The use of aminopenicillins in animals within the EU, emergence of resistance in bacteria of animal and human origin and its possible impact on animal and human health

• Published in: Journal of antimicrobial chemotherapy Vol. 78; no. 8; pp. 1827 - 1842
• Main Authors: van Duijkeren, Engeline, Rantala, Merja, Bouchard, Damien, Busani, Luca, Catry, Boudewijn, Kaspar, Heike, Pomba, Constança, Moreno, Miguel A, Nilsson, Oskar, Ružauskas, Modestas, Sanders, Pascal, Teale, Christopher, Wester, Astrid L, Ignate, Kristine, Jukes, Helen, Kunsagi, Zoltan, Schwarz, Christine
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 02.08.2023; Oxford University Press (OUP)
• Subjects: Animals; Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; Anti-Infective Agents; Bacteria; beta-Lactamases; Europe - epidemiology; Humans; Life Sciences; Microbiology and Parasitology; Penicillins; Europe; médicament humain; bacteria; one health; Europe; microbiology; aminopénicilline; utilisation d'antibiotiques; santé animale; aminopenicillin; maladie infectieuse; veterinary drug; human drug; transmission; antibiotic resistance; infectious disease; microbiologie; animal health; bactérie; antibiotic use; animal; santé unique; médicament vétérinaire; antibiorésistance
• ISSN: 0305-7453; 1460-2091
• DOI: 10.1093/jac/dkad157

Abstract Aminopenicillins have been widely used for decades for the treatment of various infections in animals and humans in European countries. Following this extensive use, acquired resistance has emerged among human and animal pathogens and commensal bacteria. Aminopenicillins are important first-line treatment options in both humans and animals, but are also among limited therapies for infections with enterococci and Listeria spp. in humans in some settings. Therefore, there is a need to assess the impact of the use of these antimicrobials in animals on public and animal health. The most important mechanisms of resistance to aminopenicillins are the β-lactamase enzymes. Similar resistance genes have been detected in bacteria of human and animal origin, and molecular studies suggest that transmission of resistant bacteria or resistance genes occurs between animals and humans. Due to the complexity of epidemiology and the near ubiquity of many aminopenicillin resistance determinants, the direction of transfer is difficult to ascertain, except for major zoonotic pathogens. It is therefore challenging to estimate to what extent the use of aminopenicillins in animals could create negative health consequences to humans at the population level. Based on the extent of use of aminopenicillins in humans, it seems probable that the major resistance selection pressure in human pathogens in European countries is due to human consumption. It is evident that veterinary use of these antimicrobials increases the selection pressure towards resistance in animals and loss of efficacy will at minimum jeopardize animal health and welfare.