Research plan for effective surveillance and control of carbapenemase-producing Enterobacteriaceae

In the Netherlands, one of the primary governmental policies is to reduce the use of antibiotics in human and animal health, in order to tackle the antimicrobial resistance problem. On 12 July 2017, the letter to Dutch Parliament on ‘Antibiotic use in livestock farming’ from the Ministry of Economic Affairs was published that describes recent advances made in this area. One of the subjects thereof is the carbapenemase-producing Enterobacteriaceae (CPE) research plan.

Until now, carbapenemase-producing isolates have only incidentally been reported in health care settings in the Netherlands. Enterobacteriaceae with plasmid-mediated carbapenemase genes have never been reported in companion animals, livestock or livestock-derived consumer products in the Netherlands.

Worldwide, information on CPE colonization, epidemiology and transmission in livestock and companion animals is very limited. This makes it difficult for risk managers to design strategies to deal with a possible CPE introduction and/or manifestation (CPE episode) in these animals. Therefore, the CPE research plan was designed with the aim to gain more knowledge on the sources and mechanisms of colonization, transmission and spread of CPE.

CPE research plan consortium

The consortium, led by Professor Arjan Stegeman, veterinary epidemiologist at Utrecht University, consists of partners from the Dutch National Institute for Public Health and the Environment (RIVM), the Faculty of Veterinary Medicine at Utrecht University, GD Animal Health, Immuno Valley, Netherlands Food and Consumer Product Safety Authority (NVWA), Public Health service (GGD), UMC Utrecht, Wageningen Bioveterinary Research, and was supported by the Ministry of Economic Affairs.

In the CPE research plan, the consortium partners describe the research activities that they estimated to be crucial to fulfill the research aim: to gain more understanding of CPE colonization, epidemiology and transmission. The proposed research is categorized in three phases: research to be performed before a CPE episode takes place, research to be performed during a CPE episode and after an episode.

The research plan was presented to the Ministry of Economic Affairs in April of this year, after which this was discussed with stakeholders from the Netherlands. Since antibiotic resistant bacteria are able to cross borders, the battle against these threats request an international approach. Therefore, the CPE research plan will also be subject of a meeting with the European Commission, as can be read in the letter to Dutch Parliament. (from 12 July 2017)