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Übertragungswege resistenter Bakterien zwischen Tieren und Menschen und deren Bedeutung – Antibiotikaresistenz im One-Health-Kontext

Transmission pathways for resistant bacteria between animals and humans: antibiotics resistance in the One Health context

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Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Zusammenfassung

Menschen und Tiere leben in einer gemeinsamen Umwelt und Antibiotika werden bei beiden eingesetzt. Daher ist das Thema Antibiotikaresistenz ein wichtiges gemeinsames Thema für Human- und Veterinärmedizin. Die Frage, welche Bedeutung der Antibiotikaeinsatz bei Tieren für die Resistenzsituation beim Menschen hat, steht dabei häufig im Mittelpunkt der Diskussionen. Im vorliegenden Beitrag werden die Übertragungswege resistenter Bakterien zwischen Tieren und Menschen erläutert und anschließend die Frage adressiert, ob die Verminderung des Antibiotikaeinsatzes in der Tierhaltung auch zu einer Verbesserung der Resistenzsituation beim Menschen beiträgt.

Als wesentliche Übertragungswege werden 1) der Kontakt zwischen Mensch und Tier, 2) die Übertragung von Bakterien über Lebensmittel und 3) die indirekte Übertragung über Emissionen in die Umwelt und die nachfolgende Exposition des Menschen über die Umwelt vorgestellt. Dabei ist festzustellen, dass sich die Bedeutung dieser Übertragungswege zwischen den Bakterienspezies deutlich unterscheidet. Zudem ist es trotz umfangreicher Untersuchungen bisher nicht möglich, die jeweilige Bedeutung der Übertragungswege und der übertragenen Bakterien für die Resistenzsituation beim Menschen exakt zu quantifizieren. Als gesichert gilt, dass der Einsatz von Antibiotika in der Tierhaltung die Ausbreitung resistenter Organismen in der Tierhaltung fördert. Neuere Studien deuten auch darauf hin, dass es eine Beziehung zwischen dem Einsatz von Antibiotika in der Tierhaltung und dem Auftreten von Resistenzen in der Humanpopulation gibt. Diese Beziehung ist jedoch komplex, und für das bessere Verständnis dieser Beziehung und der Bedeutung der verschiedenen Übertragungswege sind weitere gemeinsame Studien im veterinär- und humanmedizinischen Bereich erforderlich.

Abstract

People and animals share the same environment and antibiotics are used in both. Thus, antibiotics resistance is a major common issue for human and veterinary medicine. The potential impact of antibiotics use in animals on resistance in humans is frequently the focus of debate. In this paper the transmission pathways of resistant bacteria between animals and humans are described and the question is addressed whether a reduction in antibiotics use in animals contributes to the improvement of the resistance situation in humans. Direct contact between humans and animals, transmission of bacteria via food, and indirect transmission via emissions in the environment and the subsequent exposure of humans via the environment are the major transmission routes to be considered. It can thus be established that the relevance of these various transmission routes varies significantly among bacterial species. Furthermore, despite numerous investigations, the exact significance of transmission pathways and the bacteria transferred for the resistance situation in humans cannot yet be precisely quantified. There is evidence that antibiotics use in animals fosters the spread of resistant organisms in animals. Recent studies also suggest that there might be a relationship between antibiotics use in animals and the occurrence of resistance in humans. However, this relationship is complex, and for a better understanding of it and the role of the various transmission pathways, further collaborative studies between veterinary and medical science are needed.

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Authors and Affiliations

  1. Fachgruppe Epidemiologie, Zoonosen und Antibiotikaresistenz, Bundesinstitut für Risikobewertung, Max-Dohrn-Str. 8–10, 10589, Berlin, Deutschland

    Bernd-Alois Tenhagen & Annemarie Käsbohrer

  2. Institut für Biometrie, Epidemiologie und Informationsverarbeitung, WHO Collaborating Centre for Research and Training for Health at the Human-Animal-Environment Interface, Tierärztliche Hochschule Hannover, Hannover, Deutschland

    Nicole Werner & Lothar Kreienbrock

  3. Institut für Öffentliches Veterinärwesen, Veterinärmedizinische Universität Wien, Wien, Österreich

    Annemarie Käsbohrer

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Correspondence to Bernd-Alois Tenhagen.

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B.-A. Tenhagen, N. Werner, A. Käsbohrer und L. Kreienbrock geben an, dass kein Interessenkonflikt besteht.

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Tenhagen, BA., Werner, N., Käsbohrer, A. et al. Übertragungswege resistenter Bakterien zwischen Tieren und Menschen und deren Bedeutung – Antibiotikaresistenz im One-Health-Kontext. Bundesgesundheitsbl 61, 515–521 (2018). https://doi.org/10.1007/s00103-018-2717-z

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