Antimicrobial resistance


Antimicrobials, such as antibiotics, are substances used to kill micro-organisms or to stop them from growing and multiplying. They are commonly used in human and veterinary medicine to treat a wide variety of infectious diseases.

Antimicrobial resistance refers to the ability of micro-organisms to withstand antimicrobial treatments. The overuse or misuse of antibiotics has been linked to the emergence and spread of micro-organisms which are resistant to them, rendering treatment ineffective and posing a serious risk to public health. A well known example of a bacterium that has acquired resistance to multiple antibiotics is Meticillin-resistant Staphylococcus aureus (MRSA).

Resistant bacteria can spread through many routes. When antimicrobial resistance occurs in zoonotic bacteria present in animals and food it can also compromise the effective treatment of infectious diseases in humans.

In the field of food safety, policy-makers need to protect consumers from risks related to the food chain and to establish the best control options to reduce such risks. Scientists and risk assessors are examining the factors which may lead to the presence of antimicrobial resistant bacteria in food and animals to provide appropriate scientific advice to decision-makers.

Interactive infographic: Antimicrobial resistance in Europe
Interactive infographic: How can we reduce the use of antimicrobials in food producing animals?

Bacteria in humans, food and animals continue to show resistance to the most widely used antimicrobials. Scientists warn that resistance to ciprofloxacin, an antimicrobial that is critically important for the treatment of human infections, is very high in Campylobacter, thus reducing the options for effective treatment of severe foodborne infections. Multi-drug resistant Salmonella bacteria continue to spread across Europe. The findings of this latest annual Europe-wide report by EFSA and the European Centre for Disease Prevention and Control (ECDC) underline again that antimicrobial resistance poses a serious risk to human and animal health.

EFSA is working with key EU actors to reduce antimicrobial resistance

In 2001 the European Commission launched an EU strategy to combat the threat of antimicrobial resistance to human, animal and plant health. It included the phasing out of antibiotics for non-medical use in animals, and covered a range of actions at EU and national level in the areas of data collection, surveillance, research and awareness-raising.

EU legislation on animal nutrition banned the use of antibiotics used for growth promotion in animal feed from January 2006.

In 2007, EFSA published specifications for the harmonised monitoring of antimicrobial resistance in two important zoonotic bacteria – Salmonella and Campylobacter – found in animals and foods.

In 2008 EFSA’s Panel on Biological Hazards issued an opinion examining how food may become a vehicle for transmitting antimicrobial resistant bacteria to humans. It made recommendations for preventing and controlling transmission, highlighting good hygiene practices at all stages of the food chain as a critical prevention and control factor. EFSA published further specifications for the harmonised monitoring of antimicrobial resistance in Escherichia coli and enterococci bacteria in animals and foods.

ECDC organised the first annual European Antibiotic Awareness Day (18 November) to raise awareness about the threat to public health of antibiotic resistance and prudent antibiotic use.

In 2009 the Panel on Biological Hazards assessed the public health significance of meticillin-resistant Staphylococcus aureus (MRSA) in animals and foods. It concludes that livestock-associated MRSA represents only a small proportion of all reported MRSA infections in the EU with significant differences between Member States. EFSA also published the results of an EU-wide baseline survey on MRSA in pigs.

In a joint opinion by EFSA, ECDC, EMA and Scientific Committee on Emerging and Newly Identified Health Risks concluded that antimicrobial resistance was increasing worldwide and raised specific concern in human medicine about bacterial resistance to antibiotics used in the treatment of Salmonella and Campylobacter infections – the two most reported zoonotic infections in Europe.

In 2010, EFSA published the first EU Summary Reports on antimicrobial resistance in zoonotic bacteria found in animals and foods covering the years 2004-2008.

As of 2011 EFSA and ECDC have been compiling a joint report on antimicrobial resistance in zoonotic bacteria affecting humans, animals and food. The report makes an important contribution to work being carried out at European level and assists the European Commission as it develops its proposals for action to fight antimicrobial resistance.

In a joint report published in 2015, the three sister agencies EFSA, ECDC and EMA concluded that the use of certain antimicrobials in animals and humans is associated with the occurrence of resistance to these antimicrobials.

EFSA provides independent scientific support and advice to risk managers on the risks to human and animal health related to the possible emergence, spread and transfer of antimicrobial resistance in the food chain and in animal populations. EFSA takes an integrated approach to its work on antimicrobial resistance involving a number of its Scientific Panels and Units as it is a concern for the entire food chain.

In its work, EFSA cooperates closely with other relevant EU agencies such as the European Centre for Disease Prevention and Control (ECDC) and the European Medicines Agency (EMA).


Monitoring and analysis of antimicrobial resistance in the food chain

EFSA monitors and analyses the situation on antimicrobial resistance in food and animals across Europe. The Authority is assisted by the Task Force on Zoonoses Data Collection: a pan-European network of national representatives of EU Member States, other reporting countries, as well as the World Health Organisation (WHO) and World Organisation for Animal Health (OIE).

Based on data collected by the EU Member States, EFSA produces in cooperation with ECDC annual European Union Summary Reports on zoonotic infections, food-borne outbreaks and antimicrobial resistance illustrating the evolving situation in Europe. EFSA also publishes baseline survey reports on the prevalence of antimicrobial resistance in the EU in specific animal populations, for instance MRSA in pigs, and provides guidance to national authorities how to carry out their monitoring and reporting activities.

EFSA’s Scientific Panels review the annual reports and make recommendations on prevention and reduction measures.

Risk assessments and recommendations

EFSA’s Scientific Panels assess the risks of antimicrobial resistance and provides scientific advice on control options at the request of risk managers or on its own initiative. This work has included risk assessments by the Panel on Biological Hazards on antimicrobial resistance in the food and feed chain and the public health significance of MRSA in animals and food focusing on the specific type of MRSA found in food-producing animals. The Panel on additives and products or substances used in animal feed assesses the safety of animal feed additives, including the risks related to antibiotic resistance where micro-organisms are involved.

EFSA, ECDC, EMA and the European Commission’s Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR) have also published a joint scientific opinion on antimicrobial resistance focused on infections that can be transmitted to humans from animals and food (i.e. zoonoses).

To tackle antimicrobial resistance, a holistic, multi-sectorial approach, involving many different sectors (human medicine, veterinary medicine, research, animal husbandry, agriculture, environment, trade and communication) is needed.

The Commission's 2011 action plan against the rising threats from antimicrobial resistance contains 12 actions for implementation with EU member countries and identifies 7 areas where measures are most necessary. A progress report on the AMR Action Plan published in February 2015, shows the state of play of steps taken to address AMR.

A number of risk management measures to combat antimicrobial resistance are in place related to the food chain. EU legislation on zoonoses - animal diseases or infections transmissible between animals and humans - obliges Member States to monitor trends in antimicrobial resistance in zoonoses and other agents that may present a threat to public health.

At international level, countries cooperate through an Intergovernmental Task Force on Antimicrobial Resistance which reports to the Codex Alimentarius Commission. The EU and United States have also created a transatlantic task force on antimicrobial resistance issues.