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Author Spotlight: Understanding and Detecting Environmental Antimicrobial Resistance by Combining Culture-Based Techniques and Genomics
Published on: July 19, 2024
Antimicrobial resistance situation and control measures in Hong Kong: from a One Health perspective
Vincent Chi-Chung Cheng1, Shuk-Ching Wong2, Edmond Siu-Keung Ma3
1Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region of China; Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region of China; Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region of China.
Antimicrobial resistance (AMR) is a major threat, with high rates of resistant E. coli in Hong Kong food animals and increasing MRSA in elderly care homes. Control efforts show promise but face significant challenges in food hygiene and healthcare settings.
Area of Science:
- Public Health
- Microbiology
- Epidemiology
Background:
- Multidrug-resistant organisms (MDROs) represent a significant global public health concern.
- Hong Kong faces unique challenges due to high population density, an aging demographic, and reliance on imported food.
- Antimicrobial resistance (AMR) surveillance and control are crucial, especially within a One Health framework.
Purpose of the Study:
- To review targeted surveillance and control strategies for AMR in Hong Kong.
- To analyze trends in antimicrobial-resistant organisms (AROs) in food animals, food products, and healthcare settings.
- To evaluate the impact of interventions on AMR prevalence and antimicrobial consumption.
Main Methods:
- Systematic review of surveillance data from 2010-2023.
- Analysis of antimicrobial consumption data in food animals, hospitals, and communities.
- Evaluation of a pilot Methicillin-resistant Staphylococcus aureus (MRSA) decolonization program in residential care homes for the elderly (RCHE).
Main Results:
- High prevalence of extended-spectrum beta-lactamase-producing E. coli (ESBL-E. coli) in pigs (51.5%) and chickens (86.3%).
- Increasing detection of carbapenemase-producing E. coli in pigs (up to 19.2%) and presence in various food items.
- Significant reduction in MRSA infections and bacteremia in RCHEs following a decolonization program.
Conclusions:
- Control of ESBL and carbapenemase-producing E. coli in food animals presents considerable challenges.
- Food hygiene compliance and infection control in RCHEs and hospitals are critical for mitigating MRSA spread.
- The One Health approach is essential for comprehensive AMR surveillance and control efforts.
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