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abstract

Since the 1950s, the global increase in demand for meat has driven the use of antimicrobial drugs in agriculture. This practice has led to the development of antimicrobial resistance (AMR) in animals and food products with potentially harmful consequences for agricultural productivity, and human health. In low- and middle-income countries (LMICs), trends in AMR are poorly documented, and surveillance networks are at best nascent. In this context, independent surveys conducted by veterinarians constitutes a largely untapped source of information to document trends in AMR in LMICs.

We identified twelve thousand reports of resistance rates from point prevalence surveys on common foodborne pathogens (Escherichia coli, non-Typhoidal Salmonella, Campylobacter spp., and Staphylococcus aureus). We accounted for potential differences in accuracy of antimicrobial susceptibility testing between regions using the WHO External Quality Control System, as well as for temporal revisions of the breakpoints used for susceptibility testing. For each survey, we calculated the proportion of drugs tested with resistance higher than 50% (P50), and used ensemble geospatial modelling to produced global maps of P50 at 10Km resolution. We also established an open-access platform to share our findings, and enable reporting of surveys on AMR: resistancebank.org.

From 2000 to 2018, the proportion of antimicrobials with resistance higher than 50% increased twofold in chickens, and threefold in pigs. China, Northeast and South India represented the largest hotspots of resistance, while new hotspots are emerging in Central India, Brazil, and Kenya. Interpretations: We report a rapid but geographically heterogenous increase of AMR levels in animals in LMICs. These trends call for urgent actions to preserve the efficacy of existing drugs and limit the future economic burden of AMR on farmers. Global maps of AMR provide a baseline to outline priorities for interventions, and monitor their efficacy in the future.