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Denmark Calls for European Approach to Antimicrobial Resistance

11 December 2014

EUROPE - In today's globalised world, Danes cannot go it alone to minimise the spread of antibiotic-resistant bacteria, according to a leading Danish doctor and a pig specialist.

At a time when the stories in the media give the impression that pig production in Denmark due to resistant bacteria is a potential threat to the entire Danish public health, it is time for the public to lift their eyes and look beyond its borders, according to Steen Lomborg, a doctor and leading hospital consultant and Claus Fertin, director of the Danish Pig Research Centre.

Resistant bacteria are a serious threat to the entire world's population, they say.

In some of Europe's southern countries more than half of staphylococci are resistant to commonly used antibiotics compared with about two per cent in Denmark.

But even if we in Denmark among others have lowered consumption of antibiotics in swine production significantly to halt the spread of resistance, we must note that resistance is also a growing problem in Denmark, they continue. It is not only about the one-third of MRSA of type CC398 which is linked to pigs but also the majority of MRSA types that are unconnected to livestock.

Drs Lomborg and Fertin say there is nothing to suggest that MRSA has given rise to new types of staphylococcal infections. Looking at the statistics from 1960 to now, there has been a steady increase in the number of registered cases of blood poisoning caused by staphylococci. It must be assumed that, since humans thousands of years ago began to live closely with animals, there has always been an exchange of microorganisms between livestock and humans. It is not only recently that staphylococci have been exchanged between pigs and Man.

Danish pig production has a responsibility to prevent the spread of MRSA CC398, among other things, and we need to focus even more on reducing antibiotic use, the authors report. Antibiotic consumption may be one reason for a portion of resistance problems that we are fighting against today.

They say: "In a globalised world, it is not enough that we only Denmark has focused on minimising the spread of resistant bacteria. We do not live on an isolated island where we can 'keep our own house'. For as long as people, animals and goods traveling across borders, then we will have massive pressure of resistant bacteria from the rest of the world."

Over the last six years in Denmark, a working group of doctors, veterinarians, authorities, researchers and agriculture have examined the status of MRSA CC398 in the country and sought a number of recommendations for possible solutions.

According to Drs Lomborg and Fertin, it is precisely this community that should acknowledge the challenges and seek solutions.

The working group found that MRSA CC398 cannot be eradicated in Denmark but efforts must be made to reduce antibiotic consumption - both by humans and animals.

They stressed that more important, however, is that the challenge of MRSA must be addressed internationally. This may initially be within the EU, as most other EU countries have substantially greater challenges with resistant staphylococci than Denmark. Specifically, a number of countries in Europe could learn from Denmark about how to reduce antibiotic consumption, both medical and veterinary.

Resistant Staphylococcus aureus MRSA CC398 is a major challenge in the Danish pig production. But the two experts say that the media's doomsday predictions do not give a true picture of the actual health threat posed by this group of resistant bacteria.

There have been five deaths of MRSA CC398 over the past three years. It is five too many but in the same three-year period, more than 1000 people died of ordinary Staphylococcus infections. If you are already very sick or weak, it is very serious to get a blood infection with staphylococci, irrespective of whether the bacteria are resistant or susceptible to penicillin.

Part of Agriculture & Food, the Danish Pig Research Centre has decided to halve the use of the important antibiotic tetracycline by the end of 2015. This is a significant step that other countries should follow, say Drs Lomborg and Fertin. Furthermore, the Danish MRSA Working Group has proposed that the current Yellow Card scheme that regulates the consumption of antibiotics in pig production in the future must focus on moving to medications that are not be used to treat humans.

Drs Lomborg and Fertin conclude: "We can fight from here to doomsday to eradicate MRSA bacteria but we will not have a chance to succeed before other countries are waking up to the challenges. Denmark already leads the way on a number of parameters, leaving competitors and colleagues abroad way behind. We also take the lead on MRSA area, but the politicians at Christiansborg and Brussels should help to make it a common European effort."

TheMeatSite News Desk

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