Monitoring Antimicrobial Resistance in the Food Supply Chain and Its Implications for FDA Policy Initiatives.
In response to concerning increases in antimicrobial resistance (AMR), the Food and Drug Administration (FDA) has decided to increase veterinary oversight requirements for antimicrobials and restrict their use in growth promotion. Given the high stakes of this policy for the food supply, economy, and human and veterinary health, it is important to rigorously assess the effects of this policy. We have undertaken a detailed analysis of data provided by the National Antimicrobial Resistance Monitoring System (NARMS). We examined the trends in both AMR proportion and MIC between 2004 and 2012 at slaughter and retail stages. We investigated the makeup of variation in these data and estimated the sample and effect size requirements necessary to distinguish an effect of the policy change. Finally, we applied our approach to take a detailed look at the 2005 withdrawal of approval for the fluoroquinolone enrofloxacin in poultry water. Slaughter and retail showed similar trends. Both AMR proportion and MIC were valuable in assessing AMR, capturing different information. Most variation was within years, not between years, and accounting for geographic location explained little additional variation. At current rates of data collection, a 1-fold change in MIC should be detectable in 5 years and a 6% decrease in percent resistance could be detected in 6 years following establishment of a new resistance rate. Analysis of the enrofloxacin policy change showed the complexities of the AMR policy with no statistically significant change in resistance of both Campylobacter jejuni and Campylobacter coli to ciprofloxacin, another second-generation fluoroquinolone.
Section of Epidemiology Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA Tri-Institutional Training Program in Computational Biology and Medicine, New York City, New York, USA.
Kelson
K
Zawack
Section of Epidemiology Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.
Min
M
Li
Department of Biological Statistics and Computational Biology, Cornell University, Ithaca, New York, USA.
James G
JG
Booth
Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA.
Will
W
Love
Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA.
Cristina
C
Lanzas
Section of Epidemiology Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA ytg1@cornell.edu.
Yrjö T
YT
Gröhn
D000003:Abattoirs / Q000331:legislation & jurisprudence; D000704:Analysis of Variance; D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D017000:Campylobacter coli / Q000187:drug effects / Q000254:growth & development; D016123:Campylobacter jejuni / Q000187:drug effects / Q000254:growth & development; D002417:Cattle; D002939:Ciprofloxacin / Q000494:pharmacology; D024901:Drug Resistance, Multiple, Bacterial; D000077422:Enrofloxacin; D004926:Escherichia coli / Q000187:drug effects / Q000254:growth & development; D024841:Fluoroquinolones / Q000494:pharmacology; D005511:Food Handling / Q000331:legislation & jurisprudence; D005516:Food Microbiology; D005523:Food Supply / Q000331:legislation & jurisprudence; D006801:Humans; D008460:Meat / Q000382:microbiology*; D008826:Microbial Sensitivity Tests; D011200:Poultry / Q000382:microbiology*; D012486:Salmonella typhimurium / Q000187:drug effects / Q000254:growth & development; D013552:Swine; D014481:United States; D014486:United States Food and Drug Administration / Q000331:legislation & jurisprudence
D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D000077422:Enrofloxacin; D002939:Ciprofloxacin