Scientific Opinion on Carbapenem resistance in food animal ecosystems

Abstract

Carbapenems are broad-spectrum β-lactam antimicrobials used for the treatment of serious infections in humans. To date only sporadic studies have reported the occurrence of carbapenemase-producing (CP) bacteria in foodproducing animals and their environment. The bacteria and enzymes isolated include VIM-1 producing Escherichia coli and Salmonella Infantis from pigs and poultry in Germany, OXA-23-producing Acinetobacter spp. from cattle and horses in France and Belgium, and NDM-producing Acinetobacter spp. from pigs and poultry in China. In the German S. Infantis and E. coli isolates, the VIM-1-encoding genes were located on IncHI2 plasmids. A methodology including selective culture is proposed for the detection of CP strains of Enterobacteriaceae and Acinetobacter spp. The choice of selective media for the surveillance of carbapenem resistance for testing animal and food samples needs to be experimentally evaluated and validated. Biochemical and phenotypic tests for the confirmatory identification of CP bacteria are available. For CP bacteria in animals and food, active/passive monitoring and/or targeted surveys should cover key zoonotic agents, animal pathogens and indicator organisms. Priority should be given to broilers, fattening turkeys, fattening pigs, veal calves and meat thereof. Because there are no data on the comparative efficacy of individual control options, prioritisation is complex. Continued prohibition of the use of carbapenems in food-producing animals would be a simple and effective option. As genes encoding carbapenemase production are mostly plasmid-mediated, and co-resistance may be an important issue in the spread of such resistance mechanisms, decreasing the frequency of use of antimicrobials in animal production in the EU in accordance with prudent use guidelines is also of high priority. The effectiveness of any control measures should be monitored by targeted surveys, using selective isolation methods and pre-enrichment of samples. Control measures should be proactively implemented at national and international levels to prevent CP strains become widespread in livestock. SUMMARYThe European Food Safety Authority (EFSA) asked the Panel on Biological Hazards (BIOHAZ) to provide a scientific opinion on the carbapenem resistance in food animal ecosystems. Carbapenems are broad-spectrum beta (β)-lactam antimicrobials mostly used for the treatment of serious infections in humans, frequently in hospitalised patients, and are considered last-line therapy for infections caused by multidrug-resistant Gram-negative bacteria. In particular, the panel was asked: (i) to define the carbapenemase-producing (CP) bacterial strains and genes relevant for public health and linked to food-producing animals or food-borne transmission; (ii) to review the information on the epidemiology of acquired resistance to carbapenems, including the genes coding for such resistance, in food-producing animals and food; (iii) to perform a critical analysis of the methods (phenotypic and genotypic) and the interpr...

Carbapenem-resistant Enterobacteriaceae in wildlife, food-producing, and companion animals: a systematic review

“…This is important when planning prevalence screenings, where culture media must be designed to selectively grow CRE with a high sensitivity and specificity. The data compiled here support recently proposed protocols for CRE in livestock using ertapenem-based selection [94,95]. Alternatives to culture-based screening are molecular tests to detect carbapenemase genes directly in the collected samples.…”

Chromosome-Based bla OXA-48 -Like Variants in Shewanella Species Isolates from Food-Producing Animals, Fish, and the Aquatic Environment

“…(17,23) and are commonly detected in the aquatic environment, where intrinsically resistant bacteria like Shewanella thrive (6). Given the absence of specific phenotypic tests, high-level temocillin resistance (MIC Ͼ64 ml/liter) has been suggested as a first step in identifying OXA-48 producers (9). According to our observations, however, this methodology is likely not applicable to environmental OXA-48 enzymes.…”

“…Carbapenemase-producing microorganisms are increasingly reported in foodproducing animals (2,3), the food supply (4), and the environment (5,6). These findings are fueling a debate on the hazards for public health (7,8), and authorities have rising concerns regarding the appearance of carbapenem resistance in food animal ecosystems (9). The aim of this study is to present the results of the 2013 to 2015 carbapenemase surveillance activities in food-producing animals and environmental freshwater in The Netherlands.…”

Identification, Characterization, and Formulation of a Novel Carbapenemase Intended to Prevent Antibiotic-Mediated Gut Dysbiosis

“…Ribaxamase efficiently degrades beta-lactam antibiotics including penicillins and most cephalosporins [5], but does not inactivate carbapenems. Carbapenems are considered a last resort therapeutic, used sparingly in humans and banned for use in food animals [11]. Such measures are intended to prolong antibiotic utility by reducing emergence of carbapenem resistance.…”