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Antimicrobial resistance complex

Antimicrobial resistance complex
Latest research on antimicrobial use finds emergence of resistance not unidirectional.

A NEW scientific status summary in Comprehensive Reviews in Food Science & Food Safety outlines the challenges and complexities regarding antimicrobial resistance from the perspectives of four experts in the field, according to an announcement from the Institute of Food Technologists (IFT).

Authors Michael Doyle with the University of Georgia Center for Food Safety, Guy Loneragan at the Texas Tech University International Center for Food Industry Excellence, H. Morgan Scott with the Kansas State University department of diagnostic medicine/pathobiology and Randall Singer with the University of Minnesota department of veterinary and biomedical sciences reviewed the latest research on the public health effects of antimicrobial use in the food system and the growth and control of antimicrobial-resistant pathogens.

According to the authors, "Concerns about the public health implications of microbial resistance to antibiotics used in both human medicine and food-animal agriculture have led to the publication of the World Health Organization's (WHO) 'List of Critically Important Antimicrobials for Human Medicine' and the World Organization for Animal Health's 'List of Antimicrobials of Veterinary Importance.'

"Although more needs to be done to improve the utility of these designations, such categorization of antimicrobials is helpful in prioritizing and addressing public health concerns and antimicrobial use," the authors concluded.

IFT said the report notes a range of other key findings on antimicrobial resistance, including:

* Data available thus far fail to implicate methicillin-resistant Staphylococcus aureus as a foodborne pathogen.

* Various lists of critically important antibiotics, such as those published by WHO and OIE, are a good first step for focusing on what is most important for protecting public health. Subsequent steps will be needed and might include international collaboration to better understand appropriate science-based regulatory oversight and enforcement to meaningfully protect these critically important drugs.

* Caution should be used in relying on the broad characterization of foodborne pathogens as multi-drug resistant as this classification alone may not represent a major threat to public health if the component resistance traits are not considered by WHO or the Food & Drug Administration to be of "critical importance."

* The U.S. National Antimicrobial Resistance Monitoring System (NARMS) has become a mature and respected system for monitoring changes in antimicrobial resistance in people, animals and retail meat sources.

The report authors also pointed to several findings regarding antimicrobial-resistant microbes that NARMS has recorded during the past 5-12 years, including:

* Among specific pathogens, resistance to several of the top antibiotic classes on the WHO list of critically important antibiotics has not expanded. For some combinations, resistance increases were noted.

* Emergence of antimicrobial resistance in bacteria associated with co-resident populations of animals and people is a complex issue and does not represent a simple unidirectional pathway from animals to human individuals. While simple interventions have been sufficient to control the prevalence of resistant bacteria in some unique combinations of antimicrobial use and bacteria, many situations call for more complex interventions.

* Eliminating growth promotion claims from antimicrobial labels in Denmark has not resulted in clear improvements in various antimicrobial resistance or health metrics. This may highlight the challenges in detecting and reporting benefits of regional interventions.

* A national intervention program to reduce antimicrobial-resistant bacteria should be based on an understanding of the key factors that can select and co-select for antibiotic resistance.

"It is highly likely that actions will be taken during the next five years to further restrict the availability of critically important antimicrobials and their allowed uses in aquaculture and agriculture, particularly in the developed world. However, such practices may, in the near future, have trade implications that will apply pressures to those jurisdictions with less control over their antimicrobial practices to develop and implement appropriate risk management policies," the authors said.

"To effectively mitigate harmful effects from antimicrobial resistance in the U.S., we must work with global partners to promote prudent use in those countries where regulatory oversight of critically important antimicrobial drugs is underdeveloped," they added.

The full scientific status summary is available at http://onlinelibrary.wiley.com/doi/10.1111/1541-4337.12008/abstract.

Volume:85 Issue:12

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