Antimicrobial Resistance is a Global Problem

A. Salmanov, V. Trokhymchuk, O. M. Verner, O. Lugach
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Abstract

Infectious agents resistance to antimicrobials remains a challenging open problem of health care around the world. As a result, treatment-induced infections pose a serious threat to public health in general. This problem has become so important that the overwhelming majority of countries consider it a threat to the national security. Resistance to antimicrobials threatens to offset the very fundamentals of modern medicine and the sustainability of the public health system effective global response to a permanent infectious diseases threat. Today, antimicrobial resistance issues can be tackled provided that one implements an effective One Health approach (the principle of human and animal health interrelation), assuming that there is a coordination between different sectors and subjects, including experts in medicine, veterinary medicine, agriculture, ecology, and well-informed consumers. To ensure effectiveness of treatment, action is urgently needed to counteract the further development and spread of antibiotic resistance, which is driven by antibiotic use in all sectors. Since this resistance has no ecological, sectoral or geographical borders, its appearance in one sector affects resistance in other sectors. National authorities, veterinarians, physicians, patients and farmers all have key roles in preserving the power of antibiotics. The prevention and containment of antibiotic resistance therefore requires addressing all risk factors for the development and spread of antibiotic resistance across the full spectrum of conditions, sectors, settings (from health care to use in food-animal production) and countries. This article explores the options for prevention and containment of antibiotic resistance in the food-chain through national coordination, including the regulation and reduction of antibiotic use in food animals, training and capacity building, surveillance of resistance trends and antibiotic usage, promotion of knowledge and research, and advocacy and communication to raise awareness of the issues. The article suggests possible ways for adopting a holistic, intersectoral, multifaceted approach to this growing problem.
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抗菌素耐药性是一个全球性问题
传染性病原体对抗菌素的耐药性仍然是世界各地卫生保健的一个具有挑战性的开放性问题。因此,治疗引起的感染对一般公众健康构成严重威胁。这个问题已经变得如此重要,以至于绝大多数国家都认为它是对国家安全的威胁。对抗微生物药物的耐药性有可能抵消现代医学的根本基础和公共卫生系统的可持续性,即对永久性传染病威胁的有效全球应对。今天,只要实施有效的“同一个健康”方针(人类和动物健康相互关系的原则),假设不同部门和主体,包括医学、兽医学、农业、生态学专家和知情的消费者之间进行协调,就可以解决抗菌素耐药性问题。为了确保治疗的有效性,迫切需要采取行动,遏制抗生素耐药性的进一步发展和传播,这是由所有部门使用抗生素造成的。由于这种耐药性没有生态、部门或地理边界,它在一个部门的出现会影响其他部门的耐药性。国家主管部门、兽医、医生、患者和农民在保持抗生素效力方面都发挥着关键作用。因此,预防和遏制抗生素耐药性需要解决导致抗生素耐药性在各种条件、部门、环境(从卫生保健到食用动物生产中的使用)和国家中产生和传播的所有风险因素。本文探讨了通过国家协调预防和遏制食物链中抗生素耐药性的各种选择,包括监管和减少食用动物的抗生素使用、培训和能力建设、耐药性趋势和抗生素使用监测、促进知识和研究以及宣传和沟通,以提高对这些问题的认识。这篇文章提出了对这一日益严重的问题采取全面、跨部门和多方面办法的可能方法。
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