Better surveillance needed to fight spread of antimicrobial resistance in zoonotic infections

The European Centre for Disease Prevention and Control (ECDC), the European Food Safety Authority (EFSA), the European Medicines Agency (EMEA) and the European Commission’s Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR) have published a joint scientific opinion on antimicrobial resistance (AMR) focused on infections transmitted to humans from animals and food (zoonoses).

The joint opinion concludes that bacterial resistance to antimicrobials has increased in recent years worldwide, making it more difficult to treat some human and animal infections. It says surveillance activities should be strengthened and the development of new antimicrobials and new strategies to combat the spread of resistance encouraged. Research is needed on other strategies to control infectious diseases in animals, such as vaccination programmes.

The opinion says there is specific concern about bacterial resistance to antibiotics used in the treatment of Salmonella and Campylobacter infections - the two most reported zoonotic infections in Europe, and points out which antibiotics are considered of high concern for their treatment . It says that although the use of antibiotics is considered the main factor in the development of bacterial resistance, the use of biocides (including disinfectants, antiseptics and preservatives) may also contribute to bacterial resistance.

“Antibiotic resistance is one of the biggest threats to public health in the European Union and a priority area of work at ECDC. The major cause of antibiotic resistance in humans remains the use of antibiotics in human medicine. If the misuse and overuse of antibiotics continue, we will lose the means to treat serious infectious diseases,” said Dominique L. Monnet, Senior Expert and Coordinator of the Antimicrobial Resistance and Healthcare-Associated Infections at ECDC.

The opinion on antimicrobial resistance in zoonotic infections highlights that globalisation of food trade and frequent travel to countries outside the EU make it difficult to compare resistance data from surveillance programmes at EU level and to assess the impact of those strains coming from outside the EU. It also adds that the differences in levels of antimicrobial resistance in the various EU countries make it difficult to have a single strategy to fight against this threat.

“Resistance is caused by the ability of bacteria to undergo changes, given their increasing exposure to antimicrobials used in human and veterinary medicine. Most antimicrobial-resistant strains of zoonotic bacteria are found in the gastrointestinal tract of healthy food animals, particularly poultry, pigs, and cattle,” said Professor Dan Collins, Chair of EFSA’s Biological Hazards (BIOHAZ) Panel.

Food-borne infections caused by these bacteria very often originate from contamination during slaughter of animals or food processing. The opinion says that at present there are no data available to demonstrate that the use of antibiotics in human medicine may also have an impact on the resistance of zoonotic bacteria.

The three EU agencies and the SCENIHR have worked together on this issue, sharing their scientific expertise and advising EU decision-makers on risks and making recommendations for action. “This exercise has been an example of how different institutions within the EU can successfully work together to tackle the issue of antimicrobial resistance which currently represents a significant threat to human health,” David Mackay, Head of Unit Veterinary Medicines and Product Data Management at the European Medicines Agency, said.

The opinion on antimicrobial resistance in zoonotic infections was published ahead of European Antibiotic Awareness Day on November 18, which focuses on resistance to antibiotics. The opinion confirms previous recommendations that prudent use of antimicrobials in animals should be strongly promoted and that veterinarians and farmers should be educated on strategies to minimise antimicrobial resistance. Other previous recommendations said antibiotics such as fluoroquinolones and cephalosporins should be reserved for treating conditions which respond poorly to other antimicrobials.

Notes to editors

The European Centre for Disease Prevention and Control (ECDC) is the EU agency in charge of identifying, assessing and communicating current and emerging threats to human health posed by infectious diseases.

The European Medicines Agency (EMEA) deals with the protection and promotion of public and animal health, through the evaluation and supervision of medicines for human and veterinary use.

The European Food Safety Authority (EFSA) is the keystone of risk assessment regarding food and feed safety in the EU and provides independent scientific advice and communication on existing and emerging risks associated with the food chain.

The Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR), managed by the Directorate-General Health and Consumers of the European Commission, provides independent scientific advice to the European Commission on questions concerning emerging or newly identified health and environmental risks, and on broad, complex or multidisciplinary issues requiring a comprehensive assessment of risks to consumer safety or public health and related issues not covered by other Community risk assessment bodies.

Some definitions:

An active substance of synthetic or natural origin which destroys bacteria, suppresses their growth or their ability to reproduce in animals or humans, excluding antivirals and antiparasites. In this opinion, the term antimicrobial has been used generically to encompass antimicrobial agents, antibiotics and antibacterial agents.

A chemical substance produced by a bacterium which has the capacity, in dilute solution, to inhibit the growth of, or to kill other micro-organisms. >/p>

An active chemical molecule that is present in a biocidal product and used to control the growth of or kill bacteria.

Links to related work:

[1] When antibiotic treatment is required for Salmonella infections, the antibiotics concerned are quinolones in adults and cephalosporins in children, and for Campylobacter infections, macrolides and quinolones.

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