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TRANSMISSION OF ANTIBIOTIC RESISTANCE
FROM ANIMALS TO HUMANS AND VICE VERSA,
ONE HEALTH IN ACTION
Prof. Jeroen Dewulf
VETERINARY EPIDEMIOLOGY UNIT
SETUP
Antimicrobial usage and resistance in animals
Transmission of antimicrobial resistance from
animals to humans and vice versa
2
3
Linking antimicrobial use to antimicrobial resistance in 7 EU countries based
on monitoring data
y = -0,0002x2 + 0,0255x - 0,0707 R² = 0,93
0
0,1
0,2
0,3
0,4
0,5
0,6
0,7
0 10 20 30 40 50 60
Arc
sin
% A
M r
esis
tan
ce
Antimicrobial use (mg/PCU)
(a) Aminopenicillins (ampicillin)
y = 0,6887x2 - 0,1812x + 0,0135 R² = 0,94
0
0,02
0,04
0,06
0,08
0,1
0,12
0,14
0 0,1 0,2 0,3 0,4 0,5 0,6
Arc
sin
% A
M r
esis
tance
Antimicrobial use (mg/PCU)
(b) Third generation Cephalosporins (cefotaxime)
y = 1,1278x2 - 0,2875x + 0,0221 R² = 0,99
0
0,05
0,1
0,15
0,2
0,25
0,3
0,35
0,4
0,45
0 0,1 0,2 0,3 0,4 0,5 0,6 0,7 0,8
Arc
sin
% A
M r
esis
tance
Antimicrobial use (mg/PCU)
(c) Fluoroquinolons (ciprofloxacin)
y = 0,1313x2 + 0,1234x - 0,0112 R² = 0,99
0
0,05
0,1
0,15
0,2
0,25
0 0,2 0,4 0,6 0,8 1
Arc
sin
% A
M r
esis
tance
Antimicrobial use (mg/PCU)
(d) Amphenicols (chloramphenicol)
y = -0,0021x2 + 0,0241x - 0,0188 R² = 0,80
0
0,01
0,02
0,03
0,04
0,05
0,06
0 1 2 3 4 5 6 7
Arc
sin
% A
M r
esis
tance
Antimicrobial use (mg/PCU)
(e) Aminoglycosids (gentamicin)
y = -0,0149x2 + 0,1752x + 0,0057 R² = 0,81
0
0,1
0,2
0,3
0,4
0,5
0,6
0 1 2 3 4 5 6 7
Arc
sin
% A
M r
esis
tance
Antimicrobial use (mg/PCU)
(f) Aminoglycosids (streptomycin)
Chantziaras et al., J Antimicrob Chemother, 2014
4
Linking antimicrobial use to antimicrobial resistance in 7 EU countries based
on monitoring data
Chantziaras et al., J Antimicrob Chemother, 2014
Austria
Denmark
Netherlands
Belgium
Switzerland
Sweden Norway
1
2
3
4
5
6
7
1 2 3 4 5 6 7
Avera
ge a
nti
mic
rob
ial re
sis
tan
ce
ran
kin
g
Average antimicrobial use ranking
5
Veterinary usage of antimicrobials in Europe: ESVAC
0
50
100
150
200
250
300
350
400
450
Antimicrobial use in mg/PCU (ESVAC)
2012 2013 2014
6
Antimicrobial usage in animals in Belgium
7
Antimicrobial usage in livestock in Belgium
0
100
200
300
400
500
600
poultry pigs dairy cattle beef cattle veal calves veal calves (164 kg)
Tre
atm
en
t in
cid
en
ce o
n U
DD
(a
nim
als
/1
00
0 d
ail
y t
rea
ed
)
Antimicrobial use in livestock in Belgium
Persoons et al., 2012 Callens et al., 2012 Stevens et al., 2016 Pardon et al., 2012
RESULTS: AMU
29/01/2018 8
Sjölund et al., Prev. Vet. Med., 2016
9
Belgian surveillance on antimicrobial resistance 2011 (E. coli)
0
10
20
30
40
50
60
70
80
90
100
AMP SMX TET TMP NAL STR CIP CHL FOT TAZ KAN GEN FFN COL
An
tim
icro
bia
l re
sis
tan
ce
(%
)
Antimicrobial agent
Broiler chickens
Pigs
Bovines
Veal Calves
AMP: ampicillin, CHL: chloramphenicol, CIP: ciprofloxacin, COL: colistin, FFN: florfenicol, FOT:
cefotaxime, GEN: gentamicin, KAN: kanamycin, NAL: nalidixic acid, SMX: sulfomethoxazole, STR:
streptomycin, TAZ: ceftazidime, TET: tetracycline, TMP: trimethoprim
SETUP
Antimicrobial usage and resistance in animals
Transmission of antimicrobial resistance from
animals to humans and vice versa
10
Zoonotic
bacteria
Animal
pathogenes
Human
pathogenes
Human
commensals
Animal
commensals
Antimicrobials in animals
Antimicrobials in human
Residues
in meat
1,00E+00
1,00E+01
1,00E+02
1,00E+03
1,00E+04
1,00E+05
1,00E+06
1,00E+07
1,00E+08
0 1 2 3 4 6 7 8 9 10 11 12 13 14 16 17
time after inoculation (days)
CF
U/m
l E. coli (human)
B1-54
transconjugants
Cefotaxime
treatment
acceptor
ESBL-donor poultry
Inoculatie ESBL-
source strain
Smet et al., 2011 12
Transfer of antimicrobial resistance in the gut
TRANSMISSION OF ANTIMICROBIAL RESISTANCE FROM ANIMAL-HUMAN: LITERATURE DATA
Food Safety, 2015
One health
One health
Huijbers et al., Environmental science and technology, 2015
TRANSMISSION OF ANTIMICROBIAL RESISTANCE FROM ANIMAL-HUMAN: LITERATURE DATA
VISION 2020
50 % Reduction in AMU by 2020
75 % Reduction of the most critical AMU by 2020
50 % Reduction of use of AM medicated feed by 2017
18
National monitoring on antimicrobial usage
118,5 109,4 102,7 104,1 99,4
28,2
27,2 25,3 25,3
24,0
0,0
20,0
40,0
60,0
80,0
100,0
120,0
140,0
160,0
2011 2012 2013 2014 2015
mg
Ac
tive
Su
bs
tan
ce
/ k
g B
iom
as
s
Pharmaceuticals Medicated Premixes
2011-2012: - 6,9%
2012-2013: - 6,3%
2013-2014: + 1,1%
2014-2015: -4,7%
2011-2015: - 15,9%
VISION 2020
1.50 % Reduction in AMU by 2020
2.75 % Reduction of the most critical AMU by 2020
3.50 % Reduction of use of AM medicated feed by 2017
TRENDANALYSIS ANTIMICROBIAL RESISTANCE E. COLI BETWEEN 2011 AND 2015
MULTI-RESISTANCE 2011-2015
Jeroen Dewulf
VETERINARY EPIDEMIOLOGY
T +32 9 264 75 43
M +32 476 49 70 40
www.ugent.be
www.amcra.be
Ghent University
@jkdewulf
jkdewulf
