Antimicrobials used to treat diseases such as salmonellosis that can be transmitted between animals and humans are becoming less effective, according to data released on Tuesday by the European Centre for Disease Prevention and Control (ECDC) and the European Food Safety Authority (EFSA).
“The report released (today) should ring – again – alarm bells. It shows that we are entering into a world where more and more common infections become difficult – or even sometimes impossible – to treat. However, ambitious national policies in some countries limiting antimicrobial use have led to a decrease of antimicrobial resistance,” says Vytenis Andriukaitis, EU Commissioner for Health and Food Safety.
The joint report combines data collected from 28 EU member states from humans, pigs and calves under one year of age and confirms the rise in antibiotic resistance already identified in previous years.
“Now is the time to turn the tide on antimicrobial resistance, if we want to keep antibiotics working,” says Mike Catchpole, ECDC’s chief scientist. “It’s particularly worrying when it comes to combined resistance: even low proportions mean that many thousands of patients across the EU have limited treatment options for severe infections.”
A Look at the Data
According to the ECDC/EFSA report, which refers to 2017 data, resistance to fluoroquinolones (such as ciprofloxacin) is so high in Campylobacter bacteria in some countries that these antimicrobials no longer work for the treatment of severe campylobacteriosis cases.
Most countries reported that Salmonella in humans is increasingly resistant to fluoroquinolones. Multidrug resistance (resistance to three or more antimicrobials) is high in Salmonella found in humans (28.3%) and animals, particularly in S.Typhimurium.
In Campylobacter, high to extremely high proportions of bacteria were found to be resistant to ciprofloxacin and tetracyclines. Yet combined resistance to critically important antimicrobials was low to very low in Salmonella and Campylobacter from humans and animals, and in indicator E. coli from animals.
Marta Hugas, EFSA’s chief scientist, says, “We have seen that when member states have implemented stringent policies, antimicrobial resistance has decreased in animals. Annual reporting by European and national agencies includes noteworthy examples. This should serve as an inspiration for other countries.”
A One Health Approach
The European Commission adopted the EU One Health Action Plan against antimicrobial resistance in June 2017. The plan calls for effective action against this threat and recognizes that it needs to be tackled in both human health, animal health and the environment. The prudent use of antimicrobials is essential to limiting the emergence and spread of antibiotic-resistant bacteria in humans and animals.
When it comes to antimicrobial resistance, Heather Fowler, director of producer and public health at the National Pork Board, agrees it’s a One Health issue and we are all in this together.
“We know that use can drive resistance, inappropriate use can drive resistance, and that we use antibiotics in all different sectors – in human health, animal health and the environment,” Fowler says. “It's important to keep an eye on these types of activities and see, learn and grow in a very One Health way.”
U.S. Pork Producers Rise to Challenge
The National Pork Board is working diligently to address the issue of antimicrobial resistance through research, education and promotion, Fowler says.
“Through our Pork Quality Assurance Plus certification program, designed to help producers achieve and maintain good production practices, we’ve been able to reinforce the responsible use of antibiotics,” she adds.
In addition, Pork Checkoff dollars fund research and scientific discovery in the area of antimicrobial use and resistance to get a better handle on how producers use antimicrobials in the swine industry and how we can improve those practices.
“On top of that, we have plenty of safeguards throughout the food chain that we adhere to,” Fowler says. “The FDA has regulatory oversight and they review the approval of all antimicrobials as well as protect the food supply. We also have the USDA actively involved in how we produce pigs here to make sure at the end of the day that we're producing a product that is safe and healthy for consumers.”
Although the EU report does not contain U.S. data, there is still a big takeaway for the United States, Fowler says.
“Antimicrobial resistance is a global issue,” she says. “We must use antibiotics responsibly. This report drives home that antimicrobial resistance is something we should care about. Producers all over the world have a role in curbing resistance.”
Antimicrobial Resistance: Hospitals, Farms Share More Than You Think