“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 4182cabello@nymc.edu

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

Título de la conferencia

Nombre y filiación del conferencista.

ESPACIO PARA LOGO

Foto referencial/ Imagen depende de la conferencia