Outstanding recommendations from ACMSF 1999 report on AMR
2. Members reviewed the outstanding recommendations from ACMSF’s 1999 report on Microbial Antibiotic Resistance in Relation to Food Safety and discussed whether these were still relevant. They related to two main areas:
- Gaps in the knowledge base with regards to the prevalence of antibiotic resistance in commensal microorganisms found in food (particularly E. coli and enterococci)
- Gaps in Government funded research on antibiotic-resistance bacteria in imported food and animal feeding stuffs and in the area of microbiological risk assessment.
3. The group noted that 14 years have elapsed since the report had been published and since then a lot of work has been undertaken. This has meant that some of the recommendations may be out of date and in some cases may no longer be applicable. In addition some recommendations may need updating or re-framing, for example in light of developments in newly-developed, genomic sequence-based methods for identifying resistance genes in bacterial populations.
4. The role of commensals has been identified as important in spreading resistance genes to pathogens. This has been highlighted in a 2011 EFSA Opinion on the public health risks of bacterial strains producing extended-spectrum β-lactamases (ESBLs) and/or AmpC β-lactamases in food and food-producing animals and also in a series of recent papers from The Netherlands. When the ACMSF 1999 report was being written, methods for detection of resistance would have relied heavily on phenotypic methods including the use of surrogate markers. There is now increased emphasis on tracking the spread of resistance genes between organisms which has been facilitated by the use of molecular methods. Hazards in this area are posed by the presence of resistance genes, and their propensity to “move” (e.g. plasmid/ integron/transposon versus nucleus) from the current commensal host.
5. In relation to imported foods the group commented that the relative importance of imported foods to the development of AMR is unknown and it remains a potentially significant source. This is particularly relevant in that such foods may be imported from countries where production is cheaper and antibiotic usage in food animals is less regulated than in the UK, and in other EU Member States.
6. Some antimicrobial resistance gene/organism combinations are spread by the food-borne route and have had significant effects in some areas e.g. Salmonella Kentucky in North Africa and Eastern Europe, but not to a significant extent in the UK. Data to understand these patterns and associated risks would be desirable.
7. The new poultry inspection proposals from the Commission include requirements to define the levels of E. coli with ESBLS/AmpC-encoding resistance genes.
8. In summary the group considered that AMR in imported food remains an area of concern, and the knowledge gaps in this area need to be resolved to inform risk management.
9. The working group also considered imported feedstuffs and noted there are differences between bacteria in imported animal feed, and in imported feed that is medicated (including water). It was thought that there is little feed that is imported already medicated, but imported feed may be contaminated with resistant micro-organisms. It was considered that it was important to know whether there is an enhanced risk from imported feed and there is still insufficient data to inform assessment of these risks.
10. In relation to the outstanding, and in some cases longstanding, recommendations re AMR (ACMSF 1999, 2005 & 2007) the group noted that some significant gaps in the knowledge base remain. The working group will continue to monitor and report on these gaps, “new gaps”, and re-opening gaps (i.e. areas where the passage of time, and changes in AMR patterns mean that new/additional data is necessary to inform accurate risk assessment).