“Antimicrobianos y acuicultura y el
el paradigma de Una Salud
Dr. Felipe C. Cabello, New York Medical College
Department of Microbiology and ImmunologyBasic Sciences Building, Room 324
Phone 914 594 [email protected]
Friedrich G. Weitsch, 1806, Alte Nationalgalerie, Berlin
Friedrich G. Weitsch,1810
Humboldt y Bonpland en el Chimborazo
Todo en la naturaleza esta
relacionado
Alexander von Humboldt, 1769-1859
ColaboradoresNew York Medical College
Alexandra Tomova
Larisa Ivanova
Sandra Aedo
Henry P. Godfrey
Harriett V. Harrison
Universidad de Los Lagos, Chile
Alejandro Buschmann, Miguel Maldonado,
Alejandra Lopez, Luis Henríquez, Monica Maldonado
Universidad Austral, Chile
Ana Millanao, Marcela Barrientos,
Carolina Gómez, Humberto Dölz
Universidad de Chile
Romilio Espejo
New York University
Maria E. Aguero-Rosenfeld
Hospital Base Puerto Montt, Chile
Dra. Maria Luisa Rioseco
Norwegian School of Veterinary Science, Oslo
Dr. Henning Sørum, S. Qaswar A. Shah, Trine M. L’Abee-Lund
Funding: Lenfest Ocean Program/Pew Charitable Trust;
John Simon Guggenheim Foundation
Que sucede en medicina con la resistencia
bacteriana a los antimicrobianos?
Fatality rate of selected infection before and after the
introduction of antibiotics
Infection Fatality rates (per cent)
Prior 1935 Present
Pneumococcal pneumonia 20 to 85 5
Subacute bacterial endocarditis 99+ 5
Meningitis (H. influenzae) 100 2 to 3
Meningitis (pneumococcus) 100 8 to 10
Typhoid fever 8 to 10 1 to 2
Weinstein L.. 1976. N. York State J. Med. Oct.
Mortality after infection with Salmonella typhimurium,
by antimicrobial drug-resistance pattern,
Denmark, 1995-1999
_______________________________________________________________
No. of Relative mortality compared with
Resistance pattern patients the general population (95% Cl)
_______________________________________________________________
Pansusceptible 953 2.3 (1.5 − 3.5)
ACSSuT 283 4.8 (2.2 − 10.2)
Nx 83 1 0.3 (2.8 − 37.8)
ACSSuTNx 40 13.1 (3.3 − 51.9)
_______________________________________________________________
Molbalk, Clin. Infect Dis. 2005
Impact of imipenem resistance on mortality of patients with
Acinetobacter bacteremia
Slama, Critical Care 2008; 12(Suppl 4): S4
Costos de la resistencia a antibióticos• La neumonia producida por Staphylococcus aureus resistente al antibióticometicilina tiene una mortalidad que es 2.5 más alta, que la neumonia producida por S. aureus susceptible a éste antibiótico. Necesita hospitalización de manera másfrecuente, y su tratamiento cuesta aproximadamente $3,500 dólares más.
• Infecciones por Enterobacter resistentes a cefalosporinas de tercera generaciónse acompañan de un aumento del 30% en los días de hospitalización, el tratamiento cuesta $30,000 dólares más, y tienen una duplicación de la mortalidadque aumenta de 13 a 26%.
• El aumento de los costos de tratar infecciones producidas por bacteriasresistentes a los antibióticos fluctúan entre 150 millones (sin mortalidad) a 3 billones de dólares al año (con mortalidad).
Rubin, et al. 1999. Emerg. Infec. Dis.; Cosgrove, et al. 2002.
Arch. Inter. Med.; Harrison and Lederberg. 1998. Workshop
Report. N.A.S. U.S.A.
Tom Dukes
A healthy and active father in Southern
California whose life was torn apart by a
painful and drug-resistant E. coli infection.
Much of that night in the ER is a blur. They took me in for a CAT scan, and
I went back to the waiting room, where I got ice cold and started violently
shaking. I was getting alarmed. The doctors told me I had a perforated
colon, which had allowed ESBL-producing E. coli, an antibiotic-resistant
super bug, to escape and cause the infection that turned my life upside
down. In the OR, they removed an 8-inch chunk of my colon, called a
colostomy.
