Antimicrobial resistance is a major public health concern that has prompted a movement to reduce the use of antibiotics, including antibiotics used in food animal production. To meet the growing global demand for animal protein, new approaches are needed to maintain the health and welfare of food animals while reducing the risk of antimicrobial resistance to build up in people and the environment. This daylong meeting will discuss the drivers that could lead to antimicrobial resistance from food animal production, primary pathways of antimicrobial resistance transmission, and the drive to prioritize the use of non-medically important antibiotics. The symposium will also discuss an array of strategies to mitigate antimicrobial resistance, from herd/flock management strategies to biological approaches including biophages and vaccines, communication strategies that promote a nuanced approach for best practices and positive outcomes.
Scientific Advisory Committee
September 28, 2018
Registration and Continental Breakfast
Session 1: Setting the Stage
Antibiotic Resistance: Background and Spread
Sustainability and Antimicrobial Use in Animal Agriculture
The Urgent Need For Harmonised Definitions In Addressing Antimicrobial Resistance In Veterinary Medicine
The topic of antimicrobial resistance is both broad and extremely complex, with intricate terminology. A fundamental issue that arises in discussions between different stakeholders is how terms are defined and this leads to confusion and misinterpretation.
Multiple organisations have attempted to define terms related to antimicrobial resistance and this has only lead to further confusion. For example, the simple term ‘prevention’ is defined differently by the WHO, Codex and OIE. In fact, WHO and Codex confusingly interchange ‘prevention’ and ‘control’ whilst the OIE specifically addresses ‘prevention’ in the strictest sense. This has resulted in some cases where antimicrobials are inappropriately administered under a ‘prevention’ claim.
At a fundamental level, there remains a great deal of confusion over even the basic of terms i.e. what is a ‘non-medically important antibiotic’ vs. ‘medically important antibiotic’. Of greater concern is that a number of institutions are confusing ‘medically important antibiotics’ as being ‘critically important antibiotics’.
Confusion in definitions leads to confusion in policy documents and interpretation of regulations. Such confusions can have detrimental effects when interpreting guidelines and legislations and indeed misinterpretation due to lack of clear definitions can, in some instances, lead to animal welfare issues.
This paper discusses the urgent need for clear definitions in regards to antimicrobial resistance and the international efforts currently being undertaken to harmonise definitions at a global level.
Session 2: Reducing Buildup of Resistance
Vaccination as a Means to Reduce the Need for Antibiotics
Any use of antibiotics contributes to the growing global threat of antibiotic resistance, so minimizing their use is essential. Vaccines and other antibiotic alternatives have the potential to prevent infections in food animals and various studies have demonstrated their ability to reduce the need for antibiotics. This holds promise for efforts to decrease reliance on antibiotics. To be widely used in food animals, vaccines have to be safe, effective, easy to use, and cost-effective. Many current vaccines fall short in one or more of these respects, although focused research and development efforts will help overcome these challenges and bring promising new vaccines to the veterinary market. This presentation will provide an overview of the field of vaccines as antibiotic alternatives today and tomorrow.
Microbiome Manipulation: Probiotics and Prebiotics
Bacteriophage-based antibacterial interventions
Session 3: Assessing Risk
A One Health Perspective on Antimicrobial Resistance
Worsening antimicrobial resistance (AMR) threatens the practice of modern human and veterinary medicine. For decades, medicine and agriculture have blamed each other for the rise of resistant microbes. Widespread use and misuse of antibiotics in both medicine and agriculture have contributed to the problem, but metagenomics studies suggest that antimicrobial resistance genes are ancient and ubiquitous. Widespread use by humans has increased their prevalence and expression. The rise of vancomycin-resistance Enterococcus faecium (VRE) in the European Union (EU) led to the ban of avoparcin, an antibiotic chemically related to vancomycin, an antibiotic used in human medicine. In the years post ban, VRE surveillance data of EU hospitals showed no obvious reduction in VRE rates. The United States (US) never approved avoparcin, yet VRE has been an enormous problem in its hospitals. AMR surveillance data showed zero rates of VRE in US livestock. Genomic data suggests that VRE might have evolved from ampicillin-resistant Enterococcus faecium from dogs. Companion animals have been completely ignored in the AMR debate and should be included in AMR surveillance systems. Whole genome sequencing surveillance should be conducted in hospitals, veterinary hospitals, farms, and slaughterhouses, and it should become the gold standard in AMR surveillance systems.
Characterizing Risk: Molecular vs. Microbiological Approaches
Tracking AMR from agroecosystems to fresh produce
Session 4: Communicating Risk
Antibiotic Use Food Labels and an Alternative Approach
Antibiotic use in animal production is not considered a precompetitive issue in the United States as it is in other countries such as the European Union. Thus the way that antibiotics are used – or not used - during the raising of animals is becoming an integral part of the marketing strategy used to sell meat and poultry products by many producers. Unfortunately, most consumers are unfamiliar with animal agriculture and are increasingly confused by food labels related to antibiotics and animal production practices. The meanings and implications for consumers and animals of antibiotic related labels used by the food industry such as “No Antibiotics Ever” and “Responsible Antibiotic Use” will be discussed. There are unintended consequences and tradeoffs to these single attribute labels that are part of a package based labeling system. An alternative approach to food labels is a program or systems based certification process that does not require diversion of product. A balanced multi-point standard that addresses several important areas in animal agriculture, including responsible antibiotic use that is respectful of animal welfare, may be a better solution to provide an affordable and sustainable labeled alternative for meat and poultry that will satisfy the needs of many consumers. A new cross commodity animal production certification program currently in development based on the principles of one health will be discussed.
Ag Antibiotic Use: Tradeoffs of usage strategies
Customer and Consumer Perceptions and Demands