The role of animals in the epidemiology of antimicrobial resistance in humans

Abstract

The human body is home to billions of micro-organisms, including many types of bacteria. In general, these bacteria are harmless and even useful, but under certain circumstances, bacteria can cause infections that require antibiotic treatment. When bacteria develop antimicrobial resistance (AMR), it can lead to treatment failure. Resistant bacteria can be transmitted between humans and animals through direct contact, or through food, water or the environment. The extent to which animals contribute to the occurrence and spread of AMR in the general population has remained a topic of debate. This thesis aimed to explore the relation between exposure to animals and the carriage of resistant bacteria in healthy humans.

The epidemiological studies in this thesis do not provide clear evidence of frequent transmission of resistant bacteria from the livestock and food production sector to humans in the Netherlands. Nevertheless, the livestock and food production sector, as well as companion animals are still potential reservoirs of resistance genes, which may occasionally spill-over to humans and then successfully circulate in the general population. Thus timely detection of (new) resistant strains, antimicrobial stewardship, and targeted prevention and control measures are needed to contain the burden of AMR.