Monitoring antimicrobial resistance and drug usage in the human and livestock sector and foodborne antimicrobial resistance in six European countries

Octavio Mesa Varona; Katerina Chaintarli; Berit Muller-Pebody; Muna F. Anjum; Tim Eckmanns; Madelaine Norström; Ides Boone; Bernd Alois Tenhagen

doi:10.2147/IDR.S237038

Monitoring antimicrobial resistance and drug usage in the human and livestock sector and foodborne antimicrobial resistance in six European countries

Octavio Mesa Varona^*, Katerina Chaintarli, Berit Muller-Pebody, Muna F. Anjum, Tim Eckmanns, Madelaine Norström, Ides Boone, Bernd Alois Tenhagen

^*Corresponding author for this work

Healthcare Associated Infections Surveillance General

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Abstract

Introduction: Antimicrobial resistance (AMR), associated with antimicrobial use (AMU), is a major public concern. Surveillance and monitoring systems are essential to assess and control the trends in AMU and AMR. However, differences in the surveillance and monitoring systems between countries and sectors make comparisons challenging. The purpose of this article is to describe all surveillance and monitoring systems for AMU and AMR in the human and livestock sectors, as well as national surveillance and monitoring systems for AMR in food, in six European countries (Spain, Germany, France, the Netherlands, the United Kingdom and Norway) as a baseline for developing suggestions to overcome current limitations in comparing AMU and AMR data.

Methods: A literature search in 2018 was performed to identify relevant peer-reviewed articles and national and European grey reports as well as AMU/AMR databases.

Results: Comparison of AMU and AMR systems across the six countries showed a lack of standardization and harmonization with different AMU data sources (prescription vs sales data) and units of AMU and AMR being used. The AMR data varied by sample type (clinical/non-clinical), laboratory method (disk diffusion, microdilution, and VITEK, among others), data type, ie quantitative (minimum inhibition concentration (MIC) in mg/ L/inhibition zone (IZ) in mm) vs qualitative data (susceptible-intermediate-resistant (SIR)), the standards used (EUCAST/CLSI among others), and/or the evaluation criteria adopted (epidemiological or clinical).

Discussion: A One Health approach for AMU and AMR requires harmonization in various aspects between human, animal and food systems at national and international levels. Additionally, some overlap between systems of AMU and AMR has been encountered. Efforts should be made to improve standardization and harmonization and allow more meaningful analyses of AMR and AMU surveillance data under a One Health approach.

Original language	English
Pages (from-to)	957-993
Number of pages	37
Journal	Infection and Drug Resistance
Volume	13
DOIs	https://doi.org/10.2147/IDR.S237038
Publication status	Published - 3 Apr 2020

Bibliographical note

Funding Information: This work was carried out within the framework of the ARDIG project, the European Joint Programme (EJP) on AMU and AMR in humans, food and animals. ARDIG project has received funding from the European Union’s Horizon 2020 research and innovation programme under Grant Agreement No 773830. We thank Mike Brouwer, Jean-Yves Madec, Philippe Glaser, Ines Noll, Karin Gröschner, Alexandra Hoffmann, Robby Markwart (RKI) for their input and collaboration. The authors declare grants from European Union's Horizon 2020 research and innovation programme during the conduct of the study. The authors report no other possible conflicts of interest in this work.
The authors declare grants from European Union’s Horizon 2020 research and innovation programme during the conduct of the study. The authors report no other possible conflicts of interest in this work.

Open Access: The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).

Publisher Copyright: © 2020 2020 Mesa Varona et al. This work is published and licensed by Dove Medical Press Limited.

Citation: Mesa Varona O, Chaintarli K, Muller-Pebody B, Anjum MF, Eckmanns T, Norström M, Boone I, Tenhagen BA. Monitoring Antimicrobial Resistance and Drug Usage in the Human and Livestock Sector and Foodborne Antimicrobial Resistance in Six European Countries. Infect Drug Resist. 2020;13:957-993

DOI: https://doi.org/10.2147/IDR.S237038

Keywords

AMR
AMU
Food-producing animals
Harmonization
Monitoring
Surveillance

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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MesaVarona2020MonitoringAntimicrobialResistanceAndDrugUsageInfectDrugResistFinal published version, 1.26 MBLicence: CC BY-NC