New York Times
Aspectos de la resistencia a antibioticos
Davies and Davies, 2010
History of antimicrobial discovery and antimicrobial resistance
Timetable of antibiotic discovery and resistanceAntibiotic Discovery Clinical use Resistance Bacteria
Sulfonamides 1935 1936 1939 S. pneumoniae
Penicillin G 1928 1941 1942 S. aureus
Methicillin 1960 1960 1961 S. aureus
Oxy β lactams 1978 1978 1981 E. coli
Streptomycin 1944 1946 1946 E. coli
Tetracycline 1948 1952 1959 S. dysenteriae
Erythromycin 1952 1955 1957 S. aureus
Vancomycin 1956 1958 1987 E. faecium
Gentamicin 1963 1967 1970 P. aeruginosaJacoby GA. 2009. in Antimicrobial drug resistance. p. 3
Antimicrobial paradox
Galan et al, 2013
Evolution of antimicrobial resistance
Exaptation , Co-option
Industrial productionand use
Human microbiome
resistance genes
and antimicrobial use
Forslund et al., 2013
IDSA, 2006
Disminucion de la produccion de nuevos antibioticos
IDSA, 2006
New Antibiotic Discovery
DARWIN’S EVOLUTION
VARIATION
HEREDITY
SELECTION
BACTERIAL VARIATION
MUTATION
EXCHANGE OF GENETIC INFORMATION: TRANSFORMATION
TRANSDUCTION
CONJUGATION
TRANSPOSITION
INTEGRONS
MIGRATION
Antimicrobial resistance mobilization by HGT
Genetic exchanges between aquatic bacteria
20 millions of billions of genetic exchanges per second resulting from high concentration of bacteria in water and marine sediments (1 x 105-6/ml, 1 x 108
per g), high concentration of bacteriophages (1 x 105/ml), physical proximity in water and sediments, biofilms in suspended matter and epilithon, presence of metal ions and antibacterial residues stimulate genetic variation
Exchange in epilithon stimulated by the presence of mobilizing plasmids and biofilms
Exchange in water in spite of oligotrophic conditions
Microcosms have shown exchange in river, lake and seawater, epilithon and sediments
HGT between Bacteria and Arquea in the sea, wide presence of shared genomic islands and plasmids
Hill et al, 1992; Goodman et al, 1993; Van Elsas and Bailey; 2002;
Venter et al, 2004; Norman et al, 2009
Uso de antimicrobianos en animales para
alimento humano
• Emergence of antimicrobial resistant bacteria:
pathogens and non pathogens
• Contamination of food with antimicrobial resistant
bacteria: pathogens and non pathogens
• Contamination of food with antimicrobials
• Contamination of the environment with
antimicrobials: environmental resistance
Antimicrobial usage in food animals
Zoonotic origin of antimicrobial resistance genes and
antimicrobial resistance bacteria infecting humans
• Methicillin resistance Staphyloccocus aureus mecA gene from Staphylococcus sciuri
• Vancomycin and florfenicol resistant enterocccus van and fexB genes from poultry
and pigs
• Colistin resistant Gram-negative bacteria gene mcr-1 from poultry, pigs, and
aquaculture
• Quinolone resistant Campylobacter jejuni from poultry
• Quinolone resistant uropathogenic Escherichia coli from poultry
• MDR Salmonella from poultry, cattle and aquaculture
• Methicillin resistance Staphylococcus aureus from pigs
• C. difficile RT078. resistant to antimicrobials (pigs, cattle, horses, and poultry)Couto et al, 1996, Bates et al, 1994, Smith KE et al, 1999,
Spika et al, 1987, Smith TC et al, 2009, Liu et al, 2012, Telke
et al, 2015; Knetsch et al., 2018
Antimicrobianos y acuicultura
Aquaculture
Extensive: i. low degree of control; ii. low costs, low
technology, low production; iii. high
dependence on climate and water quality
Intensive: i. high degree of control; ii. high costs, high
technology, high production; and
iii. independence of climate and water quality
Semi
Intensive: i. some degree of control; ii. natural foods,
fertilizers; and iii. some technology
Integrated: shared resources
Antimicrobials are used in all of them FAO, 2008
Aspects of the use of antimicrobial resistance in
