antibiotic resistance crisis. Current opinion in pharmacology , 18,
protection from daptomycin (DAP) and
56-60.
vancomycin (low-level in S. aureus) are
way forward?. The Lancet infectious diseases , 12(3), 249-253.
the most clinically pertinent instances of
resistance: a tribute to a career of leadership by John Bartlett. Clinical
obstruction phenotypes that are the after
(5) Piddock, L. J. (2012). The crisis of no new antibiotics —what is the (6) Spellberg, B., & Gilbert, D. N. (2014). The future of antibiotics and infectious diseases, 59(suppl_2), S71-S75. (7) Gould, I. M., & Bal, A. M. (2013). New antibiotic agents in the
effect of a worldwide cell versatile
pipeline
reaction to the antibacterial assault.
(8) Centers for Disease Control and Prevention. (2015). Office of
Recent strategy to overcome the antimicrobial resistance: DNA "evolvability
translocase factor"
and
how
they
can
help
overcome
microbial
resistance. Virulence, 4(2), 185-191. Infectious Disease. Antibiotic resistance threats in the United States, 2013. April 2013. Accessed January, 28. (9) Wilson, D. N. (2014). Ribosome -targeting antibiotics and
(12)
mechanisms
Mfd
that
is
an
a dvances
mutagenesis and is required for fast
of
bacterial
resistance. Nature
Reviews
Microbiology, 12(1), 35. (10) Piddock, L. J. (2006). Clinically relevant chromosomally encoded multidrug resistance efflux pumps in bacteria. Clinical microbiology reviews, 19(2), 382-402. (11) Connell, S. R., Tracz, D. M., Nierhaus, K. H., & Taylor, D. E.
opposition improvement to all anti -
(2003). Ribosomal protection proteins and their mechanism of
microbials
3675-3681.
tried
crosswise
over
exceptionally dissimilar bacterial species. AMR advancement can be restrained
tetracycline resistance. Antimicrobial agents and chemotherapy , 47(12), (12) Ragheb, M. N., Thomason, M. K., Hsu, C., Nugent, P., Gage, J., Samadpour, A. N., Kariisa, A., Merrikh, C. N., Mille r, S. I., Sherman, D.R., & Merrikh, H. (2018). Inhibiting the Evolution of Antibiotic Resistance
through inactivation of evolvability
11
Articles - AMR - VPHJ #13
Articles - AMR Antibacterial Resistance in Food Producing Animals By: Puspa Rai (Agriculture and Forestry University - Nepal)
Abstracts: Antibacterial Resistance has become worldwide problem and threatening the health of both human and animals. The indiscriminate use of antibiotics for the treatment of human and animal infections has led to the rise of resistance in pathogens and in commensal bacteria. Resistance can pass between these different populations; and homologous resistance genes have been found in pathogens, normal flora and soil bacteria. Farm animals are an important component of this complex system: they are exposed to enormous quantities of antibiotics (despite attempts at reduction) and act as another reservoir of resistance genes. Keywords: Resistance; Antibiotics; Farm animals; Humans Introduction
ones may survive and multiply. This is
Resistance to antibacterial drugs
the why the responsible use of antibiotics
has become a worldwide problem for
is so important in both humans and
both
animals.
human
and
animal
health,
influenced by both human and non -
As early as 1945, Sir Alexander Fleming
human usage of antibiotics, and further
raised the alarm regarding antibiotic
enhanced
through
overuse when he warned that the "public
increasing international movement of
will demand (the drug and) ‌. then will
people, animals and food. The classes of
begin an era ‌ of abuses." 4,5
antibiotics
by
transmission
used
in
The overuse of antibiotics clearly
food -producing
animals and in human drug are mostly
drives the evolution of resistance. 6,
the same1 thereby increasing the risk of
both the developed and developing
emergence
world, antibiotics are widely used as
and
spread
of
resistant
7
In
of
growth supplements in livestock. 6, 8, 5 An
causing infections in both animals and
estimated 80% of antibiotic sold in the
humans 1-3 All humans and animals have
U.S.
bacteria, including those capable
bacteria in their gut.
Articles - AMR - VPHJ #13
12
Articles - AMR are used in animals, primarily to promote
Spread of resistance genes : The overall
growth and to prevent infection. 4,
5
burden of antibiotic resistant infections in
Treating livestock with antimicrobials is
human medicine is increased, as more types
said to improve the overall health of the
of bacteria are exposed to antibiotics and
animals, producing larger yield and a
resistance
higher-quality product. 10
bacteria
The main areas of risk
environment.
9,
The health risks associated with the over -
genes and,
are
spread
probably,
Development
of
between
through
the
resistance
to
use of antibiotics in farm animals have
antibiotics Epidemiological studies have
several related aspects:
demonstrated a direct relationship between
Antibiotic-resistant infections:
Over-use
of
food-borne
antibiotic consumption and the emergence
antibiotics
and dissemination of resistant bacteria
encourages the growth of antibiotic -
strains. 10 In bacteria,
resistant and multi-resistant foodborne
inherited from relatives or can be acquired
bacteria
from
such
as
Campylobacter,
nonrelatives
genes can be
on
mobile
genetic
Salmonella and E. coli, making it harder to
elements such as plasmids. 7 This horizontal
treat food-poisoning or other infections
gene
caused by these bacteria when they
different species of bacteria. 7 Resistance
become serious or life-threatening in
can also occur spontaneously through
people.
mutation. 7
New multi-resistant strains of bacteria
transfer
be
Antibiotics
transferred
remove
drug -sensitive
that have not in the past been food-
competitors,
related: Antibiotic use in animals has
behind to produce as a result of natural
contributed to the emergence of a new
selection. 7 Despite warnings regarding
strain of the superbug MRSA that can be
overuse, antibiotics are overprescribed
transmitted to the human population
worldwide. 8
through contact with animals or food .
13
Articles - AMR - VPHJ #13
leaving
among
resistant
bacteria
Articles - AMR Transfer of antibiotic resistance from
The
European
Food
Safety
Authority (EFSA) concluded in 2010 that
animals to people The antibiotic used in livestock are
live
chickens
colonized
with
ingested by humans when they consume
Campylobacter are 30 times more likely to
food.11
result in contaminated meat than are
Direct contact with infected animals:
uninfected birds.
farm workers and slaughterers:
Antibiotic resistance transferred into
Handling pigs and poultry and
14
the environment The agricultural use of antibiotics
working in a farm environment puts people at risk of picking up resistant
also
bacteria from the animals’ bodies or their
microbiome. 5,
feces. Studies in the Netherlands in 2001 -
transferred in water, soil and air. Up to
2002 showed the same genetic patterns of
90% of the antibiotics given to livestock
resistance in E. coli samples from turkeys
are excreted in urine and stool, then
and broiler chickens and their farmers and
widely
slaughterers.
affects 15
the
environmenta l
Resistant bacteria can be
dispersed
through
fertilizer,
groundwater, and surface runoff. 5, 15
12, 13
Consumption of food contaminated
In the US, tetracycline-resistance
with resistant bacteria (for example, the
genes have been found in groundwater
potentially
samples 250 meters downstream from the
food-poisoning
Salmonella,
slurry lagoon of a pig farm and appeared
Campylobacter and E coli ) Contamination of meat generally
to have spread among the local soil 16
results from fecal material getting onto the
microbes.
carcass
and
people living near turkey farms where the
evisceration process. Infected meat can
growth-promoter avoparcin was used were
also contaminate other foods in domestic
found
or restaurant/catering kitchens.
resistant to vancomycin, a closely related
during
the
slaughter
to
In the Netherlands, 14% of
carry
enterococcal
bacteria
and important human drug . 17
Articles - AMR - VPHJ #13
14
Articles - AMR Many
of
Salmonella,
bacteria
(such
Campylobacter
as and
use in food-producing animals kills or suppresses susceptible bacteria to thrive;
Escherichia coli) carried by animals can
2) resistant bacteria are transmitted to
also cause disease in people. These
humans through the food supply; 3)
bacteria,
frequently
these bacteria can cause infection in
antimicrobial-resistant, can contaminate
humans that may lead to adverse health
our food supply form farm to fork, such
consequences. 15
as through slaughtering, and processing.
