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CHALLENGE ON ANTIMICROBIAL USE AND ANTIMICROBIAL RESISTANCE IN AQUACULTURE: AN EXPERIENCE FROM VIETNAM Phan Thi Van- [email protected] Aquatic AMR Workshop 1: 10-11 April 2017, Mangalore, India FMM/RAS/298: Strengthening capacities, policies and national action plans on prudent and responsible use of antimicrobials in fisheries

Phan Thi Van- [email protected] Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

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Page 1: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

CHALLENGE ON ANTIMICROBIAL USE AND

ANTIMICROBIAL RESISTANCE IN AQUACULTURE: AN

EXPERIENCE FROM VIETNAM

Phan Thi Van- [email protected] AMR Workshop 1: 10-11 April 2017, Mangalore, India

FMM/RAS/298: Strengthening capacities, policies and national action plans on

prudent and responsible use of antimicrobials in fisheries

Page 2: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

CONTENT

1. Aquaculture in Vietnam

2. The main sources of antimicrobials in aquaculture

system

3. Impact of AMU and AMR

4. Regulations on AMU, AMR and its implimentation

5. Recommendations

Page 3: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

1. AQUACULTURE IN VIETNAM

Page 4: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

0

500

1000

1500

2000

2500

3000

3500

4000

Pro

du

cti

on

(‘0

00

to

ns

)

Year

Aquaculture production of Vietnam

Source: D-Fish

Page 5: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

Area of aquaculture in Vietnam

Source: D-Fish

0

200

400

600

800

1000

1200

1400

20002001200220032004200520062007200820092010201120122013201420152016

000 Ha

Year

Page 6: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Th

ou

sa

nd

US

D

Year

Value of the Vietnamese seafood export

Source: D-Fish

Page 7: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

The challenges

• Many aquaculture species

• Large area of aquaculture

• Many aquaculture systems

• Tropical and subtropical climates

• Many levels of investment: large-, medium- and

small-scale

Page 8: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

2. THE MAIN SOURCES OF ANTIMICROBIALS IN

AQUACULTURE SYSTEM

Page 9: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

From direct use of antimicrobials

• Disease prevention

• Disease treatment

• Seed

• Feed

• Postharvest

Page 10: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

From other uses of antimicrobials

• Residues from other users

• Holding water for seed transportation

• Human waste

Page 11: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

Antimicrobial products in aquaculture

• To date, Vietnam has 814 products (drug, chemical and

vitamin) registered of which:

o 12.9% products from import

o 216 products contain antimicrobials (DAH,2017)

• In 2012, there were 223 products contain antimicrobial

(Mai 2012)

Page 12: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

The challenges

• Too many sources of antimicrobial in aquaculture system

• Uncontrolled sources of antimicrobial residues in

aquaculture environment

• Too many products containing antimicrobials

• Irresponsible use of antimicrobials

• Antimicrobials appear in all stages of aquaculture

production: from seed to post harvest

Page 13: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard
Page 14: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

3. REGULATIONS ON AMU, AMR AND ITS IMPLEMENTATION

Page 15: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

Existing regulations

• Fisheries law

• Veterinary law

• 2 Decrees on AMU and AMR

• 11 Circulars of MARD on disease control, AMU & AMR

• 20 official letters by MARD to direct and enforce

controlling of AMU & AMR

Page 16: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

Existing regulation

• National Steering Committees for AMU and AMR, MARD

• “Multi-stakeholder Engagement to combat AMR in

Vietnam’ by MoH, MARD and MONRE

• Banned list of antibiotic use in aquaculture (24 antibiotics)

Page 17: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

The implementation

Diferent level of following regulations:

• Big companies vs small scale farmers

• GoV companies/hatcheries vs private companies/hatcheries

• Foreigner invested farms/hatcheries vs Domestic

farms/hatcheries

• Exporting farm vs domestic farm

Page 18: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

Antimicrobial use in aquaculture in Hai phong

and Nghe an provinces in 2015

45

65

76.6

30

0

10

20

30

40

50

60

70

80

90

Farm

use a

nti

mic

rob

ial (%

)

Hải Phòng Nghệ An

Prevention Treatment

Page 19: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

Antimicrobial use in aquaculture in Hai phong and

Nghe an provinces in 2015

Applied method Effectiveness

Page 20: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

Antimicrobial use in aquaculture in Hai phong

and Nghe an provinces in 2015

• Dosage:

o Following drug company (**)

o Following own experience (***)

o Following Vet/aquatic animal health officer (*)

o Using antimicrobial at difference dosage for the same

disease: Doxycycline, Tetracycline, Oxytetracycline, Enrofloxcin

were used at 2kg/1000m3 or 1kg/1000m3 or 0,5kg/1000m3 to

spray to shrimp pond.

