Editing Antimicrobial resistance (section)

=== Food production ===

==== Livestock ====
{{main|Antibiotic use in livestock#Antibiotic resistance}}
[[File:Ar-infographic-950px.jpg|thumb|A CDC infographic on how antibiotic resistance spreads through farm animals]]
The antimicrobial resistance crisis also extends to the food industry, specifically with food producing animals. With an ever-increasing human population, there is constant pressure to intensify productivity in many agricultural sectors, including the production of meat as a source of protein.<ref>{{cite journal | vauthors = Monger XC, Gilbert AA, Saucier L, Vincent AT | title = Antibiotic Resistance: From Pig to Meat | journal = Antibiotics | volume = 10 | issue = 10 | pages = 1209 | date = October 2021 | pmid = 34680790 | pmc = 8532907 | doi = 10.3390/antibiotics10101209 | doi-access = free }}</ref> Antibiotics are fed to livestock to act as growth supplements, and a preventive measure to decrease the likelihood of infections.<ref>{{cite web |vauthors=Torrella K |date=2023-01-08 |title=Big Meat just can't quit antibiotics |url=https://www.vox.com/future-perfect/2023/1/8/23542789/big-meat-antibiotics-resistance-fda |access-date=2023-01-23 |website=Vox|archive-date=23 January 2023 |archive-url=https://web.archive.org/web/20230123115850/https://www.vox.com/future-perfect/2023/1/8/23542789/big-meat-antibiotics-resistance-fda |url-status=live }}</ref>

Farmers typically use antibiotics in animal feed to improve growth rates and prevent infections. However, this is illogical as antibiotics are used to treat infections and not prevent infections. 80% of antibiotic use in the U.S. is for agricultural purposes and about 70% of these are medically important.<ref name="CA">{{cite journal | vauthors = Martin MJ, Thottathil SE, Newman TB | title = Antibiotics Overuse in Animal Agriculture: A Call to Action for Health Care Providers | journal = American Journal of Public Health | volume = 105 | issue = 12 | pages = 2409–2410 | date = December 2015 | pmid = 26469675 | pmc = 4638249 | doi = 10.2105/AJPH.2015.302870 }}</ref> Overusing antibiotics gives the bacteria time to adapt leaving higher doses or even stronger antibiotics needed to combat the infection. Though antibiotics for growth promotion were banned throughout the EU in 2006, 40 countries worldwide still use antibiotics to promote growth.<ref>{{cite web |title=Farm antibiotic use |url=https://www.saveourantibiotics.org/the-issue/antibiotic-overuse-in-livestock-farming/ |website=saveourantibiotics.org|access-date=21 March 2024 |archive-date=3 April 2024 |archive-url=https://web.archive.org/web/20240403061957/https://www.saveourantibiotics.org/the-issue/antibiotic-overuse-in-livestock-farming/ |url-status=live }}</ref>

This can result in the transfer of resistant bacterial strains into the food that humans eat, causing potentially fatal transfer of disease. While the practice of using antibiotics as growth promoters does result in better yields and [[meat]] products, it is a major issue and needs to be decreased in order to prevent antimicrobial resistance.<ref>{{cite journal | vauthors = Tang KL, Caffrey NP, Nóbrega DB, Cork SC, Ronksley PE, Barkema HW, Polachek AJ, Ganshorn H, Sharma N, Kellner JD, Ghali WA | title = Restricting the use of antibiotics in food-producing animals and its associations with antibiotic resistance in food-producing animals and human beings: a systematic review and meta-analysis | journal = The Lancet. Planetary Health | volume = 1 | issue = 8 | pages = e316–e327 | date = November 2017 | pmid = 29387833 | pmc = 5785333 | doi = 10.1016/S2542-5196(17)30141-9 }}</ref> Though the evidence linking antimicrobial usage in livestock to antimicrobial resistance is limited, the World Health Organization Advisory Group on Integrated Surveillance of Antimicrobial Resistance strongly recommended the reduction of use of medically important antimicrobials in livestock. Additionally, the Advisory Group stated that such antimicrobials should be expressly prohibited for both growth promotion and disease prevention in food producing animals.<ref name="Innes" />

By mapping antimicrobial consumption in livestock globally, it was predicted that in 228 countries there would be a total 67% increase in consumption of antibiotics by livestock by 2030. In some countries such as Brazil, Russia, India, China, and South Africa it is predicted that a 99% increase will occur.<ref name="Ferri_2017" /> Several countries have restricted the use of antibiotics in livestock, including Canada, China, Japan, and the US. These restrictions are sometimes associated with a reduction of the [[prevalence]] of antimicrobial resistance in humans.<ref name="Innes">{{cite journal | vauthors = Innes GK, Randad PR, Korinek A, Davis MF, Price LB, So AD, Heaney CD | title = External Societal Costs of Antimicrobial Resistance in Humans Attributable to Antimicrobial Use in Livestock | journal = Annual Review of Public Health | volume = 41 | issue = 1 | pages = 141–157 | date = April 2020 | pmid = 31910712 | pmc = 7199423 | doi = 10.1146/annurev-publhealth-040218-043954 }}</ref>

