Antimicrobial use in shrimp farming in Ecuador and emerging multi-resistance during the cholera epidemic of 1991: A re-examination of the data

In 1991, the 7th cholera pandemic reached Ecuador. During this epidemic, the emergence of multi-resistance strains of V. cholerae was observed. It has been argued that the use of antimicrobials in Ecuadorian shrimp farms was causally related to this emergence of multi-resistance in a human pathogen and that this linkage provides important evidence that must be incorporated into any assessment of the risks to human health presented by use of antimicrobials in aquaculture.This review re-examines the data that has been published concerning the epidemic and the emergence of resistance in Ecuador. It reports that none of the available data provides credible support for the claim that antimicrobial agent use in shrimp farms played a significant role in either the epidemic or in the emergence of multi-resistant human pathogens. It concludes that our knowledge of the events that occurred in Ecuador in 1991 can add nothing to our understanding of the risks associated with the use of antimicrobials in aquaculture.