Page 21: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

The challenges

• Too many regulations

• Long regulations

• No recommended/allowed list used for animals

• Very easy to access chemicals even human

antimicrobials.

• No standard on dosage, applied methods

Page 22: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

4. THE IMPACT OF AMU AND AMR

Page 23: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

Overall impact of AMU and AMREnvironment

Human

Animal

AMU

AMR

Page 24: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

Impact on public health

The exact public health impact of AMR in Vietnam is unknown

but…...

Page 25: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

Impact on public health

• High level of AMR, is increasing over time (GARP, 2010;

Nguyen et al., 2013)

• 43.8% ESBL (extended-spectrum beta-lactamase)

producing bacteria amongst hospitalized patients

• 81% ESBL amongst Enterobacteriaceae in intensive care

units in HoChiMinh city(Kiratisin et al., 2012).

Page 26: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

Impact on public health

• Resistance to fluoroquinolones in Salmonella typhi isolates

increased from 4% to 97% during 1993-2005 (Chau et al.,

2007).

• Increase in tetracycline and chloramphenicol resistance

• Occurrence of multi-drug resistance seen in Streptococcus

suis from 1997-2008 associated with agricultural

antimicrobial use (Hoa et al., 2011).

Page 27: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

The impact on seafood export

Reason for Vietnam seafood shipments rejected by importers in 2016

Antibiotic26%

Bacteria conta.20%

Other54%

Page 28: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

Impact on seafood export

Antibiotic EU Korea Japan Australia USA Total

Total 10 2 32 3 11 58

CAP 5(Sq, F) 11 (S) 16

AOZ 2 (S) 08 (S) 10

SEM 3(P) 3

Enrofloxacin 14 (S) 3(F, S) 17

Tetracycline gr 4 (S) 4

Doxycycline 2 (S) 2

Sulfamid 5 (S) 5

Azithromycin 1(F) 1

Vietnam seafood shipments rejected by importers due to antibiotic residue in

2016 (NAFIQUAD)

Page 29: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

AMR of Vibrio alginolyticus

0

0.5

1

1.5

2

2.5

3

3.5Erythromycin

Rifamycin

Sufamethoxazole+Trimethoprim

Tetracyclin

Oxytetracyclin

2004 2005 2006 2013 2014

Inhibition zone diameter

Page 30: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

0

0.5

1

1.5

2

2.5

3Rifamycin

Doxycycline

OxytetracyclinTetracyclin

Erythomycin

2013 2015 2016 2017

AMR of Aeromonas hydrophila

Inhibition zone diameter

Page 31: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

5. RECOMMENDATIONS

Page 32: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

Recommendation on regulations

• Summary of regulations on AMU and AMR into a specific format

that is short and easy to understand by the farmers

• The use of recommended/allowed list of antimicrobials in

aquaculture

• Regulation on that use of antimicrobials needs a pharmaceutical

prescription by an authorized and educated professional both for

human and animal purpose

• National Action Plan inplace and implimented

Page 33: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

o Farmer awareness on antimicrobial use and resistance

o Build up capacity on AMU and AMR

o Systematic baseline survey on AMU and AMR for better

surveillance, mornitoring and control

o Apply VietGAP standard.

o Alternative to antimicrobials such as herbal, probiotic use

o Multi-displine work

Recommendation on awareness and techinical issue

Page 34: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

ACKNOWLEDGEMENT

• FAO

• NITTE University

• MARD

• Vietnam country delegate

Page 35: Phan Thi Van- phanvan@ria1...o Build up capacity on AMU and AMR o Systematic baseline survey on AMU and AMR for better surveillance, mornitoring and control o Apply VietGAP standard

THANK YOU FOR YOUR ATTENTION