Antimicrobial resistance from use of antimicrobials in food animals

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Jorgen Schlundt and Awa Aidara-Kane, Department of Food Safety and Zoonoses, World Health Organization

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  • World Health Organization 6 May 2010
  • World Health Organization 6 May 2010 WHO Headquarters, shown here, is located in Geneva, Switzerland. WHO is one of the most decentralized of the UN agencies with Regional Offices in Copenhagen, Washington, Manila, New Dehli, Cairo and Brazzaville, Congo.
  • World Health Organization 6 May 2010
  • World Health Organization 6 May 2010
  • World Health Organization 6 May 2010
  • World Health Organization 6 May 2010
  • World Health Organization 6 May 2010
  • World Health Organization 6 May 2010
  • World Health Organization 6 May 2010
  • World Health Organization 6 May 2010
  • World Health Organization 6 May 2010
  • World Health Organization 6 May 2010
  • Antimicrobial resistance from use of antimicrobials in food animals

    1. 1. Antimicrobial resistance from use of Antimicrobials in Food Animals Washington, May 4, 2010 Jorgen Schlundt and Awa Aidara-Kane Department of Food Safety and Zoonoses,
    2. 2. WHO Food Safety and Zoonoses Promoting Science Enabling Action
    3. 3. The Problem <ul><li>Antimicrobials save many million human lives every year – works against most infections </li></ul><ul><li>Antimicrobials lose effectiveness when bacteria become resistant – and all use of antimicrobials potentially creates resistance </li></ul><ul><li>Same classes of antimicrobials are used both in humans and animals </li></ul><ul><li>Widespread use of antimicrobials in livestock production - not only to treat disease </li></ul><ul><li>Few new antibiotics are being developed to replace those becoming ineffective through resistance </li></ul><ul><li>Food is the most important vector for spread of resistant bacteria between animals and humans – food trade globalized, international action needed </li></ul>
    4. 4. Health consequences of AMR <ul><li>Increased number of infections </li></ul><ul><li>Increased frequency of treatment failures </li></ul><ul><li>Increased severity of infections </li></ul><ul><ul><li>Prolonged duration of illness </li></ul></ul><ul><ul><li>Increased frequency of bloodstream infections </li></ul></ul><ul><ul><li>Increased hospitalization </li></ul></ul><ul><ul><li>Increased mortality – people die, who could have </li></ul></ul><ul><ul><li>been easily saved </li></ul></ul><ul><li>Increased costs to society </li></ul>
    5. 5. So – the question is: <ul><li>Does animal use mean anything? </li></ul>
    6. 6. Quinolone-resistant Salmonella Typhimurium DT104 (UK) November 93 – Enrofloxacin licensed for animal use
    7. 7. Fluoroquinolone resistance in human Campylobacter (USA) Approved for use in humans Approved for use in poultry FDA withdrew approval 0% Sentinel survey CDC began surveillance
    8. 8. Drug use for humans and animals France, 2005 Denmark, 2007
    9. 9. Total amount (mg/kg) antimicrobial for animal use
    10. 10. Total amount (mg/kg) antimicrobial for animal use
    11. 11. WHO Global Principles for the Containment of AMR in food-animals <ul><li>Based on World Health Assembly Resolution </li></ul><ul><li>June 2000 </li></ul><ul><li>To minimise the public health impact of the use of antimicrobial agents in food animals </li></ul><ul><li>Large consultation incl. stakeholders </li></ul>
    12. 12. So – which types of animal use: <ul><li>Treatment – save sick animals </li></ul><ul><li>Prophylactic – prevent disease in herd settings </li></ul><ul><li>Growth Promotion – grow animals faster </li></ul>
    13. 13. WHO Global Principles Antimicrobial Growth Promoters Use of antimicrobial growth promoters … in humans and animals should be terminated or rapidly phased-out in the absence of risk-based evaluations. Prophylactic use of antimicrobials Use of antimicrobials for prevention only justified where disease is present or likely , never as substitute for good animal health management.
    14. 14. WHO major strategic directions (animal use) <ul><li>Ban antimicrobial use for growth promotion </li></ul><ul><li>Avoid prophylactic use of antimicrobials </li></ul><ul><li>Limit use of critically important antimicrobials </li></ul><ul><li>(World Health Day 2011 on antimicrobial resistance) </li></ul>
    15. 15. WHO Global strategy for Prevention and Control of Foodborne Antimicrobial Resistance <ul><li>Prudent use of antimicrobial agents in all sectors </li></ul><ul><ul><li>No use of antimicrobial agents for growth promotion </li></ul></ul><ul><ul><li>A good regulatory system for approval and licensing </li></ul></ul><ul><ul><li>Prescription-only </li></ul></ul><ul><li>Critically Important Antimicrobials for humans – restricted use in animals Fluoroquinolones, 3 + 4 generation Cephalosporins </li></ul><ul><li>Monitoring of antimicrobial resistance and antimicrobial usage in human and animals </li></ul><ul><ul><li>Useful information on prevalence and trends </li></ul></ul><ul><ul><li>Input for risk assessment and risk management </li></ul></ul><ul><ul><li>A basis for choosing, implementing and evaluating interventions </li></ul></ul>
    16. 16. 2003 WHO-panel on impacts of growth promoter termination in Denmark <ul><li>Independent review panel </li></ul><ul><li>Productivity only marginally affected </li></ul><ul><li>Resistance against specific antimicrobials declined </li></ul><ul><li>Too early to measure decline in general antimicrobial resistance </li></ul>

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