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Prof. dr. J.Fink-GremmelsDVM, PhD, Dip ECVPTPresident [email protected]
22-04-2015MP-EU
EPP: Antimicrobial resistance: urgent need to act in human & veterinary medicine
Implementing the One HealthConcept
Medical Faculty Part
Veterinay Faculty, Utrecht UniversityPart of Utrecht Life Sciences
The point of departure: the global emergence of AMR
Global trade and global mobility have become major drivers of the spread of infectious diseases AND
antimicrobial resistance
Humans & animals share the same bacteria and often also the same resistance genes
Wendlandt et al., 2015
The antibiotic eco-system: need fora multi-actor approach
Animal health care
Industry
Human health careCommunity
&Hospital (ICU)
Agriculture
FAO-WHO-OIE Tripartite action plan
Antibiotic use in veterinary medicineRaising awareness & implementing the an action plan
Human (humane) responsibilityfor animal health and wellbeing Animal health care &
(global) food demands
Urgent need to act in veterinary medicine: Enforcement of triple R
Reduction – Refinement - Replacement
See also EIP-AGRI Focus Groups
The triple R action plan
Reduction: The use of antimicrobial as herd managment tools is no longer accepted
Improvement of hygiene programmes biosecurity
Improvement of disease prevention vaccination
Improvement of health monitoring & diagnostics (sensor based disease monitoring)
Improvement of immune competence: feed quality – life cycle management
Creating Awareness – improving sustainability
Action points 1 & 2 FAO/WHO/OIE
In the Netherlands between 2009 (reference) and 2013: a decrease of the antibiotic use by 58% was achieved,
with a further decline in 2014
Reduction of antibiotic use (ADD): the primary target
The point of concern: Extreme reduction without accompanying measures endangers animal welfare!
The triple R action plan
Refinement: Re-evaluating current prescription attitudes
CONTINUING EDUCATION & COMMUNICATIONCAPACITY BUILDING
The gut microbiota are an undesirable target
Long persistence in the intestines….selecting for resistant bacterial populations
Impairment of the microbiome results in immune-mediated diseases (allergies, diabetes, inflammatory bowel diseases
1000 000 000 000 000 bacteria; > 500 species10 x more than body cells
Reservoir for resistant bacteria / resistance genes
Refinement: Avoidance of collateral damage: Intra-intestinal antibiotics concentrations:
The triple R action plan
Replacement: Improvement of hygiene programmes biosecurityImprovement of disease prevention vaccinationImprovement of health monitoring & diagnostics
Improvement of immune competence: feed quality – life cycle management
Animal health care Starts at the 1st day of life
Chang in mind-set: From Cure to Care
From cure to care: options & opportunities
Vaccines(including PNAG-like surface antigen antibodies)
Hygiene programsBiosecurity
Bacteriophages
Peptides
Bacteriocines
Defensininducers
Killing factors(complement opsonins)
non-antibiotic antibacterials (ZnO)
Quorumsensing modulators
Phytobiotics
ProbioticsPrebiotics
Improvement of animal health – reduces the need for antibiotics
Building strategic cooperation
Food Safety & Food Security
One health – our responsibility
Thank you!
