Scientific Opinion on the public health risks of bacterial strains producing extended-spectrum β-lactamases and/or AmpC β-lactamases in food and food-producing animals

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Article
Panel on Biological Hazards
Acknowledgements

The Panel wishes to thank the members of the Working Group on Extended spectrum cephalosporinases for the preparation of this opinion: Alessandra Carattoli, Teresa M Coque, Henrik Hasman, Dik Mevius, Luisa Peixe, Laurent Poirel, Gertraud Schupbach, John Threlfall, Karolina Torneke, Carmen Torres for the preparatory work on this scientific opinion and Mia Egervarn for her contribution as hearing expert and ECDC staff Anna-Pelagia Magiorakos, EMA staff Jordi Torren and EFSA staff Ernesto Liebana for the support provided to this scientific opinion.

EFSA Journal
EFSA Journal 2011;9(8):2322 [95 pp.].
doi
10.2903/j.efsa.2011.2322
Panel members at the time of adoption
Olivier Andreoletti, Herbert Budka, Sava Buncic, John D Collins, John Griffin, Tine Hald, Arie Hendric Havelaar, James Hope, Günter Klein, Kostas Koutsumanis, James McLauchlin, Christine Müller-Graf, Christophe, Nguyen-The, Birgit Noerrung, Luisa Peixe, Miguel Prieto Maradona, Antonia Ricci, John Sofos, John Threlfall, Ivar Vågsholm and Emmanuel Vanopdenbosch
Type
Opinion of the Scientific Committee/Scientific Panel
On request from
European Commission, Health and Consumers Directorate General
Question Number
EFSA-Q-2010-00812
Adopted
7. Juli 2011
Published
2. August 2011
Affiliation
European Food Safety Authority (EFSA), Parma, Italy
Note
Abstract

The potential contribution of food-producing animals or foods to public health risks by ESBL and/or AmpC-producing bacteria is related to specific plasmid-mediated ESBL and/or AmpC genes encoded by a number of organisms. The predominant ESBL families encountered are CTX-M, TEM, and SHV; the predominant AmpC-family is CMY. The most common genes associated with this resistance in animals are blaCTX-M-1 (the most commonly identified ESBL), and blaCTX-M-14, followed by blaTEM-52 and blaSHV-12. Among the genes encoding AmpC-type β-lactamases, blaCMY-2 is the most common.The bacterial species most commonly identified with these genes are Escherichia coli and non-typhoidal Salmonella. ESBL/AmpC transmission is mainly driven by integrons, insertion sequences, transposons and plasmids, some of which are homologous in isolates from both food-production animals and humans. Cefotaxime is used as the drug of choice for optimum detection of blaESBL and/or blaAmpC genes. The preferred method for isolation of ESBL- and/or AmpC-producers is screening on selective agar preceded by selective enrichment in a broth.The establishment of risk factors for occurrence of ESBL/AmpC-producing bacteria is particularly complicated by the data unavailability or lack of its accuracy. The use of antimicrobials is a risk factor for the selection and spread of resistant clones, resistance genes and plasmids. Since most ESBL- and AmpC-producing strains carry additional resistances to other commonly-used veterinary drugs, generic antimicrobial use is a risk factor for ESBL/AmpC and it is not restricted specifically to the use of cephalosporins. An additional risk factor is extensive trade of animals in EU MS. There are no data on the comparative efficiency of individual control options in reducing public health risks caused by ESBL and/or AmpC-producing bacteria related to food-producing animals. Prioritisation is complex, but it is considered that a highly effective control option would be to stop all uses of cephalosporins/systemically active 3rd/4th generation cephalosporins, or to restrict their use (use only allowed under specific circumstances). As co-resistance is an important issue, it is also of high priority to decrease the total antimicrobial use in animal production in the EU.

Keywords
Resistance, ESBLs, AmpC, occurrence, transmission, control options, public health microbiology
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Number of Pages
95