{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T14:42:51Z","timestamp":1753886571974},"reference-count":66,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,4,21]],"date-time":"2020-04-21T00:00:00Z","timestamp":1587427200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Risk Analysis"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Virginiamycin (VM), a streptogramin antibiotic, has been used to promote healthy growth and treat illnesses in farm animals in the United States and other countries. The combination streptogramin Quinupristin\u2010Dalfopristin (QD) was approved in the United States in 1999 for treating patients with vancomycin\u2010resistant <jats:italic>Enterococcus faecium<\/jats:italic> (VREF) infections. Many chickens and swine test positive for QD\u2010resistant <jats:italic>E. faecium<\/jats:italic>, raising concerns that using VM in food animals might select for streptogramin\u2010resistant strains of <jats:italic>E. faecium<\/jats:italic> that could compromise QD effectiveness in treating human VREF infections. Such concerns have prompted bans and phase\u2010outs of VM as growth promoters in the United States and Europe. This study quantitatively estimates potential human health risks from QD\u2010resistant VREF infections due to VM use in food animals in China. Plausible conservative (risk\u2010maximizing) quantitative risk estimates are derived for future uses, assuming 100% resistance to linezolid and daptomycin and 100% prescription rate of QD to high\u2010level (VanA) VREF\u2010infected patients. Up to one shortened life every few decades to every few thousand years might occur in China from VM use in animals, although the most likely risk is zero (e.g., if resistance is not transferred from bacteria in food animals to bacteria infecting human patients). Sensitivity and probabilistic uncertainty analyses suggest that this conclusion is robust to several data gaps and uncertainties. Potential future human health risks from VM use in animals in China appear to be small or zero, even if QD is eventually approved for use in human patients.<\/jats:p>","DOI":"10.1111\/risa.13466","type":"journal-article","created":{"date-parts":[[2020,4,21]],"date-time":"2020-04-21T17:36:04Z","timestamp":1587490564000},"page":"1244-1257","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Quantifying Human Health Risks from Virginiamycin Use in Food Animals in China"],"prefix":"10.1111","volume":"40","author":[{"suffix":"Jr.","given":"Louis Anthony","family":"Cox","sequence":"first","affiliation":[{"name":"Cox Associates and University of Colorado  Denver CO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas A.","family":"Popken","sequence":"additional","affiliation":[{"name":"Cox Associates and University of Colorado  Denver CO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Sun","sequence":"additional","affiliation":[{"name":"National Risk Assessment Laboratory for Antimicrobial Resistance of Animal Original Bacteria South China Agricultural University  Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao\u2010ping","family":"Liao","sequence":"additional","affiliation":[{"name":"National Risk Assessment Laboratory for Antimicrobial Resistance of Animal Original Bacteria South China Agricultural University  Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liang\u2010Xing","family":"Fang","sequence":"additional","affiliation":[{"name":"National Risk Assessment Laboratory for Antimicrobial Resistance of Animal Original Bacteria South China Agricultural University  Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,4,21]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.96.12.6908"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.37.12.3912-3916.1999"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.05072-14"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ444"},{"key":"e_1_2_6_6_1","unstructured":"Cervantes H.(2005).Assessing the results of the EU ban on antibiotic feed additives.The Poultry Site Nov 4. 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