CONCLUSIONS
Fruits
which
and
are
vegetables
maybe
Rapidly
emerging
resistant
contaminated by such bacteria at the
bacteria threaten the extraordinary health
farm
cr oss-
benefits that have been achieved with
contamination. People can get resistant
antibiotics. 5This crisis is global, reflecting
infections by handling or eating raw or
the worldwide overuse of these drugs
undercooked
and the lack of development of new
or
later
through
meat
or
produce
contaminated with resistant bacteria.
antibiotic
They can also get sick from contact with
companies to address the challenge. 5
animal poop, either through contact with
Coordinated efforts to implement new
animals and animal envir onments, or
policies, renew research efforts, and
through
pursue steps to manage the crisis are
contaminated
drinking
or
agents
by
pharmaceutical
greatly needed. 4 It is global public health
swimming water. The transfer of resistant bacteria
challenge with severe health and socio -
to humans by farm animals was first
economic
noted more than 35 years ago, when
significantly influenced by antibiotic use
high rates of antibiotic resistance were
in
found in the intestinal flora of both farm
Antibacterial-resistant effectively at a global scale means addressing it equally
animals
and
farmers. 5
through
the
following
This
occurs
sequence
of
food
animals.
that
Articles - AMR - VPHJ #13
is
Combating
in the developed and developing world.
events: 1) antibiotic
15
repercussions
Articles - AMR Countries should follow WHO, OIE,
and
implement
FAO
recommendations
national
action
to
plans
encompassing human, (food) animal, and environmental sectors to improve policies, interventions and activities that address the prevention
and
containment
of
Antibacterial-resistant from farm-to-fork.
Med Public Health. 2014;2014(1):147.[PMC free article] [PubMed] 8. The antibiotic alarm. Nature. 2013;495(7440):141. [PubMed] 9. Gross M. Antibiotics in crisis. Curr Biol. 2013;23(24):R1063–R1065. [PubMed] 10. Michael CA, Dominey-Howes D, Labbate M. The antibiotic resistance crisis: causes, consequences, and management. Front Public Health. 2014;2:145. [PMC free article] [PubMed] 11. Golkar Z, Bagazra O, Pace DG. Bacteriophage therapy: a potential solution for the antibiotic resistance crisis. J Infect Dev Ctries. 2014;8(2):129–136. 13. [PubMed]
References 1. Joint FAO/WHO/OIE Expert Meeting on Critically Important Antimicrobials Rome, Italy, Food and Agriculture Organization of the United Nations / World Organisation for Animal Health / World Health Organiz ation /2007. (http://www.who.int/foodborne_disease/resources/Report%2 0joint%20CIA%20Meeting.pdf, accessed 16 October 2013). 2. European Centre for Disease Prevention and Control (ECDC), European Food Safety Authority (EFSA), European Drugs Agency (EMEA), Scie ntific Committee on Emerging and Newly Identified Health Risks (SCENIHR). Joint opinion on antimicrobial resistance (AMR) focused on zoonotic infections. EFSA Journal, 2009, 7(11):1372. (http://www.ema.europa.eu/docs/en_GB/document_library/O ther/2009/11/WC500015452.pdf, accessed 27 December 2013). 3. Reports of Joint Committee on the Use of Antibiotics in Animal Husbandry and Veterinary Drug (Swann Committee). London, Her Majesty’s Stationary O´ce, 1969. 4. Spellberg B, Gilbert DN. The future of antibiotics and resistance: a tribute to a career of leadership by John Bartlett. Clin Infect Dis. 2014;59 (suppl 2):S71–S75. [PMC free article] [PubMed] 5. Bartlett JG, Gilbert DN, Spellberg B. Seven ways to preserve the miracle of antibiotics. Clin Infect
12. A E van den Bogaard et al. (2002) Antibiotic resistance of faecal enterococci in poultry, poultry farmers and poultry slaughterers. Journal of Antimicrobial Chemotherapy 49:497-505 13. A E van den Bogaard et al. (2001) Antibiotic resistance of faecal Escherichia coli in poultry, poultry farmers and poultry slaughterers.Journal of Antimicrobial Chemotherapy 47:763–771 14. European Food Safety Authority (2010) Analysis of the baseline survey on the prevalence of Campylobacter in broiler batches and of Campylobacter and Salmonella on broiler carcasses in the EU, 2008. Part B Campylobacter . EFSA Journal 2010; 8(8):1522, p 1-132, http://www.efsa.europa.eu/en/efsajournal/doc/1522.pdf 15. Centers for Disease Control and Prevention, Office of Infectious Disease Antibiotic resistance threats in the United States, 2013. Apr, 2013. Available at: http://www.cdc.gov/drugresistance/threat -report-2013. Accessed January 28, 2015. 16. J C Chee-Sanford et al. (2001) Occurrence and diversity of tetracycline resistance genes in lagoons and groundwater underlying two swine production facilities. Applied and Environmental Microbiology 67(4):1494 -1502 17. E Stobberingh et al. (1999) Enterococci with glycopeptide resistance in turkeys, turkey farmers, turkey slaughterers,
Dis. 2013;56(10):1445–1450. [PubMed] 6.
7. Read AF, Woods RJ. Antibiotic resistance management. Evol
Centers for Disease Control and Prevention, Office of Infectious Disease Antibiotic resistance threats in the United States, 2013. Apr, 2013. Available at: http://www.cdc.gov/drugresistance/threat -report-2013.
and (sub)urban residents in the south of The Netherlands: evidence for transmission of vancomycin resistance from animals to humans? Antimicrob Agents Chemother. 43(9):2215-21
Articles - AMR - VPHJ #13
16
Articles - AMR HOW CAN I RESIST YOU? By: Valeria Rizzo (University of Teramo - Italy) Nowadays antimicrobial resistance is
antimicrobials. Nonetheless it is extremely
one of the most compelling and urgent
important to distinguish between resistance
issues in medical field.
and tolerance. The latter, in fact, is the
important
to
Therefore it’s
understand
what
this
phenomenon is and why it is so important.
natural inclination of a microorganism to resist a particular chemical, while resistance
Antimicrobial resistance is the ability
is induced by a necessity. In other words, if
that every microorganism can develop to
the microorganism does not develop any
resist the action of the drugs designed to kill
resistance, it dies.
him.
