The use of aminopenicillins in animals within the EU, emergence of resistance in bacteria of animal and human origin and its possible impact on animal and human health

Author:

van Duijkeren Engeline1,Rantala Merja2,Bouchard Damien3,Busani Luca4ORCID,Catry Boudewijn56,Kaspar Heike7,Pomba Constança8ORCID,Moreno Miguel A9,Nilsson Oskar10,Ružauskas Modestas11,Sanders Pascal12ORCID,Teale Christopher13,Wester Astrid L14,Ignate Kristine15,Jukes Helen15,Kunsagi Zoltan15,Schwarz Christine716

Affiliation:

1. Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven , Utrecht , The Netherlands

2. Faculty of Veterinary Medicine, University of Helsinki , Helsinki , Finland

3. French Agency for Food, Environmental, and Occupational Health and Safety, National Agency for Veterinary Medicinal Products , Fougères , France

4. Instituto Superiore di Sanita, Center for Gender-Specific Medicine , Rome , Italy

5. Sciensano, Department of Epidemiology and Public Health , Brussels , Belgium

6. Faculty of Medicine, Université Libre de Bruxelles , Brussels , Belgium

7. Federal Office of Consumer Protection and Food Safety, Department Method Standardisation, Reference Laboratories, Resistance to Antibiotics , Berlin , Germany

8. Faculty of Veterinary Medicine, University of Lisbon , Lisbon , Portugal

9. Faculty of Veterinary Medicine, Complutense University , Madrid , Spain

10. National Veterinary Institute, SVA, Department of Animal Health and Antimicrobial Strategies , Uppsala , Sweden

11. Faculty of Veterinary Medicine, Lithuanian University of Health Sciences , Kaunas , Lithuania

12. French Agency for Food, Environmental, and Occupational Health and Safety, Strategy and Programme Department , Maisons-Alfort , France

13. Animal and Plant Health Agency , Weybridge , UK

14. Norwegian Institute of Public Health , Oslo , Norway

15. European Medicines Agency , Amsterdam , The Netherlands

16. Federal Office of Consumer Protection and Food Safety, Veterinary Drugs , Berlin , Germany

Abstract

Abstract Aminopenicillins have been widely used for decades for the treatment of various infections in animals and humans in European countries. Following this extensive use, acquired resistance has emerged among human and animal pathogens and commensal bacteria. Aminopenicillins are important first-line treatment options in both humans and animals, but are also among limited therapies for infections with enterococci and Listeria spp. in humans in some settings. Therefore, there is a need to assess the impact of the use of these antimicrobials in animals on public and animal health. The most important mechanisms of resistance to aminopenicillins are the β-lactamase enzymes. Similar resistance genes have been detected in bacteria of human and animal origin, and molecular studies suggest that transmission of resistant bacteria or resistance genes occurs between animals and humans. Due to the complexity of epidemiology and the near ubiquity of many aminopenicillin resistance determinants, the direction of transfer is difficult to ascertain, except for major zoonotic pathogens. It is therefore challenging to estimate to what extent the use of aminopenicillins in animals could create negative health consequences to humans at the population level. Based on the extent of use of aminopenicillins in humans, it seems probable that the major resistance selection pressure in human pathogens in European countries is due to human consumption. It is evident that veterinary use of these antimicrobials increases the selection pressure towards resistance in animals and loss of efficacy will at minimum jeopardize animal health and welfare.

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Pharmacology (medical),Pharmacology,Microbiology (medical)

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