Report Shows Antimicrobial Resistance Still High in Europe

March 7, 2018 — 

A report, released by European Food Safety Authority (EFSA) and the European Centre for Disease Prevention and Control (ECDC), highlights some emerging issues and confirms antimicrobial resistance as one of the biggest threats to public health, mainly by reducing the effectiveness of treatment options. [Source: National Hog Farmer, February 27, 2018]

Vytenis Andriukaitis, European Commissioner for Health and Food Safety, states "Levels of antimicrobial resistance still differ significantly from one EU country to another. 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."

Among the new findings, based on data from 2016, are the detection of resistance to carbapenems in poultry, an antibiotic which is not authorized for use in animals, and of ESBL-producing Salmonella Kentucky with high resistance to ciprofloxacin in humans, which was reported for the first time in four countries.

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."

Key findings from the report:
Animals and foods

• Resistance to carbapenem antibiotics was detected at a very low level in poultry and chicken meat in two Member States (fifteen E. coli bacteria). Carbapenems are used to treat serious infections in humans and are not authorized for use in animals.
• Two Livestock-Associated Methicillin-Resistant Staphylococcus aureus bacteria found in pigs were reported to be linezolid-resistant. Linezolid is one of the last-resort antimicrobials for the treatment of infections caused by highly-resistant MRSA.
• 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.
• 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%). 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.

Humans

• One out of four infections in humans is caused by Salmonella bacteria that show resistance to three or more antimicrobials commonly used in human and animal medicine. The proportion is significantly higher in S. Kentucky and S. Infantis (76.3 and 39.4% respectively).
• For the first time, ESBL-producing S. Kentucky with high resistance to ciprofloxacin was detected in four countries. These bacteria are not possible to treat with critically important antibiotics.
• Campylobacter bacteria, which cause the most common foodborne disease in the EU, show high resistance to widely used antibiotics (ciprofloxacin resistance 54.6% in C. jejuni and 63.8% in C. coli; tetracycline resistance 42.8% in C. jejuni and 64.8% in C. coli). The levels of resistance increased in two of the three analyzed antibiotics (ciprofloxacin and tetracycline), but combined resistance to the critically important antimicrobials is stable and overall low (0.6% in C. jejuni and 8.0% in C. coli). In some countries, however, at least one in three C. coli infections were multidrug-resistant to important antibiotics, leaving very few treatment options for severe infections.

Read the entire report here.