Antimicrobial Resistance in Rural Settings in Latin America: A Scoping Review with a One Health Lens
Abstract
:1. Introduction
2. Materials and Methods
2.1. Inclusion Criteria
2.2. Exclusion Criteria
2.3. Article Selection
2.4. Data Management and Characterisation/Charting
2.5. Analysing, Summarising, and Reporting the Results
3. Results
3.1. Literature Profile
3.2. Antimicrobial Resistance through the One Health Lens
3.2.1. Human Contribution
3.2.2. AMR and Contributions from Animals
3.2.3. Environment Contribution
3.3. Information Gaps
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
#1: “Antimicrobial Resistance” Terms | #2: “Type of Geographical Setting” Terms | #3: “Environmental” Terms | #4: “Animal Handling or Agriculture” Terms | #5: “Countries in LA” Terms | #6: Combined Search |
---|---|---|---|---|---|
(“antimicrobial drug resistances” OR “antimicrobial drug resistance” OR “antibiotic resistance” OR “drug resistances, microbial”) OR” antibiotic resistance, microbial” OR “antimicrobial resistance” AND | (rural OR “rural populations” OR “rural settings” OR “rural health services”) AND | (environment * OR water OR soil OR lixiviation) AND | (“animal production” OR animal OR livestock OR agricultur * OR “animal husbandry” OR poultry OR food) AND | (Argentina OR Bolivia OR Brazil OR Chile OR Colombia OR “Costa Rica” OR Cuba OR “Dominican Republic” OR Ecuador OR “El Salvador OR Guatemala OR Haiti OR Honduras OR Mexico OR Nicaragua OR Panama OR Paraguay OR Peru OR Uruguay OR Venezuela) | #1 AND #2 AND #3 AND #4 AND #5 |
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Citation | One Health Component 1 | Human Contribution to AMR | Animal Contribution to AMR | Environment Contribution to AMR | Location | Important Results (Summary) |
---|---|---|---|---|---|---|
Armas-Freire 2015 [35] | AH, HH | FQ 3 resistance linked to humans, especially in clinical settings where its use is widespread. | FQ resistance linked to food-producing animals, no restriction to the use of FQ 3. | Water samples collected but not discussed. | Ecuador | Higher FQ 3 resistance in E. coli isolates from chickens than in rural human isolates. The latter showed higher rates of qnrB genes compared to chicken isolates. Urban clinical human isolates: low occurrence of qnrB genes. |
Barbosa 2014 [36] | HH, EH | Expansion of aquaculture/incorrect animal husbandry practices. | Farm animals’ pathogens can colonise fish and become carriers of AMR. | Water gets polluted with animal faeces. | Brazil | E. coli strains isolated from fish for human consumption, 43% were EPEC. MDR 12 was high in isolates. |
Braykov 2016 [37] | HH, AH, EH | Animal production systems boost and are sources for AMR. Broad spectrum antibiotics used in humans contributed to AMR in poultry. | Potential extrinsic sources of resistance: birds could become colonised by resistant strains from hatcheries. | Surfaces of poultry coops: AMR profiles most similar to samples from poultry. | Ecuador | Higher levels of AMR in bacteria from production versus household birds. Prevalence of AMR in production birds declined with bird age. |
Brisola 2019 [38] | HH, AH, EH | Pig farming production systems contaminate environment and spread AMR/MDR 12 resistant genes. | Pig faeces contaminated environment with E. coli carrying MDR genes. | MDR 12 isolates found in water and soil. | Brazil | E. coli isolates in pig faeces, water, and soil samples: 37.04% showed MDR 12, 7.41% were ESBL 10 producers. Most MDR 12 strains presented a high risk of transmission to humans. |
Campioni 2014 [39] | HH, AH | Overuse of QN 4 in poultry production spreads AMR. | Resistance to NA 5 in Salmonella enteritidis isolates from chicken; the pathogen is vehicle for AMR. | Environs not the source of AMR; they become contaminated by chicken breeders sharing the same strains. | Brazil | Some strains isolated from two sources were indistinguishable. Forty-four strains were resistant to NA 5. QN 4 resistance was present. |
Cervelin 2018 [40] | HH, AH | Swine production generates manure and overuses antibiotics, fostering AMR spread through vectors. | Pigs carry AMR zoonotic bacteria, which are pathogenic to animals and humans. | Flies are an environmental factor of importance in the spread of AMR. | Brazil | Resistance detected in 2 out of 4 antibiotics tested (used in human or veterinary medicine). Some farms showed MDR 12 bacteria. |
Gambero 2018 [41] | HH, EH | Animal farming impacts on quality of surface and groundwater by spreading AMR E. coli. Small proportion of E. coli resistant to antibiotics used in humans. | Animal faeces contaminate water. High proportion E. coli resistant to veterinary antimicrobials. | Water unsafe for human consumption due to E. coli concentrations, which foster AMR spread. | Argent-ina | Source of faecal contamination in water is mainly animal residues. |
