Monitoring antimikrobne rezistencije

Abstract

Overuse of antibiotics in humans and animals can promote the development of antibiotic resistant bacteria. According to data from European Food Safety Authority, there is an increase in number of humans infected with multidrug resistant “super bug” bacteria every year. Antimicrobial resistance monitoring in zoonotic and commensal bacteria is compulsory in all the member states of the EU and the monitoring is conducted by European Commission, Decision 2013/652/EU. The member states are obligated to examine the resistance levels annually for 170 isolates of E. coli Salmonella spp, Campylobacter jejuni/coli and Enterococcus fecalis/fecium, by determining minimal inhibitory concentration of antibiotic (MIC). Emerging trends in antimicrobial resistance in Serbia as well as in its neighborhood countries are worrying especially because bacteria are becoming resistant to antibiotics used in human medicine, such as fluoroquinolones, third and fourth generation cephalosporins, and gentamicin. For these reasons, it is necessary to monitor resistance to antibiotics in indicator bacteria in the food chain, which includes determination of mechanisms of resistance in order to evaluate the risks of spreading “super bugs” in humans and animals. In order to implement resistance monitoring in Serbia, it is important to establish adequate sampling strategy, collecting data and storing of the isolates. Isolates must originate from healthy animals and therefore the preferable sampling is in abattoirs. In laboratories assigned for resistance monitoring it is important to implement the laboratory protocols by European Committee on Antimicrobial Susceptibility Testing (EUCAST) and Clinical and Laboratory Standards Institute (CLSI), by international reference method ISO 20776-1:2006 (E) under the following title: Clinical laboratory testing and in vitro diagnostic test systems - Susceptibility testing of infectious agents and evaluation of performance of antimicrobial susceptibility test device.