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Increased resistance due to ”non-human” antibiotic use (veterinary and zootechnical use). Christina Greko Dept of Antibiotics National Veterinary Institute (SVA) Uppsala, Sweden. Why use antibiotics for animals?. Therapy Prophylaxis Growth promotion. spiramycin (-99) tylosin (-99)
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Increased resistance due to”non-human” antibiotic use(veterinary and zootechnical use) Christina Greko Dept of Antibiotics National Veterinary Institute (SVA) Uppsala, Sweden
Why use antibiotics for animals? • Therapy • Prophylaxis • Growth promotion
spiramycin (-99) tylosin (-99) virginiamycin (-99) avoparcin (-97) ardacin (-97) bacitracin (-99) avilamycin carbadox (-99) olaquindox (-99) flavofosfolipol monensin salinomycin Feed additives for performance enhancement, 70/524/EEC
Individual medication penicillin-G penicillin-DHS amoxicillin ceftiofur macrolides (16-M) pleuromutilins trim/sulph. tetracyclines fluoroquinolones aminoglycosides Group medication macrolides (16-M) pleuromutilins tetracyclines fluoroquinolones Antibiotics approved for use in bovines and/or porcines (Sweden 2001) From: FASS VET. 2001
Sales of antibiotics for animals, EU 1997 asg antibiotic/tonnes of livewheight slaughtered Calculated from data in: EMEA/CVMP/342/99-Final, table 17 (FEDESA data)
Resistance to APE in E.faecium from broilers in Denmark From: DANMAP 95,96,97,98,99,00 (www.svs.dk)
Penicillin resistance among S.aureus from clinical mastitis in cows and sales of penicillin Data as cited in Greko, 1996 KSLA 135 (15) p27- and SVARM 2000 (www.sva.se)
Antibiotic resistance,S. Typhimurium from animals Data from: DEFRA: Salmonella in livestock production 2000, DANMAP 2000 and SVARM 2000
Quinolone resistance in Campylobacter (NL) From: Endtz et al, 1991, JAC, 27:211-217
Resistance to nalidixic acid among C. jejuni, Denmark Source: DANMAP 00 (www.svs.dk)
Quinolone resistance in Campylobacter jejuni (DK, 1999) From: DANMAP 99 (www.svs.dk)
Fluoroquinolones - human vs veterinary use in Sweden Data from Naturvårdsverket, 1994 and Statistics Sweden
Food as source - tetracycline resistance in coliforms of helthy volunteers on control or sterile diet From: Corpet, NEJM 1988, 318:1205-
Transfer of genes - spread of streptothricin-resistance (Tn1825), GDR From: Witte, 1996 (Ciba Foundation Symposium 207)
Transfer of genes- base pair variants of Tn1546 from VRE From: Jensen, AAC 1998 42:2463
Effect of interventions - withdrawal of growth promoting antibiotics
Sales of antibacterials for animal use (Sweden) Compiled from published data, references given in SVARM 2000 (www.sva.se)
Resistance among E. faecium– SVARM 2000 vs DANMAP 97 (Pig: Se n=48, Dk n=54; chicken: Se n=151, Dk n=207)
Resistance to vancomycin in E.faecium from chicken and chicken meat, Denmark From: DANMAP 95,96,97,98,99,00 (www.svs.dk)
Avoparcin and vancomycin resistant enterococci (VRE) of vanA type • VRE easily found in animals (and food) in most countries - but NOT in Sweden • Community carriage in humans EU 2-5%? • Community carriage in Sweden <0.1% (1/670; Torell et al, JCM 1999, 37:3509)
The flow of resistance genes geneX geneX geneX geneX geneX geneX geneX geneX geneX geneX geneX geneX geneX geneX geneX geneX geneX geneX geneX geneX geneX geneX
monitor use • monitor resistance • promote prudent use • control infectious diseases • increase knowledge Who is to blame? What can be done? What can I do?