Abstract：
BACKGROUND: In the last decades, a more prudent and rational use of antimicrobials has been progressively directed towards animal production to reduce antimicrobial selective pressure and antimicrobial resistance (AMR) in microorganisms and safeguard the antimicrobial efficacy of treatments in human medicine. This systematic review evaluated the effectiveness of interventions that have been applied to reduce or improve veterinary antimicrobial usage and aimed at decreasing resistant bacteria in chicken broiler and pig production contexts.
METHODS: Original articles were identified by searching PubMed™, Scopus™, The Cochrane Library™, and Web of Science™, and grey literature by searching DANS EASY™, WorldCat™ and RCAAP™. Inclusion criteria included: chicken broiler or pig populations (predestined for meat production), interventions intended to reduce/improve antimicrobial use, comparator with standard or no use of antimicrobials, outcomes related to prevalence of resistant bacteria, farm level studies, original data, and analytical observational studies. Data was extracted from eligible studies and meta-analysis using random or fixed effects models was conducted for combinations including type of intervention, bacterial species, production type and animal populations. Models were selected according to heterogeneity between studies. The effectiveness of interventions was assessed using pooled odds ratio of resistance to antimicrobial substances/classes by bacteria for associations between animal populations with and without intervention.
RESULTS: A total of 46 studies were eligible for review. For chicken broilers, most interventions were identified as antimicrobial restrictions on all non-therapeutic use (46%), complete restriction (27%), and prohibition on antimicrobials used for growth promotion (23%). As for pig populations, restrictions were mainly observed on all non-therapeutic use (37%), complete restriction (37%) and group treatments (22%). For meta-analysis, 21 studies were pooled after assessment of existing combinations. These combinations demonstrated a protective effect for most antimicrobial classes in Escherichia coli, Campylobacter and Enterococcus isolates from samples of chicken broilers as well in Escherichia coli and Campylobacter spp. from samples of pigs, compared to animals raised under conventional production or without intervention. Increased odds of resistance were only observed for cephalosporins in E. coli and broilers raised without antimicrobials, and to fluoroquinolones and quinolones in Campylobacter and pigs raised without antimicrobials, compared to conventional production.
CONCLUSIONS: Our study indicates that organic production, antimicrobial-free farms, and group treatment restrictions are recommended for AMR reduction, providing information that may support decision-making to tackle AMR and better reporting to improve comparability of results between studies.
METHODS: Original articles were identified by searching PubMed™, Scopus™, The Cochrane Library™, and Web of Science™, and grey literature by searching DANS EASY™, WorldCat™ and RCAAP™. Inclusion criteria included: chicken broiler or pig populations (predestined for meat production), interventions intended to reduce/improve antimicrobial use, comparator with standard or no use of antimicrobials, outcomes related to prevalence of resistant bacteria, farm level studies, original data, and analytical observational studies. Data was extracted from eligible studies and meta-analysis using random or fixed effects models was conducted for combinations including type of intervention, bacterial species, production type and animal populations. Models were selected according to heterogeneity between studies. The effectiveness of interventions was assessed using pooled odds ratio of resistance to antimicrobial substances/classes by bacteria for associations between animal populations with and without intervention.
RESULTS: A total of 46 studies were eligible for review. For chicken broilers, most interventions were identified as antimicrobial restrictions on all non-therapeutic use (46%), complete restriction (27%), and prohibition on antimicrobials used for growth promotion (23%). As for pig populations, restrictions were mainly observed on all non-therapeutic use (37%), complete restriction (37%) and group treatments (22%). For meta-analysis, 21 studies were pooled after assessment of existing combinations. These combinations demonstrated a protective effect for most antimicrobial classes in Escherichia coli, Campylobacter and Enterococcus isolates from samples of chicken broilers as well in Escherichia coli and Campylobacter spp. from samples of pigs, compared to animals raised under conventional production or without intervention. Increased odds of resistance were only observed for cephalosporins in E. coli and broilers raised without antimicrobials, and to fluoroquinolones and quinolones in Campylobacter and pigs raised without antimicrobials, compared to conventional production.
CONCLUSIONS: Our study indicates that organic production, antimicrobial-free farms, and group treatment restrictions are recommended for AMR reduction, providing information that may support decision-making to tackle AMR and better reporting to improve comparability of results between studies.
