European report: Antimicrobial resistance remains widespread in foodborne bacteria

Antimicrobial resistance (AMR) in common foodborne bacteria such as Salmonella and Campylobacter continues to be a public health concern across Europe, according to a new joint report from the European Food Safety Authority (EFSA) and the European Centre for Disease Prevention and Control (ECDC).

While resistance to commonly used antimicrobials remains widespread in foodborne bacteria such as Salmonella and Campylobacter, several countries have reported progress in reducing resistance levels in humans and in food-producing animals. Because these foodborne bacteria can spread from animals and food to humans, causing severe infections that may require antimicrobial treatment, continued action under a One Health approach remains essential. 

Antimicrobial resistance in common foodborne bacteria remains high

A high proportion of Campylobacter and Salmonella from both humans and food-producing animals continue to show resistance to ciprofloxacin, an important antimicrobial used to treat severe infections in humans. While resistance in Salmonella from food-producing animals has been consistently high, resistance in human Salmonella infections has increased in recent years. 

This trend is concerning, as resistance to ciprofloxacin limits the effectiveness of available treatment options. In Campylobacter, resistance is now so widespread in Europe that ciprofloxacin is no longer recommended for the treatment of human infections. To safeguard its continued effectiveness in human medicine, restrictions have been placed on its use in animals.

Across Europe, a high proportion of Salmonella and Campylobacter from both humans and targeted food-producing animals also show resistance to commonly used antimicrobials, including ampicillin, tetracyclines and sulfonamides.

Furthermore, the detection of carbapenemase-producing E. coli bacteria in food-producing animals and meat in several countries requires close attention. Carbapenems are last-resort antimicrobials for humans and are not authorised for use in food-producing animals. The number of reported detections is increasing, and the sources need further investigation. 

Despite ongoing concerns, there are encouraging signals 

Although a high proportion of Salmonella and Campylobacter from humans and food-producing animals remain resistant to commonly used antimicrobials, several countries have reported declining resistance to specific antimicrobials over time, showing that targeted efforts can make a difference.

For Salmonella, resistance in bacteria from humans to ampicillin and tetracyclines decreased significantly over the past ten years in 19 and 14 countries, respectively. Positive trends were also identified in food-producing animals at the EU level, with decreasing resistance to tetracyclines in broilers and to ampicillin and tetracyclines in turkeys. 

For Campylobacter, resistance to erythromycin, a first-line treatment for Campylobacter infections in humans, has declined in several countries over the past decade, both in humans and in some food-producing animals. 

In addition, combined resistance to critically important antimicrobials, meaning resistance to more than one of these antimicrobials at the same time, remains generally low in Salmonella, Campylobacter and E. coli. 

Finally, earlier improvements have slowed down in some areas, particularly in E. coli, where resistance levels to some substances in poultry have stabilized rather than continued to decline. However, some countries were able to reduce antimicrobial resistance in food-producing animals, contributing to an overall improvement at EU level. 

Why continued action on antimicrobial resistance is essential

Antimicrobial resistance affects everyone. When bacteria become resistant to antimicrobials, infections are harder to treat, and treatment options become limited. Resistance patterns vary widely between countries, bacteria and antimicrobials, reflecting differences in how antimicrobials are used, as well as in farming practices, animal health measures and infection prevention strategies.

These findings highlight the importance of a One Health approach, recognizing the close links between human health, animal health and food production. While progress has been made in some areas, continued and responsible use of antimicrobials across all sectors, combined with effective infection prevention, animal health, and food safety practices, remains essential to slow the emergence and spread of antimicrobial-resistant bacteria, and to protect public health across Europe.