Kalter 2010 [42] | HE, HH | Human use of antibiotics impacts on risk of AMR bacteria carriage in children. | Meat consumption of animals produced commercially drives AMR carriage risk in humans. | Lack of protection of excreta and water play a role in increasing AMR carriage risk in children. | Peru | Individuals taking “any antibiotic” increased children’s risk for resistant E. coli. Residence in zones where home-raised chicken was consumed protected against carrying resistant E. coli. |
Lowen-stein 2016 [43] | AH, HH | Small-scale livestock production could have an impact on the risk of zoonosis and spread of AMR. | Handling and consumption of sick and dead animals: perceived risk factor for AMR spread. Unregulated use of veterinary antimicrobials. | Animal environment sanitation not addressed. Animals and humans sharing water sources and living spaces. | Ecuador | Qualitative study. Handling and consumption of sick and dead animals and over-the-counter purchase of veterinary drugs increase zoonoses risk and AMR spread. Commercial poultry considered less healthy due to antibiotics. |
Mattiello 2015 [44] | HH, EH | Use of antibiotics as growth promoters. Improper sanitation favours MDR 12 Salmonella. | Animals’ contribution is explained by their carrying AMR pathogenic Salmonella enterica. | Poultry house environment is major contributor to AMR. Environmental isolates showed MDR 12 to human antibiotics. | Brazil | Poultry house environment produced more AMR isolates. Highest resistance: SA 6. Most resistant isolates: sul genes. Twenty-one isolates with reduced susceptibility to b-lactams and had blaTEM, blaCMY and/or blaCTX-M. |
Rodriguez 2015 [45] | AH, HH | Poultry and egg industry malpractices promote dissemination of pathogenic and resistant Salmonella spp. | Hens and eggs carry AMR Salmonella. | Feed and water carried Salmonella. Farm workers’ faecal samples collected but not discussed. | Colom-bia | Salmonella prevalence: 33%; two isolates were MDR 12. Farm practices as potential risk factors for Salmonella spread: on-farm feed milling, inappropriate sanitation, egg storage, and inadequate construction material. |
Santamaría 2011 [46] | EH, AH | Grassland-based production systems (antibiotics only for disease control) still create reservoirs for AMR bacteria. | Grasslands: cattle are reservoirs of TCN 7 resistance genes and are more diverse than environment. | Soil and water are reservoirs of TCN 7 resistance genes. | Colom-bia | Remarkable presence of tet genes. Predominant distribution of tet(W) and tet (Q) in both animal and environmental reservoirs. Probable gene transmission from animals to environment. |
dos Vieira 2010 [47] | AH, EH, HH | AMR in aquatic environments increased by indiscriminate use of antimicrobials (human and veterinary). | AMR transferred from animals to humans through food. | AMR transferred from shrimps to the environment (pond water and sediment). | Brazil | More than 90.5% of strains of Escherichia coli showed a variety of AMR profiles. |
Miranda 2002 [48] | AH, HH, EH | Prophylactic therapy in Chilean salmon farming produces higher AMR. | Poor fish farming management and incorrect use of antimicrobials. | Water and feed: likely reservoirs of MDR 12 bacteria. | Chile | Gram-negative OXT 8-resistant bacteria recovered. MDR 12 was frequent. |
Palhares 2014 [49] | HH, AH, EH | Antimicrobials in livestock linked to AMR in animals and humans. Inadequate animal husbandry, agricultural, and environmental practices favour presence of Salmonella. | Farm animals, manure, fish farming, and wild animals contribute to AMR Salmonella spread. | Rain, agricultural runoff, and river flow contribute to AMR Salmonella spread. | Brazil | 54 different AMR profiles; 49.5% of isolates with AMR. MDR 12: 18% of isolates. Link among animal-based agriculture, Salmonella and AMR. |
Pehrsson 2016 [50] | HH, EH, AH | Subsistence farming: antibiotic use without prescription and inadequate excreta management favour AMR. | Rural site: backyard farming contributed to AMR spread. | Rural site: soil faecally contaminated with human and animal AMR genes. Limited access to drinking water and sanitation. | Salvador and Peru | Large network of AMR genes shared: microbial communities of humans, animals, and environment. |
Lopez 2 2012 [51] | EH, AH | Extensive cattle production impacts environment and animals, creating AMR reservoirs despite low antibiotic use. | TCN 7- resistance genes can flow from animal waste to soil and water. | Faecally contaminated soil can pollute underground and surface water. | Colom-bia | No differences in isolates from environmental samples vs. animal samples. TCN 7 resistance in grasslands likely caused by horizontal gene transfer from animals to environment. |