aquaculture
Antimicrobial resistance : Normal flora: Fish and other sea animals,
environmental flora, animal and
humans
Pathogens: Fish, animals and humans
Microbiota perturbations: Fish, animals and humans
Environmental changes: Alteration of bacterial populations and other
microorganisms
Potenciales problemas de salud producidos por la manipulación de grandes cantidades de
antibióticos
Alérgicos Síntomas gastro intestinales
Síntomas cutáneos, oculares, respiratoriosShock anafiláctico
Microbiológicos Alteración de la flora normal
Mayor susceptibilidad a infecciónSelección de resistencia a antibióticosTransmisión de la resistencia de la floranormal a patógenosTransmisión de bacteria resistentesy de genes de resistencia a contactos
Tóxicos Toxicidad propia de los antibióticos
Causes of stress for fishes an shellfishes
in the aquaculture process
• Transport
• Immersion
• Closed pens
• Anesthesia
• Temperature changes in water
• Changes in salinity
• Changes in the environmental color
• Manipulation
• Water movements
• Labeling
• Exposure to gases: CO2
• Light
• Hypoxia
• Overcrowding
• Pollution
• Enclosures Barton and Iwama, Ann. Rev. Fish Dis., 1991
Pathways and effects of administration
of antimicrobials in salmon farming
Cabello et al., 1916
Antibiotic resistance elements and genes present in
human pathogens probably originated in the aquatic environment Genetic elements
Integron 1, β proteobacteria
ICE SXT/391, Shewanella, Vibrio, Photobacterium
IncA/C plasmids, A. salmonicida, Vibrio, Photobacterium, Y. ruckeri
IncU plasmids, Aeromonas
Antibiotic resistances genes
qnrA, Shewanella
qnrB, Citrobacter
qnrS, Vibrio, Photobacterium
tetD (E), tetH, tetC, Aeromonas, Moraxella, Acinetobacter, Aeromonas
floR, Past.piscicidaAngulo and Griffith, 2000; Stokes et al, 2006; Fricke et al, 2009; Rhodes et
al, 2000; Poirel et al, 2005 and 2007; Miranda et al, 2003; Roberts M, 2009;
Wosniak et, 2009
Tetracycline resistance genes and their traffic,
probably from aquatic bacteria
tetA, encoding an efflux protein, present in many bacteria worldwide including E. coli, and in a conjugative plasmid IncU, probably originated from Aeromonas
tetE, encoding an efflux pump present in E. coli, Vibrio, and Providencia, probably originated from A. hydrophila and is widely spreaded worldwide
tetH, encoding and efflux pump present in P. multocida, probably originated from Moraxella and Acinetobacter
tetC, encoding and efflux pump, present in Chlamydia suis genomic island (can be transferred to C. trachomatis) and Helicobacter, probably originated from A. salmonicida passaging through pigs
Nine different efflux genes for resistance to tetracycline are present in Vibrio and Aeromonas (total 18)
Tetracycline is one of the most used antibiotics in aquaculture
Forty percent of tetracycline resistance bacterial isolates from aquaculture sites harbor new and unknown tetracycline resistance genes
Miranda et al, 2003 Rhodes et al, 2004; Roberts M. 2009;
Suchland et al, 2009
Dissemination of plasmids and genes encoding for multiple antibacterial resistance between fish, animal and human
pathogens
• pIP1202 in Yersinia ruckeri, Salmonella enterica serotype Newport, Yersinia pestis, Escherichia coli, Klebsiella
• pMRV150 in Vibrio cholerae O139, Yersinia ruckeri, Salmonella enterica serotype Newport, Yersinia pestis, Escherichia coli, Klebsiella
• P99-018 and P91278 en Vibrio cholerae, Providencia rettgeri, Salmonella typhi, Salmonella enteritica, Photobacterium damselae subs. Piscicida
• pAB5S9 in Aeromonas bestiarium, Vibrio cholerae, Photobacterium damselae subs. Piscicida
• pSN254 in Aeromonas salmonicida y Salmonella enterica
• pRA1 in Aeromonas hydrophyla, Aeromonas salmonicida y Enterobacteriaceae
Welch et al. 2007; Cao Pan et al 2008; Jung Kim et al.
