Managing the transmission of antimicrobial-resistant bacteria

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Lorna Malkin, Junior Editor of HEQ, speaks to the European Food Safety Authority to find out how antimicrobial resistance is being monitored and controlled in the food industry

Food safety standards are in place to help prevent foodborne infections that can result from the misuse of antimicrobials and the spreading of antimicrobial-resistant bacteria within the food chain. Following hygiene guidelines, storing, and cooking food correctly are some of the ways AMR microbes in food can be reduced. Lorna Malkin, Junior Editor of HEQ, speaks to the European Food Safety Authority (EFSA) to find out how antimicrobial resistance is being monitored and controlled in the food industry.

Food safety is a key component in helping to prevent the spread of antimicrobial-resistant organisms. Considering antimicrobial resistance (AMR) is responsible for approximately 1.5 million deaths worldwide each year, how common is the spread of AMR organisms via food and are there any societal groups who are particularly affected?

Antimicrobial resistance is the ability of microorganisms, such as bacteria, to become increasingly resistant to an antimicrobial to which they were previously susceptible, which, in the case of bacteria can cause disease and lead to therapy failure in humans or animals, resulting in increased severity of disease and mortality.

The abuse or inappropriate use of antimicrobials in both humans and animals can cause bacteria to become resistant to antimicrobials.

Antimicrobial-resistant bacteria can be transmitted to humans through many different routes. These include transmission from other humans, or from animals to humans, through direct contact, as well as other routes, such as via food, water, or environmental contamination. Therefore, food is one potential route of transmission of antimicrobial-resistant bacteria, whose importance compared to other sources is very difficult to estimate.

Good hygiene practices in food production, preparation and consumption are equally important for reducing the exposure to and possible infection of both resistant and non-resistant bacteria. Similarly to all other food-borne infections with non-resistant bacteria, societal groups such as pregnant women, the elderly and immunocompromised individuals are more at risk of acquiring infections with resistant bacteria.

How easy is it to monitor the spread of AMR in food and what frameworks or practices are currently in place to help manage this?

The monitoring of AMR is essential in order to gain comprehensive and reliable information on the development and spread of resistant bacteria. It is also important in gaining an understanding of the evolution of resistance over the years, in different countries, and to identify as soon as possible emerging or specific resistance patterns. AMR data provide insights to inform decision-making and facilitate the development of appropriate strategies and actions to fight against AMR at the EU level. The monitoring of AMR is mandatory when looking at salmonella, campylobacter and E. coli in the major, domestically produced animals, and their derived meat. In addition, the data can be compared with similar data originating from humans, allowing further analysis on the possible associations between antimicrobial consumption and resistance occurrence in food produced by animals and humans.

What are the main challenges in monitoring food safety at a national level?

To respond effectively to the constantly evolving threat of AMR, further enhancements and specific adaptations of the monitoring schemes are required on a regular basis. The new AMR monitoring rules are based on the latest EFSA scientific reports and on the field experience acquired by Member States since 2014. They address known implementation issues while scientifically responding to the evolving threat of AMR and ensuring continuity in assessing future trends in AMR after 2020. As AMR is a global threat that can easily spread across borders, it is important to improve coordination across countries and gain knowledge to help reduce the impact of AMR globally. Therefore, the new rules also lay down harmonised AMR monitoring requirements for certain fresh meat imported into the European Union. A particular challenge is the collection of samples from food-producing animals in a harmonised way across the different European countries. For this purpose, the Commission Implementing Decision 2020/1729 of 17 November 2020 lays down specific technical requirements, for the period of 2021 to 2027, for AMR testing of representative isolates deriving from food-producing animals performed at farm and/or at slaughter and derived meat performed at retail and at border control posts.

What are some of the main goals and objectives over the next 12 months in relation to AMR and how will this be regulated?

The EU action plan against AMR (2017), which addresses AMR in both humans and animals with a One Health approach, is motivated by the need for the EU to play a leading role in the fight against AMR and to add value to Member States’ actions. Its overarching goal is to preserve the possibility of effective treatment of infections in humans and animals. It provides a framework for continued, more extensive action to reduce the emergence and spread of AMR and to increase the development and availability of new effective antimicrobials inside and outside the EU. The new plan contains concrete actions that the Commission will develop and strengthen as appropriate in the coming years. All these actions are interdependent and need to be implemented in harmony in order to achieve the best outcome.

The EFSA is currently working on different topics related to AMR, in close collaboration with other European agencies. These include the analysis of AMR data monitoring, which is collected by all EU Member States, and the analysis of the association between consumption of antimicrobials and antimicrobial resistance occurrence in both food-producing animals and humans. In addition, EFSA’s Panel on Biological Hazards (BIOHAZ) is finalising a scientific opinion related to the role of the environment on the emergence and spread of AMR and is assessing the impact of residues of antimicrobials in feed in the development of resistant bacteria in food-producing animals.

How has the COVID-19 pandemic affected the management of AMR infections?

In the current situation, countries’ priorities have rightly shifted to the fight against COVID-19, and we are observing an increase in competition for resources. Moreover, the new SARS-CoV-2 virus appears to be exacerbating the problem of AMR through the heavy use of antibiotics in COVID-19 patient treatment. A side effect of COVID-19 may be due to the transmission of AMR beyond medical infrastructures. One example is the release of increased levels of antimicrobials and disinfectants in wastewater from hospital systems that will affect levels of antimicrobial residues in the environment. This may in turn impact the level of resistance in nature, farming systems and in animals. We need to keep our attention high on AMR and ensure it remains a priority for governments.

European Food Safety Authority
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This article is from issue 17 of Health Europa. Click here to get your free subscription today.


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