Decreasing and stabilising trends of antimicrobial consumption and resistance in Escherichia coli and Klebsiella pneumoniae in segmented regression analysis, European Union/European Economic Area, 2001 to 2018.
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ABSTRACT:
SUBMITTER: Penalva G
PROVIDER: S-EPMC6864974 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:This report of the European Food Safety Authority and the European Centre for Disease Prevention and Control presents the results of zoonoses monitoring activities carried out in 2018 in 36 European countries (28 Member States (MS) and 8 non-MS). The first and second most commonly reported zoonoses in humans were campylobacteriosis and salmonellosis, respectively. The European Union (EU) trend for confirmed human cases of these two diseases was stable during 2014-2018. The proportion of human salmonellosis cases due to Salmonella Enteritidis was at the same level in 2018 as in 2017. Of the 27 reporting MS, 16 met all Salmonella reduction targets for poultry, whereas 11 MS failed meeting at least one. The EU flock prevalence of target Salmonella serovars in breeding hens, laying hens, broilers and fattening turkeys decreased during recent years but stalled in breeding turkeys. Salmonella results from Competent Authorities for pig carcasses and for poultry tested through National Control Programmes were more frequently positive compared with food business operators. Shiga toxin-producing Escherichia coli (STEC) infections in humans were the third most commonly reported zoonosis in the EU and increased from 2014 to 2018. Yersiniosis was the fourth most frequently reported zoonosis in humans in 2018 with a stable trend in 2014-2018. The number of reported confirmed listeriosis cases further increased in 2018, despite Listeria rarely exceeding the EU food safety limit tested in ready-to-eat food. In total, 5,146 food- and waterborne outbreaks were reported. Salmonella was the most commonly detected agent with S. Enteritidis causing one in five outbreaks. Salmonella in eggs and egg products was the highest risk agent/food pair. A large increase of human West Nile virus infections was reported in 2018. The report further updates on bovine tuberculosis, Brucella, Trichinella, Echinococcus, Toxoplasma, rabies, Coxiella burnetii (Q fever) and tularaemia.
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Project description:Under EU legislation (Article 32, Regulation (EC) No 396/2005), EFSA provides an annual report which analyses pesticide residue levels in foods on the European market. The analysis is based on data from the official national control activities carried out by EU Member States, Iceland and Norway and includes a subset of data from the EU-coordinated control programme which uses a randomised sampling strategy. For 2018, 95.5% of the overall 91,015 samples analysed fell below the maximum residue level (MRL), 4.5% exceeded this level, of which 2.7% were non-compliant, i.e. samples exceeding the MRL after taking into account the measurement uncertainty. For the subset of 11,679 samples analysed as part of the EU-coordinated control programme, 1.4% exceeded the MRL and 0.9% were non-compliant. Table grapes and sweet peppers/bell peppers were among the food products that most frequently exceeded the MRLs. To assess acute and chronic risk to consumer health, dietary exposure to pesticide residues was estimated and compared with health-based guidance values. The findings suggest that the assessed levels for the food commodities analysed are unlikely to pose concern for consumer health. However, a number of recommendations are proposed to increase the efficiency of European control systems (e.g. optimising traceability), thereby continuing to ensure a high level of consumer protection.
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Project description:Autochthonous outbreaks of chikungunya have occurred in the European Union (EU) after virus introduction by infected travelers. We reviewed the surveillance data of travel-related cases reported in the EU during 2012-2018 to document factors associated with increased infection rates among travelers and to assess how surveillance data could support preparedness against secondary transmission and timely control of outbreaks. Thirteen EU countries reported 2,616 travel-related chikungunya cases. We observed 3 successive epidemiologic periods; the highest number of cases (75%) occurred during 2014-2015, when most cases were associated with the Caribbean and South America. The highest infection rates among travelers were observed during the same phase. Although surveillance of travel-related cases is relevant for estimating the infection risk for travelers, we could not identify a relationship between the number of infected travelers and a higher likelihood of secondary transmission in the EU.
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Project description:This update on the African swine fever (ASF) outbreaks in the EU demonstrated that out of all tested wild boar found dead, the proportion of positive samples peaked in winter and summer. For domestic pigs only, a summer peak was evident. Despite the existence of several plausible factors that could result in the observed seasonality, there is no evidence to prove causality. Wild boar density was the most influential risk factor for the occurrence of ASF in wild boar. In the vast majority of introductions in domestic pig holdings, direct contact with infected domestic pigs or wild boar was excluded as the route of introduction. The implementation of emergency measures in the wild boar management zones following a focal ASF introduction was evaluated. As a sole control strategy, intensive hunting around the buffer area might not always be sufficient to eradicate ASF. However, the probability of eradication success is increased after adding quick and safe carcass removal. A wider buffer area leads to a higher success probability; however it implies a larger intensive hunting area and the need for more animals to be hunted. If carcass removal and intensive hunting are effectively implemented, fencing is more useful for delineating zones, rather than adding substantially to control efficacy. However, segments of fencing will be particularly useful in those areas where carcass removal or intensive hunting is difficult to implement. It was not possible to demonstrate an effect of natural barriers on ASF spread. Human-mediated translocation may override any effect of natural barriers. Recommendations for ASF control in four different epidemiological scenarios are presented.
