Wit B, Veldman K, Hordijk J, Wagenaar J, Heuvelink A, Vellema P, Dierikx CM, Backer JA, Takumi K, van Duijkeren E
RIVM Report 2017-0088
This report contains an erratum on the last page
This study examined whether current monitoring of carbapenemase-producing bacteria (CPE) can reliably detect the presence or absence of CPE in animals and/or animal products. The report concludes that it is necessary to take more samples of animals and animal products in a more targeted manner to be able to monitor a low prevalence of CPE This will also increase the chance of finding CPE before it has spread to different farms, animals and/or (animal) products.
CPE are antibiotic-resistant bacteria that are resistant to the last resort in infections, carbapenem antibiotics. These bacteria are seen as a threat to public health. Fortunately, they are not often found in humans in the Netherlands as yet. When this type of bacteria is found in hospitals, measures are taken to ensure they cannot spread further to risk groups.
Although CPE have not been found in animals and/or animal products in the Netherlands as yet, animals and/or animal products can play a role in spreading it to humans. CPE are occasionally found in animals abroad. Dutch livestock, pets and animal products are currently monitored for CPE. However, it is uncertain whether this monitoring is sufficient to detect changes in CPE presence and to find CPE when they are not yet widely distributed among farms, animals and/or (animal) products. For this reason, the Ministry of Health, Welfare and Sport has asked RIVM to conduct a preliminary study. It gives a detailed assessment of current monitoring of CPE in Dutch livestock, pets and animal products, provides an overview of the reliability of these measurements and identifies potential improvements.
The study shows that the numbers of samples taken from animals and products are too low to make reliable statements about the absence of CPE among livestock and to detect trends when the prevalence is low. Therefore more samples will have to be examined in order to monitor these trends. It is also useful to investigate where the greatest risks for the introduction of CPE in animals and/or animal products lie so that additional measurements can be carried out in the most targeted manner. A first exploratory risk inventory shows that import of animals and/or animal products from areas where CPE occurs is a potential risk for CPE entry into the Netherlands. Production animals can also acquire CPE through transmission from farms higher in the production chain. No monitoring currently takes place in the farms higher in the production chain. In addition, transmission can also occur via human carriers.
Absence of CPE can be investigated more reliably by taking more samples from animals and (animal) products in a more targeted manner. This will also increase the chance of finding CPE before it has spread to more farms, animals and/or (animal) products.