Some recent AMR news (third JIACRA report, antibiotic use by UK pig farmers, GLASS report and more)
In the last month or so we had some exciting news on AMR which are worth reporting.
First of all, at the end of June 2021 we saw the publication of the third JIACRA report, the result of a flagship One Health cooperation between EFSA, ECDC and EMA (JIACRA clearly stands for joint inter-agency report on integrated analysis of consumption of antimicrobial agents and occurrence of antimicrobial resistance in bacteria from humans and food-producing animals in the EU/EEA). For those not familiar, the JIACRA reports analyse the possible relationships between antimicrobial consumption (AMC) and the occurrence of antimicrobial resistance (AMR) both in human and in food producing animals. This is the third of such reports, considering data from 2016-18.
Expectedly, the report found differences between countries, however there are reasons to be satisfied with the way the EU is dealing with AMR, especially in the animal sector. A general “significant fall in antibiotic use in food-producing animals” has been observed. In particular the use of polymyxins, which includes colistin, “nearly halved between 2016 and 2018 in food-producing animals”. And colistin is a “critically important antimicrobial” according to the WHO classification.
But probably the main, pretty exciting message of the third report is that “This is the first time that the EU/EEA population-weighted average AMC in humans overall exceeds AMC in food-producing animals when measured in mg/kg biomass”.
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| Credit: third JIACRA report. DOI: https://doi.org/10.2903/j.efsa.2021.6712 |
My favourite part of the JIACRA reports is always the association between AMC in animals, and the occurrence of AMR in humans.
“The report also identifies links between antimicrobial consumption in animals and AMR in bacteria from food-producing animals, which in turn is associated with AMR in bacteria from humans. An example of this is Campylobacter spp. bacteria, which are found in food producing animals and cause foodborne infections in humans. Experts found an association between resistance in these bacteria in animals and resistance in the same bacteria in humans.”
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| Credit: third JIACRA report. DOI: https://doi.org/10.2903/j.efsa.2021.6712 |
In parallel to the JIACRA report, we saw another couple of interesting EFSA publications concerning AMR: one deals with AMR from dogs and cats, the other with environment and AMR. Let us take a closer look at the latter. The report is authored by EFSA Panel on Biological Hazards (BIOHAZ) and it assesses the role played by the environment in the emergence and spread of AMR through the foodchain (so it considers just AMR from the environment to food producing systems). The report found that “Fertilisers of faecal origin, irrigation, and water are the most significant sources of antimicrobial resistance (AMR) in plant-based food and/or aquaculture. In terrestrial animal production, potential sources are feed, humans, water, air or dust, soil, wildlife, rodents, arthropods, and equipment”. Very interesting report that hints to the recently renewed EU interest in the environmental side of One Health.
Now let us slowly zoom out of the EU, remaining in Europe. In the UK, the situation of AMR in food producing animals is a bit less clear when compared to the picture in the EU given by the JIACRA report (at least if one considers just the recent news). On the one hand the UK Agriculture and Horticulture Development Board (AHDB, a levy board) shows that antibiotic use by UK pig farmers declined in 2020, on the other hand investigative journalism articles report that the use of aminoglycosides more than doubled in UK pig farms between 2015 and 2019. Aminoglycosides include gentamicin, and are a “critically important” class of antibiotic according to the WHO classification.
To tackle AMR, the UK launched the GW4 Alliance, an alliance of top-UK universities (University of Bath, the University of Bristol, Cardiff University and the University of Exeter) thought to “become the UK’s leading ‘One Health’ research consortium”.
Now let us keep zooming out of Europe, and consider the recent AMR updates at the global level. The WHO published its 2021 GLASS report (the data is from 2019), covering AMC and AMR in humans. It found major difference between high income and low and middle income countries: “the data suggest troubling [AMR] trends, particularly in low- and middle-income countries (LMICs)”. In addition the report points out that despite some “improvement in AMR surveillance systems in many countries, better and more representative AMR data are needed” to have a better understanding of the real global status of AMR, and how it affects human health.
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| Countries enrolled in GLASS 2021. Credit: https://www.who.int/data/gho/data/themes/topics/global-antimicrobial-resistance-surveillance-system-glass |
Also aiming at tackling AMR, G7 leaders signed a Declaration to strengthen Global Health Security. The Declaration understandably focuses on the COVID-19 crisis, but it also acknowledges the One Health approach (see point 9), highlighting the role of the environmental sector, and the primary importance of considering AMR. Should the good intentions declared by G7 and G20 leaders (see my article of last month) be put into practice, we would live in a golden era of Global Health cooperation. Will the intents be followed by concrete actions?