2008, Gordon el al. 2008, McIntosh et al., 2008; Fricke
et., 2009
Un ejemplo
ChiloeIsland
Lakes
Chile Region Los Lagos
Buschmann et al, 2009
Salmon farms Chiloe Island, Chile
Uso de antimicrobianos
Classes of chemical compounds used in Atlantic salmon aquaculture, quantities used in 2007
and quantities applied relative to production
Country
Salmon
production
(metric ton)a
Therapeutant
type
kg (active
ingredient)
used
kg therapeutant/
metric ton
produced
Norway 821,997 Antibiotics
Anti-louse
649
132
0.0008
0.00016
Chile 330,791 Antibiotics
Anti-louse
385,600
600.1
1.17
0.00018
UK 132,528 Antibiotics
Anti-louse
1,553
194.8
0.0117
0.0015
Canada (includes
data from Maine,
USA)
121,370b Antibiotics
Anti-louse
21,330c
19.8
0.175
0.00016
a Data accessed at FAO (April 2010) (http://www.fao.org/fi/website/FIRetrieveAction.do?dom=collection&xml=global-aquaculture-
production.xml&xp_nav=1).
b Data accessed at http://www.dfo-mpo.gc.ca/communic/statistics/aqua/index_e.htm (October 2009) and New Brunswick Salmon growers
Association (personal communication 2009).
c Government of British Columbia (October 2009) (http://www.al.gov.bc.ca/ahc/fish_health/antibiotics.htm and New Brunswick Salmon
Growers Association (personal communication).
Qu
ino
lon
es-f
luo
roq
uin
olo
nes
(m
etri
c to
ns)
150
100
0
50
200
Authorized and imported quantities of quinolones and
fluorquinolones for human and veterinary medical
use in Chile, 1998-2005
YearCabello et al., 2013
Tiene este uso excesivo de
antimicrobianos algun efecto?
Geographical location of the study
Buschmann et al, 2012
C.
Date
AR
F (
%)
A.
AR
F (
%)
Date
*
*
*
B.
AR
F (
%)
Date
Antimicrobial resistant bacteria in sediment samples
from aquaculture and control sites
Tc
Oxo
Flor
Buschmann et al, 2012
a aa
b
A.
AR
F (
%)
Distance from aquaculture site (km)
P = 0.008
B.
Distance from aquaculture site (km)
P = 0.002
AR
F (
%)
a
a
a
b
C.
Distance from aquaculture site (km)
AR
F (
%)
P = 0.015
a
a
b
a
b
Variation in antimicrobial resistance fraction (ARF)
to selected antimicrobials from aquaculture site
Tc
Oxo
Flor
Buschmann et al, 2012
Existe transferencia de genes de resistencia
entre las bacteria acuaticas, las de animals y
las humanas?
Resistencia a antibioticos en bacterias de agallas de peces de la
bahia de Concepcion, Chile
Cuentas Viables % Resistentes
Totales Amp Strep Tetra Cloram
Pelagicos
Anchoas 5.8 x 104 10.5 11.1 13.3 9.1
Sardinas 5.6 x 104 4.2 1.4 5.2 0.0
Bonito 3.6 x 105 1.7 12.9 10.7 8.0
Demersales
Merluza 2.0 x 105 6.7 10.7 11.2 4.5
Lenguado 3.6 x 106 2.1 1.9 8.9 1.9
Pez perro 2.0 x 104 1.1 7.8 13.3 0.0
Miranda y Zemelman. 2001. Marine Pollution Bulletin
Phenotypic and genotypic characteristics of donor marine bacteria from aquaculture
and control sites tested in conjugation________________________________________________________________________________________________________________________________
Phenotypic resistance Genotypic resistance
Site Use Strain ______________________________________ _______________________________________________
Tet Smt Tmp Amo Str Oxo Tet Sul Tmp Amo Str
_______________________________________________________________________________________________________________________________
Aquaculture Donor A-1 R R S R R S ─ sul1 ─ ─ aadA9
Aquaculture Donor B-1 R R R S R S ─ sul1 ─ ─ aadA9
Aquaculture Donor F-7 S S R R S S ─ --- dfrA12 blaTEM ─
Aquaculture Donor F-12b
R R R R R S tetA sul2 ─ ─ strA-B
tetG
Aquaculture Donor G-9 R R R R S R ─ ─ dfrA1,5,7,12 blaTEM ─
Aquaculture Donor G-23b
R R R R S R tetA sul2 ─ ─ ─
Control Donor B-21 S S R R S R ─ ─ dfrA1,5,12 blaTEM
Control Donor C-19 S R R S S R ─ ─ dfrA1,5,12 ─ strA-B
Control Donor D-15 S S R S S S ─ ─ dfrA1,5,12 ─ ─
─ Recipient E. coli DH5 S S S S S R ─
─ Recipient E. coli HB101 S S S S R S ─
________________________________________________________________________________________________________________________________
a Bacterial growth inhibited (S) or not inhibited (R) by: tetracycline (Tet), 80 μg; sulfamethizol (Smt), 240 μg; trimethoprim (Tmp), 5.2 μg;
amoxicillin (Amo), 30 μg; oxolinic acid (Oxo), 10 μg; and streptomycin (Str), 10 μg.
