Tag Archives: ETH Zurich

ETH Zurich study: Antimicrobial resistance is drastically rising

22 Sep

The National Pesticide Information wrote in Antimicrobials: Topic Fact Sheet:

What are antimicrobials?
Antimicrobial products kill or slow the spread of microorganisms. Microorganisms include bacteria, viruses, protozoans, and fungi such as mold and mildew.1 You may find antimicrobial products in your home, workplace, or school.
The U.S. Environmental Protection Agency (EPA) regulates antimicrobial products as pesticides, and the U.S. Food and Drug Administration (FDA) regulates antimicrobial products as drugs/antiseptics. As pesticides, antimicrobial products are used on objects such as countertops, toys, grocery carts, and hospital equipment. As antiseptics, antimicrobial products are used to treat or prevent diseases on people, pets, and other living things.
If a product shows “EPA” anywhere on the label, you know it’s a pesticide and NOT meant for use on the body. This fact sheet will focus on antimicrobials used as pesticides.
If a product label claims to kill, control, repel, mitigate or reduce a pest, it is a pesticide regulated by the U.S. EPA.2 When manufacturers make this kind of claim on the label, they must also include:
• application instructions that are effective at killing or controlling the pest, and
• first aid instructions, in case of accidental exposure.
What types of antimicrobial pesticides are there?
There are two general categories for antimicrobial pesticides: those that address microbes in public health settings, and those that do not. “Public health products” are designed to handle infectious microbes. See Table 1.
Table 1. Sites of application for antimicrobial pesticides1
Non-public health settings Public health settings
Microbes that may cause objects to spoil or rot Microbes that may cause people to get sick
• cooling towers
• fuel
• wood textiles
• paint
• paper products • bathrooms
• kitchens
• homes
• hospitals
• restaurants
There are three types of public health antimicrobials: sterilizers, disinfectants, and sanitizers. See Table 2.
Sanitizers are the weakest public-health antimicrobials. They reduce bacteria on surfaces.1 Some sanitizers may be used on food-contact surfaces such as countertops, cutting boards, or children’s high chairs. The label will indicate how a sanitizer can be used. Some sanitizers can be used only for non-food contact surfaces like toilet bowls and carpets, or air.5,6
Sterilizers are the strongest type of public health antimicrobial product. In addition to bacteria, algae, and fungi, they also control hard-to-kill spores.5 Many sterilizers are restricted-use pesticides. These require applicator training and certification. Sterilizers are used in medical and research settings when the presence of microbes must be prevented as much as possible. In addition to chemical sterilizers, high-pressure steam and ovens are also used to sterilize items.5
What do I need to know?
• Always follow the label directions. The “Directions for Use” are specific, and the product may not work if you don’t follow them.
• Never mix different antimicrobial products.
• Most antimicrobial products take time to work. Read the label to find out how long the product must remain in contact with the surface in order to sanitize, disinfect or sterilize it.10
• Dirt, food, slime, and other particles may reduce the effectiveness of antimicrobial products.10
• Take steps to reduce your exposure to antimicrobial pesticides. Some products can be harmful when touched or inhaled.
References:
1. What are Antimicrobial Pesticides?; U.S Environmental Protection Agency, Office of Prevention, Pesticides, and Toxic Substances, Office of Pesticide Programs, U.S. Government Printing Office: Washington, DC, 2010.
2. Pesticide Registration and Classification Procedures, Protection of the Environment; Code of Federal Regulations, Part 152, Title 40, 2010.
3. Anthrax Spore Decontamination Using Bleach (Sodium hypochlorite); U.S. Environmental Protection Agency, Office of Prevention, Pesticides, and Toxic Substances, Office of Pesticide Programs. U.S. Government Printing Office: Washington, DC, 2010.
4. Label Review Manual – Chapter 2: What is a Pesticide?; U.S Environmental Protection Agency, Office of Prevention, Pesticides, and Toxic Substances, Office of Pesticide Programs, U.S. Government Printing Office: Washington, DC, 2006.
5. Antimicrobial Pesticide Products; U.S Environmental Protection Agency, Office of Prevention, Pesticides, and Toxic Substances, Office of Pesticide Programs, U.S. Government Printing Office: Washington, DC, 2010.
6. Pesticide Labeling Questions & Answers; U.S Environmental Protection Agency, Office of Prevention, Pesticides, and Toxic Substances, Office of Pesticide Programs, U.S. Government Printing Office: Washington, DC, accessed Dec 2010. updated Dec 2010.
7. Antimicrobial Products Registered for Use Against the H1N1 Flu and Other Influenza A Viruses on Hard Surfaces; U.S Environmental Protection Agency, Office of Prevention, Pesticides, and Toxic Substances, Office of Pesticide Programs, U.S. Government Printing Office: Washington, DC, 2010.
8. Selected EPA-registered Disinfectants; U.S Environmental Protection Agency, Office of Prevention, Pesticides, and Toxic Substances, Office of Pesticide Programs, U.S. Government Printing Office: Washington, DC, 2010.
9. Gilbert, P.; McBain, A. J. Potential Impacts of Increased Use of Biocides in Consumer Products on Prevalence of Antibiotic Resistance. Clinical Microbiology Reviews, 16, 2, 189-208.
10. Rutala, W. A.; Weber, D. J. Guideline for Disinfection and Sterilization in Health Care Facilities, 2008. U.S. Center for Disease Control, Healthcare Infection Control Practices Advisory Committee (HICPAC). https://www.cdc.gov/infectioncontrol/pdf/guidelines/disinfection-guidelines.pdf (accessed Dec 2010), updated Dec 2010.
11. Sanitizer Test for Inanimate Surfaces; U.S Environmental Protection Agency, Office of Prevention, Pesticides, and Toxic Substances, Office of Pesticide Programs, U.S. Government Printing Office: Washington, DC, 2010. http://npic.orst.edu/factsheets/antimicrobials.html