Camotti 2018 [52] | EH, AH | Use of manure as fertiliser drives accumulation of pharmaceutical residues or induces AMR bacteria in soils. | Poultry, cattle, and swine manure contaminate soils and disseminate AMR bacteria. | Fertilised soils contaminate forest soils. | Brazil | Manure application associated with antibiotic residues and AMR in soils. Swine manure had highest antibiotic concentrations. Extended dairy cow grazing linked to high SA 6 resistance. |
Resende 2014 [53] | AH, EH | Cattle manure recycling may impact animal, human, and environmental health. | Biodigestion of cattle manure does not guarantee “safe” fertiliser. | Effluent use from ambient temperature biodigesters contaminates soil with AMR bacteria. | Brazil | 55.65% of isolated bacteria were MDR 12. Some isolates recovered from biodigestor (influent and effluent) were AMR. |
Corzo-Ariyama 2019 [54] | HH, EH | Agricultural practices and sewage water contribute to spread of AMR pathogenic E. coli. | Compost use, and animal waste: sources of contamination for pathogenic and resistant strains. | Workers’ hands, water, and soil can contaminate produce with pathogenic AMR bacteria. | Mexico | High resistance to TCN 7 and AMP 9. 3.5% were MDR 12. Potential consumer risk: AMR, pathogenicity, and biofilm formation. |
Cicuta 2014 [55] | HH, AH | Human contribution not discussed. ESBL 10-producing enterobacteria more frequent in humans and animals. | Animals can carry variety of potentially pathogenic ESBL 10-producing enterobacteria. | Water samples collected but not discussed nor linked to other samples. | Argent-ina | Neither phenotypically ESBL 10 nor CB 11-producing bacteria detected. |
Study Characteristics | Number (n =); Included Articles, n (%) | Article Number in References |
---|---|---|
Type | ||
Quantitative research | 20 (95.2) | [35,36,37,38,39,40,41,42,44,45,46,47,48,49,50,51,52,53,54,55] |
Qualitative research | 1 (4.8) | [43] |
Country of origin | ||
Brazil | 9 (42.9) | [36,38,39,40,44,47,49,52,53] |
Ecuador | 3 (14.3) | [35,37,43] |
Colombia | 3 (14.3) | [45,46,51] |
Argentina | 2 (9.5) | [41,55] |
Chile | 1 (4.8) | [48] |
Mexico | 1 (4.8) | [54] |
Peru * | 2 (9.5) | [42,50] |
El Salvador * | 1 (4.8) | [50] |
Publication year | ||
2001–2005 | 1 (4.8) | [48] |
2006–2010 | 2 (9.5) | [42,47] |
2011–2016 | 13 (61.9) | [35,36,37,39,43,44,45,46,49,50,51,53,55] |
2017–2019 | 5 (23.8) | [38,40,41,52,54] |
Language | ||
English | 21 (100) | [35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55] |
Approach used to study AMR | ||
Microbiological and molecular | 6 (28.6) | [35,38,39,44,51,54] |
Molecular | 2 (9.5) | [46,50] |
Microbiological | 8 (38.1) | [36,40,41,47,48,49,53,55] |
Microbiological and epidemiological | 3 (14.3) | [37,42,45] |
Chemical and molecular | 1 (4.8) | [52] |
Other (qualitative) | 1 (4.8) | [43] |
Type of Data Collection | Number (n =); Included Articles, n (%) | Article Number in References |
---|---|---|
Animal collection (cloacal swabs, faeces, manure, compost, muscle, eggs, veterinary clinical samples) | 16 (76.2) | [35,36,37,38,39,42,44,45,46,47,48,49,50,51,53,55] |
Environment collection (soil, water, pond mud, surfaces, workers’ hands, vectors, feed) | 18 (85.7) | [35,36,37,38,39,40,41,42,44,45,46,47,48,49,50,51,52,54] |
Human collection (faeces) | 4 (19.1) | [35,42,45,50] |
Questionnaires and interviews, observation | 4 (19.1) | [37,42,43,45] |
Produce collection | 1 (4.8) | [54] |
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Medina-Pizzali, M.L.; Hartinger, S.M.; Salmon-Mulanovich, G.; Larson, A.; Riveros, M.; Mäusezahl, D. Antimicrobial Resistance in Rural Settings in Latin America: A Scoping Review with a One Health Lens. Int. J. Environ. Res. Public Health 2021, 18, 9837. https://doi.org/10.3390/ijerph18189837
Medina-Pizzali ML, Hartinger SM, Salmon-Mulanovich G, Larson A, Riveros M, Mäusezahl D. Antimicrobial Resistance in Rural Settings in Latin America: A Scoping Review with a One Health Lens. International Journal of Environmental Research and Public Health. 2021; 18(18):9837. https://doi.org/10.3390/ijerph18189837
Chicago/Turabian StyleMedina-Pizzali, Maria Luisa, Stella M. Hartinger, Gabriela Salmon-Mulanovich, Anika Larson, Maribel Riveros, and Daniel Mäusezahl. 2021. "Antimicrobial Resistance in Rural Settings in Latin America: A Scoping Review with a One Health Lens" International Journal of Environmental Research and Public Health 18, no. 18: 9837. https://doi.org/10.3390/ijerph18189837