The development and spread of antimicrobial resistance are major concerns for human and animal health. The effects of the overuse of antimicrobials in domestic animals on the dissemination of resistant microbes to humans and the environment are of concern worldwide. Rhodococcus equi is an ideal model to illustrate the spread of antimicrobial resistance at the animal-human-environment interface because it is a natural soil saprophyte that is an intracellular zoonotic pathogen that produces severe bronchopneumonia in many animal species and humans. Globally, R. equi is most often recognized as causing severe pneumonia in foals that results in animal suffering and increased production costs for the many horse-breeding farms where the disease occurs. Because highly effective preventive measures for R. equi are lacking, thoracic ultrasonographic screening and antimicrobial chemotherapy of subclinically affected foals have been used for controlling this disease during the last 20 years. The resultant increase in antimicrobial use attributable to this “screen-and-treat” approach at farms where the disease is endemic has likely driven the emergence of multidrug-resistant (MDR) R. equi in foals and their environment. This review summarizes the factors that contributed to the development and spread of MDR R. equi, the molecular epidemiology of the emergence of MDR R. equi, the repercussions of MDR R. equi for veterinary and human medicine, and measures that might mitigate antimicrobial resistance at horse-breeding farms, such as alternative treatments to traditional antibiotics. Knowledge of the emergence and spread of MDR R. equi is of broad importance for understanding how antimicrobial use in domestic animals can impact the health of animals, their environment, and human beings.

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马红球菌多药耐药的流行病学和分子基础

抗菌素耐药性的发展和传播是人类和动物健康的主要问题。在家畜中过度使用抗微生物药物对耐药微生物向人类和环境传播的影响是全世界关注的问题。马红球菌是说明抗菌素耐药性在动物-人类-环境界面传播的理想模型，因为它是一种天然土壤腐生菌，是一种细胞内人畜共患病原体，可在许多动物物种和人类中产生严重的支气管肺炎。在全球范围内，R. equi最常被认为会导致小马驹严重肺炎，导致动物痛苦并增加发生该疾病的许多养马场的生产成本。由于缺乏对马鹿的高效预防措施，在过去的 20 年中，已使用胸部超声筛查和对亚临床受影响的马驹进行抗菌化疗来控制这种疾病。在这种疾病流行的农场中，这种“筛选和治疗”方法导致抗菌药物使用量的增加可能推动了马驹及其环境中出现耐多药 (MDR) R. equi 。这篇综述总结了促成 MDR R. equi的发展和传播的因素，MDR R. equi出现的分子流行病学，MDR R. equi对兽医和人类医学的影响，以及可能减轻马场抗菌素耐药性的措施，例如传统抗生素的替代疗法。了解 MDR R. equi的出现和传播对于了解在家畜中使用抗菌药物如何影响动物、它们的环境和人类的健康具有广泛的重要性。