Third joint inter-agency report on integrated analysis of consumption of antimicrobial agents and occurrence of antimicrobial resistance in bacteria from humans and food-producing animals in the EU/EEA: JIACRA III 2016-2018.

The third 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 2016-2018. AMC in both sectors, expressed in mg/kg of estimated biomass, was compared at country and European level. Substantial variations in AMC between countries were observed in human and food animal sectors. In each year over the period 2016-2018, overall AMC was lower in food-producing animals (for example in 2017, 108.3 mg/kg, range 3.1-423.1) than in humans (for example in 2017, 130.0 mg/kg; range 52.8-212.6). This is the first time this situation has been reported since JIACRA analyses were initiated on 2011 data. Univariate and multivariate analyses were applied to study associations between AMC and AMR for selected combinations of bacteria and antimicrobials. In both food-producing animals and humans, associations were generally observed between the consumption of an antimicrobial class and bacterial resistance to the antimicrobials in this class in the same population. The multivariate analysis proved to be a useful approach for assessing the statistical significance and relative strength of associations between the occurrence of AMR in bacteria from humans, AMR in bacteria from food-producing animals and AMC in both food-producing animals and humans. For certain combinations of bacteria and antimicrobials, resistance in bacteria from humans was associated with resistance in bacteria from food-producing animals which, in turn, was related to antimicrobial consumption in animals. The analyses showed that the relative strength of these associations differed markedly depending on antimicrobial class, microorganism and sector. Overall, the findings suggest that further interventions to reduce AMC will have a beneficial impact on AMR, which underlines the need to promote prudent use of antimicrobial agents in conjunction with infection control, prevention of infection and other relevant measures in both humans and foodproducing animals. The high levels of AMC and AMR still being reported in animals and humans from several countries show that these interventions should be reinforced.