Title: Increased resistance due to
1Increased resistance due tonon-human
antibiotic use(veterinary and zootechnical use)
- Christina Greko
- Dept of Antibiotics
- National Veterinary Institute (SVA)
- Uppsala, Sweden
2Why use antibiotics for animals?
- Therapy
- Prophylaxis
- Growth promotion
3Feed additives for performance enhancement,
70/524/EEC
- spiramycin (-99)
- tylosin (-99)
- virginiamycin (-99)
- avoparcin (-97)
- ardacin (-97)
- bacitracin (-99)
- avilamycin
- carbadox (-99)
- olaquindox (-99)
- flavofosfolipol
- monensin
- salinomycin
4Some indications for veterinary use
5Antibiotics approved for use in bovines and/or
porcines (Sweden 2001)
- 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
From FASS VET. 2001
6Sales 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)
7Resistance to APE in E.faecium from broilers in
Denmark
From DANMAP 95,96,97,98,99,00 (www.svs.dk)
8Penicillin 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)
9Transfer ofzoonotic bacteria
10Antibiotic resistance,S. Typhimurium from animals
Data from DEFRA Salmonella in livestock
production 2000, DANMAP 2000 and SVARM 2000
11Quinolone resistance in Campylobacter (NL)
From Endtz et al, 1991, JAC, 27211-217
12Resistance to nalidixic acid among C. jejuni,
Denmark
Source DANMAP 00 (www.svs.dk)
13Quinolone resistance in Campylobacter jejuni (DK,
1999)
From DANMAP 99 (www.svs.dk)
14Fluoroquinolones - human vs veterinary use in
Sweden
Data from Naturvårdsverket, 1994 and Statistics
Sweden
15Transfer ofresistance genes
16Food as source - tetracycline resistance in
coliforms of helthy volunteers on control or
sterile diet
From Corpet, NEJM 1988, 3181205-
17Transfer of genes - spread of streptothricin-resis
tance (Tn1825), GDR
From Witte, 1996 (Ciba Foundation Symposium 207)
18Transfer of genes- base pair variants of Tn1546
from VRE
From Jensen, AAC 1998 422463
19Effect of interventions - withdrawal of growth
promoting antibiotics
20Sales of antibacterials for animal use (Sweden)
Compiled from published data, references given in
SVARM 2000 (www.sva.se)
21Resistance among E. faecium SVARM 2000 vs
DANMAP 97
(Pig Se n48, Dk n54 chicken Se n151, Dk
n207)
22Resistance to vancomycin in E.faecium from
chicken and chicken meat, Denmark
From DANMAP 95,96,97,98,99,00 (www.svs.dk)
23Avoparcin 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 lt0.1 (1/670
Torell et al, JCM 1999, 373509)
24The flow of resistance genes
geneX geneX geneX geneX geneX geneX geneX geneX
geneX geneX
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geneX geneX
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25- monitor use
- monitor resistance
- promote prudent use
- control infectious diseases
- increase knowledge
Who is to blame?
What can be done?
What can I do?