b Bacterial isolates able to transfer resistance genes. Shah et al, 2014
1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
1000
700500
200
bp
tetK tetB tetM aac(6')-Ib-cr
Sharing of tetracycline resistance genes and
PMQR gene aac(6')-Ib-cr
between marine bacteria and four urinary tract Escherichia coli
Cabello et al, 2013
Aedo et al, 2014
Identity of the Aac(6’)-1b-cr enzyme protein that inactivates
kanamycin and fluoroquinolones, from marine bacteria and
bacteria and uropathogenic E. coli
Dietzia sp. UMB75
orf5 drfA12int1 aadA2 qacEΔ1 sul1
qnrS
E. coli 9
drfA17int1 aadA5 chrA orf98tpnM qacEΔ1 sul1
qnrB
Rhodococcus sp. UMB26
chrA orf98drfA12int1 aadA2 qacEΔ1 sul1
E. coli 7
IS26IS26transposase
qacEΔ1 sul1drfA17int1 aadA5
qnrA
Isolate UMB84
orf98drfA12int1 aadA2 qacEΔ1 sul1
E. coli 6
tpnM drfA12int1 aadA2 qacEΔ1 sul1 chrA orf98
Integron structure in marine bacteria and uropathogenic
E. coli
Tomova et al, 2016
Quinolone-resistant qnrA+ marine isolates from an area of intensive salmon aquaculture in
the Calbuco Archipelago, Región de los Lagos (Región X), Chile (left), and Escherichia
coli isolated from patients with urinary tract infections (right) in an adjacent coastal region
contain structurally similar class I integrons and PMQR genes .
Marine isolate UMB84
orf98drfA12int1 aadA2 qacEΔ1 sul1
E. coli isolate 6
tpnM drfA12int1 aadA2 qacEΔ1 sul1 chrA orf98
Intercambio de genes de resistencia entre bacterias
aquaticas y patogenos humanos
Tomova et al., 2018
Identical qnr genes identified in marine bacteria and uropathogenic E. coli from Chile
__________________________________________________________________________________
qnrA qnrB qnrS__________________________________________________________________________________
E. coli 9 A1 E. coli 7 B1 E. coli 8 S1
E. coli 12 unknown B E. coli 13 S1
Marinobacter sp. A1 Rhodococcus sp. B1 Microbacterium sp. S1
Uncultured bacterium A1 Rhodococcus sp. B1__________________________________________________________________________________
Tomova et al, 2014
Problemas del excesivo uso de antimicrobianos
en acuicultura
Mortality rate of Atlantic salmon in Chile
Year 2008 2009 2010 2011 2012 2013
Mortality rate 74.7% 97.7% 6.5% 12.1% 19.1% 12.4%
Bustos and Irarrazabal, 2016
Number of days in water and average weight
per smolt of salmon
Year 2003 2004 2005 2006 2007
Kg/smolt 3.71 3.66 3.57 3.34 3.14
Number of
days in water 487 497 484 488 543
Katz, Lizuka and Munoz, 20011,
Bustos and Irarrazabal, 2016
Camarones, antimicrobianos y
resistencia: algunas precisiones
Infecciones bacterianas del camaron en
Latino America
Necrosis hepatopancreatica septica: vibrios, photobacterium
Hepatopancreatitis necrotizante: Hepatobacter penaei
Streptococosis: S. uberis y S. parauberis
Enfermedad necrotica hepatopancreatica aguda: V. parahaemolyticus
Spiroplasmosis: Spiroplasma penaei
Morales-Covarrubias et al, 2018
Fig. 3. Relative impact of EMS/AHPND on shrimp production using Thai shrimp production from
1988 to 2014 as an example. Data based on FishStat from the Food and Agriculture Organization of
the United Nations, except for 2014 (from the Thai Frozen Foods Association). WSD=beginning of
white spot disease outbreaks; MSGS=beginning of the severe impact from monodon slow growth
syndrome and the reason for the switch to P. vannamei; AHPND = beginning of the severe impact
from EMS/AHPND. Thitamadee et al., 2015
Appl Microbiol Biotechnol (2015) 99:6911–
6919
DOI 10.1007/s00253-015-6632-z
ENVIRONMENTAL BIOTECHNOLOGY
Changes in intestinal
bacterial communities
are closely associated
with shrimp disease
severity
Jinbo Xiong1,2 & Kai Wang1,2 & Jinfeng Wu1 &
Linglin Qiuqian1 & Kunjie Yang1 &
Yunxia Qian1 & Demin Zhang1,2
Fig. 2. Concentration of ciprofloxacin and sulfonamide in pacific white shrimp gut. Values are
means ± SEMs. The abundance of antibiotics drops rapidly
Zeng at al., 2019
Fig. 3. Relative quantity of a qnrB,b qnrD, c qnrS, d sul1, e sul2, and f sul3. Each graph
represents the relative abundance of ARG compared to 16SrRNA. The significant difference
calculated by ANOVA was shown by marking a, b, and cZeng at al., 2019
Fig. 3. Influence of florfenicol on the relative
