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

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

3. 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

4. C. Greko, SVA Some indications for veterinary use

5. 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

6. 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)

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

8. 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 (www.sva.se)

9. Transfer of zoonotic bacteria

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

11. C. Greko, SVA Quinolone resistance in Campylobacter (NL) From: Endtz et al, 1991, JAC, 27:211-217

12. C. Greko, SVA Resistance to nalidixic acid among C. jejuni, Denmark Source: DANMAP 00 (www.svs.dk)

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

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

15. Transfer of resistance genes

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

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

18. C. Greko, SVA Transfer of genes- base pair variants of Tn1546 from VRE From: Jensen, AAC 1998 42:2463

19. Effect of interventions - withdrawal of growth promoting antibiotics

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

21. 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)

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

23. 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)

24. C. Greko, SVA The flow of resistance genes

25. monitor use monitor resistance promote prudent use control infectious diseases increase knowledge