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ECDC/EFSA/EMA second joint report on the integrated analysis of the consumption of antimicrobial agents and occurrence of antimicrobial resistance in bacteria from humans and food‐producing animals

机译:ECDC / EFSA / EMA的第二份联合报告关于人类和食品生产动物的细菌中抗菌药物的消耗量和抗菌素耐药性的综合分析

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摘要

The second ECDC/EFSA/EMA joint report on the integrated analysis of antimicrobial consumption (AMC) and antimicrobial resistance (AMR) in bacteria from humans and food‐producing animals addressed data obtained by the Agencies’ EU‐wide surveillance networks for 2013–2015. AMC in both sectors, expressed in mg/kg of estimated biomass, were compared at country and European level. Substantial variations between countries were observed in both sectors. Estimated data on AMC for pigs and poultry were used for the first time. Univariate and multivariate analyses were applied to study associations between AMC and AMR. In 2014, the average AMC was higher in animals (152 mg/kg) than in humans (124 mg/kg), but the opposite applied to the median AMC (67 and 118 mg/kg, respectively). In 18 of 28 countries, AMC was lower in animals than in humans. Univariate analysis showed statistically‐significant (p Escherichia coli in both sectors, for 3rd‐ and 4th‐generation cephalosporins and in humans, and tetracyclines and polymyxins and in animals. In humans, there was a statistically‐significant association between AMC and AMR for carbapenems and polymyxins in . Consumption of macrolides in animals was significantly associated with macrolide resistance in in animals and humans. Multivariate analyses provided a unique approach to assess the contributions of AMC in humans and animals and AMR in bacteria from animals to AMR in bacteria from humans. Multivariate analyses demonstrated that 3rd‐ and 4th‐generation cephalosporin and fluoroquinolone resistance in from humans was associated with corresponding AMC in humans, whereas resistance to fluoroquinolones in spp. and spp. from humans was related to consumption of fluoroquinolones in animals. These results suggest that from a ‘One‐health’ perspective, there is potential in both sectors to further develop prudent use of antimicrobials and thereby reduce AMR.
机译:ECDC / EFSA / EMA的第二份联合报告,关于人类和食用动物细菌中的抗菌素消耗量(AMC)和抗菌素耐药性(AMR)的综合分析,涉及了机构2013-2015年欧盟范围内的监测网络获得的数据。在国家和欧洲两级比较了两个部门的AMC,以mg / kg估计生物量表示。在这两个部门之间,国家之间存在很大差异。首次使用了猪和家禽AMC的估计数据。单变量和多变量分析用于研究AMC和AMR之间的关联。 2014年,动物的平均AMC值(152 mg / kg)高于人的平均水平(124 mg / kg),但中值的AMC(分别为67和118 mg / kg)却相反。在28个国家中的18个国家,动物的AMC低于人类。单变量分析显示,在第三和第四代头孢菌素和人以及四环素和多粘菌素和动物中,两个部门的p大肠杆菌均具有统计学意义。在人类中,碳青霉烯类的AMC和AMR之间存在统计学意义的关联动物中大环内酯类的消费与动物和人中大环内酯类药物的耐药性密切相关,多变量分析提供了一种独特的方法来评估人和动物中AMC和动物细菌中AMR对人类细菌中AMR的贡献。多变量分析表明,人的第三代和第四代头孢菌素和氟喹诺酮耐药与人类相应的AMC相关,而人种和人种对氟喹诺酮类药物的耐药性与动物对氟喹诺酮类药物的消耗有关。从“单一健康”的角度来看,有潜力第三部门进一步发展对抗生素的谨慎使用,从而减少AMR。

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