In the United States the [[Veterinary Feed Directive]] went into practice in 2017 dictating that ''All medically important antibiotics to be used in feed or water for food animal species require a veterinary feed directive (VFD) or a prescription.''<ref>{{Cite web |title=Veterinary feed directive (VFD) basics {{!}} American Veterinary Medical Association |url=https://www.avma.org/resources-tools/one-health/antimicrobial-use-and-antimicrobial-resistance/veterinary-feed-directive-basics |access-date=2024-04-24 |website=avma.org|archive-date=24 April 2024 |archive-url=https://web.archive.org/web/20240424183927/https://www.avma.org/resources-tools/one-health/antimicrobial-use-and-antimicrobial-resistance/veterinary-feed-directive-basics |url-status=live }}</ref>

==== Pesticides ====
{{main|Pesticide resistance}}

Most [[pesticide]]s protect crops against insects and plants, but in some cases antimicrobial pesticides are used to protect against various microorganisms such as bacteria, viruses, fungi, algae, and protozoa. The overuse of many pesticides in an effort to have a higher yield of crops has resulted in many of these microbes evolving a tolerance against these antimicrobial agents. Currently there are over 4000 antimicrobial pesticides registered with the US [[United States Environmental Protection Agency|Environmental Protection Agency]] (EPA) and sold to market, showing the widespread use of these agents.<ref>{{cite web|url=https://www.epa.gov/pesticide-registration/what-are-antimicrobial-pesticides|title=What are Antimicrobial Pesticides?|last=US EPA|first=OCSPP|date=2013-03-15|website=US EPA|access-date=2020-02-28|archive-date=27 November 2022|archive-url=https://web.archive.org/web/20221127101423/https://www.epa.gov/pesticide-registration/what-are-antimicrobial-pesticides|url-status=live}}</ref> It is estimated that for every single meal a person consumes, 0.3&nbsp;g of pesticides is used, as 90% of all pesticide use is in agriculture. A majority of these products are used to help defend against the spread of infectious diseases, and hopefully protect public health. But out of the large amount of pesticides used, it is also estimated that less than 0.1% of those antimicrobial agents, actually reach their targets. That leaves over 99% of all pesticides used available to contaminate other resources.<ref>{{cite journal | vauthors = Ramakrishnan B, Venkateswarlu K, Sethunathan N, Megharaj M | title = Local applications but global implications: Can pesticides drive microorganisms to develop antimicrobial resistance? | journal = The Science of the Total Environment | volume = 654 | pages = 177–189 | date = March 2019 | pmid = 30445319 | doi = 10.1016/j.scitotenv.2018.11.041 | s2cid = 53568193 | bibcode = 2019ScTEn.654..177R }}</ref> In soil, air, and water these antimicrobial agents are able to spread, coming in contact with more microorganisms and leading to these microbes evolving mechanisms to tolerate and further resist pesticides. The use of antifungal [[azole]] pesticides that drive environmental azole resistance have been linked to azole resistance cases in the clinical setting.<ref>{{cite journal | vauthors = Rhodes J, Abdolrasouli A, Dunne K, Sewell TR, Zhang Y, Ballard E, Brackin AP, van Rhijn N, Chown H, Tsitsopoulou A, Posso RB, Chotirmall SH, McElvaney NG, Murphy PG, Talento AF, Renwick J, Dyer PS, Szekely A, Bowyer P, Bromley MJ, Johnson EM, Lewis White P, Warris A, Barton RC, Schelenz S, Rogers TR, Armstrong-James D, Fisher MC | title = Population genomics confirms acquisition of drug-resistant Aspergillus fumigatus infection by humans from the environment | journal = Nature Microbiology | volume = 7 | issue = 5 | pages = 663–674 | date = May 2022 | pmid = 35469019 | pmc = 9064804 | doi = 10.1038/s41564-022-01091-2}}</ref> The same issues confront the novel antifungal classes (e.g. [[orotomide]]s) which are again being used in both the clinic and agriculture.<ref name="Verweij_2022">{{cite journal | vauthors = Verweij PE, Arendrup MC, Alastruey-Izquierdo A, Gold JA, Lockhart SR, Chiller T, White PL | title = Dual use of antifungals in medicine and agriculture: How do we help prevent resistance developing in human pathogens? | journal = Drug Resistance Updates | volume = 65 | pages = 100885 | date = December 2022 | pmid = 36283187 | doi = 10.1016/j.drup.2022.100885 | pmc = 10693676 | s2cid = 253052170 | doi-access = free}}</ref>