Cite this

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title = "Monitoring antimicrobial resistance and drug usage in the human and livestock sector and foodborne antimicrobial resistance in six European countries",

abstract = "Introduction: Antimicrobial resistance (AMR), associated with antimicrobial use (AMU), is a major public concern. Surveillance and monitoring systems are essential to assess and control the trends in AMU and AMR. However, differences in the surveillance and monitoring systems between countries and sectors make comparisons challenging. The purpose of this article is to describe all surveillance and monitoring systems for AMU and AMR in the human and livestock sectors, as well as national surveillance and monitoring systems for AMR in food, in six European countries (Spain, Germany, France, the Netherlands, the United Kingdom and Norway) as a baseline for developing suggestions to overcome current limitations in comparing AMU and AMR data. Methods: A literature search in 2018 was performed to identify relevant peer-reviewed articles and national and European grey reports as well as AMU/AMR databases. Results: Comparison of AMU and AMR systems across the six countries showed a lack of standardization and harmonization with different AMU data sources (prescription vs sales data) and units of AMU and AMR being used. The AMR data varied by sample type (clinical/non-clinical), laboratory method (disk diffusion, microdilution, and VITEK, among others), data type, ie quantitative (minimum inhibition concentration (MIC) in mg/ L/inhibition zone (IZ) in mm) vs qualitative data (susceptible-intermediate-resistant (SIR)), the standards used (EUCAST/CLSI among others), and/or the evaluation criteria adopted (epidemiological or clinical). Discussion: A One Health approach for AMU and AMR requires harmonization in various aspects between human, animal and food systems at national and international levels. Additionally, some overlap between systems of AMU and AMR has been encountered. Efforts should be made to improve standardization and harmonization and allow more meaningful analyses of AMR and AMU surveillance data under a One Health approach.",

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author = "Varona, {Octavio Mesa} and Katerina Chaintarli and Berit Muller-Pebody and Anjum, {Muna F.} and Tim Eckmanns and Madelaine Norstr{\"o}m and Ides Boone and Tenhagen, {Bernd Alois}",

note = "Funding Information: This work was carried out within the framework of the ARDIG project, the European Joint Programme (EJP) on AMU and AMR in humans, food and animals. ARDIG project has received funding from the European Union{\textquoteright}s Horizon 2020 research and innovation programme under Grant Agreement No 773830. We thank Mike Brouwer, Jean-Yves Madec, Philippe Glaser, Ines Noll, Karin Gr{\"o}schner, Alexandra Hoffmann, Robby Markwart (RKI) for their input and collaboration. The authors declare grants from European Union's Horizon 2020 research and innovation programme during the conduct of the study. The authors report no other possible conflicts of interest in this work. The authors declare grants from European Union{\textquoteright}s Horizon 2020 research and innovation programme during the conduct of the study. The authors report no other possible conflicts of interest in this work. Open Access: The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). Publisher Copyright: {\textcopyright} 2020 2020 Mesa Varona et al. This work is published and licensed by Dove Medical Press Limited. Citation: Mesa Varona O, Chaintarli K, Muller-Pebody B, Anjum MF, Eckmanns T, Norstr{\"o}m M, Boone I, Tenhagen BA. Monitoring Antimicrobial Resistance and Drug Usage in the Human and Livestock Sector and Foodborne Antimicrobial Resistance in Six European Countries. Infect Drug Resist. 2020;13:957-993 DOI: https://doi.org/10.2147/IDR.S237038",

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T1 - Monitoring antimicrobial resistance and drug usage in the human and livestock sector and foodborne antimicrobial resistance in six European countries

AU - Varona, Octavio Mesa

AU - Chaintarli, Katerina

AU - Muller-Pebody, Berit

AU - Anjum, Muna F.