Several
microorganisms
such
as
What
role
bacteria, fungi, viruses and protozoans have
medicine
developed this ability. As result, it is very
resistance, then?
play
in
does the
veterinary antimicrobial
hard to cure illnesses caused by this
Veterinary medicine plays a leading
bacteria. It must be also emphasized that
role in it. About 10 years ago, veterinarians
this problem concerns different medical
were accustomed to use antibiotics in order
fields: from human medicine, veterinary
to prevent illness in livestock a nd fish. The
medicine to agriculture and public health.
abuse of antibiotics and the use of low
It’s universally known that this phenomenon
dosage of drugs have given the time to
affects the world we live in.
bacteria to develop resistance. Multiple drug
It has been observed that a wide
resistance is spread by bacteria. This means
variety of resistance is more common in
that the bacterial population has developed
some regions than others. Still, it must be
resistance; therefore any dru g will never be
kept under control by any country in the
effective Antibiotics, by the way, are also
world.
used privately, at home by families who The resistance is induced by the
selection pressure that follows the use of
tend not to pay attention to dosage and sometimes
underestimate
prescribed course.
17
Articles - AMR - VPHJ #13
the
entire
Articles - AMR Not only does this process refer to
The
horizontal
gene
transfer
is
bacteria but even to viruses, parasites and
another process that accelerates the creation
other
fact,
of resistant populations. This method allows
antibiotic resistance remains the most urgent
the transfer of a gene from a bacterium to
one.
this
another bacterium of the same kind or of a
phenomenon is going way further than
different kind without reproduction, bacteria
expected: in US at least 2 million people are
just pass the genetic information from one
infected with resistant bacteria and at least
to another.
pathogens. Experts
As
have
matter claimed
of that
23.000 people died (CDC).
This
Bacteria become resistant with two
is
microorganisms
possible have
because mobile
these genetic
different methods: genetic mutation and
elements that allow the acquisition and
horizontal gene transfer. They reproduce
rearrangement of their genome.
themselves very quickly, as result, the DNA
Antibiotics are inactivated by bacteria in
replication
different ways:
cannot
be
accurate.
Thus,
bacteria always have random mutations in
I.
through blocking the entrance of
their DNA. When the new mutation is useful, it is preserved and the mutated
antibiotics in the cell, II.
bacteria survives reproducing himself and transmitting the mutation to new bacteria
cell before it can work, III.
that will in turn spread the resistance to others.
by
degrading
antibiotics
with
enzymes, IV.
This mechanism creates within a
by pumping the antibiotic out the
by changing the target that the antibiotics use to recognize them.
brief spare of time, a population of resistant
Antibiotic resistance is currently the
bacteria. This does not happen when the
main type of resistance and the most
antibiotics are used in the correct way
frightening, but we must know that it is not
because they are designed to kill all the
the only one.
bacteria and there should not be any residual bacteria after the cure.
Antiparasitic resistance, for instance, is a reality and it’s very important to know that
Articles - AMR - VPHJ #13
18
Articles - AMR the improper use of these drugs is leading to
egg, it counts by more than 95 percent.
resistant populations of parasites.
Antiparasitic resistance originates from the
Veterinarians firstly have to educate
efficacy of the drug, the mechanism with
themselves and their clients on how to
witch it works and the characteristics of the
properly use antiparasitic drugs. It is very
singular animal treated.
common for owners or farmers not to pay
Why do we need antibiotic and other
attention to the correct use of antiparasitic
antimicrobics?
and this can easily result in resistance.
Antibiotics have saved millions of
In 2012 a survey conducted on pet
people: medical treatments such as cancer
owners using spot-on tick treatments found
therapy, organ transplants, and treatments
that in 52% of dogs the treatments weren’t
of chronic diseases are based on the use of
applied as recommended. (Beck et al., 2013)
antibiotics, if they fail, al lot of people will
When it comes to resistance in pets, it is
be in danger.
difficult to distinguish between treatment
Furthermore, antimicrobics have also
failure and resistance, itself. As mentioned
saved a lot of animals from death and bad
before, resistance becomes an important
illnesses, bettering the productions of food -
issue when the population of parasites
producing animals and the living conditions
change
pressure
of pets. There is a global action plan to
determined by the exposure to an insecticide
tackle antimicrobial resistance promoted by
and therefore it is difficult to prove.
the sixth-eight World Health Assembly, in
because
of
selection
In ruminants, from goats to cattle, and
May 2015. The main goal of this plan is to
horses there are more evidences about
maintain the efficacy of medicines through
parasitic resistance: anthelmintic resistance
five objectives:
is a real problem veterinarians and farmers
1. improve
deal with every day and it has been caused
understanding
by the improper use of antiparasitic drugs in
resistance,
the past. Drug resistance exists when an
2. strengthen
anthelmintic treatment fails to reduce fecal
19
awareness of
antimicrobial
knowledge
surveillance and research,
Articles - AMR - VPHJ #13
and
through
Articles - AMR REFERENCES:
1. reduce the incidence of infection, 2. optimize the use of antimicrobial agents 3. develop
the
economic
case
for
sustainable investment that takes account of the needs of all countries, and increase investment in new medicines, diagnostic tools, vaccines and other interventions This means that every veterinarian has to raise awareness and educate their clients in order to minimize the risk of contamination.
1. Laura Christine McCaughey, L.C.M. (2016, 10 JUNE ). We know why bacteria become resistant to antibiotics, but how does this actually happen? [Webl og]. Retrieved 10 JUNE 2016, from https://theconversation.com/we -know-why-bacteriabecome-resistant-to-antibiotics-but-how-does-thisactually-happen-59891 2. Demeke nega and zewdu seyum , D.N.A.N.D. .Z.S. (2017). A Review on Anthelmintic Resistance and Potential Risk Factors in Domestic Ruminants . Acta Parasitologica Globalis , 8(58 -67, 2017 ), 60-63. 3. Tad b coles and Michael w Dryden, T.B.C. .A.N.D. .M.W.D. (2014). Insecticide/acaricide resistance in fleas and ticks infesting dogs and cats . Parasites & Vectors 4. World Health Organization. Retrieved 25 November, 2018, from http://www.who.int/antimicrobial resistance/global-action-plan/en/
5. Oieint. Retrieved 25 November, 2018, from http://www.oie.int/en/for-the-media/amr/
In conclusion it must be taken into account that antimicrobial resistance can be defeated. We can make the difference and we must be better than our ancestors. We have no excuses
anymore.
Our
researchers
are
ensuring that their work has an impact. Cooperation is what we need the most now, so we can proceed further with the creation of a strategic action pl an that will
considerably
reduce
the
risk
of
resistance evolution in every possible way.