abundance of total ARGs and MGEs before,
during, and after exposure.a Relative
abundance of total ARGs and MGEs.b Relative
abundance of group sof MGEs (phage
integrases, transposases, transposons, and
resolvases). Day 0 (pre-exposure); days 1, 4,
and 7 (exposure/florfenicol); and days 11, 13,
18, 26, and 34 (post-exposure). A control
sample was taken on day 34 from a tank that
did not receive the antibiotic during the whole
experiment
Saenz et al., 2019
Fig. 1A conceptual model for the interplay among rearing condition, pathogens, and shrimp
health and its gut microbiota. In the healthy shrimp, gut commensals barrier against the
establishment or bloom of pathogens. However, the deteriorated water and sediment qualities
can induce pathogen virulence and stress shrimp, leading to dysbiosis in the gut microbiota over
disease exacerbation, e.g., linearly increased mortality rate, toxin abundance, and immune stress
response Xiong, 2018
Fig. 1 A conceptual model for the correlation between shrimp health and rearing microbiota.
a A healthy microbiota contains a balanced composition of diverse bacteria. Probiotics are
bacteria with known health-promoting functions. Detrimentals are potential or opportunistic
pathogens. Commensals are permanent residents of intestinal microbiota that provide no
benefit or detriment to the host. b In disease conditions, there is an unnatural shift in the
composition of the intestinal microbiota, which results in either a reduction in the numbers of
probiotics and/or an increase in the numbers of detrimental strains and environmental
stressorsXiong et al., 2016
Can. J. Microbiol. 53: 919–924 (2007)
Comparing antibiotic resistance in
commensal and pathogenic bacteria
isolated from wild-caught South Carolina
shrimps vs. farm-raised imported
Shrimps
Kavitha Boinapally and Xiuping Jiang
Shrimp containing antibiotic-
resistant bacteria found in
Canadian grocery stores
'It's a gap': Canada checks for
antibiotics in imported seafood,
but not for superbugs that could
be resistant
CBC News · Posted: Mar 15, 2019 4:00 AM ET | Last Updated: March 15
Roschanski et al. 2017
Outbreaks produced by imported food, U.S.A.
Gould et al., 2017
Metodos alternativos a los antimicrobianos
Bacteriocinas
Peptidos antimicrobianos
Aceites vegetales
Bacteriofagos
Inhibidores de sistemes de quorum
Prebioticos, probioticos y sinbioticos
Anticuerpos
Nanoterapeutica
Economou and Gousia, 2015; Vivas et al., 2019
Cotopaxi, 1862
Detroit Institute of Art, Detroit
Frederic Edwin Church, 1826-1900
El corazon de los Andes, 1859
Metropolitan Museum of Art, New Yok
Prevencion de la resistencia bacteriana
a antimicrobianos en acuicultura
One Health surveillance framework to prevent
antimicrobial resistance Antimicrobial
Consumption
Antimicrobial
Resistance Queenan et al., 2016
Medidas destinadas a disminuir y a estudiar el impacto del uso de
antibacterianos en la salmonicultura
Medidas sanitarias y epidemiológicas
● Mejorar las condiciones higiénicas y sanitarias de la salmonicultura
● Establecer barreras que eviten la diseminación de patógenos entre los sitios de
salmonicultura
● Mejorar el diagnóstico de enfermedades bacterianas, virales y parasitarias de
peces
● Establecer y registrar la susceptibilidad a antibacterianos de patógenos de
peces y de bacterias autóctonas y foráneas al ambiente acuático
● Regular y registrar los volúmenes de antibacterianos importado y usados en
medicina veterinaria, incluyendo la salmonicultura, como se realiza en
medicina humana
● Investigar la presencia de antibacterianos en el ambiente terrestre y acuático,
viviente e inanimado, donde se realiza crianza industrial de animales
● Educar a todo el personal que trabaja en la salmonicultura sobre el uso
adecuado de antibacterianos, los problemas generados por la profilaxis antibacteriana
y por la resistencia a antibacterianos
Medidas destinadas a disminuir y a estudiar el impacto del uso de
antibacterianos en la salmoniculturaMedidas de investigación
● Comparar la frecuencia de la resistencia a antibacterianos usados en la acuicultura con la que
emerge en la flora normal y patógena en la comunidad y en hospitales de la X Región.