AU - Eckmanns, Tim

AU - Norström, Madelaine

AU - Boone, Ides

AU - Tenhagen, Bernd Alois

N1 - Funding Information: This work was carried out within the framework of the ARDIG project, the European Joint Programme (EJP) on AMU and AMR in humans, food and animals. ARDIG project has received funding from the European Union’s Horizon 2020 research and innovation programme under Grant Agreement No 773830. We thank Mike Brouwer, Jean-Yves Madec, Philippe Glaser, Ines Noll, Karin Gröschner, Alexandra Hoffmann, Robby Markwart (RKI) for their input and collaboration. The authors declare grants from European Union's Horizon 2020 research and innovation programme during the conduct of the study. The authors report no other possible conflicts of interest in this work. The authors declare grants from European Union’s Horizon 2020 research and innovation programme during the conduct of the study. The authors report no other possible conflicts of interest in this work. Open Access: The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). Publisher Copyright: © 2020 2020 Mesa Varona et al. This work is published and licensed by Dove Medical Press Limited. Citation: Mesa Varona O, Chaintarli K, Muller-Pebody B, Anjum MF, Eckmanns T, Norström M, Boone I, Tenhagen BA. Monitoring Antimicrobial Resistance and Drug Usage in the Human and Livestock Sector and Foodborne Antimicrobial Resistance in Six European Countries. Infect Drug Resist. 2020;13:957-993 DOI: https://doi.org/10.2147/IDR.S237038

PY - 2020/4/3

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N2 - Introduction: Antimicrobial resistance (AMR), associated with antimicrobial use (AMU), is a major public concern. Surveillance and monitoring systems are essential to assess and control the trends in AMU and AMR. However, differences in the surveillance and monitoring systems between countries and sectors make comparisons challenging. The purpose of this article is to describe all surveillance and monitoring systems for AMU and AMR in the human and livestock sectors, as well as national surveillance and monitoring systems for AMR in food, in six European countries (Spain, Germany, France, the Netherlands, the United Kingdom and Norway) as a baseline for developing suggestions to overcome current limitations in comparing AMU and AMR data. Methods: A literature search in 2018 was performed to identify relevant peer-reviewed articles and national and European grey reports as well as AMU/AMR databases. Results: Comparison of AMU and AMR systems across the six countries showed a lack of standardization and harmonization with different AMU data sources (prescription vs sales data) and units of AMU and AMR being used. The AMR data varied by sample type (clinical/non-clinical), laboratory method (disk diffusion, microdilution, and VITEK, among others), data type, ie quantitative (minimum inhibition concentration (MIC) in mg/ L/inhibition zone (IZ) in mm) vs qualitative data (susceptible-intermediate-resistant (SIR)), the standards used (EUCAST/CLSI among others), and/or the evaluation criteria adopted (epidemiological or clinical). Discussion: A One Health approach for AMU and AMR requires harmonization in various aspects between human, animal and food systems at national and international levels. Additionally, some overlap between systems of AMU and AMR has been encountered. Efforts should be made to improve standardization and harmonization and allow more meaningful analyses of AMR and AMU surveillance data under a One Health approach.

AB - Introduction: Antimicrobial resistance (AMR), associated with antimicrobial use (AMU), is a major public concern. Surveillance and monitoring systems are essential to assess and control the trends in AMU and AMR. However, differences in the surveillance and monitoring systems between countries and sectors make comparisons challenging. The purpose of this article is to describe all surveillance and monitoring systems for AMU and AMR in the human and livestock sectors, as well as national surveillance and monitoring systems for AMR in food, in six European countries (Spain, Germany, France, the Netherlands, the United Kingdom and Norway) as a baseline for developing suggestions to overcome current limitations in comparing AMU and AMR data. Methods: A literature search in 2018 was performed to identify relevant peer-reviewed articles and national and European grey reports as well as AMU/AMR databases. Results: Comparison of AMU and AMR systems across the six countries showed a lack of standardization and harmonization with different AMU data sources (prescription vs sales data) and units of AMU and AMR being used. The AMR data varied by sample type (clinical/non-clinical), laboratory method (disk diffusion, microdilution, and VITEK, among others), data type, ie quantitative (minimum inhibition concentration (MIC) in mg/ L/inhibition zone (IZ) in mm) vs qualitative data (susceptible-intermediate-resistant (SIR)), the standards used (EUCAST/CLSI among others), and/or the evaluation criteria adopted (epidemiological or clinical). Discussion: A One Health approach for AMU and AMR requires harmonization in various aspects between human, animal and food systems at national and international levels. Additionally, some overlap between systems of AMU and AMR has been encountered. Efforts should be made to improve standardization and harmonization and allow more meaningful analyses of AMR and AMU surveillance data under a One Health approach.

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VL - 13

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JO - Infection and Drug Resistance

JF - Infection and Drug Resistance

ER -

Monitoring antimicrobial resistance and drug usage in the human and livestock sector and foodborne antimicrobial resistance in six European countries

Abstract

Bibliographical note

Keywords

UN SDGs

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