Abstract
Antimicrobial resistance (AMR) should be tackled through a One Health approach, as stated in the World Health Organization Global Action Plan on AMR. We describe the landscape of AMR surveillance in the European Union/European Economic Area (EU/EEA) and underline a gap regarding veterinary medicine. Current AMR surveillance efforts are of limited help to veterinary practitioners and policymakers seeking to improve antimicrobial stewardship in animal health. We propose to establish the European Antimicrobial Resistance Surveillance network in Veterinary medicine (EARS-Vet) to report on the AMR situation, follow AMR trends and detect emerging AMR in selected bacterial pathogens of animals. This information could be useful to advise policymakers, explore efficacy of interventions, support antimicrobial stewardship initiatives, (re-)evaluate marketing authorisations of antimicrobials, generate epidemiological cut-off values, assess risk of zoonotic AMR transmission and evaluate the burden of AMR in animal health. EARS-Vet could be integrated with other AMR monitoring systems in the animal and medical sectors to ensure a One Health approach. Herein, we present a strategy to establish EARS-Vet as a network of national surveillance systems and highlight challenges of data harmonisation and bias. Strong political commitment at national and EU/EEA levels is required for the success of EARS-Vet.
Highlights
A One Health surveillance approach is needed to face the challenges of antimicrobial resistance (AMR), as stated in the World Health Organization (WHO) Global Action Plan on Antimicrobial resistance (AMR) [1] and the European Union (EU) One Health Action Plan against AMR [2]
We describe the landscape of AMR surveillance in the European Union/European Economic Area (EU/EEA) and underline a gap regarding veterinary medicine
At the EU/ European Economic Area (EEA) level, in the human sector, the European Centre for Disease Prevention and Control (ECDC) coordinates the European Antimicrobial Resistance Surveillance Network (EARS-Net), which monitors AMR in invasive bacteria isolated from blood and cerebrospinal fluid in hospitalised patients [3], and the European Food- and Waterborne Diseases and Zoonoses Network (FWD-Net), which monitors
Summary
A One Health surveillance approach is needed to face the challenges of antimicrobial resistance (AMR), as stated in the World Health Organization (WHO) Global Action Plan on AMR [1] and the European Union (EU) One Health Action Plan against AMR [2]. One of the first steps in designing EARS-Vet would be the definition of a surveillance framework, including its: (i) surveillance scope (i.e. the animal species, production types (e.g. dairy or beef cattle, laying hens or broilers), age categories, bacterial species, specimens and antimicrobials it covers), (ii) AST standards, (iii) metadata to be collected (including minimum and desirable variables), (iv) data governance, (v) frequency of data reporting, (vi) general data management system and (vii) required procedures (including data cleaning and validation), as well as (viii) how data would be analysed and communicated This framework should ensure that EARS-Vet can meet the aforementioned surveillance objectives and facilitate broad country participation. Some countries have decided to subsidise ASTs (e.g. Czech Republic and Spain) to collect more representative AMR data comprising a broader range of cases, i.e. those after treatment failure Several successful initiatives, such as EARS-Net and ESVAC, have proven that a European surveillance network can be developed gradually, starting with a group of countries collaborating despite initial lack of harmonisation. Developing EARS-Vet is timely and could set the basis for a future regulated surveillance network
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