EFSA J. 2024 Feb 23;22(2):e8589. doi: 10.2903/j.efsa.2024.8589. eCollection 2024 Feb.
The fourth joint inter-agency report on integrated analysis of antimicrobial consumption (AMC) and the occurrence of antimicrobial resistance (AMR) in bacteria from humans and food-producing animals (JIACRA) addressed data obtained by the Agencies' EU-wide surveillance networks for 2019-2021. The analysis also sought to identify whether significant trends in AMR and AMC were concomitant over 2014-2021. AMC in both human and animal sectors, expressed in mg/kg of estimated biomass, was compared at country and European level. In 2021, the total AMC was assessed at 125.0 mg/kg of biomass for humans (28 EU/EEA countries, range 44.3-160.1) and 92.6 mg/kg of biomass for food-producing animals (29 EU/EEA countries, range 2.5-296.5). Between 2014 and 2021, total AMC in food-producing animals decreased by 44%, while in humans, it remained relatively stable. Univariate and multivariate analyses were performed to study associations between AMC and AMR for selected combinations of bacteria and antimicrobials. Positive associations between consumption of certain antimicrobials and resistance to those substances in bacteria from both humans and food-producing animals were observed. For certain combinations of bacteria and antimicrobials, AMR in bacteria from humans was associated with AMR in bacteria from food-producing animals which, in turn, was related to AMC in animals. The relative strength of these associations differed markedly between antimicrobial class, microorganism and sector. For certain antimicrobials, statistically significant decreasing trends in AMC and AMR were concomitant for food-producing animals and humans in several countries over 2014-2021. Similarly, a proportion of countries that significantly reduced total AMC also registered increasing susceptibility to antimicrobials in indicator from food-producing animals and originating from human invasive infections (i.e., exhibited 'complete susceptibility' or 'zero resistance' to a harmonised set of antimicrobials). Overall, the findings suggest that measures implemented to reduce AMC in food-producing animals and in humans have been effective in many countries. Nevertheless, these measures need to be reinforced so that reductions in AMC are retained and further continued, where necessary. This also highlights the importance of measures that promote human and animal health, such as vaccination and better hygiene, thereby reducing the need for use of antimicrobials.
关于人类和食用动物细菌中抗菌药物消费（AMC）及抗菌药物耐药性（AMR）发生情况综合分析的第四次机构间联合报告（JIACRA）阐述了各机构2019 - 2021年全欧盟监测网络获取的数据。该分析还试图确定2014 - 2021年期间AMR和AMC的显著趋势是否同步。按毫克/千克估计生物量表示的人类和动物领域的AMC在国家和欧洲层面进行了比较。2021年，人类的总AMC评估为每千克生物量125.0毫克（28个欧盟/欧洲经济区国家，范围为44.3 - 160.1），食用动物的总AMC为每千克生物量92.6毫克（29个欧盟/欧洲经济区国家，范围为2.5 - 296.5）。2014年至2021年期间，食用动物的总AMC下降了44%，而人类的总AMC保持相对稳定。进行了单变量和多变量分析，以研究特定细菌和抗菌药物组合的AMC与AMR之间的关联。观察到某些抗菌药物的消费与人类和食用动物细菌中对这些物质的耐药性之间存在正相关。对于某些细菌和抗菌药物的组合，人类细菌中的AMR与食用动物细菌中的AMR相关，而食用动物细菌中的AMR又与动物中的AMC相关。这些关联的相对强度在抗菌药物类别、微生物和领域之间存在显著差异。对于某些抗菌药物，2014 - 2021年期间，几个国家的食用动物和人类的AMC和AMR在统计上呈现显著下降趋势。同样，一部分大幅降低总AMC的国家在食用动物和源自人类侵袭性感染的指示菌对抗菌药物敏感性方面也有所提高（即对一组统一的抗菌药物表现出“完全敏感”或“零耐药”）。总体而言，研究结果表明，许多国家为减少食用动物和人类中的AMC而实施的措施是有效的。然而，这些措施需要加强，以便保持AMC的减少并在必要时进一步持续下去。这也凸显了促进人类和动物健康的措施的重要性，如接种疫苗和改善卫生条件，从而减少对抗菌药物的使用需求。