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20
Articles - AMR Antimicrobial Resistance: An OVERVIEW By: Dauda Ayomide Onawola (Usmanu Danfodiyo University - Sokoto, Nigeria) INTRODUCTION
be
the
result
of
mutation
but
happens
secondary resistance occurs after
when microorganisms change when they are
therapy with the antimicrobial has
exposed to antimicrobial drugs (such as
begun.
antibiotics,
and
difference between mutational and
anthelminthics) into a form that makes them
secondary resistance is that the the
capable of defying the activities of the
use of the drug induces secondary
antimicrobial drugs or
develop certain
resistance while mutational resistance
features that make them able to avoid or
is pre-existing. Also highly relevant
evade the effects the antimicrobial drugs.
clinically,
Microorganisms that develop antimicrobial
antimicrobial therapy may select for
resistance to many antibiotics are sometimes
resistant organisms. In the absence of
referred to as “superbugs”.
such
Antimicrobial
resistance
antifungal,
antivirals
The
clinically
is
the
'selection
important
fact
pressure',
that
many
organisms with mutations will be at competitive disadvantages with their peers. « Transferrable antimicrobial
resistance; resistance
may
be
transferred from one organism to another. CATEGORIES
OF
ANTIMICROBIAL
RESISTANCE « Natural
drug
resistance is plasmid-mediated i.e. extrachromosomal DNA containing
resistance;
this
is
chromosomally mediated. « Mutational/secondary
code for the mechanism of resistance is transferred from one organism to
resistance;
these are similar in that both may
21
Transferrable
another. The most threatening fact about this type of
Articles - AMR - VPHJ #13
Articles - AMR resistance multiple
is
that
resistance
antimicrobials
may
to
of fake or adulterated antimicro bial drugs.
be
In
contained in one plasmid.
attempt
to
maximize
profit,
drug
manufacturers embraced the act of reducing
ÂŤ Induced resistance; here, bacteria
the concentration or amount of active
are originally sensitive but because
chemical components in antimicrobials and
of the damaging effect of the drug
this of course favors secondary resistance -
on the bacteria, they can no longer
the microbes are affected below lethal
take up the drug and therefore they
threshold and they mutate in order to be
become relatively unresponsive to
able to handle subsequent attack by the
the addition of more drug. This is
antimicrobial.
relevant with the aminoglycosides
contribute to this menace. This is a rampant
(streptomycin, gentamicin, etc.). CAUSES
OF
Prolonged use of antimicrobials also
ANTIMICROBIAL
finding in humans. People tend to extend the time of use of antimicrobial drugs
RESISTANCE The chief aetiology of antimicrobial
instead of reaching out to their physician on
resistance is the misuse and/or overuse of
the success or failure of the therapy after
antimicrobials. In many places, antibiotics
exhausting
are overused and/or misused in animals and
impression that drugs only have positive
humans
without
effects is also in favor of superbugs. This
professional oversight. Examples of misuse
results from the fact that people are not
include when they are taken by people with
exposed to the realities of antimicrobial
viral infections like colds and flu, and when
resistance and other possible complications
they are given as growth promoters in
(sometimes side effects) that might arise as
animals or used for preventive purpose in
a result of chronic use of a drug.
and
often
given
healthy animals which happens to be a commonplace
in
modern
livestock
prescription.
The
The apparent failure of scientists to produce a new class of drugs with different properties and mechanism of
production. Another
their
factor
in
support
of
superbugs is the production and availability
action from the existing ones to handle microbes is also casting a vote for the
Articles - AMR - VPHJ #13
22
Articles - AMR development of resistant genes in
some organisms previously exposed to low
microbes. All antimicrobial drugs currently
levels of drugs that affect the e nzyme such
availabe are formulations and brands of
as trimethoprim etc.
previously established antimicrobial age nts
HOW
containing same active chemical compounds
SPREADS
ANTIMICROBIAL
RESISTANCE
that act via same or similar mechanisms of
When antibiotics are overused or
action as the previously established ones -
misused in livestock (e.g. when used at low
the same alcohol in bottles of different
levels in feed to boost gr owth and prevent
shapes and colors!
infection in healthy food animals), resistant
Pharmaceutical companies share a
microbes develop in them which would be
large portion of the blame in this, their
taken along with the meat or other animal
commitment
on and
products especially when they are not
development of novel class of antibiotics is
properly cooked or processed. Animals with
far less than their focus on profit -making
resistant microbes may also pa ss them out in
from
Incomplete
faeces (dungs and droppings) and when this
administration or usage of antibiotics in
is used as manure in farms, the resistant
animal
microbes
the or
towards
available human
research
ones. patients
helps
the
may contaminate
plants
and
development of resistance in microbes in the
eventually the farm products meant for
sense that there are very high chances that
consumption. Animals play a great role in
some of the microbes would not be
the spread of resistant microbes hence the
completely destroyed and these surviving
use of antibiotics in the production of food
ones would try to develop a shield to
animals needs to be monitored strictly.
protect themselves from subsequent attack
Continuous use of the same or sub -lethal
depending on the mechanism of action of
concentrations of disinfectants for cleaning
the antibiotic they were exposed to in the
in veterinary and human hospitals or clinics
first place e.g increased secretion of β-
facilitate the development and spre ad of
lactamase
bacteria
resistant microbes and this exposes animal
previously exposed to sub -lethal level of
and human patients to higher risks of
penicillin
nosocomial infection by
by or
gram
positive
cephalosporins,
increased
production of dihydrofolate reduc tase by
23
Articles - AMR - VPHJ #13
Articles - AMR resistant microbes. Resistant microbes may
ü Attention should be paid to the
spread to and through the environment like
improvement
many of the non-resistant ones, proper
techniques in the health sector and
hygiene using different disinfectants in
veterinarians as well as physicians
alternating
should
pattern
and
at
the
right
carefully
of
diagnostic
observe
clinical
concentrations does much good in both
signs and symptoms then examine
cases.
patients
REMEDIES
TO
ANTIMICROBIAL
meticulously
before
administering antibiotic drugs. REFERENCES
RERESISTANCE ü Governmental laws prohibiting over the-counter sale of antibiotics should be established and enforced. ü The use of valid point-of-care tests and sensitivity test in order to avoid using the wrong antibiotics and having to change from one antibiotic to another should be promoted. ü The use of antibiotics as growth promoters and for disease prevention by livestock farmers on food animals
1. James, A. A., Michel, N. and Andrew, N. A. (2017). The threat of antimicrobi al resistance eveloping countries: causes and control strategies. 2. Antimicrobial Resistance and Infection Control . 6-47. DOI10.1186/s13756-017-0208-x 3. Gordon, L. C. (1996). Introduction to antimicrobial drugs. Indiana, US. Purdue Researh foundation. 4. Elroy, P. W., Elizabeth, K. W., Jules, C. A. and Dickson, S. N. (2017). Pros and cons and future of antibiotics. New Horizon in Translational Medicine. 419 5. Carl, L. and Lars, B. (2014). Antimicrobial resistance: Fisk associated with antibiotic overuse and initiatives to reduce the problem. Ther Adv in Drug Saf, 5(6), 229241. SAGE Pub, doi:10.1177/2042098614554919 6. Huang, S. S. and Platt, R. (2003). Risk of methicillin resistant Staphylococcus aureus infection after previous infection or colonization. Club. Infect. Dis., 36(3). 281 285. 7. World Health Organization. Retrieved from http://www.who.int/antimicrobial -resistance/en/
should be prohibited. ü Public
enlightenment
on
causes,
effects and how to curb antimic robial resistance should be taken seriously by relevant governmental and non governmental
bodies,
health
professionals and medical students.
