Use of Antimicrobials in Livestock Production and Antimicrobial Resistance in Asia-Pacific

170 Pages·2012·3.16 MB·English

by  Carolyn Benigno

Proceedings of the

International Workshop on the Use

of Antimicrobials in Livestock

Production and Antimicrobial

Resistance in the Asia-Pacific Region

22-23 October 2012
Negombo, Sri Lanka
THE EIGHTEEN APHCA MEMBER COUNTRIES

AUSTRALIA MONGOLIA
BANGLADESH MYANMAR
BHUTAN NEPAL
INDIA PAKISTAN
INDONESIA PAPUA NEW GUINEA
IRAN PHILIPPINES
DPR KOREA SAMOA
LAO PDR SRI LANKA
MALAYSIA THAILAND
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Negombo, Sri Lanka, 22–23 October 2012 i
The designations employed and the presentation of the material in this publication
do not imply the expression of any opinion whatsoever on the part of the Food and
Agriculture Organization of the United Nations (FAO) nor the Animal Production and
Health Commission for Asia and the Pacific (APHCA) concerning the legal status of
any country, territory, city or area or of its authorities, or concerning the
delimitation of its frontiers or boundaries.

All rights reserved. No part of this publication may be reproduced, stored in a
retrieval system, or transmitted in any form or by any means, electronic, mechanical,
photocopying or otherwise, without the prior permission of the copyright owner.
Applications for such permission, with a statement of the purpose and extent of the
reproduction, should be addressed to the FAO Regional Office for Asia and the Pacific
(RAP), 39 Maliwan Mansion, Phra Atit Road, Bangkok 10200, Thailand

© FAO 2012

For a copy of the report and correspondence, please contact:

Senior Animal Production and Health Officer
and Secretary of APHCA
FAO Regional Office for Asia and the Pacific (RAP)
39 Maliwan Mansion, Phra Atit Road
Bangkok 10200, THAILAND

E-mail: [email protected]
FAO Homepage: http://www.fao.org
APHCA Homepage: http://www.aphca.org
ii Negombo, Sri Lanka, 22–23 October 2012
Table of Contents

Page

SESSION 1 -INTRODUCTION
Introduction .............................................................................................................................................. 1
Keynote - Epidemiology and Impact of AMR: Links Between Antimicrobial Use in
Livestock and AMR in Human Pathogens and Impacts of AMR ............................................ 4

SESSION 2 - COUNTRY REPORTS
Australia ..................................................................................................................................................... 6
Bhutan ...................................................................................................................................................... 18
India .......................................................................................................................................................... 24
Indonesia ................................................................................................................................................. 30
Iran ............................................................................................................................................................ 40
Korea DPR ............................................................................................................................................... 43
Lao PDR.................................................................................................................................................... 46
Malaysia ................................................................................................................................................... 57
Myanmar ................................................................................................................................................. 66
Nepal ......................................................................................................................................................... 71
Pakistan ................................................................................................................................................... 78
Papua New Guinea ............................................................................................................................... 80
Philippines .............................................................................................................................................. 81
Samoa ....................................................................................................................................................... 86
Sri Lanka .................................................................................................................................................. 90
Thailand ................................................................................................................................................... 99

SESSION 3 - COUNTRY CASE STUDIES
An Integrated Surveillance Study of AMR in Salmonella subspp, Campylobacter spp,
Escherichia coli and Enterococcus spp in Poultry in Cambodia ........................................ 106
Monitoring Antimicrobial Resistance in Food-borne Pathogens from Selected
Species in Sri Lanka........................................................................................................................... 107
Acquisition of Multi-Resistance of Campylobacter jejuni Isolates with Antimicrobial
Usage in Poultry ................................................................................................................................. 108
Negombo, Sri Lanka, 22-23 October 2012 iii
Vancomycin Resistant Enterococci – Thailand Experience ............................................... 119
Antimicrobial Resistance at the Human-Animal Interface in Vietnam ......................... 124

SESSION 4 - APPROACHES TO AMR MANAGEMENT
Systems for Monitoring and Integrated Surveillance of Antimicrobial Use in
Livestock and AMR in Different Parts of the World ............................................................. 134
Alternatives to Antimicrobials (ATAs) and Strategies for Minimizing Risk of AMR
Development and Spread ................................................................................................................ 144
FAO and WHO Initiatives to Reduce the Risk of AMR Development and Spread ..... 145
OIE’s Contribution to the Promotion of Responsible and Prudent Use of
Antimicrobials ..................................................................................................................................... 146

