The threat of antimicrobial resistance is increasing around the globe, including in the European Union (EU), where the European Centre for Disease Prevention and Control (ECDC) and the European Food Safety Authority (EFSA) released a new report on this urgent matter.¹

Antimicrobial resistance refers to microorganisms — bacteria, fungi, viruses and parasites — that, after exposure to antimicrobial drugs (such as antibiotics, antifungals, antivirals, antimalarials, and anthelmintics), evolve and become impervious to them.²

The resulting “superbugs” pose a serious threat to public health. In the EU, 25,000 deaths occur every year due to infections caused by antimicrobial-resistant bacteria alone.³

EU Reports High Levels of Drug-Resistant Bacteria, Especially Salmonella

Data submitted by 28 EU member states in 2015 revealed antimicrobial resistance remains high in bacteria from humans, animals and food in the E.U., with multidrug-resistant salmonella noted as a particularly serious threat.

Nearly 30 percent of the salmonella isolates that can cause illness in humans displayed multidrug resistance, including to sulfonamides (more than 32 percent), tetracyclines (28 percent) and ampicillin (nearly 28 percent).⁴

One particularly common type of salmonella in humans, monophasic salmonella typhimurium, had “extremely high” multidrug-resistance rates of 81 percent, leading Mike Catchpole, chief scientist at ECDC, to state:⁵

“Prudent use of antibiotics in human and veterinary medicine is extremely important to address the challenge posed by antimicrobial resistance. We all have a responsibility to ensure that antibiotics keep working.”

Infection with salmonella is the second-most common foodborne infection in the EU, second only to infections caused by campylobacter. Among campylobacter isolates from humans, “very high to extremely high” resistance to the drug ciprofloxacin was reported — in some cases 80 percent to 100 percent.⁶

Reducing the Use of Antibiotics in Food Animals Is Associated With Lower Rates of Antimicrobial Resistance

Of note, the report found lower levels of antimicrobial resistance in Northern and Western Europe compared to the Southern and Eastern regions. The differences most likely are due to differences in antimicrobial use, particularly in agricultural cases.

Marta Hugas, head of EFSA’s biological hazards and contaminants unit, said in a press release:

” … [C]ountries where actions have been taken to reduce, replace and re-think the use of antimicrobials in animals show lower levels of antimicrobial resistance and decreasing trends.”⁷

In animals and meat, meanwhile, the presence of superbugs was also concerning. The report noted that bacteria resistant to carbapenems, which are antibiotics typically used as a last resort when all other antibiotics have failed, were detected for the first time in EU animals and food.⁸

Resistance to colistin, another last-resort antibiotic, was also revealed, as was resistance to salmonella, campylobacter and E. coli in animals and meat. University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP) reported:⁹

“Among the salmonella isolates from pig meat, the highest levels of resistance were reported for ampicillin (44.7 percent), sulfamethoxazole (48.5 percent), and tetracyclines (49.1 percent).

… Among salmonella isolates from fattening pigs, moderate or high to extremely high resistance was reported for tetracyclines and sulfonamides, with slightly lower levels of ampicillin resistance.

In C [campylobacter] coli isolates from fattening pigs, overall resistance was very high for ciprofloxacin (62.1 percent), nalidixic acid (60.8 percent), and tetracycline (66.6 percent), and high for erythromycin (21.6 percent).

In E coli from fattening pigs, high levels of resistance were found to tetracyclines (54.7 percent), sulfamethoxazole (44.2 percent), ampicillin (39.3 percent), and trimethoprim (35.3 percent), with 38.1 percent of isolates displaying MDR [multidrug resistance]. Resistance levels in indicator E coli isolates from calves were also high … ”