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24
Articles - AMR THE RISE OF ANTIBACTERIAL RESISTANCE By: (Dimitra Chiou Faculty of Veterinary Science, University of Thessaly - Greece) The rapid emergence of resistant bacteria is
The inoculum effect generally occurs
occurring worldwide,
with the beta-lactam antibiotics and with
Endangering the effectiveness of antibiotics,
the beta lactamase-producing bacteria. Beta-
which have transformed medicine and have
lactam antibiotics contain a four-membered
saved millions of lives.
ring, who is the key to the mode of action
Historically, the era of antibiotics
of these drugs, which target the synthetic
started with the discovery of penicillin by
cell wall enzymes (PBPs= penicillin binding
Alexander Fleming in 1928. Drug -resistant
proteins) of the bacteria. B- lactamase
strains initially appeared in hospitals, where
resistance
results
most antibiotics were being used.
interaction,
in
In
from
which
a
the
chemical b-lactamase
particular, the first case of sulfonamid e-
molecule binds to the b-lactam antibiotic
resistant
was
and hydrolyses the b-lactam ring structure.
identified in military hospitals in the 1930s,
High affinity and rapid hydrolysis mean that
whereas resistance to multiple drugs was
the PBPs can be defended with relatively
first detected among enteric bacteria such as
few b-lactamase molecules compared to the
E. coli, Shigella and Salmonella in the la te
number of b-lactam molecules likely to be
1950s.
present in the vicinity of the PBPs.
Streptococcus
But
how
did
pyogenes
bacteria
obtain
resistance to antibacterial agents?
A second ability of bacteria, to which
The inoculum effect is a laboratory phenomenon
a
or resistance to killing at antimicrobia l
significant increase in the minimal inhibitory
concentrations sufficient to inhibit further
concentration of an antibiotic when the
growth.
number increased.
of
that
is
inoculated
described
as
antimicrobial resistance is due, is tolerance
organisms
is
In activity
some requires
instances, high
bactericidal
percentages
treatment in order to lead to success.
25
Articles - AMR - VPHJ #13
of
Articles - AMR There are circumstances in which the
There is a range of techniques for the
immune system is severely compromised,
acquisition of exogenous resistance genes.
such as in patients undergoing hi gh-dose
The most simple and rare is natural
chemotherapy or inflammations caused by
transformation, referring to the ability of
bacteria (endocarditis, osteomyelitis), where
some bacteria to absorb DNA mole cules
the immune system has limited access. Also,
from the environment. If this ‘’new’’ gene
there is the intrinsic resistance of some
encodes a protein that has less antibiotic -
bacteria to antibiotics that means that the
affinity than the native protein, we observe
antibiotic will never be able to cover this
a reduction in the susceptibility of the
bacterial species with treatment doses,
bacteria. A very common mechanism for
because the normal minimal inhibitory
genetic exchange is the transfer of plas mids
concentration range is near or above the
R, extrachromosomal self-replicating DNA
level of drug that is reached in vivo. Lastly,
forms found in bacterial cells. The resistance
in rare occasions, products of inflammatory
of the plasmids is, in most cases, the result
reaction such as pus and necrotic debris
of encoding new enzymes which either
may absorb antibacterial agents.
block the antibiotic uptake or neutralize or
But the most common type of
push
it
out
of
the
cell.
In
some
antimicrobial resistance refers to genetic
circumstances, the plasmid may contain
changes, like through the mutation of
different resistance genes and each gene
cellular genes. Some antibiotics i nhibit
encodes
protein
with
different antibiotic. Entering a new genus,
ribosomes. Bacterial genes encode these
plasmids provide resistance to the recipient.
proteins, which are essential for cell growth
Transposable elements, also known as
and proper function. As a result, the
‘’jumping genes’’ are DNA sequences that
alteration of a single base in that gene can
move from one location of the genome to
change the amino acid and reduce the drug
another. In some cases, transposons encode
affinity. Resistance, also, can be obtained by
conjunction
synthesis
by
interacting
a
neutralizing
enzyme
of
a
gene exchange.
Articles - AMR - VPHJ #13
26
Articles - AMR conjunction functions, which allow
Moreover, if bacteriostatic agents
them to transfer from bacterial chromosome
aren’t maintained at effective concentrations
to bacterial chromosome. This has the effect
in the tissues, dissociation of drug-cell
of them engaging in the transfer of resistant
complex can occur, permitting bacterial
genes.
biochemical
existence. Furthermore, the chronic use of
resistance mechanisms, bacteria may either
subtherapeutic amounts of antibiotics for
have functions that prevent the entry of
growth promotion in animal food leads in a
antibiotics or lead to their extrusion. The
high-level resistance. Enteric are propagated
antibiotic must reach his target through
primarily among animals and subsequently
barriers to be effective. If these barriers
infect people through the food chain or
become stronger, they act as a resistance
animal handlers. Last but not least, from an
mechanism. In some bacteria, that can be
environmental
achieved with the reduction of porins
discharge and persist intact in nature,
(channels of movement of material across
contributing to the environmental selection
the outer membrane of gram negative). On
of antibiotic-resistant organisms.
the contrary, other bacteria have pumps in
In conclusion, the ability to produce new
their cytoplasmic membrane that use proton
and more efficient antibiotics is diminishing
motive force to drive to drug efflux. Finally,
and so, we have to act. Prescriptions for
antibiotics generally exhibit eclectic toxicity
antimicrobial drugs should be granted only
due to biochemical differences in structures
when needed and from authorized medical
or metabolic pathways between mammalian
and veterinary sources. Also, there should
and bacterial cells. At therapeutic levels,
be a strict adherence to therapeutic dose
antibacterial
either
and prescription period of time. If we follow
bacteriostatic or bactericidal. Bactericidal
these simple steps, it is certain that the
drugs are effective against actively dividing
present situation will improve significantly.
cells, unlike bacteriostatic drugs that inhibit
BIBLIOGRAPHY
With
bacterial antagonism
regard
agents
growth. may
to
are
usually
When occur
combined,
and
therefore
bactericidal activity may be abolished, leading to the survival of the bacteria.
