Monitoring Antimicrobial Resistance and Drug Usage in the Human and Livestock Sector and Foodborne Antimicrobial Resistance in Six European Countries

被引:34
|
作者
Varona, Octavio Mesa [1 ]
Chaintarli, Katerina [2 ]
Muller-Pebody, Berit [3 ]
Anjum, Muna F. [2 ]
Eckmanns, Tim [4 ]
Norstrom, Madelaine [5 ]
Boone, Ides [4 ]
Tenhagen, Bernd-Alois [1 ]
机构
[1] German Fed Inst Risk Assessment BfR, Dept Biol Safety, Berlin, Germany
[2] Anim & Plant Hlth Agcy, Dept Bacteriol, Addlestone, Surrey, England
[3] Publ Hlth England, Healthcare Associated Infect & Antimicrobial Resi, Natl Infect Serv, London, England
[4] Robert Koch Inst, Dept Infect Dis Epidemiol, Berlin, Germany
[5] Norwegian Vet Inst, Dept Anal & Diagnost, Sect Epidemiol, Oslo, Norway
来源
INFECTION AND DRUG RESISTANCE | 2020年 / 13卷
关键词
AMR; AMU; food-producing animals; harmonization; monitoring; surveillance; SURVEILLANCE;
D O I
10.2147/IDR.S237038
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
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.
引用
收藏
页码:957 / 993
页数:37
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