There is growing alarm about antimicrobial resistance.

The Centers for Disease Control and Prevention describe antimicrobial resistance in

About Antimicrobial Resistance:
Antibiotic resistance happens when germs like bacteria and fungi develop the ability to defeat the drugs designed to kill them. That means the germs are not killed and continue to grow.
Infections caused by antibiotic-resistant germs are difficult, and sometimes impossible, to treat. In most cases, antibiotic-resistant infections require extended hospital stays, additional follow-up doctor visits, and costly and toxic alternatives.
Antibiotic resistance does not mean the body is becoming resistant to antibiotics; it is that bacteria have become resistant to the antibiotics designed to kill them.
Antibiotic Resistance Threatens Everyone

Antibiotic resistance has the potential to affect people at any stage of life, as well as the healthcare, veterinary, and agriculture industries, making it one of the world’s most urgent public health problems.
Each year in the U.S., at least 2 million people are infected with antibiotic-resistant bacteria, and at least 23,000 people die as a result.
No one can completely avoid the risk of resistant infections, but some people are at greater risk than others (for example, people with chronic illnesses). If antibiotics lose their effectiveness, then we lose the ability to treat infections and control public health threats.
Many medical advances are dependent on the ability to fight infections using antibiotics, including joint replacements, organ transplants, cancer therapy, and treatment of chronic diseases like diabetes, asthma, and rheumatoid arthritis…. https://www.cdc.gov/drugresistance/about.html

ETH Zurich studied antimicrobial resistance.

Science Daily reported in Antimicrobial resistance is drastically rising:

The world is experiencing unprecedented economic growth in low- and middle-income countries. An increasing number of people in India, China, Latin America and Africa have become wealthier, and this is reflected in their consumption of meat and dairy products. In Africa, meat consumption has risen by more than half; in Asia and Latin America it is up by two-thirds.
To meet this growing demand, animal husbandry has been intensified, with among other things, an increased reliance on the use of antimicrobials. Farmers use antimicrobials to treat and prevent infections for animals raised in crowded conditions but these drugs are also used to increase weight gain, and thus improve profitability.
This excessive and indiscriminate use of antimicrobials has serious consequences: the proportion of bacteria resistant to antimicrobials is rapidly increasing around the world. Drugs are losing their efficacy, with important consequences for the health of animals but also potentially for humans.
Mapping resistance hotspots
Low- and middle income countries have limited surveillance capacities to track antimicrobial use and resistance on farms. Antimicrobial use is typically less regulated and documented there than in wealthy industrialized countries with established surveillance systems.
The team of researchers led by Thomas Van Boeckel, SNF Assistant Professor of Health Geography and Policy at ETH Zurich, has recently published a map of antimicrobial resistance in animals in low- and middle-income countries in the journal Science.
The team assembled a large literature database and found out where, and in which animals species resistance occurred for the common foodborne bacteria Salmonella, E. coli, Campylobacter and Staphylococcus.
According to this study, the regions associated with high rates of antimicrobial resistance in animals are northeast China, northeast India, southern Brazil, Iran and Turkey. In these countries, the bacteria listed above are now resistant to a large number of drug that are used not only in animals but also in human medicine. An important finding of the study is that so far, few resistance hotspots have emerged in Africa with the exception of Nigeria and the surroundings of Johannesburg.
The highest resistance rates were associated with the antimicrobials most frequently used in animals: tetracyclines, sulphonamides, penicillins and quinolones. In certain regions, these compounds have almost completely lost their efficacy to treat infections.
Alarming trend in multi-drug resistance
The researchers introduced a new index to track the evolution of resistance to multiple drugs: the proportion of drugs tested in each region with resistance rates higher than 50%. Globally, this index has almost tripled for chicken and pigs over the last 20 years. Currently, one third of drugs fail 50% of the time in chicken and one quarter of drug fail in 50% of the time in pigs.
“This alarming trend shows that the drugs used in animal farming are rapidly losing their efficacy,” Van Boeckel says. This will affect the sustainability of the animal industry and potentially the health of consumers.
It is of particular concern that antimicrobial resistance is rising in developing and emerging countries because this is where meat consumption is growing the fastest, while access to veterinary antimicrobials remains largely unregulated. “Antimicrobial resistance is a global problem. There is little point in making considerable efforts to reduce it on one side of the world if it is increasing dramatically on the other side,” the ETH researcher says…. https://www.sciencedaily.com/releases/2019/09/190919142211.htm

Citation:

Antimicrobial resistance is drastically rising
Date: September 19, 2019
Source: ETH Zurich
Summary:
Researchers have shown that antimicrobial-resistant infections are rapidly increasing in animals in low and middle income countries. They produced the first global of resistance rates, and identified regions where interventions are urgently needed.
Journal Reference:
Thomas P. Van Boeckel, João Pires, Reshma Silvester, Cheng Zhao, Julia Song, Nicola G. Criscuolo, Marius Gilbert, Sebastian Bonhoeffer, Ramanan Laxminarayan. Global trends in antimicrobial resistance in animals in low- and middle-income countries. Science, 2019; 365 (6459): eaaw1944 DOI: 10.1126/science.aaw1944

Here is the press release from ETH Zurich:

Antimicrobial resistance is drastically rising
19.09.2019 | News
By: Peter Rüegg
An international team of researchers led by ETH has shown that antimicrobial-resistant infections are rapidly increasing in animals in low and middle income countries. They produced the first global of resistance rates, and identified regions where interventions are urgently needed.

The world is experiencing unprecedented economic growth in low- and middle-income countries. An increasing number of people in India, China, Latin America and Africa have become wealthier, and this is reflected in their consumption of meat and dairy products. In Africa, meat consumption has risen by more than half; in Asia and Latin America it is up by two-thirds.
To meet this growing demand, animal husbandry has been intensified, with among other things, an increased reliance on the use of antimicrobials. Farmers use antimicrobials to treat and prevent infections for animals raised in crowded conditions but these drugs are also used to increase weight gain, and thus improve profitability.
This excessive and indiscriminate use of antimicrobials has serious consequences: the proportion of bacteria resistant to antimicrobials is rapidly increasing around the world. Drugs are losing their efficacy, with important consequences for the health of animals but also potentially for humans.
Mapping resistance hotspots
Low- and middle income countries have limited surveillance capacities to track antimicrobial use and resistance on farms. Antimicrobial use is typically less regulated and documented there than in wealthy industrialized countries with established surveillance systems.
The team of researchers led by Thomas Van Boeckel, SNF Assistant Professor of Health Geography and Policy at ETH Zurich, has recently published a map of antimicrobial resistance in animals in low- and middle-income countries in the journal Science.
The team assembled a large literature database and found out where, and in which animals species resistance occurred for the common foodborne bacteria Salmonella, E. coli, Campylobacter and Staphylococcus.