27
aspect,
antimicrobials
•Brock Biology of Microorganisms by Michael T. Madigan •Manual of Clinical Microbiology 8th edition volume 1 •Bailey & Scott’s Diagnostic Microbiology 11th edition •Veterinary Microbiology and Microbial Disease - Blackwell Science •Laboratory Diagnosis of Bacterial Infections edited by Nevio Cimolai •LevyMarshall-2004-Nature-Medicine.pdf •Wikipedia
Articles - AMR - VPHJ #13
Articles - AMR “Use of Antimicrobials along with its Consequences in Context of Nepal� By: Samiksha Phuyal (Tribhuwan University - Nepal)
Antimicrobials
which
includes
Ampicillin,
metronidazole,
antibiotics, antiviral, antifungal and so on
amoxicillin,
are very much crucial, life -saving drugs
chloramphenicoletc. are commonly used
against various infectious diseases. But
drugs whose working ef ficiency is in
nowadays, the growing issue regarding
degrading rate since recent years.
its resistance property is in rapid access of flourishing globally. According
to
cotrimoxazole,
The relationship of decreasing effectiveness of drugs and increasing the
the
detailed
resistance properties of microbes have
Antibiotic Resistance Partnership (GARP)
created a suitable environment for the
- Nepal working group, it has found that
rise and wide dissemination of the
many important bacterial pathogens are
resistance microbes globally favoring the
highly resistant to most first -line and
state of antimicrobial resistance.
some second-line antibiotics. More than
In context of Nepal, the major
half of E. coli, Klebsiella pneumoniae
reasons behind this situation includes
and Streptococcus pneumoniae as well as
insufficient surveillance system, lack of
over 30 percent of some Shigella spp and
appropriate policies i.e. our country does
Vibrio Cholerae were found resistant to
not have proper legislations to control
first-line antibiotics. In case of Neisseria
the
gonorrheae
acquired
awareness regarding the right use and
Staphylococcus aureus were also found
right way of using various antimicrobial
similar.
agent, no knowledge regarding hygiene
and
hospital
antibiotics
consumption,
poor
As microbes are being resistant,
and sanitations as well as absence of new
different well known drugs are currently
antimicrobials being discovered and so
ineffective to several microbial diseases.
on.
Articles - AMR - VPHJ #13
28
Articles - AMR Since,
antimicrobial
agent
are
being suffered presenting a hazard to
recommended specially for treating the
human
health
when
these
resistant
infectious disease but in context of Nepal
microbes causes the disease either being
it has been found that it is used extensively
transmitted through direct contact or
for preventing disease neglecting its basic
through the contaminated foods.
use form. Moreover, farmers are even
Regardless of its resistance property,
being found using it haphazardly in excess
proper use of antimicrobial age nt are
amount for the proper growth and better
effective in curing sick and suffered
performance
various
animals and also accelerate the recovery
localities. Statistics have shown that the
rate of others, improve the welfare of
volume of use of veterinary antimicrobials
treated one as well as reduce the rate of
agent have increased by 50% from 2008
spread of infection from one animal to
to 2012, most through retai lers without
another, also from the animal to us i.e. we
veterinarian prescriptions as if like a
the human beings being suffered from
sweets. All these have resulted in the
zoonotically transmitted diseases.
of
animals
in
survival and persistence of resistant strains.
For all these, the great challenge is
Since we know that, the concern of
to use the antimicrobial agents wisely,
“One Health” which stands on the
minimizing
triangular relationship between the human
resistance leading to provide a great
health,
the
benefit to the society and helping to
environment explaining that these three
ensure high standard of welfare for those
components are directly dependent on
animals in our care.
each other. Due to which if we talk about
Reference:
the
animal
health
and
the development of resistance property of antimicrobial
agents
in
the
obviously human health is found
29
·
animals ·
the
risk
of
antimicrobial
Dixit, S.M. (2015). Antibiotic Use, Its Resistance in Nepal and Recommendations for Action: A situation Analysis. Journal of Nepal Health Research Council, 13(30) Malla, S. (2014). The challenges and successes of implementing sustainable antimicrobial resistance surveillance programme in Nepal. Journal of BMC Public Health, (Pub Med)
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Articles - AMR “AMR and Animal Welfare – Eternal Enemies?” By: Laure Chevalier ( VetAgro Sup's Lyon Veterinary Campus) Journal Creator for IVSA Standing Committee for Animal Welfare 2018-2019
Antibiotics cure, therefore, they
This preventive way of thinking is
must be beneficial to animal welfare.
old as the world, but as curative means
Though this seems obvious to medical
got increasingly efficient it was often
students, this is not the view that seems
denied the importance it deserves. Now,
to be preeminent in the general public
AMR
these days – in a 2017 study, 64% of the
consequences is leading us to put welfare
surveyed
that
centre stage again, not only as an ethical
antibiotic-free meat guaranteed good
concern but as a health necessity – for
animal husbandry practices and cleaner
the greater good?
animal living conditions [ORC, 2017].
Antibiotics are a necessity – and AMR
How right exactly are they? Though
threatens them…
population
belie ved
and
its
short -term
dramatic
antibiotics today allow us to prevent suffering in animals, prolong animal lives and expand the livestock industry, it can be argued that antimicrobial resistance may lead to advances in animal welfare. This derives from the fact that antibiotics are helping us keep unhealthy animals viable and treating them when they are sick, but the loss of antibiot ics efficiency is bringing us to consider a different approach to medicine in which we would keep animals healthy enough that they fend off pathogens themselves.
Some issues cannot be treated entirely without antibiotics, and untreated may lead to great pain. In poultry, for instance, footpad lesions, eye
Articles - AMR - VPHJ #13
30
Articles - AMR burns
and
airsacculitis
equine
hospital
conditions commonly used as markers to
affected
eight
gauge the welfare of a flock, and
approximately US$170,000. [Bergstrom
symptoms for the three of them are
K.] Some animal owners may not be able
considerably alleviated by the use of
to bear these costs, and this will lead to
antibiotics. [Karavolias] Bengtsson and
more and more situations where the only
Greko’s
option left is euthanasia.
2014
article
are
painful
summarizing
in
Sweden,
horses
and
which costed
consequences of AMR on animal welfare
AMR also leads to a critical
provides us with multiple examples of
ethical dilemma, where veterinarians may
cases where antibiotics are used today.
find themselves weighing the lives of animals that they are treating against those of potentially infected humans. The most widely supported stance today is that the latest efficient antibiotics be used in animals only when all else has been tried – but some antibiotics are already forbidden for veterinary use in some countries and reserved for human use [see the website of the European Medicines Agency, for some examples of
As resistance forms of different pathogens take on more and more
rulings regarding antibiotic use]. With social media blurring the
increasingly
boundary between fact and opinion, it is
complicated and costly to treat them,
important that people do not reduce
especially in hospitals or large clinics
antibiotics to “a bad thing that allows
where they tend to thrive. For instance,
evil practices to thrive”: as Karavolias’
an
2018 study on the effects of antibiotics
importance,
outbreak
it
becomes
of
methicillin-resistant
Staphylococcus aureus (MRSA) in an
31
in poultry underlines, there is a
Articles - AMR - VPHJ #13
Articles - AMR considerable amount of misinformation
…
yet
AMR
is
bringing
today: people believe they understand
reconsider our practices .
us
to
the problem of AMR and inappropriate
Interestingly, welfare could help
antimicrobial use because they have
us fight infection without antibiotics.
access
of
“Welfare” is usually defined as the state
information, but selecting informative
of an animal as regards its attempts to
and scientific-based evidence among
cope with its environment. This includes
those can be tricky. Around 60% of
how much it is having to do to cope, the
consumers
as
extent to which it is succeeding or failing
knowledgeable in poultry, yet 75% of
to cope, and its associated feelings
them believed that hormones or steroids
[Broom, 1996]. If an animal’s welfare is
are present in chicken meat although
not respected, this means it is constantly
they
spending
to
are
considerable
considered
never
amounts
themselves
used
in
poultry
energy
to
cope
with
its
[Karavolias, 2018]. There is a large
environment. Any disturbance of this
information gap between the scientific
environment,
community and the consumers and
change,
animal owners, and AMR has led to a
environment, a confrontation with a
swing
pathogen, will be an added difficulty that
in general opinion
from an
a
like
a
brutal
sudden
climate
change
of
acceptance of antibiotics as the norm to
the animal might not be fully able to
a demonization of them. Consumers have
adapt to. On the other hand, an animal
many false convictions about the meat
which is not constantly putting its energy
they are buying and about the effect
into
antibiotics might have had on the animal
because it is adapted to its needs , can
it came from. It is crucial that this
face
information gap be bridged, and that we
animal-environment
avoid over-simplifying AMR and its
resilient. Respecting the five freedoms of
implications.
