ANTIMICROBIAL RESISTANCE IN COMMENSAL E. COLI FROM LIVESTOCK IN BELGIUM: TREND ANALYSIS 2011-2017 Veterinary Epidemiology 03.05.2018
General objectives Monitoring and reporting of antimicrobial resistance in zoonotic and commensal bacteria (Decision 2013/652/EC) Commensal E. coli isolated from faeces between 2011-2017 (trends analysis) in: Veal calves: young cattle kept in specialized units for fattening and slaughtered at an average age of 8 months Beef Cattle (meat production): young animals (7 months or younger) from farms raising beef cattle for meat production Broiler chickens Fattening pigs: fattening pigs older than 3 months Several statistical models are used.
Antimicrobial resistance Isolate E. coli and determine Minimal Inhibitory Concentration (MIC) for Ampicillin Chloramphenicol Ciprofloxacin Colistin Cefotaxime Gentamicin Meropenem (2014-) Nalidixic acid Sulphamethoxazole Ceftazidime Tetracycline If MIC>cut-off Resistant WHO Epidemiological list of Critically Important Cut-offs defined Antimicrobials (highest by the priority) European for Human Committee Medicine on Antimicrobial Susceptibility Testing National monitoring program: +-170 faecal isolates per year (2011-2017) for veal calves, beef cattle, broiler chickens, pigs (n = 4 000 samples) Tigecyclin (2014-) Trimethoprim If MIC cut-off Susceptible
Resistance (%) Results prevalence 2011-2017: Descriptive Statistics Resistance >50% 2011-2017 Ampicillin, Tetracycline, Sulphamethoxazole Trimethoprim 100 Resistance strains prevalence Veal calves - E. coli 90 80 70 60 50 40 30 20 10 Ampicillin Chloramphenicol Gentamicin Meropenem Sulphamethoxazole Tetracycline Tigecyclin Trimethoprim 0
Resistance (%) Results prevalence 2011-2017: Descriptive Statistics 100 Resistance strains prevalence Veal calves - E. coli Critically important antimicrobials Highest priority 90 Ciprofloxacin 80 70 Colistin 60 50 Cefotaxime 40 30 Nalidixic acid 20 10 Ceftazidime 0
NS Gentamicin, Cefotaxime, Ceftazidime but prevalence very low
Resistance (%) Results prevalence 2011-2017: Descriptive Statistics Sulphamethoxazole: 22,50 % (2017) Resistance strains prevalence Beef cattle - E. coli 100 Ampicillin 90 80 70 Chloramphenicol Gentamicin 60 Meropenem 50 40 30 Sulphamethoxazole Tetracycline 20 Tigecyclin 10 0 2011 2012 2013 2014 2015 2016 2017 Trimethoprim
Resistance (%) 100 Results prevalence 2011-2017: Descriptive Statistics Resistance strains prevalence Beef cattle - E. coli Critically important antimicrobials Highest priority Ciprofloxacin 90 80 70 Colistin 60 50 Cefotaxime 40 30 Nalidixic acid 20 10 0 Ceftazidime
NS for Chloramphenicol, Gentamicin*, Ceftazidime*, Cefotaxime * * Prevalence is low
Resistance (%) Results prevalence 2011-2017: Descriptive Statistics Resistance >50% 2011-2017 pour: Ampicilin, Sulphamethoxazole, Ciprofloxacon, Trimethoprim Cefotaxime: +9,95% Ceftazidime: +8,63% 100 Resistance strains prevalence Chickens - E. coli 90 Ampicillin 80 Chloramphenicol 70 Gentamicin 60 50 40 30 Meropenem Sulphamethoxazole Tetracycline 20 Trimethoprim 10 Tigecyclin 0
Resistance (%) Prevalence 2011-2017: Statistiques descriptives 100 Resistance strains prevalence Chickens - E. coli Critically important antimicrobials Highest priority Ciprofloxacin 90 80 Colistin 70 60 Cefotaxime 50 40 Nalidixic acid 30 20 Ceftazidime 10 0
NS pour Gentamicine
Resistance (%) Results prevalence 2011-2017: Descriptive Statistics Sulphamethoxazole,Tetracyclin,Trimethoprim Ampicilin 100 90 80 70 Resistance strains prevalence Pigs - E. coli Ampicillin Chloramphenicol Gentamicin 60 Meropenem 50 Sulphamethoxazole 40 30 20 10 Tetracycline Tigecyclin Trimethoprim 0
Resistance (%) Results prevalence 2011-2017: Descriptive Statistics 100 Resistance strains prevalence Pigs - E. coli Critically important antimicrobials Highest priority 90 Ciprofloxacin 80 70 Colistin 60 50 Cefotaxime 40 30 Nalidixic acid 20 10 Ceftazidime 0
NS Ampicilin, Chloramphenicol, Ceftazidime,, Cefotaxime, Gentamicine*, Colistine* *low prevalence
MULTI-RESISTANCE Resistance to at least three different antimicrobials, representing different antimicrobial families
Full susceptibility 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% Veal calves 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% Beef cattle 0% 0% 100% 90% 80% 70% 60% Pigs 100% 90% 80% 70% 60% Chickens 50% 50% 40% 40% 30% 30% 20% 10% 0% 20% 10% 0%
Resistance to 0, 1, 2 and 3 or more antimicrobials 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Veal calves 0 1 2 3 3 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Beef cattle 0 1 2 3 3 Pigs Chickens 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 0 1 2 3 3 0 1 2 3 3
Discussion Phenotypic data: genotypic analysis could confirm Probability to be resistant globally decreases in all species Veal calves: constant decrease of resistance of highest priority AB, but is slowing down in the last years. Beef cattle: resistance remains lower compared to other species. Increases/decreases from one year to another should be nuanced in view of the low sample size and laboratory methodologies, Pigs: Other AB: situation similar as last year, Chickens: substances with a high level a resistance but statistically significant decrease in resistance over time. However, prevalences of cefotaxime and ceftazidime have been increasing since 2015. No resistance to carbapenems (mero) and glycylcyclines (tig) for the fourth year on a row: two classes not authorized for use in animals Proportion of full sensitive and non-multiresistant strains is stable over time
THANK YOU FOR YOUR ATTENTION Cargnel Mickaël Mickael.Cargnel@sciensano.be