Mycotoxin induced antibiotic resistance, an unsuspected public health impact: a perspective review

Abstract

Resistance-to-antibiotics (ABR) in bacteria is an ever increasing critical global public health concern, as is the prevalence of mycotoxins in human food and animal feed. Mycotoxins are toxins produced by fungi, and so are antibiotics, albeit some soil bacteria also produce antibiotics. While fungal compounds toxic to humans and animals were categorised as mycotoxins, compounds having bactericidal/bacteriostatic activity were pharmacologically used as antibiotics. Nevertheless, the line of demarcation between antibiotics and mycotoxins is not absolute, as many mycotoxins possess antibiotic properties. However, until now mycotoxins were usually not-suspected to induce cross-resistance to antibiotics. The current article demonstrates the plausible mechanistic link for the induction of cross-resistance by mycotoxins to antibiotics. Evidence presented shows that in addition to common origin both mycotoxins and antibiotics have similar chemical structures, genetic backbone, biosynthetic pathway as well as role in the life of producing organism and even induce similar resistance mechanisms in bacteria, scientifically substantiating that mycotoxin induced ABR is a plausible phenomenon. Further the unavoidable presence of mycotoxins in animal feed albeit at low levels, mimics long-term exposure of commensal bacteria in farm animals to antibiotic-growth-promoters at low levels. Additionally, chronic low-level antibiotic exposure in animals is argued to be a serious factor contributing to antibiotic-resistant bacteria in humans. Finally the article provides experimental design to help evaluate the mycotoxin-induced-ABR. The given scientific evidence necessitates future investigations through appropriate studies to confirm the potential of mycotoxins as critical inducers of ABR, from possibility to plausibility.