Antimicrobial resistance ‘biggest threat’ to public health
The report, published by the European Food Safety Authority (EFSA) and European Centre for Disease Prevention and Control (ECDC), revealed a number of emerging issues around antimicrobial resistance (AMR) and reconfirmed the threat posed, mainly because AMR could reducing the effectiveness of treatment options.
In the food chain, the report revealed resistance to carbapenem antibiotics was detected at “very low level in poultry and in chicken meat” in two Member States. Carbapenems are used to treat serious infections in humans and are not authorised for use in animals.
Two livestock associated methicillin resistant staphylococcus aureus (MRSA) bacteria were found in pigs reported to be linezolid-resistant. Linezolid is one of the last-resort antimicrobials for the treatment of infections caused by highly-resistant MRSA.
Marta Hugas, EFSA’s chief scientist said: “The detection of resistance to carbapenems in poultry and to linezolid in methicillin-resistant Staphylococcus aureus in pigs is alarming because these antibiotics are used in humans to treat serious infections. It is important that risk managers follow-up on these findings.”
Combined clinical resistance to critically important antimicrobials was observed at low to very low levels in Salmonella (0.2%), Campylobacter (1%) and E. coli (1%) in poultry. Resistance to colistin was observed at low levels (2%) in Salmonella and E. Coli in poultry.
Differences across the EU
Prevalence of ESBL-producing E. coli in poultry varies markedly between the Member States, from low (less than 10%) to extremely high levels (more than 70%), the report revealed.
Bacteria that produce ESBL enzymes show multi-drug resistance to β-lactam antibiotics – a class of broad spectrum antibiotics which include penicillin derivatives, cephalosporins and carbapenems. This is the first time that the presence of extended-spectrum beta-lactamase (ESBL)-producing E. coli was monitored in poultry and poultry meat, the EFSA and ECDC said.
“Levels of antimicrobial resistance still differ significantly from one EU country to another,” Vytenis Andriukaitis, European Commissioner for Health and Food Safety, commented.
Reaffirming his commitment to tackle AMR, Andriukaitis continued: “To win the fight, we need to join our efforts and implement stringent policies on the use of antibiotics across sectors. It is vital that we all renew our commitment to fight antimicrobial resistance by focusing on the key areas set out in the EU One Health Action Plan against antimicrobial resistance.”
The World Health Organisation has called for a total ban on the use of antibiotics to promote growth in animals destined to enter the food chain.
The EU banned the use of growth promoting antibiotics back in 2006 but regulators have stressed that differences in antibiotic usage levels remain between EU member states. In order to tackle this, the European Commission adopted the EU One Health action plan against AMR in June last year.
Human impact
Globally, antibiotic resistant bacteria are linked to around 700,000 deaths a year. This figure could increase to 10m by 2050 if current trends continue, according to a report commissioned by the UK government.
This latest study showed that AMR resistance is having an impact on the effectiveness of drugs used to treat infections in humans. Bacteria that show resistance to three or more antimicrobials cause one in four Salmonella infections in humans. The proportion is “significantly higher” in Salmonella Kentucky and Salmonella Infantis, at 76.3% and 39.4% respectively.
For the first time, ESBL-producing Salmonella Kentucky with high resistance to ciprofloxacin was detected in four countries. These bacteria are not possible to treat with critically important antibiotics.
Meanwhile, Campylobacter bacteria, which cause the most common foodborne disease in the EU, show “high resistance” to widely used antibiotics.
“We are concerned to see that Salmonella and Campylobacter bacteria in humans show high levels of antimicrobial resistance. The fact that we keep detecting multidrug-resistant bacteria means that the situation is not improving. We need to investigate the origins and prevent the spread of highly resistant strains, such as ESBL-producing Salmonella Kentucky,” Mike Catchpole, ECDC’s chief scientist, said.
