欧洲疾控中心-2022-2023年欧盟关于人类_动物和食品中人畜共患细菌和指示细菌抗菌药物耐药性的总结报告（英）_174页_37mb

2022–2023 European Union Summary Report on Antimicrobial Resistance in Zoonotic and Indicator Bacteria

Core Content Overview

This report provides an analysis of antimicrobial resistance (AMR) in zoonotic and indicator bacteria from humans, food-producing animals, and derived meat across 27 EU Member States (MSs), the United Kingdom (Northern Ireland), and five non-MS reporting countries. The data covers Salmonella spp., Campylobacter jejuni and Campylobacter coli, indicator Escherichia coli, presumptive ESBL-/AmpC-/carbapenemase (CP)-producing E. coli, and methicillin-resistant Staphylococcus aureus (MRSA). The analysis is based on harmonised monitoring and highlights trends and variations in resistance levels across different bacterial species and populations.

Main Findings

1. Resistance in Zoonotic Bacteria

• Salmonella spp.:

  • High resistance to ampicillin, tetracycline, and sulfonamides was observed in isolates from both humans and animals.
  • Resistance to third-generation cephalosporins (e.g., cefotaxime, ceftazidime) was generally low in humans but very high in imported broiler and turkey meat.
  • Ciprofloxacin resistance increased in several countries, especially in Salmonella Enteritidis and Salmonella Kentucky.
  • Combined resistance to ciprofloxacin and cefotaxime (hpCIA) was low in most isolates, but elevated in certain serovars like S. Kentucky and S. Infantis.
  • Tigecycline and colistin resistance was noted in some animal populations, particularly in broilers and turkeys.

• Campylobacter spp.:

  • High to extremely high resistance to fluoroquinolones (ciprofloxacin) was observed in both C. jejuni and C. coli.
  • Erythromycin resistance was low in human C. jejuni but higher in C. coli.
  • Combined resistance to ciprofloxacin and erythromycin was more prevalent in C. coli than in C. jejuni.
  • Multidrug resistance (MDR) was more common in C. coli than in C. jejuni.

2. Resistance in Indicator E. coli

• Indicator E. coli from food-producing animals and meat showed moderate to very high resistance to ampicillin, tetracycline, and sulfonamides.
• Resistance to third-generation cephalosporins was very low or low in all animal populations except broilers and turkeys, where it was moderate.
• (Fluoro)quinolone resistance (ciprofloxacin and nalidixic acid) was high to very high in E. coli from broilers and turkeys, but low to moderate in pigs and cattle.
• ESBL and AmpC resistance was observed in E. coli isolates, with ESBL more common than AmpC.
• CP-producing E. coli was detected in several countries, with bla_{OXA-181}, bla_{OXA-48}, bla_{NDM-5}, and bla_{VIM-1} being the most frequently reported resistance genes.
• Resistance to azithromycin and tigecycline was low to very low in all populations.

3. MRSA in Food and Animals

• MRSA was monitored voluntarily and not harmonised.
• Livestock-associated (LA) clonal complex (CC) 398 was the most common MRSA type found in both animals and food.
• Resistance to rifampicin was detected in breeding pigs, pig meat, and poultry meat.
• Resistance to linezolid and vancomycin was not detected in any MRSA isolates.

4. Key Outcome Indicators (KOIs)

• KOI_{CS} (complete susceptibility to the harmonised panel of antimicrobials in E. coli) showed increasing trends in 12 MSs and decreasing in 1 MS.
• KOI_{ESC} (prevalence of ESBL-/AmpC-producing E. coli) showed statistically significant decreasing trends in 19 MSs and 2 non-MSs, while increasing in 3 MSs and 1 non-MS.
• These trends indicate progress in reducing AMR in food-producing animals in several EU countries over the past decade.

Main Views and Key Information

1. Resistance Patterns

• Resistance levels varied greatly between countries and antimicrobials.
• Salmonella from laying hens showed lower resistance compared to other animal sources.
• Ciprofloxacin resistance in Salmonella and Campylobacter is a growing concern, especially in poultry-associated isolates.

2. Emerging Resistance Threats

• CP-producing Salmonella were not detected in animals, but five cases in 2022 and six in 2023 were reported, mostly carrying bla_{OXA-48} or bla_{OXA-48-like} genes.
• CP-producing E. coli was found in broilers, turkeys, pigs, and cattle in several MSs, with bla_{OXA-181}, bla_{NDM-5}, and bla_{VIM-1} being the most common resistance genes.

3. Temporal Trends

• A statistically significant decline in resistance to ampicillin and tetracycline was observed in 14 and 12 countries, respectively, over 2014–2023.
• Ciprofloxacin resistance in Salmonella and Campylobacter showed increasing trends in multiple countries, especially in C. jejuni and C. coli.
• ESBL-producing E. coli showed decreasing prevalence in several animal populations, indicating positive progress in AMR reduction.

4. Molecular Typing and Whole Genome Sequencing (WGS)

• WGS data revealed mutations in the 23S rRNA gene (A2075G) and no transferable erm(B) gene in most erythromycin-resistant isolates.
• Resistance mechanisms were identified in C. coli and C. jejuni, with ESBL and AmpC genes being more prevalent than CP genes.

5. Public Health Implications

• Fluoroquinolone resistance in Campylobacter has reduced the effectiveness of these antimicrobials in human treatment.
• Combined resistance to ciprofloxacin and erythromycin is a high public health concern.
• MRSA and E. faecalis/E. faecium resistance patterns were noted in limited countries, with vancomycin resistance being exclusive to E. faecium.

Conclusion

The report highlights significant variation in AMR levels across the EU and underscores the need for continued surveillance and targeted interventions to reduce resistance in food-producing animals and humans. While some positive trends in reducing resistance have been observed, high levels of resistance to certain antimicrobials, especially fluoroquinolones and third-generation cephalosporins, remain a major concern. The role of zoonotic bacteria in AMR transmission and the importance of harmonised monitoring are critical for effective AMR control in the EU.