We welcome another guest post from Prof Peter Collignon (bio below) on the risk of antibiotic resistance in the food chain…

Codex has recently announced they are doing more work on antimicrobial resistance.  This is an opportunity get Codex to have a couple of standards to better protect public health from one of the worst types of antibiotic resistance that might develop in the next few years or decade. Specifically to help prevent carbapenem-resistant bacteria transferring to people via the food chain including via imported foods into countries (some useful background on this issue from European Food Safety Authority (EFSA) here).

We were in a situation in 1980s and early 1990s when we had few or no fluoroquinolone-resistant bacteria in our food supply. Nor did we have bacterial strains resistant to 3rd generation cephalosporins. Unfortunately this is now common. We now in many countries have very large percentages of strains resistant to these “Critically Important” antibiotics found in food animals and in foods. We need to do whatever we can to stop this also happening with carbapenems. Now is the time to act. Not risk only doing something ineffective in 10 years time because the problem is already widespread.

My suggestion is that Codex adopts or introduces rules or recommendations that:

• Prohibits the use of carbapenems use in food animals, and
• Prohibits the presence of carbapenem-resistant Salmonella or coli in foods.

To ensure carbapenems were not used in food animal would mean some monitoring to ensure Maximum Residue Limits (MRLs) were met. MRL’s in all countries should be set at a level of zero as carbapenems are not currently approved for use in food animals in any countries. We need to also monitor indicator bacteria (Salmonella and E.coli) to ensure that no carbapenem-resistant strains of Salmonella or E.coli are present in foods (and food animals).

Codex seems to act on requests and advice from individual countries. We need to all approach our own governments and agencies in our countries that deal with Codex. I think proposals to control carbapenem resistance would be supported by all Scandinavian countries plus The Netherlands, France, Germany, the UK, Japan, South Korea, Australia and New Zealand.  Hopefully all countries might come on board.

If these two prohibitions could occur, people around the world would benefit – now and more importantly in the future. We need to prevent a recurrence of the fluoroquinolone and 3rd generation cephalosporin resistance problem with now large numbers of food animals and foods around the world containing these resistant bacteria.

Bio

Peter Collignon. Infectious Diseases physician and microbiologist. Canberra Hospital and Professor Medical School, Australian National University.