One Health drivers of antibacterial resistance: Quantifying the relative impacts of human, animal and environmental use and transmission
Booton, RD; Meeyai, A; Alhusein, N; et al.Buller, H; Feil, E; Lambert, H; Mongkolsuk, S; Pitchforth, E; Reyher, KK; Sakcamduang, W; Satayavivad, J; Singer, AC; Sringernyuang, L; Thamlikitkul, V; Vass, L; Avison, MB; Turner, KME; Avison, MB; Alhusein, N; Booton, RD; Buller, H; Chantong, B; Charoenlap, N; Couto, N; Dulyayangkul, P; Feil, E; Gibbon, MJ; Gould, VC; Lambert, H; Meeyai, A; Mongkolsuk, S; Montrivade, V; Pitchforth, E; Phoonsawad, K; Rangkadilok, N; Ratanakorn, P; Reyher, KK; Sakcamduang, W; Satayavivad, J; Singer, AC; Sirikanchana, K; Sringernyuang, L; Suriyo, T; Suwanpakdee, S; Thamlikitkul, V; Turner, KME; Vass, L; Wichuwaranan, K; Wiratsudakul, A
Date: 26 January 2021
Journal
One Health
Publisher
Elsevier
Publisher DOI
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Abstract
Objectives
Antibacterial resistance (ABR) is a major global health security threat, with a disproportionate burden on lower-and middle-income countries (LMICs). It is not understood how ‘One Health’, where human health is co-dependent on animal health and the environment, might impact the burden of ABR in LMICs. Thailand's 2017 “National ...
Objectives
Antibacterial resistance (ABR) is a major global health security threat, with a disproportionate burden on lower-and middle-income countries (LMICs). It is not understood how ‘One Health’, where human health is co-dependent on animal health and the environment, might impact the burden of ABR in LMICs. Thailand's 2017 “National Strategic Plan on Antimicrobial Resistance” (NSP-AMR) aims to reduce AMR morbidity by 50% through 20% reductions in human and 30% in animal antibacterial use (ABU). There is a need to understand the implications of such a plan within a One Health perspective.
Methods
A model of ABU, gut colonisation with extended-spectrum beta-lactamase (ESBL)-producing bacteria and transmission was calibrated using estimates of the prevalence of ESBL-producing bacteria in Thailand. This model was used to project the reduction in human ABR over 20 years (2020–2040) for each One Health driver, including individual transmission rates between humans, animals and the environment, and to estimate the long-term impact of the NSP-AMR intervention.
Results
The model predicts that human ABU was the most important factor in reducing the colonisation of humans with resistant bacteria (maximum 65.7–99.7% reduction). The NSP-AMR is projected to reduce human colonisation by 6.0–18.8%, with more ambitious targets (30% reductions in human ABU) increasing this to 8.5–24.9%.
Conclusions
Our model provides a simple framework to explain the mechanisms underpinning ABR, suggesting that future interventions targeting the simultaneous reduction of transmission and ABU would help to control ABR more effectively in Thailand.
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Except where otherwise noted, this item's licence is described as © 2021 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).