SESSION 5 - WORKING GROUPS
Priority Tasks at Country Level to Contain the Risk of AMR Development ................ 153

ANNEXES
Annex 1: Workshop Programme.................................................................................................. 157
Annex 2: List of Participants .......................................................................................................... 159

iv Negombo, Sri Lanka, 22–23 October 2012
APHCA Workshop Proceedings

Session 1
Introduction
Negombo, Sri Lanka, 22-23 October 2012 1
Antimicrobial Use and Resistance

Introduction

Joachim Otte
Senior Animal Health and Production Officer
Regional Office for Asia and the Pacific
Food and Agriculture Organization of the UN

Antimicrobial resistance (AMR) is a growing global threat across drug classes and around
the world. Although much of the evolving antimicrobial resistance (AMR) can be
attributed to (mis-)use of antimicrobials in humans, research by international scientific
bodies supports the conclusion that the overuse of drugs in food animal production - in
high-income countries, more than 80% of all antimicrobials produced are used in farm
animals – is a threat for continued availability of effective treatment of human diseases.

Resource-constrained countries are particularly vulnerable to AMR as they bear 95% of
the global infectious disease burden and rely on effective antimicrobial medicines to
treat these diseases. Little quantitative information is available about antimicrobial use
(AMU) in rapidly growing livestock sectors of Asia-Pacific countries but research
conducted in Asia clearly demonstrates that resistance to a range of compounds is fairly
common in micro-organisms isolated from livestock and livestock products.

Many previously easily curable infectious diseases are becoming increasingly difficult
and costly to treat as single and multi-drug resistance grows. Turning the clock back to
the days before penicillin will leave many lives at risk. In addition to the human cost, the
health care bill for antibiotic resistance is staggering. One study estimated that
antibiotic‐resistant infections annually cost US hospitals alone more than $20 billion.
Again, little quantitative information on the human health cost of AMR in Asia has been
generated. It is no exaggeration that we are at risk of losing one of the most important
curative and preventive tools for human and animal disease management. And this
happens at a time when animal and human population densities continue to increase
overall, but to complicate things further in a highly clustered fashion, which results in
increased risk of transmission, which allows pathogens to spread and mutate ever more
quickly.

Society can no longer rely mainly on the expectation that a continuous stream of new
antimicrobials will come onto the market, as pharmaceutical companies find it
increasingly difficult justify the investment into research and development in this area in
an extremely competitive global market. AMR is a complex problem and the
contributing factors to its emergence and spread are diverse and multifaceted.
Numerous stakeholders from across multiple sectors have a role to play in AMR
2 Negombo, Sri Lanka, 22–23 October 2012
APHCA Workshop Proceedings
containment. Unfortunately, coordinated containment activities have been lacking,
especially at the national and regional level.

Microbes do not respect borders and no individual country or country group can contain
AMR on its own. Strategic coalitions and partnerships are required to advance sustained
AMR advocacy and containment at the regional, country, and local levels. Therefore, the
Animal Production and Health Commission for Asia and the Pacific (APHCA) is combining
its 36th Annual Session with an International Workshop on ‘Antimicrobial Use and
Resistance in Livestock Production in the Asia-Pacific Region’ to be held in Negombo, Sri
Lanka.

The objectives of the workshop are:
 To obtain an overview of the extent of antimicrobial use (AMU) in livestock
production in the Asia-Pacific region (quantities, compounds, production systems);
 To obtain an overview of existing legal framework regulating AMU use in livestock
production and instruments for enforcement in Asia-Pacific countries;
 To obtain an overview of sources of data on antimicrobial resistance (AMR) in the
Asia-Pacific region;
 To review evidence linking AMU in livestock with AMR in pathogens isolated from
humans, preferably from the region;
 To familiarize participants with systems for monitoring and integrated surveillance
of AMU in livestock and AMR in different parts of the world;
 To provide an update on alternatives to antimicrobials (ATAs) and strategies for
minimizing risk of AMR development and spread;
 And finally, to jointly define actions towards responsible antimicrobial use in
livestock production in the region.

Details of the workshop structure and programme are provided in the annex.

Negombo, Sri Lanka, 22-23 October 2012 3
Antimicrobial Use and Resistance

Keynote - Epidemiology and Impact of AMR: Links Between
Antimicrobial Use in Livestock and AMR in Human
Pathogens and Impacts of AMR

Jaap Wagenaar

[in preparation]

4 Negombo, Sri Lanka, 22–23 October 2012