摘要：
背景：在过去的几十年中，抗微生物剂的更谨慎和合理的使用已逐步用于动物生产,以降低微生物中的抗微生物剂选择压力和抗微生物剂耐药性(AMR),并保护人类医学治疗的抗微生物功效。本系统评价评估了干预措施的有效性，这些干预措施已用于减少或改善兽用抗菌药物的使用，旨在减少鸡肉鸡和猪生产环境中的耐药细菌。
方法：通过搜索PubMed™，Scopus™,CochraneLibrary™,和WebofScience™，和灰色文献通过搜索DANSEASY™，WorldCat™和RCAAP™。纳入标准包括：肉鸡或猪种群（预定用于肉类生产），旨在减少/改善抗菌药物使用的干预措施，使用标准或不使用抗菌剂的比较器，结果与耐药细菌的流行有关，农场一级的研究，原始数据,和分析性观察研究。从符合条件的研究中提取数据，并使用随机或固定效应模型对包括干预类型在内的组合进行荟萃分析。细菌种类,生产类型和动物种群。根据研究之间的异质性选择模型。使用细菌对抗菌物质/类别的耐药性的汇总比值比评估干预措施的有效性，以评估有干预措施和没有干预措施的动物种群之间的关联。
结果：共有46项研究符合审查条件。对于鸡肉肉鸡，大多数干预措施被确定为对所有非治疗性使用的抗菌药物限制(46%)，完全限制(27%)，和禁止用于促进生长的抗菌药物(23%)。至于猪的数量，限制主要适用于所有非治疗性使用（37%），完全限制（37％）和组治疗（22％）。对于荟萃分析，在评估现有组合后，汇集了21项研究。这些组合对大肠杆菌中的大多数抗菌类别具有保护作用，从鸡肉鸡样本以及大肠杆菌和弯曲杆菌属中分离出的弯曲杆菌和肠球菌。从猪的样本中，与在常规生产或没有干预的情况下饲养的动物相比。仅在没有抗微生物剂的情况下饲养的大肠杆菌和肉鸡中观察到头孢菌素的耐药几率增加，以及弯曲杆菌中的氟喹诺酮和喹诺酮类药物和不使用抗菌剂的猪，与传统生产相比。
结论：我们的研究表明，有机生产，不含抗菌药物的农场,和团体治疗限制建议减少AMR，提供可能支持决策的信息，以解决AMR和更好的报告，以提高研究之间结果的可比性。
方法：通过搜索PubMed™，Scopus™,CochraneLibrary™,和WebofScience™，和灰色文献通过搜索DANSEASY™，WorldCat™和RCAAP™。纳入标准包括：肉鸡或猪种群（预定用于肉类生产），旨在减少/改善抗菌药物使用的干预措施，使用标准或不使用抗菌剂的比较器，结果与耐药细菌的流行有关，农场一级的研究，原始数据,和分析性观察研究。从符合条件的研究中提取数据，并使用随机或固定效应模型对包括干预类型在内的组合进行荟萃分析。细菌种类,生产类型和动物种群。根据研究之间的异质性选择模型。使用细菌对抗菌物质/类别的耐药性的汇总比值比评估干预措施的有效性，以评估有干预措施和没有干预措施的动物种群之间的关联。
结果：共有46项研究符合审查条件。对于鸡肉肉鸡，大多数干预措施被确定为对所有非治疗性使用的抗菌药物限制(46%)，完全限制(27%)，和禁止用于促进生长的抗菌药物(23%)。至于猪的数量，限制主要适用于所有非治疗性使用（37%），完全限制（37％）和组治疗（22％）。对于荟萃分析，在评估现有组合后，汇集了21项研究。这些组合对大肠杆菌中的大多数抗菌类别具有保护作用，从鸡肉鸡样本以及大肠杆菌和弯曲杆菌属中分离出的弯曲杆菌和肠球菌。从猪的样本中，与在常规生产或没有干预的情况下饲养的动物相比。仅在没有抗微生物剂的情况下饲养的大肠杆菌和肉鸡中观察到头孢菌素的耐药几率增加，以及弯曲杆菌中的氟喹诺酮和喹诺酮类药物和不使用抗菌剂的猪，与传统生产相比。
结论：我们的研究表明，有机生产，不含抗菌药物的农场,和团体治疗限制建议减少AMR，提供可能支持决策的信息，以解决AMR和更好的报告，以提高研究之间结果的可比性。
