ANSES's work on antimicrobial resistance
Antimicrobial resistance: a major issue for overall health
The extensive use of antimicrobials over the past few decades has led to the selection of micro-organisms with genes giving them the ability to resist these drugs. They pose a major threat to animal, human and plant health, because antimicrobials effective against pathogens are diminishing in number, and are even non-existent for certain multidrug-resistant strains. Particular attention is now being paid to resistance to so-called "critical" antibiotics, which are mainly used as a last resort in human medicine when the first antibiotics prescribed have failed to cure a patient.
ANSES's role in combating antimicrobial resistance
ANSES is responsible for monitoring antimicrobial resistance in veterinary medicine, whether it relates to livestock farming or food of animal origin intended for humans.
Monitoring and studying the presence of bacterial resistance in animals
The National Reference Laboratory for antimicrobial resistance
The Fougères and Ploufragan-Plouzané-Niort laboratories share the mandate of National Reference Laboratory (NRL) for antimicrobial resistance. As such, they monitor the resistance of bacteria that can contaminate humans via food of animal origin, as part of harmonised European monitoring plans.
In addition, the NRL implements annual monitoring plans, overseen by the Ministry of Agriculture and Food, which follow developments at national and European level. The NRL also validates authorised methods for testing the resistance of bacteria of animal origin to antibiotics of critical importance to humans.
How does the NRL's monitoring plan work?
Monitoring focuses on "indicator" bacteria such as Escherichia coli, which enable the reservoir of circulating resistance to be estimated, as well as bacteria such as Salmonella and Campylobacter that cause human infections. Samples are collected from healthy food-producing animals.
Depending on the bacterium and livestock sector, samples are collected on the farm (surface sampling), at the slaughterhouse (in intestinal contents) or at distribution (in meat). Sampling is random and takes place throughout the year and across the country. Each year, the results for France are published by the Directorate General for Food (DGAL), and those at European level by the European Food Safety Authority (EFSA) and the European Centre for Disease Prevention and Control (ECDC).
RESAPATH: a network for monitoring antimicrobial resistance
Since 1982, the French Surveillance Network for Antimicrobial Resistance in Pathogenic Bacteria of Animal Origin (RESAPATH) has been monitoring changes in resistance to antibiotics for all domestic animal species in France.
The RESAPATH network's objectives are to:
- monitor trends in resistance to antibiotics in bacteria of importance to animal health (including Escherichia coli) ;
- detect the emergence of resistance to antibiotics and characterise its mechanisms at the molecular level ;
- provide all its stakeholders with methodological and scientific support.
How does RESAPATH work?
The network is coordinated by ANSES's Lyon and Ploufragan-Plouzané-Niort laboratories and encompasses more than 100 volunteer veterinary testing laboratories. As part of their practitioner activity, veterinarians are required to collect samples from sick animals, in order to isolate bacteria and perform antibiotic resistance tests (antibiograms). These data are then sent to RESAPATH. Monitoring focuses primarily on the Escherichia coli bacterium, as it is indicative of antibiotic resistance since it is a known reservoir of resistance genes, which it can transmit to other bacteria.
Monitoring exposure to antimicrobials and assessing the risks associated with resistance when veterinary medicinal products are placed on the market
The French Agency for Veterinary Medicinal Products (ANMV), part of ANSES, grants marketing authorisation for veterinary medicines in France. Its monitoring of sales of veterinary antimicrobials also enables the authorities to assess animal exposure to these medicines and monitor changes in practices for different animal species. The information gathered is one of the essential elements, together with monitoring of bacterial resistance, needed for assessing the risks associated with antimicrobial resistance. These data are also used to recommend measures for managing these risks and monitor their effectiveness.
Investigating the presence of antibiotics and resistant bacteria in the environment
While antimicrobial resistance in humans and animals is a well-researched phenomenon, its dissemination in the environment is less well known. This is despite the fact that certain resistance genes that are currently a problem in medicine come from micro-organisms in the environment. In November 2020, ANSES published an expert appraisal on the presence of resistant bacteria and antibiotics in the environment, the first review of knowledge on this topic.
Conducting research to better monitor and understand antimicrobial resistance
ANSES's laboratories also conduct a great deal of research that helps further knowledge of antimicrobial resistance.
Some of their projects may aim to improve the monitoring of antimicrobial resistance, for example by perfecting the methods used to detect resistant bacteria or improving the functioning of monitoring systems.
Others seek to better understand how resistant micro-organisms are selected and spread. To do so, they use an overall approach, taking humans, animals and the environment into account.
Research is also carried out into alternatives to antimicrobials. The aim is to reduce the use of these medicines and find ways around the resistance of certain micro-organisms.
Participating in European and international reference work on antimicrobial resistance
ANSES is a World Organisation for Animal Health (WOAH) Collaborating Centre for veterinary medicinal products and a Reference Centre for antimicrobial resistance of the Food and Agriculture Organization of the United Nations (FAO). Under these mandates, the Agency provides advice to these institutions and support to Member States to ensure the rational use of antimicrobials in veterinary medicine and reduce antimicrobial resistance.