● Determinar si existen diferencias respecto de las frecuencias y de las características de la
resistencia a las quinolonas, a las tetraciclinas y al florfenicol entre patógenos humanos de la X
Región y otras regiones del país
● Determinar la presencia de bacterias resistentes a los antibacterianos en el sedimento marino y la
columna de agua en lugares donde se ha realizado salmonicultura y en lugares de control.
Relacionarlos con la presencia de residuos de antibacterianos en el ambiente animal e
inanimado
● Estudiar la transferencia horizontal de genes de resistencia de bacterias acuáticas a bacterias
terrestres y viceversa, incluyendo patógenos animales y humanos, para trazar el flujo de los
genes de resistencia
● Con el mismo propósito, identificar en estas bacterias los mecanismos genéticos de resistencia
(plasmidos, integrones, transposones, elementos SXT) y determinar su secuencia de ADN
● Analizar la presencia de bacterias resistentes en la flora normal faríngea, intestinal y cutánea de
operarios responsables de la manipulación de alimentos para peces con antibacterianos, y
también las de sus familias
● Desarrollar modelos oceanográficos de barreras y control epidemiológico de patógenos de peces
● Estudiar potenciales reservorios naturales y antrópicos de patógenos de peces
Instituciones que contribuyen a un mejoramiento
de la salud de peces• Organismos reguladores del Estado
• La industria de acuicultura
• El sistema educacional
• Instituciones de investigación públicas y privadas
• La industria farmacéutica
• Las compañías de alimentos
• Las compañías productoras de huevos y de smolt
• Los servicios de salud animal públicos y privados
• Los productores de equipo e instrumentalA. Lynjoy. 2004. Comunicación personal
Fundamentals to control antimicrobial resistance
Decrease and control antimicrobial use
Restrict critically effective antimicrobials only to humans
Ban critical antimicrobials from animal use, education,
One Health
Do not use antimicrobials in plants, education
Prevent bacterial infections, education
Do not dump antimicrobials in the environment, education
Check food and water for residual antimicrobials,
surveillance
Stop the spread of antimicrobial resistant bacteria and genes
Control spread in the environment, surveillance
Hygiene, surveillance, One Health
Infection control, surveillance
Agriculture and aquaculture
No superbugs in food or water Collignon, 2015
Infectious Diseases Society of America y el uso de antibioticos en alimentos para animales
Implementar legislacion que prohiba el uso en animales, como factores
de crecimiento y en profilaxis, de los antibioticos usados en medicina
humana.
Propiciar investigacion para estableces los riesgos que representa para
la salud humana el uso de antibioticos en animales
Apoyar legislacion que haga obligatorio que la industria de antibioticos
reporte las cantidades usadas en medicina humana y animal y en otras
actividades y que haya vigilancia epidemiologica de la resistencia a
antibioticos en bacterias
Apoyar la investigacion como los antibioticos en diversos productos de
uso humano afectan a la salud.
IDSA, 2006
Gracias
Mother Jones
Total antimicrobial use
2000 - 2008 Quinolones 950 metric tons
2000 -2007 Tetracyclines 1.500 metric tons
2000 -2007 Florfenicol 478 metric tons
In 2013 and 2014 salmon aquaculture still used 451 and 563 m ts of
antimicrobials respectively
Millanao et al, 2011
Antimicrobial resistance in S. typhimurium type 29 in Britain
E.S. Anderson, 1968
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