The European Food Safety Authority (EFSA) and the European Centre for Disease Prevention and Control (ECDC) have just released their annual report on antimicrobial resistance (AMR) in bacteria.
Mike Catchpole, chief scientist, ECDC, said: “It is of particular concern that some common types of Salmonella in humans, such as monophasic Salmonella Typhimurium, exhibit extremely high multi-drug resistance. Prudent use of antibiotics in human and veterinary medicine is extremely important to address the challenge posed by antimicrobial resistance.”
The report also highlighted that antimicrobial resistance levels in Europe continue to vary by geographical region, with countries in Northern and Western Europe generally having lower resistance levels than those in Southern and Eastern Europe.
Marta Hugas, head of EFSA’s biological hazards and contaminants unit, said: “These geographic variations are most likely related to differences in antimicrobial use across the EU. For example, countries where actions have been taken to reduce, replace and re-think the use of antimicrobials in animals show lower levels of antimicrobial resistance and decreasing trends.”
Colistin and ESBL
Resistance to colistin was found at very low levels in Salmonella and E. coli in pigs and cattle. Extended-spectrum beta-lactamase (ESBL)-producing E. coli were detected in beef, pork, pigs and calves. Bacteria that produce ESBL enzymes show multi-drug resistance to β-lactam antibiotics, which include penicillin derivatives and cephalosporins.
High resistance to ciprofloxacin and tetracyclines was observed in C. coli isolates from fattening pigs, said the EU agencies.
Richard Murphy, research director, Alltech, who has a particular focus on AMR, told us:
“With this type of analysis its hard make definitive inferences, as the relative reporting rates can vary from year to year and from country to country but the trend towards an increase in reported rates is worrying.”
The reports this year of resistance to carbapenems and colistin should be taken seriously, as these are drugs of last resort: “If we start to see longer term temporal increases among isolates with resistance to these drugs then it really will be only a matter of time before we see an increase in associated health issues for EU consumers. Given their critical importance to human medicine, we need to take action now to prevent longer term increases and issues,” said Murphy.
Professor Guy Poppy, Chief Scientific Advisor at the Food Standards Agency (FSA), said:
“These reports highlight again why our new surveillance of AMR in food at retail is crucial. AMR is a global issue that requires effort right across the food supply chain if we are to reduce the levels of AMR in bacteria associated with human and animal disease.
“By understanding the levels of AMR in food at retail, we will begin to understand the scale of exposure to humans and the effectiveness of responsible management tools and techniques in agriculture and aquaculture on this important mode of transmission from farm to fork.”
He said a review of the annual surveys on antimicrobial resistance issued by EFSA each year reveals some interesting temporal trends - for the most part an increase in antibiotic resistance amongst Salmonella isolates is notable.
“In particular and of concern for human health, an increase in the last number of years of resistance amongst Salmonella in broiler meat has been reported.
“The majority of antibiotic resistance can be noted amongst broilers and this may in part be due to the lower level of antibiotic use in the layer industry relative to the broiler market.
"An increase in antibiotic resistance in Salmonella isolated from poultry meat has been noted since 2010. These temporal changes would need to be monitored for a longer period to determine the extent of this rise; however, there is a relatively high rate amongst some classes of antibiotics e.g. nalidixic acid, ciprofloxacin and the sulphonamides.”
Overall, he said, the trend is towards a decline in overall Salmonellosis rates in the EU while the Campylobacteriosis rates have remained relatively stable: “As such the reports of resistance to fluoroquinolones and macrolides in over 10% of the tested Campylobacter coli bacteria in humans is an issue.”
Reacting to the EFSA and ECDC report, Professor Leo den Hartog, R&D Director for Nutreco’s animal nutrition division, Trouw Nutrition, said:
“This report is yet another call to action to substantially reduce the use of antibiotics in animal husbandry. We know that if we achieve significant reductions, we actually revert antimicrobial resistance. Reduction strategies pay off.”
“But we can only achieve this if we redirect our focus to alternative strategies based on a holistically integrated approach. It is about a combination of farm, feed and health management.”
Translating that into regulatory action, he said it is important to redirect part of the innovation focus and funding to alternatives, including nutritional programs: “Equally important, we need to adapt the regulatory framework so that health and performance attributes of those nutritional programs are acknowledged for and recognized.”