Transmission pathways of World Health Organization critical priority carbapenemase-producing pathogens: cross-sectoral transmission dynamics in food systems, wildlife and aquaculture

Summary

Antimicrobial resistance (AMR) is a versatile and dynamic genetic process that transcends sectors and ecosystems, leading microorganisms to develop mechanisms to resist drugs (antibiotics and antifungal) and chemical biocides (disinfectants and agrotoxics) designed to kill them. The emergence and spread of AMR are influenced by human, animal and environmental interactions, requiring a One Health framework. Currently, AMR has the potential to be almost everywhere, with carbapenem resistance in particular emerging as the major global health concern. Carbapenem-resistant Enterobacterales are now considered by the World Health Organization (WHO) as ‘critical priority pathogens’, for which novel antibiotics are urgently needed. Carbapenem resistance is a challenge in clinical settings due to its rapid dissemination and limited treatment options. Although the molecular mechanisms and epidemiology of carbapenem resistance have been widely studied in clinical settings, little is known about their spread in the food chain, seafood and aquaculture, wildlife and the environment, and their associated risks to human and animal health. Therefore, integrated measures complying with the One Health approach are imperative to prevent and control the emergence and rapid spread of AMR, preserving the efficacy of clinically relevant antibiotics. It is thus highly recommended that countries follow WHO, World Organisation for Animal Health, and Food and Agriculture Organization of the United Nations recommendations to implement national action plans encompassing the human, food chain and environmental sectors to improve policies and activities addressing the prevention and containment of AMR, enabling the implementation of evidence-based approaches through sharing best practices. This review article provides a concise update on WHO critical priority pathogens in the food chain, wildlife and aquaculture worldwide, as well as cross-sectoral transmission pathways of AMR.

Keywords

Antibiotic resistance – Aquaculture – Carbapenemases – Carbapenem resistance – Food chain – One Health – Seafood – WHO critical priority pathogens – Wildlife.