Antimicrobial resistance (AMR) is a pressing public health issue in Europe, particularly when it comes to common foodborne bacteria like Salmonella and Campylobacter. A recent report from the European Food Safety Authority (EFSA) and the European Centre for Disease Prevention and Control (ECDC) highlights the ongoing concern.
While some countries have made progress in reducing resistance levels in humans and food-producing animals, the problem persists. These bacteria can spread from animals and food to humans, leading to severe infections that may require antimicrobial treatment. This is where the One Health approach comes into play, recognizing the interconnectedness of human, animal, and environmental health.
The Resistance Remains High
A significant proportion of Campylobacter and Salmonella, whether from humans or food-producing animals, continue to show resistance to ciprofloxacin, a crucial antimicrobial for treating severe human infections. Resistance in Salmonella from food-producing animals has been consistently high, but what's more concerning is the recent increase in resistance in human Salmonella infections.
This trend is alarming because resistance to ciprofloxacin limits our treatment options. In fact, ciprofloxacin is no longer recommended for treating human Campylobacter infections due to widespread resistance in Europe. To preserve its effectiveness in human medicine, its use in animals has been restricted.
Furthermore, a high proportion of Salmonella and Campylobacter from humans and targeted food-producing animals also demonstrate resistance to commonly used antimicrobials like ampicillin, tetracyclines, and sulfonamides.
A Cause for Concern: Carbapenem-Resistant E. coli
The detection of carbapenemase-producing E. coli in food-producing animals and meat in several countries is a red flag. Carbapenems are last-resort antimicrobials for humans and are not authorized for use in food-producing animals. The increasing number of reported detections warrants further investigation into the sources.
Encouraging Signs Amidst Ongoing Concerns
Despite the high resistance levels, there are positive developments. Several countries have reported declining resistance to specific antimicrobials over time, proving that targeted efforts can yield results. For instance, resistance in Salmonella bacteria from humans to ampicillin and tetracyclines has significantly decreased over the past ten years in 19 and 14 countries, respectively. Similar positive trends were observed in food-producing animals at the EU level, with decreasing resistance to tetracyclines in broilers and to ampicillin and tetracyclines in turkeys.
In Campylobacter, resistance to erythromycin, a first-line treatment for human infections, has declined in several countries over the past decade, both in humans and some food-producing animals. Additionally, combined resistance to critically important antimicrobials remains generally low in Salmonella, Campylobacter, and E. coli.
However, some areas have seen a slowdown in improvements, particularly in E. coli, where resistance levels to certain substances in poultry have stabilized rather than continued to decline. Nevertheless, some countries have successfully reduced antimicrobial resistance in food-producing animals, contributing to an overall improvement at the EU level.
The Importance of Continued Action
Antimicrobial resistance is a universal concern. When bacteria become resistant, infections become harder to treat, and our treatment options become limited. Resistance patterns vary widely between countries, bacteria, and antimicrobials, reflecting differences in antimicrobial use, farming practices, animal health measures, and infection prevention strategies.
These findings underscore the importance of a One Health approach, recognizing the close links between human health, animal health, and food production. While progress has been made in certain areas, continued and responsible use of antimicrobials across all sectors, combined with effective infection prevention, animal health, and food safety practices, is essential to slow the emergence and spread of antimicrobial-resistant bacteria and protect public health across Europe.
So, while there are encouraging signs, the battle against antimicrobial resistance is far from over. It's a complex issue that requires a multifaceted approach, and we need to stay vigilant and proactive to protect public health.