| S-EPMC7009685 | biostudies-literature
Project description:Beta-lactam- and in particular carbapenem-resistant Enterobacteriaceae represent a major public health threat. Despite strong variation of resistance across geographical settings, there is limited understanding of the underlying drivers. To assess these drivers, we developed a transmission model of cephalosporin- and carbapenem-resistant Klebsiella pneumoniae. The model is parameterized using antibiotic consumption and demographic data from eleven European countries and fitted to the resistance rates for Klebsiella pneumoniae for these settings. The impact of potential drivers of resistance is then assessed in counterfactual analyses. Based on reported consumption data, the model could simultaneously fit the prevalence of extended-spectrum beta-lactamase-producing and carbapenem-resistant Klebsiella pneumoniae (ESBL and CRK) across eleven European countries over eleven years. The fit could explain the large between-country variability of resistance in terms of consumption patterns and fitted differences in hospital transmission rates. Based on this fit, a counterfactual analysis found that reducing nosocomial transmission and antibiotic consumption in the hospital had the strongest impact on ESBL and CRK prevalence. Antibiotic consumption in the community also affected ESBL prevalence but its relative impact was weaker than inpatient consumption. Finally, we used the model to estimate a moderate fitness cost of CRK and ESBL at the population level. This work highlights the disproportionate role of antibiotic consumption in the hospital and of nosocomial transmission for resistance in gram-negative bacteria at a European level. This indicates that infection control and antibiotic stewardship measures should play a major role in limiting resistance even at the national or regional level.
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Project description:Background. Despite use of highly effective conjugate vaccines, invasive pneumococcal disease (IPD) remains a leading cause of morbidity and mortality and disproportionately affects Indigenous populations. Although included in the 13-valent pneumococcal conjugate vaccine (PCV13), which was introduced in 2010, serotype 3 continues to cause disease among Indigenous communities in the Southwest USA. In the Navajo Nation, serotype 3 IPD incidence increased among adults (3.8/100 000 in 2001-2009 and 6.2/100 000 in 2011-2019); in children the disease persisted although the rates dropped from 5.8/100 000 to 2.3/100 000.Methods. We analysed the genomic epidemiology of serotype 3 isolates collected from 129 adults and 63 children with pneumococcal carriage (n=61) or IPD (n=131) from 2001 to 2018 of the Navajo Nation. Using whole-genome sequencing data, we determined clade membership and assessed changes in serotype 3 population structure over time.Results. The serotype 3 population structure was characterized by three dominant subpopulations: clade II (n=90, 46.9 %) and clade Iα (n=59, 30.7 %), which fall into Clonal Complex (CC) 180, and a non-CC180 clade (n=43, 22.4 %). The proportion of clade II-associated IPD cases increased significantly from 2001 to 2010 to 2011-2018 among adults (23.1-71.8 %; P<0.001) but not in children (27.3-33.3 %; P=0.84). Over the same period, the proportion of clade II-associated carriage increased; this was statistically significant among children (23.3-52.6 %; P=0.04) but not adults (0-50.0 %, P=0.08).Conclusions. In this setting with persistent serotype 3 IPD and carriage, clade II has increased since 2010. Genomic changes may be contributing to the observed trends in serotype 3 carriage and disease over time.
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Project description:In December 2018, a ceftazidime-avibactam (CAZ-AVI)-resistant KPC-2-producing Klebsiella pneumoniae strain was isolated in Finland. CAZ-AVI resistance was observed 34 days after CAZ-AVI treatment in a trauma patient transferred from a hospital in Greece who had been colonised with blaKPC-2-producing K. pneumoniae ST39, and later developed a bloodstream infection. The CAZ-AVI-resistant strain contained a novel 15 amino acid insertion in the KPC-2 protein causing structural changes proximal to the KPC-2 active site.
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Project description:Between January 2018 and May 2019, 349 cases of Candida auris were reported in the European Union/European Economic Area*, 257 (73.6%) colonisations, 84 (24.1%) bloodstream infections, seven (2.0%) other infections and one case of unknown infection/colonisation status (0.3%). Most cases (97.1%, n = 339) were reported from Spain or the United Kingdom, but also for the first time in Greece, the Netherlands and Poland. Laboratory capacity and preparedness has improved since January 2018.
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Project description:This report presents the results of surveillance on transmissible spongiform encephalopathies (TSE) in bovine animals, sheep, goats, cervids and other species, and genotyping in sheep, carried out in 2018 by 28 Member States (MS) according to legislation, and by Iceland, North Macedonia, Norway and Switzerland (non-MS). In total, 1,181,934 cattle were tested by MS, a 10% decrease from 2017 and 20,402 by the four non-MS. One case of classical bovine spongiform encephalopathy (BSE) was reported in 2018 by the UK, born after the enforcement of the total feed ban. Three atypical BSE cases (2 L-type/1 H-type) were reported by France. Over the year, a total of 325,386 sheep and 138,128 goats were tested in the EU, an increase of 3.4% and 17.8%, respectively, compared to 2017. In sheep, 934 cases of scrapie were reported: 821 classical (99 index cases and 97.8% with genotypes of susceptible groups) by 7 MS and 113 atypical (105 index cases) by 14 MS. Twenty-nine ovine scrapie cases were reported by Iceland and Norway. Random genotyping was only reported by eight MS and after excluding Cyprus showed that 18.7% of the genotyped sheep carried genotypes of the susceptible groups. In goats, 523 cases of scrapie were reported: 517 classical (38 index cases) by seven MS and six atypical (all index cases) by four MS. The heterogenous enforcement of a 3-year surveillance programme for chronic wasting disease (CWD) from 1/1/2018 in six MS (Estonia, Finland, Latvia, Lithuania, Poland and Sweden) resulted in the testing of 5,110 cervids and the confirmation of the first case of CWD in the EU: a wild moose in Finland. Other six MS tested 3,075 cervids with no positive results. Norway tested 33,037 cervids in 2018, resulting in seven new cases: six reindeer and one moose. In total, 105 animals from three other species were tested by two MS, with negative results.
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