animal welfare and the basic hygiene
coping
with
disturbances
Articles - AMR - VPHJ #13
its
environment,
much system
better: is
the more
32
Articles - AMR rules implied by them will mean that our
over the course of humanity,
animals are “better armed” against
especially in the last century as selection
potential pathogens [Graveland, 2010],
got more drastic and we acquired more
which makes sense: their immune system
knowledge concerning genetics. The fact
will be available and efficient, and they
that we provided animals too weak to
will be less prone to infect ion.
fend
off
infection
with
and
antibiotics,
An animal contracting a bacterial
though, means that little to no selection
disease is a sign of two things: the
has occurred on resistance to pathogens
bacteria’s virulence and the animal’s
in animals (unlike in plants) . Today,
weakness.
on
genetics labs are carrying out research on
weakening the bacteria. Antimicrobial
whether it is possible to select animal
resistance means we cannot go on with
resistance to
this approach and is pushing us to focus
specific pathogens to improve the global
rather on the other side of the scale, on
resistance of the population [Gunia M.,
strengthening our animals’ defences.
2018]. Incorporating pathogen resistance
While developing new vaccines is already
(ranging from bacteria to parasites) could
something that is deeply researched into,
be a dramatic improvement for anima l
the simplicity of welfare is too often
welfare in the long run, and a much
overlooked. We need to fulfil our
more
animals’ needs to allow them to be
infections.
strong in the face of pathogens and stay
Conclusion
Antibiotics
focus
competitive on the evolutionary stage. “Healthy
animals
do
not
need
antibiotics.” [Bengtsson & Greko, 2014] The operated
selection so
far
on
that
we
animals
approach
than
curing
Stopping the use of antibiotics all together and antimicrobial resistance will both lead to terrible consequences if we
have
do not adapt our means of caring for
has
animals, be they pets, sports animals, or
considerably changed the way they are
33
viable
various, more or less
production animals. Thera pies must
Articles - AMR - VPHJ #13
Articles - AMR change, and it must be acknowledged that animals and humans alike will suffer from the transition away from antibiotics. We need to work around this new difficulty gradually, not brutally stop all antibiotics
and
their
affiliates
everywhere. In time, the changes we
Karavolias J., M. J. Salois, K. T. Baker, and K. Watkins. (2018). Raised without antibiotics: impact on animal welfare and implications for food policy. Published by Oxford University Press on behalf of the American Society of Animal Science. Transl. Anim. Sci. 2018.2, 337–348. DOI: 10.1093/tas/txy016 Graveland H., Wagenaar J.A., Heesterbeek H., Mevius D., van Duijkeren E., Heederik D. (2010). Methicillin Resistant Staphylococcus aureus ST398 in Veal Calf Farming: Human MRSA Carriage Related with Animal Antimicrobial Usage and Farm Hygiene. PLOS ONE 5(6): e10990. https://doi.org/10.1371/journal.pone.0010990
make towards having healthier animals will
undoubtedly
lead
to
more
sustainable practices and an improved animal welfare. References: Bengtsson B., C. Greko. (2014). Antibiotic resistance—consequences for animal health, welfare, and food production. Upsala Journal of Medical Sciences 2014 (119), 96-102. DOI: 10.3109/03009734.2014.901445 Bergstrom K., Nyman G., Widgren S., Johnston C., GronlundAndersson U., Ransjo U. (2012). Infection prevention and control interventions in the first outbreak of methicillin-resistant Staphylococcus aureus infections in an equine hospital in Sweden. Acta Vet Scand. 2012, 54:14. Boyer, A., J. Neth, and M. Nunlist. (2017). Consumer chicken consumption survey results. Presented at the 2017 Chicken Marketing Summit. Asheville, NC: July 17–July 19, 2017. Broom D.M. (1996). Animal Welfare defined in terms of attempts to cope with the environment. Acta. Agric. Scand., Sec. A, Animal Sci. Supplementum 27, 22-28. European Medicines Agency webpage: www.ema.europa.eu/en/ (visited last in November 2018) Gunia M., I. David, J. Hurtaud, M. Maupin, H. Gilbert, H. Garreau. (2018). Genetic Parameters for Resistance to Non-specific Diseases and Production Traits Measured in Challenging and Selection Environments; Application to a Rabbit Case. Front Genet (9), 467. DOI: 10.3389/fgene.2018.00467
Article by:
Standing Committee on Animal Welfare 2018/2019 International Veterinary Students’ Association
Articles - AMR - VPHJ #13
34
PROJECT REPORTS
Project Reports One Health Day - WEBINAR By: Leanne Jankelunas (Cornell University DVM '20, University of Minnesota MPH '20) Project Manager Team - Standing Committee on One Health 2018/2109
1. Why did you organize this webinar
3. Can you tell us about the Speakers
and what did you want to achieve
and their topics? (Brief Explanation)
from this webinar?
The speakers were from a variety
I organized the 2018 One Health
of
backgrounds
and
encompassed
Webinar Series with a goal to try to
multiple interests including infectious
showcase the multitude of fields that
diseases,
relate to One Health as areas other than
environmental health, the impa ct of
zoonotic
always
veterinary medicine on human health, the
adequately discussed during One Health
human-animal bond, and wellness issues
conversations.
related to
diseases
are
not
food
safety,
veterinary
conservation,
medicine.
The
opening speaker was Dr. Steven Osofsky, 2. How is the process of arranging this
a wildlife veterinarian, who has been
webinar?
involved in work on updating regulations
The process of arranging the
on foot and mouth disease commerce
webinar involved reaching out by email
restrictions.
to professionals and being connected to
speakers were two veterinarians, Dr. Lea
other individuals through contacts from
KNOPF from the Department of the
other members of the IVSA SCOH
Control of Neglected Tropical Disease
Committee. Each speaker was then asked
WHO Headquarters, and Dr. Frederic
to record a topic related to One Health
Lohr from Mission Rabies. Dr. Lea
which then was uploaded to the SCOH
KNOPF discussed the importance of
YouTube Channel.
veterinarians in working to control and
35
The
Project Reports - AMR - VPHJ #13
second
and
third
Project Reports eradicate rabies and Dr. Frederic Lohr
4.
How
discussed ways veterinarians globally are
webinar?
did
you
promote
the
working to try to eliminate dog -mediated
The webinar was advertised using
rabies by 2030. The fourth speaker Dr.
social media platforms including the
Martin Gilbert, a wildlife veterinarian,
SCOH Facebook and Instagram pages in
discussed
veterinary
an attempt to allow participants to
procedures, like medication use, could
engage with the advertisements and
have
share
on
the
impact
of
environmental
health
and
species conservation efforts, specifically
them
with
other
virtual
communities.
of the Asian vulture populations. Two other speakers, Brandon Hess, CVPM,
5.
