ECDC/EFSA/EMA second joint report on the integrated analysis of the consumption of antimicrobial agents and occurrence of antimicrobial resistance in bacteria from humans and food-producing animals
The second ECDC/EFSA/EMA joint report on the integrated analysis of antimicrobial consumption (AMC) and antimicrobial resistance (AMR) in bacteria from humans and food-producing animals addressed data obtained by the Agencies’ EU-wide surveillance networks for 2013–2015.
Antimicrobial consumption (AMC) in both sectors, expressed in mg/kg of estimated biomass, were compared at country and European level. Substantial variations between countries were observed in both sectors.
Estimated data on AMC for pigs and poultry were used for the ﬁrst time. Univariate and multivariate analyses were applied to study associations between AMC and AMR. In 2014, the average AMC was higher in animals (152 mg/kg) than in humans (124 mg/kg), but the opposite applied to the median AMC (67 and 118 mg/kg, respectively).
In 18 of 28 countries, AMC was lower in animals than in humans. Univariate analysis showed statistically-signiﬁcant (p < 0.05) associations between AMC and AMR for ﬂuoroquinolones and Escherichia coli in both sectors, for 3rd- and 4th-generation cephalosporins and E. coli in humans, and tetracyclines and polymyxins and E. coli in animals.
In humans, there was a statistically-signiﬁcant association between AMC and AMR for carbapenems and polymyxins in Klebsiella pneumoniae. Consumption of macrolides in animals was signiﬁcantly associated with macrolide resistance in Campylobacter coli in animals and humans. Multivariate analyses provided a unique approach to assess the contributions of AMC in humans and animals and AMR in bacteria from animals to AMR in bacteria from humans. Multivariate analyses demonstrated that 3rd- and 4th-generation cephalosporin and ﬂuoroquinolone resistance in E. coli from humans was associated with corresponding AMC in humans, whereas resistance to ﬂuoroquinolones in Salmonella spp. and Campylobacter spp. from humans was related to consumption of ﬂuoroquinolones in animals.
These results suggest that from a ‘One-health’ perspective, there is potential in both sectors to further develop prudent use of antimicrobials and thereby reduce AMR.
© 2017 European Centre for Disease Prevention and Control, © European Food Safety Authority and © European Medicines Agency. EFSA Journal published by John Wiley and Sons Ltd on behalf of European Food Safety Authority.