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ANTIMICROBIAL RESISTANCE

A one-health approach to antimicrobial resistance

Nature Microbiology volume 3, pages 854–855 (2018)Cite this article

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Widespread use of antibiotics in animals either as growth promoters or for metaphylaxis may drive the spread of clinically relevant drug resistance genes and pathogens. New work uncovers drug resistance gene patterns from livestock across European farms and finds a correlation with agricultural antibiotic use.

The face of antimicrobial resistance (AMR) has changed rapidly. Fifteen years ago, our focal point rested on Gram-positive pathogens that were being circulated in hospitals, such as methicillin-resistant Staphylococcus aureus (MRSA), penicillin-resistant pneumococcus (PRP) and vancomycin-resistant enterococci (VRE). Clinical management of PRP and MRSA, for example, was relatively straightforward and focused on infection control and hospital containment (at least before the emergence of community-acquired MRSA)1. Today, however, the spotlight has shifted to Gram-negative pathogens — particularly multidrug-resistant (MDR) or extensively drug-resistant (XDR) Enterobacteriaceae. Specifically, over the last 15 years, extended-spectrum β-lactamases and, in the last 10 years, mobile carbepenmases (for example, New Delhi metallo-β-lactamase 1 (NDM-1)) have now become globally ubiquitous in Gram-negative pathogens2,3; and in the last 3 years, the discovery of a mobile colistin resistance mechanism, MCR (ref. 4), has meant that some strains are virtually untreatable with our current pharmacopoeia.

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Fig. 1: Complex AMR interactions across one-health sectors.

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  1. Institute of Infection and Immunity, Cardiff University, Cardiff, Wales, UK

    Timothy R. Walsh

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  1. Timothy R. Walsh
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Correspondence to Timothy R. Walsh.

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Walsh, T.R. A one-health approach to antimicrobial resistance. Nat Microbiol 3, 854–855 (2018). https://doi.org/10.1038/s41564-018-0208-5

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