Understanding the Epidemiology of Multi-Drug Resistant Gram-Negative Bacilli in the Middle East Using a One Health...

Area of Science:

• Microbiology
• Public Health
• Veterinary Medicine

Background:

• Extended-spectrum cephalosporin and carbapenem-resistant Gram-negative bacilli (GNB) are increasingly prevalent in humans, animals, and the environment.
• Emergence of colistin resistance in animals and its subsequent detection in humans has exacerbated the challenge of treating infections caused by these resistant organisms.
• Studies indicate transmission of resistant organisms from animals to humans, with a notable spread in hospitals within Middle Eastern countries.

Purpose of the Study:

• To review the prevalence of antibiotic resistance, antibiotic consumption, infection control measures, and risk factors contributing to resistance spread in Middle Eastern countries.
• To highlight knowledge gaps regarding antibiotic consumption, particularly in community and animal farm settings.
• To emphasize the need for global intervention measures within the One Health framework to mitigate the dissemination of antibiotic resistance.

Main Methods:

• Literature review focusing on antibiotic resistance in Gram-negative bacilli.
• Analysis of resistance patterns in human, animal, and environmental samples.
• Examination of factors influencing resistance spread, including socio-economic conditions and population mobilization.

Main Results:

• Carbapenemase producers are dominant in hospitals, while extended-spectrum beta-lactamases (ESBL) and colistin resistance are significant issues in animals.
• Colistin use in veterinary medicine contributes to resistance, despite its abandonment in human medicine.
• ESBL and carbapenemase producers have been detected in the environment, underscoring its role as a transmission bridge between humans and animals.
• Limited data exists on antibiotic consumption in community and animal farm settings in most Middle Eastern countries.
• Socio-economic factors such as immigration, poverty, and poor living conditions, exacerbated by conflict, facilitate resistance dissemination.

Conclusions:

• Antibiotic resistance poses a significant One Health challenge in the Middle East, requiring integrated intervention strategies.
• Addressing antibiotic use in veterinary medicine and improving infection control in healthcare settings are crucial.
• Environmental surveillance and understanding socio-economic drivers are essential for effective control of antimicrobial resistance.