Set 12 2013
Exposure assessment of extended-spectrum beta-lactamases/AmpC beta-lactamases-producing Escherichia coli in meat in Denmark
Extended-Spectrum Beta-Lactamases (ESBL) and AmpC Beta-Lactamases (AmpC) are of great concern because of their ability to cause antimicrobial resistance in Enterobacteriaceae hampering the effect of treatment with beta-lactam antibiotics. The main objective of this study was to assess the relative importance of different types of meat for the exposure of consumers to ESBL/AmpC and their potential relevance for human cases in Denmark.
This was assessed by weighting the prevalence of each genotype of ESBL/AmpC-producing E. coli (ESBL/AmpC-PEC) in imported and nationally produced broiler meat, pork and beef with the meat consumption patterns in Denmark. Data originated from the Danish surveillance programme for antibiotic use and antibiotic resistance (DANMAP) for 2009 to 2011. Data about human ESBL cases in 2011 were also collected to assess a possible genotype overlap. Uncertainty was assessed by inspecting beta distributions of the genotypes in each type of meat.
Broiler meat represented the largest part of the estimated ESBL/AmpC contaminated pool of meat (83.8%) compared to pork (12.5%) and beef (3.7%). CMY-2 was the genotype with the highest relative importance for human exposure (58.3%). However, it is rarely found in humans in Denmark.
In general the overlap between ESBL/AmpC genotypes in meat and those found in human E. coli infections isolates was limited. CTX-M-1 had a relative importance of 28.8% for human exposure through meat. The prevalence of CTX-M-1 in humans was 7.3% of E. coli urinary tract infections and 8.0% of E. coli bloodstream infections. Hence, the genotype CTX-M-1 was considered the most relevant genotype found in meat when referring to human exposure. This suggests that meat might constitute a less important source of ESBL/AmpC exposure of humans in Denmark than previously thought. Nonetheless, more detailed surveillance data are required to determine the contribution of meat compared to other sources, such as pets and hospitals.