Contacto/Contact:

Letters to the Editor / Cartas al Editor




"ONE HEALTH": STATE IN OUR ENVIRONMENT.

Marta Hernández Pérez¹, Iván Sanz Muñoz¹, David Rodríguez-Lázaro², José M Eiros¹

¹Facultad de Medicina y Centro Nacional de la Gripe de la OMS. Universidad de Valladolid.
²Area de Microbiología. Facultad de Ciencia y Tecnología de los Alimentos. Universidad de Burgos.
España

Email: marta.hernandez.perez @ uva.es

Rev Electron Biomed / Electron J Biomed 2023;1 (en prensa / in press).


Dear Editor:

The "One Health" concept is assimilated to the value represented by human and animal health and welfare as well as the optimization of environmental services. It is achieved through inter-, multi- and transdisciplinary collaboration between professionals and institutions related to Public Health, Animal Health, and other related disciplines, which goes beyond the results that could be obtained independently by each of the parties involved¹. As glossed by Capua and Cattoli² the term was initially coined as "One Medicine" in 1890 by William Osler. In 1976 Calvin Schwabe, as pointed out by Zinsstag et al³, took up the concept in order to address infectious diseases from a holistic approach.

This field of knowledge evolved into "Global Health" with the emergence of avian influenza from 2003 to 2005, when wild birds spread the highly pathogenic influenza A H5N1 virus to poultry on three continents, its hemagglutinin (HA) diversified into several clades and the different isolates were grouped into different genetic lineages throughout the world⁴. It was undoubtedly more recent events that have contributed to consolidate the term. In 2009, there was the pandemic caused by a new influenza A H1N1 virus whose genome brought together segments of a quadruple origin: two porcine, one avian and one human lineage⁵. Then, in 2012, the world witnessed the emergence of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in Saudi Arabia from camelids⁶, which has caused several thousand cases to date with a case fatality rate of 36%. Subsequently during the Ebola outbreak between 2013 and 2016 in West Africa, almost thirty thousand cases were reported from this agent, with a lethality close to 50%⁷. In December 2019, the SARS-CoV-2 pandemic appeared of which, according to the "Johns Hopkins" University, 676,609,955 cases and 6,881,955 deaths have been recorded, reported until March 10, 2023, date on which the prestigious North American Institution has stopped counting data in this regard⁸. In line with this trajectory, it seems imperative to monitor the evolution of viruses, especially in the natural environment and in animals, in order to minimize the potential emergence of new pathogens⁹.

An undeniable reflection of this human-animal-environment link is that 60% of all human pathogens known to date are zoonotic, the latter representing the majority of all emerging agents in our species¹⁰. Currently, rabies, zoonotic influenza viruses and antimicrobial resistance are included as priority lines of global action within the One Health strategy, to which SARS-CoV-2 have been added¹¹.

In this sense, from the area of Microbiology of the University of Valladolid we contribute to the knowledge of these lines through the study of the microbial genome in three areas. Firstly, in the molecular characterization of influenza viruses in one of the 152 National Influenza Centers recognized by the WHO in the world¹². Secondly, through the genetic study of SARS-CoV-2 and its variants¹³ and other respiratory viruses¹⁴ by coordinating the sequencing and monitoring of their evolution in Castilla y León, of which there was already experience in international platforms¹⁵ and at present as part of the National Network of Laboratories dedicated to this field of knowledge. Thirdly, we have undertaken the definition of different mechanisms of bacterial resistance to antibiotics, collaborating with other groups and organizations to investigate the resistance genes circulating in humans, animals and food, making both methodological^16,17 and original contributions^18-22.

To date, almost 50,000 viral genomes, 10,000 bacterial genomes and around 5,000 samples have been analyzed to determine microbiota. Of the total bacteria sequenced, we studied the resistome in 6,222 genomes of which 67.7% were found to be multidrug resistant, with Enterobacteriaceae, Staphylococcus and Pseudomonas being the most resistant. Among the antibiotics, resistance to aminoglycosides, beta-lactams and tetracyclines was documented, and in particular the most abundant resistance genes were against streptomycin, doxycycline, tetracycline and erythromycin. The blaTEM, blaOXA, blaNDM and blaVIM genes were identified in 17%, 14%, 7.5% and 7%, respectively, of the sequenced isolates. A higher number of plasmids carrying these genes have been identified in Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae and Salmonella enterica species²³.

It seems appropriate to consolidate interdisciplinary collaborations and unify efforts to improve surveillance systems and characterization of relevant agents both in health care practice and in Public Health²⁴. At the same time, it is obligatory to show recognition and gratitude to the microbiology and preventive medicine professionals of the network of public hospitals of the Castilla y León health system for their participation in the collection of samples and elaboration of epidemiological data on the patients to whom we provide care.



