Food Protection Trends - January/February 2018 - 73

in zoonotic and commensal bacteria in food-producing
animals and food thereof is useful for assessing the occurrence and better understanding the distribution and
evolution of antimicrobial-resistant bacteria as well as the
contribution of those sources to AMR in humans. It also
provides relevant risk assessment data and the opportunity
to evaluate the effect of targeted interventions, in particular
when combined with data on antimicrobial consumption
(AMC). It also allows identification of emerging patterns of
resistance in food-producing animals and food.
At the EU level, EFSA is responsible for collecting and
analyzing data on AMR gathered by the EU Member
States on the occurrence of antimicrobial-resistant
bacteria in food-producing animals and derived food. It is
assisted by EFSA's network on zoonoses data collection,
a pan-European network of national representatives of
EU Member States, European Free Trade Association
(EFTA) countries, and EU candidate and potential
candidate countries. On a yearly basis, EFSA produces,
in close collaboration with ECDC, the EU Summary
Report on AMR (EUSR-AMR), which includes data on
the occurrence of AMR and multidrug resistance (MDR)
in zoonotic and indicator bacteria from food-producing
animals and food, as well as in Salmonella spp. and
Campylobacter spp. isolates from human cases of foodborne
infections. The first EUSR-AMR report covered years
2004-2007 (15), while the last one available covers human
and animal/food data in 2015 (6).
EFSA also published baseline survey reports on
the prevalence of antimicrobial-resistant bacteria in
the EU in specific animal populations, such as MRSA
in breeding pigs (12, 14), and has regularly provided
guidance to national authorities on how to carry out
AMR monitoring and reporting activities (16, 17, 18, 19,
21). Scientific advice from EFSA (17, 18) was the basis
of the reviewed legislation on harmonized monitoring
of AMR in food-producing animals and food thereof
(Commission Implementing Decision 2013/652/EU).
The new legislation established a list of combinations of
bacterial species, panels of antimicrobial substances, foodproducing animal populations and food products subject
to AMR monitoring by EU Member States. Following the
publication of the new legislation on AMR monitoring,
EFSA developed detailed technical specifications on
randomized sampling for harmonized monitoring of AMR
in zoonotic and commensal bacteria (19), to give guidance
to Member States and ensure that representative sampling
is carried out. The new legislation set up priorities for the
monitoring of AMR from a public health perspective, while
improving the comparability and reliability of the AMR
data collected.
Following the implementation of the Decision as of January 2014, monitoring of AMR in E. coli became mandatory,
as it is for Salmonella spp. and Campylobacter jejuni in the

major food-producing animal populations and meat thereof,
with a biennial schedule (broilers, laying hens and fattening
turkeys on even years, and fattening pigs and bovines under
one year of age on uneven years). Specific monitoring of extended-spectrum beta-lactamase (ESBL), AmpC beta-lactamase (AmpC) and carbapenemase-producing Salmonella
spp. and indicator commensal E. coli was also introduced.
Data on the prevalence, genetic diversity and resistance
of MRSA are provided to EFSA on a voluntary basis. The
collection and reporting of data are to be performed at the
isolate level, to allow more in-depth analyses to be conducted, in particular on the occurrence of MDR. Microdilution
methods for testing shall be used and results should be
interpreted by the application of the European Committee on Antimicrobial Susceptibility testing (EUCAST)
epidemiological cut-off (ECOFF) values for the interpretation of "microbiological resistance." ECOFFs are
preferred for surveillance since they permit the identification of small changes in bacterial susceptibility, which
may indicate emerging resistance and allow appropriate
control measures to be considered at an early stage. The
concentration ranges used in the testing ensure that
both the ECOFF and the clinical breakpoints (CBP) are
included, making comparability of results with human
data possible.
Since the implementation of the new monitoring
prescribed by Decision 2013/652/EU, two EUSR-AMR
have been published: data on AMR in bacteria from
broilers, fattening turkeys and meat thereof were collected
by Member States in 2014 (5), while similar data from
fattening pigs and bovines younger than one year of age
were collected in 2015 (6).
Results from the monitoring indicate that resistance to
commonly used antimicrobials in food-producing animals
are usually high (20-50%), very high (50-70%) or extremely high (more than 70%) in most Member States. For
example, in Salmonella spp. and indicator E. coli isolates
from most animal species and meat thereof, resistance to
ampicillin, tetracyclines and sulfonamides was frequently
detected. In addition, resistance to fluoroquinolones, which
according to the World Health Organization (WHO)
are critically important antimicrobials (CIAs) in human
medicine (33), was also high or extremely high in Salmonella spp., E. coli and Campylobacter spp. isolated from
most animal species, especially in poultry (Table 1). More
reassuring findings concern the level of resistance to other
CIAs tested (macrolides, 3rd- and 4th-generation cephalosporins), which was generally low (1-10%) in all bacterial
species and animal species, with few exceptions, especially
for resistance to macrolides in pigs and sometimes in broilers. Interestingly, very low (0.1-1%) levels of co-resistance
to different CIAs were detected, indicating that treatment
options would remain available to treat possible invasive
infections originating from those strains, again with some

January/February Food Protection Trends

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