Increased resistance due to ”non-human” antibiotic use (veterinary and zootechnical use) Christina Greko Dept of Antibiotics National Veterinary Institute (SVA) Uppsala, Sweden

C. Greko, SVA Why use antibiotics for animals?  Therapy  Prophylaxis  Growth promotion

C. Greko, SVA Feed additives for performance enhancement, 70/524/EEC 6 spiramycin (-99) 6 tylosin (-99) 6 virginiamycin (-99) 6 avoparcin (-97) 6 ardacin (-97) 6 bacitracin (-99) mavilamycin 6 carbadox (-99) 6 olaquindox (-99) mflavofosfolipol mmonensin msalinomycin

C. Greko, SVA Some indications for veterinary use

C. Greko, SVA Antibiotics approved for use in bovines and/or porcines (Sweden 2001) Individual medication  penicillin-G  penicillin-DHS  amoxicillin  ceftiofur  macrolides (16-M)  pleuromutilins  trim/sulph.  tetracyclines  fluoroquinolones  aminoglycosides Group medication  macrolides (16-M)  pleuromutilins  tetracyclines  fluoroquinolones From: FASS VET. 2001

C. Greko, SVA Sales of antibiotics for animals, EU 1997 as g antibiotic/tonnes of livewheight slaughtered Calculated from data in: EMEA/CVMP/342/99-Final, table 17 (FEDESA data)

C. Greko, SVA Resistance to APE in E.faecium from broilers in Denmark From: DANMAP 95,96,97,98,99,00 (

C. Greko, SVA Penicillin resistance among S.aureus from clinical mastitis in cows and sales of penicillin Data as cited in Greko, 1996 KSLA 135 (15) p27- and SVARM 2000 (

Transfer of zoonotic bacteria

C. Greko, SVA Antibiotic resistance, S. Typhimurium from animals Data from: DEFRA: Salmonella in livestock production 2000, DANMAP 2000 and SVARM 2000

C. Greko, SVA Quinolone resistance in Campylobacter (NL) From: Endtz et al, 1991, JAC, 27:

C. Greko, SVA Resistance to nalidixic acid among C. jejuni, Denmark Source: DANMAP 00 (

C. Greko, SVA Quinolone resistance in Campylobacter jejuni (DK, 1999) From: DANMAP 99 (

C. Greko, SVA Fluoroquinolones - human vs veterinary use in Sweden Data from Naturvårdsverket, 1994 and Statistics Sweden

Transfer of resistance genes

C. Greko, SVA Food as source - tetracycline resistance in coliforms of helthy volunteers on control or sterile diet From: Corpet, NEJM 1988, 318:1205-

C. Greko, SVA Transfer of genes - spread of streptothricin-resistance (Tn1825), GDR From: Witte, 1996 (Ciba Foundation Symposium 207)

C. Greko, SVA Transfer of genes- base pair variants of Tn1546 from VRE From: Jensen, AAC :2463

Effect of interventions - withdrawal of growth promoting antibiotics

C. Greko, SVA Sales of antibacterials for animal use (Sweden) Compiled from published data, references given in SVARM 2000 (

C. Greko, SVA Resistance among E. faecium – SVARM 2000 vs DANMAP 97 (Pig: Se n=48, Dk n=54; chicken: Se n=151, Dk n=207)

C. Greko, SVA Resistance to vancomycin in E.faecium from chicken and chicken meat, Denmark From: DANMAP 95,96,97,98,99,00 (

C. Greko, SVA Avoparcin and vancomycin resistant enterococci (VRE) of vanA type  VRE easily found in animals (and food) in most countries - but NOT in Sweden  Community carriage in humans EU 2-5%?  Community carriage in Sweden <0.1% (1/670; Torell et al, JCM 1999, 37:3509)

C. Greko, SVA The flow of resistance genes

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