Een risicoprofiel voor MRSA en ESBL

Het Centraal Veterinair Instituut (CVI) van Wageningen UR, onderzoekt de ontwikkeling van de antibioticaresistente MRSA-bacterie en ESBL-vormende bacteriën en de gevaren voor de volksgezondheid. Want de resistentie bacteriën kunnen zich op vele manieren verspreiden

Reduction of antibiotic use and antibiotic resistance in commercial poultry

Use of antibiotics for companion animals and livestock in the Netherlands has reduced by more than 60% over the last 10 years (SDa 2019; MARAN-2019). This reduction is the result of a change in policy towards the use of antibiotics in veterinary practice and is characterized by a series of coherent political decisions which changed the playing field for farmers and veterinarians considerably. In the years before 2009 the Netherlands was a high consumer of antibiotics in veterinary practice (Grave et al., 2010). The ban of antimicrobial growth promoters (AGPs) did not result in a reduction in total use since in the Netherlands the AGPs were fully replaced by antibiotics licensed for therapy. The total sales of all antibiotics remained stable at around 600 tons from 2000 to 2009.This use pattern resulted in high levels of antimicrobial resistance in bacteria from livestock and food thereof and high prevalence of Livestock Associated MRSA and ESBL-producing E. coli and Salmonella (MARAN, 2019; RIVM, 2009). Specifically, ESBL-producing isolates in the food chain were considered a risk for public health and their high prevalences, predominantly but not solely in poultry and poultry meat products were the direct reason to initiate the change in policy towards antibiotic use in animals.In this manuscript the trends in antibiotic use in poultry will be explored in the context of total use in livestock and its effect on the occurrence and trends in ESBL-producers and antimicrobial resistance in other bacterial species from poultry

Inaccuracy of routine susceptibility tests for detection of erythromycin resistance of Campylobacter jejuni and Campylobacter coli

In The Netherlands, both an increase in and regional differences in erythromycin resistance of Campylobacter jejuni and Campylobacter coli have been reported. To determine the accuracy of routine tests for erythromycin resistance, 48 erythromycin-resistant isolates from various laboratories that participate in the Dutch surveillance of Campylobacter infections were reinvestigated. Initial susceptibility testing for erythromycin had been performed by disk diffusion in six and MIC-based methods in two laboratories. Reinvestigation was carried out using broth microdilution as a reference standard, as well as E-test and genetic resistance testing. Of 36 C. jejuni isolates reported by the initial laboratories as erythromycin-resistant, four (11%) and five (14%) were confirmed as erythromycin-resistant using broth microdilution according to CLSI and EUCAST resistance criteria, respectively. Erythromycin resistance was found in eight of 12 (67%) C. coli isolates according to both criteria. Results of E-tests were in accordance with these results in all isolates. Resistance-associated mutations in the 23S rRNA gene (A2059G and A2058T) were found in all isolates showing high-level resistance, whereas none were found in susceptible isolates. Routine determination of the erythromycin resistance of C. jejuni and C. coli shows unacceptable interlaboratory variation. In the absence of standardized protocols and interpretive criteria for disk diffusion, and while we await the development of easily applicable and reliable methods for molecular resistance testing, the use of broth microdilution remains the best method

Antibioticagebruik en veehouderij: ESBL en MRSA in dieren en de genomen controlemaatregelen

Het antibioticagebruik in Nederlandse veehouderij is hoog, zeker in vergelijking met de humane sector. Daardoor zijn ook de resistentieniveaus in dieren in de veehouderij hoog. De bezorgdheid over de gevolgen hiervan voor de volksgezondheid heeft geleid tot een aantal maatregelen, waaronder de reductiedoelstellingen in antibioticumgebruik (20% in 2011 en 50% in 2013). Het streefcijfer voor 2011 is bereikt, maar voor het oplossen van de huidige en toekomstige bedreigingen door multiresistente organismen in (voedselproducerende) dieren voor de volksgezondheid is een aanzienlijke verdere afname in gebruik noodzakelijk en op de langere termijn een verandering in de dierlijke productiesystemen

Registratie en monitoring van antibioticumgebruik in dieren

Gebruik antibiotica bij dieren kan zowel bij mens als dier resistentie veroorzaken. Alhoewel er regels zijn voor het gebruik van antibiotica, stijgt het antibioticagebruik toch. Dit onderzoek poogt inzicht te geven in de redenen van het antibioticagebrui

Reduction of antibiotic use in animals "let's go Dutch".

