Exposure Pathways to Antimicrobial Resistance at the Human-Animal Interface-A Qualitative Comparison of Swiss Expert and Consumer Opinions

Abstract

Antimicrobial resistance (AMR) is an emerging global health concern, affecting both the animal and the human population. Transmission pathways of AMR are therefore abundant and complex, and ways to prevent or reduce transmission to consumers must be identified. The overall goal of this study was to define the content of an intervention study aimed at reducing the transmission of AMR from animal sources to humans. To identify the most relevant pathways, Swiss experts and consumers were interviewed about their opinions on the risks of transmission of AMR. Opinions of experts and consumers were then qualitatively compared and the main gaps identified. The results revealed that Swiss consumers had several misconceptions regarding the sources and transmission of AMR, and that they in particular underestimated the importance of poultry meat and pets as a potential source of AMR. Furthermore, high uncertainty was noted in experts regarding the prevalence of AMR in pets and the potential of transmission to their owners. Consequently, awareness of AMR transmission pathways should be increased among consumers to overcome common misconceptions, which will help reduce the risk of transmission. Further research is needed to better understand the pets' potential to harbor and transmit AMR to their owners, and to identify most effective methods to increase risk awareness in consumers as well as intervention strategies promoting consumer behaviors to mitigate AMR transmissions at the human-animal interface.

Keywords: AMR; animals; behavior; food safety; pets; risk; transmission.

Figure 1

Map of AMR sources and transmission pathways relevant for the Swiss population. The map is simplified and only one-way transmission pathways to humans are considered, illustrated by arrows. The arrows link each AMR source with its relevant population (i.e., Swiss consumers) or specific subpopulation (e.g., pet owners), but do not inform about the nature of the interaction. The overlapping circles illustrate that an individual may be exposed to multiple sources at the same time.

Figure 2

Bubble chart representing the exposure of the Swiss population to AMR hazards originating from food and animal sources. Y-axis: Release of AMR hazards from different sources. X-axis: Exposure to sources of AMR hazards for different subpopulations. Bubble size: Person days at risk [million days per year].