According to this study, the regions associated with high rates of antimicrobial resistance in animals are northeast China, northeast India, southern Brazil, Iran and Turkey. In these countries, the bacteria listed above are now resistant to a large number of drug that are used not only in animals but also in human medicine. An important finding of the study is that so far, few resistance hotspots have emerged in Africa with the exception of Nigeria and the surroundings of Johannesburg.
The highest resistance rates were associated with the antimicrobials most frequently used in animals: tetracyclines, sulphonamides, penicillins and quinolones. In certain regions, these compounds have almost completely lost their efficacy to treat infections.
Alarming trend in multi-drug resistance
The researchers introduced a new index to track the evolution of resistance to multiple drugs: the proportion of drugs tested in each region with resistance rates higher than 50%. Globally, this index has almost tripled for chicken and pigs over the last 20 years. Currently, one third of drugs fail 50% of the time in chicken and one quarter of drug fail in 50% of the time in pigs.
“This alarming trend shows that the drugs used in animal farming are rapidly losing their efficacy,” Van Boeckel says. This will affect the sustainability of the animal industry and potentially the health of consumers.
It is of particular concern that antimicrobial resistance is rising in developing and emerging countries because this is where meat consumption is growing the fastest, while access to veterinary antimicrobials remains largely unregulated. “Antimicrobial resistance is a global problem. There is little point in making considerable efforts to reduce it on one side of the world if it is increasing dramatically on the other side,” the ETH researcher says.
Input from thousands of studies
For their current study, the team of researchers from ETH, Princeton University and the Free University of Brussels gathered thousands of publications as well as unpublished veterinary reports from around the world. The researchers used this database to produce the maps of antimicrobial resistance.
However, the maps do not cover the entire research area; there are large gaps in particular in South America, which researchers attribute to a lack of publicly available data. “There are hardly any official figures or data from large parts of South America,” says co-author and ETH postdoctoral fellow Joao Pires. He said this surprised him, as much more data is available from some African countries , despite resources for conducting surveys being more limited than in South America.
Open-access web platform
The team has created an open-access web platform resistancebank.org to share their findings and gather additional data on resistance in animals. For example, veterinarians and state-authorities can upload data on resistance in their region to the platform and share it with other people who are interested.
Van Boeckel hopes that scientists from countries with more limited resources for whom publishing cost in academic journal can be a barrier will be able to share their findings and get recognition for their work on the platform. “In this way, we can ensure that the data is not just stuffed away in a drawer” he says, “because there are many relevant findings lying dormant, especially in Africa or India, that would complete the global picture of resistance that we try to draw in this first assessment. The platform could also help donors to identify the regions most affected by resistance in order to be able to finance specific interventions.
As meat production continues to rise, the web platform could help target interventions against AMR and assist a transition to more sustainable farming practices in low- and middle-income countries. “The rich countries of the Global North, where antimicrobials have been used since the 1950s, should help make the transition a success,” says Van Boeckel.
The research was funded by the Swiss National Science Foundation and the Branco Weiss Fellowship.
Reference
Van Boeckel TP, Pires J, Silvester R, Zhao C , Song J, Criscuolo NG, Gilbert M, Bonhoeffer S, Laxminarayan R. Global trends in antimicrobial resistance in animals in low- and middle-income countries. Science 365, 2019, doi: 10.1126/science.aaw1944
Research|
International|
Agricultural sciences|
Sustainability|
World food system https://ethz.ch/en/news-and-events/eth-news/news/2019/09/antimicrobial-resistances-on-the-rise.html

The Centers for Disease Control and Prevention have a page devoted to prevention of antimicrobial resistance.

Antibiotic resistance is one of the biggest public health challenges of our time. Each year in the U.S., at least 2 million people get an antibiotic-resistant infection, and at least 23,000 people die. Fighting this threat is a public health priority that requires a collaborative global approach across sectors. CDC is working to combat this threat. Find out how you can help.

About Antimicrobial Resistance
Food & Food Animals
Combat Resistance Globally
Biggest Threats & Data
Laboratory Testing & Resources
Latest News & Resources
Protect Yourself & Your Family
What CDC is Doing
AR Isolate Bank
Healthcare Providers
U.S. Action

https://www.cdc.gov/drugresistance/index.html

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