Use of antibiotics for animals in the Netherlands has reduced considerably over the last 5 years. This reduction is the result of a change in policy towards the use of antibiotics in veterinary practice and is characterized by a series of coherent political decisions which changed the playing field for farmers and veterinarians considerably. In the years before the reducing trend in use of antibiotics started off, the Netherlands was a relative high consumer of antibiotics in veterinary practice. The trends in antibiotic use will be explored in this paper, in particular focussing on the reducing trends in recent years, and the measures which led to the strong reducing trend which can be observed over a period of more than 3 years now

Multiresistant Salmonella enterica serovar 4,[5],12:i:- in Europe: a new pandemic strain?

A marked increase in the prevalence of S. enterica serovar 4,[5],12:i:- with resistance to ampicillin, streptomycin, sulphonamides and tetracyclines (R-type ASSuT) has been noted in food-borne infections and in pigs/pig meat in several European countries in the last ten years. One hundred and sixteen strains of S. enterica serovar 4,[5],12:i:- from humans, pigs and pig meat isolated in England and Wales, France, Germany, Italy, Poland, Spain and the Netherlands were further subtyped by phage typing, pulsed-field gel electrophoresis and multilocus variable number tandem repeat analysis to investigate the genetic relationship among strains. PCR was performed to identify the fljB flagellar gene and the genes encoding resistance to ampicillin, streptomycin, sulphonamides and tetracyclines. Class 1 and 2 integrase genes were also sought. Results indicate that genetically related serovar 4,[5],12:i:- strains of definitive phage types DT193 and DT120 with ampicillin, streptomycin, sulphonamide and tetracycline resistance encoded by blaTEM, strA-strB, sul2 and tet(B) have emerged in several European countries, with pigs the likely reservoir of infection. Control measures are urgently needed to reduce spread of infection to humans via the food chain and thereby prevent the possible pandemic spread of serovar 4,[5],12:i:- of R-type ASSuT as occurred with S. Typhimurium DT104 during the 1990s

Veel soorten antibiotica in mest gevonden

Het Rikilt vindt met nieuwe methode veel antibioticasoorten in dierlijke mest. Het gevaar voor de volksgezondheid is nog onbekend

Quantifying antimicrobial resistance at veal calf farms

This study was performed to determine a sampling strategy to quantify the prevalence of antimicrobial resistance on veal calf farms, based on the variation in antimicrobial resistance within and between calves on five farms. Faecal samples from 50 healthy calves (10 calves/farm) were collected. From each individual sample and one pooled faecal sample per farm, 90 selected Escherichia coli isolates were tested for their resistance against 25 mg/L amoxicillin, 25 mg/L tetracycline, 0.5 mg/L cefotaxime, 0.125 mg/L ciprofloxacin and 8/152 mg/L trimethoprim/sulfamethoxazole (tmp/s) by replica plating. From each faecal sample another 10 selected E. coli isolates were tested for their resistance by broth microdilution as a reference. Logistic regression analysis was performed to compare the odds of testing an isolate resistant between both test methods (replica plating vs. broth microdilution) and to evaluate the effect of pooling faecal samples. Bootstrap analysis was used to investigate the precision of the estimated prevalence of resistance to each antimicrobial obtained by several simulated sampling strategies. Replica plating showed similar odds of E. coli isolates tested resistant compared to broth microdilution, except for ciprofloxacin (OR 0.29, p=0.05). Pooled samples showed in general lower odds of an isolate being resistant compared to individual samples, although these differences were not significant. Bootstrap analysis showed that within each antimicrobial the various compositions of a pooled sample provided consistent estimates for the mean proportion of resistant isolates. Sampling strategies should be based on the variation in resistance among isolates within faecal samples and between faecal samples, which may vary by antimicrobial. In our study, the optimal sampling strategy from the perspective of precision of the estimated levels of resistance and practicality consists of a pooled faecal sample from 20 individual animals, of which 90 isolates are tested for their susceptibility by replica plating