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Updated on 23/04/2021

Antimicrobial resistance

Keywords : Antimicrobial resistance, Animal health, Veterinary medicinal products, Antibiotics

Antimicrobial resistance is a major international human and animal health issue, because the emergence and spread of drug-resistant strains of bacteria call into question the efficacy of these treatments in humans and animals alike. Preserving the effectiveness of antibiotics is therefore a genuine public health challenge requiring an integrated approach across all types of medicine, according to the "One Health" concept covering both humans and animals.
ANSES has mobilised significant resources to address the topic of antibiotic resistance. Through all its research, reference, surveillance and risk assessment activities, the Agency contributes to a greater understanding of the risks associated with antimicrobial resistance related to farming, food and the environment and, therefore, ultimately the risks to human health.

Where does antimicrobial resistance come from?

Antimicrobials are substances that fight infection-causing bacteria. They were first produced and used on a large scale after the Second World War. Their introduction was a major medical breakthrough, and it is estimated that their use has resulted in an increase of at least ten years in life expectancy, making it possible to successfully treat many previously fatal diseases.

This effectiveness has led to their use becoming increasingly frequent and sometimes unjustified (treatment periods that are too short or too long, unsuitable doses), both in humans and in veterinary medicine. This has promoted the emergence of bacterial resistance to these treatments, through the selection of strains capable of surviving antimicrobials. Today, numerous bacteria are resistant to several different antimicrobials (multi-resistant).
This global phenomenon has individual repercussions, since it calls into question the effectiveness of the available treatments and threatens human and animal health.

Why is it necessary to monitor antimicrobial use and the development of resistance in animal health?

Some resistant bacteria can infect humans and other animal species, thus contributing to the emergence of "therapeutic dead-ends", i.e. situations where no antimicrobial is effective against a bacterium. This is why antimicrobial resistance has emerged as a major public health issue requiring a global approach, both in terms of species (it concerns all animal species, including humans) and geographical area (it is a worldwide problem). Particular attention is now being paid to resistance to so-called "critical" antimicrobials, which are mainly used in human medicine as a last resort when the first antimicrobials prescribed have failed to cure a patient.

Preserving the effectiveness of antimicrobials requires rational use, along with careful monitoring of their use and of changes in resistance to these substances.

What is ANSES's role in combating antimicrobial resistance?

ANSES is responsible for monitoring antimicrobial resistance in veterinary medicine, whether related to livestock farming, food or the environment. This is part of an integrated approach to human, animal and environmental health, in accordance with the One Health concept recommended by the World Health Organisation and implemented by France.

As the National Reference Laboratory for antimicrobial resistance, the Agency monitors the exposure of animals to antimicrobial treatments (in particular through surveys of antimicrobial sales), monitors and studies the development of resistance in bacteria infecting animals, and assesses the risks of resistance in connection with the placing on the market of veterinary antimicrobials.

Monitoring exposure of animals to antimicrobials

Monitoring of antimicrobial sales, which provides information on the use of antimicrobials to treat farmed animals or pets, is one of the main sources of information used to assess and manage animal exposure to antimicrobials.

In France, the first EcoAntibio plan (2012-2016) aimed to reduce the use of antimicrobials by 25% in five years, a target that was achieved and even exceeded with a 37% reduction in animal exposure to antimicrobials. The new EcoAntibio plan (2017-2021) aims to ensure that the decline in animal exposure to antimicrobials is sustained. A specific target was also set for a 50% reduction in exposure to colistin within five years in the cattle, pig and poultry sectors. This has been achieved, with the exposure rate to this antibiotic falling by 64.2% compared to the average reference level between 2014 and 2015.

Since 1999, in partnership with the French Union for the Veterinary Medicinal Product and Reagent Industry (SIMV), ANSES has been monitoring veterinary antimicrobial sales each year.

ANSES's Ploufragan-Plouzané-Niort and Lyon laboratories also conduct ad hoc livestock surveys to collect descriptive data on the prescription and use of antimicrobials. These data are analysed to better estimate the exposure of different animal species (food-producing animals and pets).  

Monitoring and studying the presence of bacterial resistance in animals

ANSES is the National Reference Laboratory (NRL) for antimicrobial resistance. As such, it monitors the resistance of bacteria in the food chain as part of surveillance plans that have been harmonised at European level. In particular, it carries out annual surveillance plans, overseen by the DGAL, which help monitor developments at national and European level. They enable "sentinel" bacteria (i.e. those responsible for infections) to be collected at the slaughterhouse. Sampling is random and take place throughout the year and across the country. Each year, the results are published in France by the DGAL and at European level by the European Food Safety Authority (EFSA). The NRL also validates authorised methods for testing the resistance of a bacterium of animal origin to an antimicrobial of critical importance to humans.

ANSES's laboratories also conduct a great deal of research, reference and surveillance work that helps further knowledge of antimicrobial resistance. 
In particular, they coordinate RESAPATH, a network for monitoring antimicrobial resistance in bacteria of importance to animal health. It compiles antibiogram data from bacteria sampled from sick animals in a veterinary clinic or on a farm.

Assessing the risks associated with antimicrobial resistance as part of the marketing of veterinary antimicrobials

ANSES assesses the risks associated with antimicrobial resistance as part of the Marketing Authorisation (MA) procedures for veterinary medicinal products.

The French Agency for Veterinary Medicinal Products (ANMV), part of ANSES, grants MAs in France for veterinary antimicrobials. In this context, it assesses their quality, efficacy and safety for the animal, the user (safety during administration), the consumer and the environment, taking into account the specific risk of development of resistance. It also monitors them after they have been placed on the market.