REFERENCIAS

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4.- World Health Organization WHO, World Organisation for Animal Health OIE, Food and Agriculture Organization FAO. H5N1 highly pathogenic avian influenza: Timeline of major events. Diciembre del 2014. https://cdn.who.int/media/docs/default-source/influenza/avian-and-other-zoonotic-influenza/h5n1_avian_influenza_update20141204.pdf [consultado el 18 de abril de 2024].

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15.- Hernández M, García Morán E, Abad D, Eiros JM. GISAID: iniciativa internacional para compartir datos genómicos del virus de la gripe y del SARS CoV-2. Rev Esp Salud Pública 2021;95: perspectivas15. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1135-57272021000100203&lng=es. Epub 04-Jul-2022.

16.-Hernández M, Rodríguez Lázaro D, Eiros JM. Aplicación de la secuenciación masiva y la bioinformática al diagnóstico microbiógico clínico. Rev Argentina de Microbiología 2019 Nov 26. pii: S0325-7541(19)30081-1. doi: 10.1016/j.ram.2019.06.003 RAM-D-19-00023R2.

17.- Quijada NM, Rodríguez Lázaro D, Eiros JM, Hernández M TORMES: an automated pipeline for whole bacterial genome analysis. Bioinformatics 2019; 35: 4207-12. https://doi.org/10.1093/bioinformatics/btz220.

18.- Rodríguez-Lázaro D, Oniciuc EA, González-García P, Gallego D, Fernández-Natal I, Domínguez-Gil M, Eiros Bouza JM, Wagner M, Nicolau AI, Hernández M. Detection and characterization of S aureus and Methicillin-resistent Staphylococcus aureus in foods confiscated in EU borders. Front Microbiol 2017; 8: 1344. doi: 10.3389/fmicb.2017.01344.

19.- Hernández M, Quijada NM, López-Urrutia L, De Frutos M, Rodríguez Lázaro D, Eiros Bouza JM. Infrequent isolation of extensively drug-resistant (XDR) Klebsiella penumoniae resistant. Int J Antimicrob Agents 2018 doi: 10.1016/j.ijantimicag.2017.12.033.

21.- Rodríguez-Lázaro D, Alonso-Calleja C, Oniciuc Ea, Capita R, Gallego D, González-Machado C, Wagner M, Barbu V, Eiros Bouza JM, Nicolau Ai, Hernández M. Characterization of Biofilms Formed by Foodborne Methicillin-Resistant Staphylococcus aureus. Front Microbiol. 2018 Dec 4; 9: 3004. doi: 10.3389/fmicb.2018.03004.

20.- Hernández M, De Frutos M, Rodríguez-Lázaro D, López-Urrutia L, Quijada Nm, Eiros JM. Fecal Microbiota of Toxigenic Clostridioides difficile-Associated Diarrhea. Front Microbiol 2019 Jan 14; 9: 3331. doi: 10.3389/fmicb.2018.03331.

21.- Quijada NM, Hernández M, Oniciuc EA, Eiros JM, Fernández-Natal I, Wagner M, Rodríguez-Lázaro D. Oxacillin-susceptible mecA-positive Staphylococcus aureus associated with processed food in Europe. Food Microbiol. 2019; 82: 107-10.

22.-Hernández M, López-Urrutia L, Abad D, De Frutos Serna M, Ocampo-Sosa A, Eiros JM. First report of an extensively drug-resistant ST23 Klebsiella pneumoniae of capsular serotype K1 coproducing CTX-M-15, OXA-48 and ArmA in Spain. Antibiotics 2021; 10, 157. Https://doi.org/10.3390/ antibiotics 10020157.

23.- Eiros Bouza JM, González Zorn B, Oteo Revuelta JA, Hernández Pérez M. MESA 3. One Health: humana, animal y ambiental. Próximos retos. Congreso Sociedad Norte de Medicina Preventiva y Salud Pública. Valladolid, 25 de abril de 2024. https://socinorte.com/programa/congreso-socinorte-8/

24.- Eiros Bouza JM. El papel de la Microbiología Clínica en el marco de "Una Salud". Anales de la Real Academia de Medicina y Cirugía de Valladolid, 2018; 55: 359-64.



CORRESPONDENCE:
Marta Hernández Pérez.
Área de Microbiología. Sexta Planta.
Facultad de Medicina.
Avda Ramón y Cajal, 7.
47005 Valladolid. email: marta.hernandez.perez@uva.es




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