CCFP
webinar?
from
VetSupport
Consulting
Services and the director of Cornell University’s
College
The significance of the second
Veterinary
annual SCOH One Health Webinar Series
Medicine’s Wellness Director, Makenzie
is that it highlights the importance of the
Peterson, Msc, presented information on
veterinary community recognizing that
two
no matter the role each of us takes on
wellness
issues
including
Compassion
Imposter
Syndrome
veterinarians
and
of
What is the significance of the
of
importance
Fatigue and
veterinary
and
throughout our careers, we all h ave a
what
role to play in promoting One Health. It
students
also
showcases
the
need
for
could do to maintain and improve mental
interdisciplinary
health. Lastly, Dr. Karyn Havas, a public
different professions so that, together,
health veterinarian, discussed the role of
we can address major One health issues.
collaboration
across
veterinary medicine in improving global nutrition and economics and the greater role vets could have in global health.
Project Reports - AMR - VPHJ #13
36
Project Reports 6.
Can you give us some closing
patients, developing policies to ensure
statement or some quotes at the end
food safety, promoting environmental
of this section?
conservation, worki ng to protect human
a.
and
As stated by Dr. Havas, “[One
animal
health
by
eradicating
Health is]… not just veterinarians. It ’s
zoonoses and educating the public about
not
just
these diseases, or, simply, recognizing
environmental scientists. It ’s multiple
and working to reduce the potential
disciplines coming together to work on
negative impacts that serving as a health
local, national, and global problems to
professional and animal caretaker can
obtain optimal health for not just people,
have on an individuals’ wellness. There
but,
the
are so many more ways we as the
environment.” As current and future
veterinary community are capable of
ambassadors of One Health, it is our job
impacting One Health, but, as a global
to work with multiple disciplines to ta ke
profession, we must acknowledge and
on the role of transforming world health
take on our duty to work towards the
for the better. This may be through being
goal of creating a world with optimal
more conscientious with the choices of
health for all living creatures.
just
physicians,
[also,]
antimicrobials
It ’s
animals
we
not
and
prescribe
to
our
Leanne Jankelunas Project Manager Standing Committee on One Health 2018-2019 International Veterinary Students' Association (IVSA)
37
Project Reports - AMR - VPHJ #13
Project Reports
IVSA SCOH one health day webinar series
7 Webinar Series about One Health, with incredible speakers! Uploaded on our Youtube Channel : IVSA SCOH 1. One World, One Health - Dr. Steven Osofsky, DVM 2. Mission Rabies - Dr. Frederic Lohr, DVM 3. Rabies? One Health in Practice - Dr. Lea Knopf, DVM 4. The Asian Vulture Crisis: Diclofenac And It's Profound Impact On A Keystone Species - Dr. Martin Gilbert 5. One Health for the Individual: Compassion Fatigue in Veterinary Medicine - Brandon hess, CVPM, CCFP 6. The Whole One Health Concept - Karyn Havas, DVM, PhD, MS, DACVPM 7. One Health for The Individual: Imposter Syndrome - Makenzie Peterson, MSc
Project Reports - AMR - VPHJ #13
38
Project Reports Rabies day Project Collaboration with IVSA mo around the world BY: IVSA KFS in partnership with IVSA Cluj-Napoca - ONline Campaign Our social media accounts posted around 10 posts about the rabies. Collective reach to the posts is about 9000 people. Our Facebook Page: https://www.facebook.com/IVSAKFS/
- Offline Campaign -
Street campaign in El hamrawy village in Kafr El Sheikh to educate people more about how to deal with animals especially stray ones. We were able to talk to more than 150 people and discuss everything with
¡Campaign with the help of the local medical center in Kafr El-Sheikh where we give over 60 people all the information about Rabies.
39
Project Reports - AMR - VPHJ #13
Project Reports
Campaign in the midschool of El Hamrawy village to discuss with the students the disease and how they can make a difference. We talked in 10 different classes, each one had 45 students about the role that every one in the society has to get to our Target which is zero by 30.
A visit to an animal shelter with the participations of veterinary student to include them in the conversation. We offered rabies vaccines along with donations to the chapter to help castration of stray dogs.
¡In all the campaigns, we used brochures to simplify the subject with illustrated cycles, symptoms and correct actions that should be taken to appeal to all people.
Project Reports - AMR - VPHJ #13
40
Project Reports AMR Week Project BY: IVSA KFS It's a well -known fact that if you want to make a change, you should always start at by planting and irrigating the roots. For this year’s AMR week, our IVSA team in Kafr El
-Sheikh, Egypt, decided to take actions
on both online and offline levels.
- ONline Campaign Our social media accounts covered the AMR week with awareness posts along our offline run with a reach of more than 7000.
- Offline Campaign Since the wrong usage of antibiotics is imbedded deep in our culture and life, we decided to reach out for all the ages and different sections of people. We wanted to provide all the information that they might need to correct our wrong concepts. th
â?– We started on the 14 of November with the young generation in a school campaign where we used interactive and fun ways to simplify the issue. We acted out a short play using puppets to illustrate the antimicrobial mechanism for the elementary students in Hoda Shaa'rawy schools in Kafr El Sheikh. The students' reaction was great and very promising. So we didn't only educate the families of now, but we also helped change the view for the future.
41
Project Reports - AMR - VPHJ #13
Project Reports
â?– On the 15th of November we launched a s t r e et c a m p a ig n w h er e w e distributed 500 AMR awareness flyers in the Khalifa St. of Kafr ElSheikh.
th
â?– On the 16 of November we interviewed the owner of Khedr Labs in Kafr El-Sheikh, Dr. Mohammed Khedr where our SCoVE members discussed with him the bacterial cultures and sensitivity tests importance in the AMR move.
Project Reports - AMR - VPHJ #13
42
InterVIEW
GALLERY One Health Day Photo Competition Winner
WINNER
AMR Case Study Competition Winner
WINNER
Thank You VPHJ #13
GALLERY VPHJ #13 Article Contributors
IVSA Cairo: Nadeen Mohamed, Nurhan Hanafy, Kholoud Khaled, Mohamed tarek
Valeria Rizzo (University of Teramo - Italy)
Review article: Antimicrobial resistance
HOW CAN I RESIST YOU?
Antimicrobial Resistance: An OVERVIEW
Puspa Rai (Agriculture and Forestry University - Nepal)
Dimitra Chiou (Faculty of Veterinary Science, University of Thessaly - Greece)
Samiksha Phuyal (Tribhuwan University - Nepal)
Antibacterial Resistance in Food Producing Animals
THE RISE OF ANTIBACTERIAL RESISTANCE
Thank You VPHJ #13
Dauda Ayomide Onawola Usmanu Danfodiyo University - Nigeria
“Use of Antimicrobials along with its Consequences in Context of Nepal”
VPHJ #13
ivsa.scoh thescoh ivsa_global ivsapage scoh@ivsa.org ivsascoh.publicationsteam@gmail.com
SCOH - IVSA
