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NethMap 2021. Consumption of antimicrobial agents and antimicrobial resistance among medically important bacteria in the Netherlands in 2020 / MARAN 2021. Monitoring of Antimicrobial Resistance and Antibiotic Usage in Animals in the Netherlands in 2020
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Series / Report no.
RIVM rapport 2021-0062
Open Access
Type
Report
Language
en
Date
2021-06-24
Research Projects
Organizational Units
Journal Issue
Title
NethMap 2021. Consumption of antimicrobial agents and antimicrobial resistance among medically important bacteria in the Netherlands in 2020 / MARAN 2021. Monitoring of Antimicrobial Resistance and Antibiotic Usage in Animals in the Netherlands in 2020
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Abstract
De uitbraak van SARS-CoV-2 (het coronavirus) heeft de gezondheidszorg in Nederland erg belast. Er hebben meer mensen op de IC gelegen en de reguliere zorg is afgeschaald. Toch lijkt het er niet op dat er in 2020 meer bacteriën resistent zijn geworden tegen antibiotica. Bij sommige bacteriesoorten is de resistentie zelfs afgenomen ten opzichte van de jaren ervoor. Ook is het aantal bacteriën dat resistent is tegen verschillende antibiotica tegelijk, waardoor ze moeilijker te behandelen zijn, gelijk gebleven. De effecten van de coronauitbraak op de antibioticaresistentie op de langere termijn zijn nog niet duidelijk.
Wereldwijd komt het steeds vaker voor dat infecties worden veroorzaakt door bacteriën die resistent zijn tegen antibiotica. In Nederland is dat probleem minder groot dan in veel andere landen. Vanwege de situatie in de wereld blijft het belangrijk om in Nederland waakzaam te blijven. Dan kan het op tijd worden opgemerkt als het resistentieprobleem toeneemt.
Om antibioticaresistentie te voorkomen is het belangrijk om antibiotica op de juiste manier te gebruiken en alleen als het nodig is. Huisartsen schreven het afgelopen jaar in Nederland ongeveer 10 procent minder antibioticakuren voor dan de jaren daarvoor. Door de maatregelen tegen het coronavirus, zoals afstand houden en thuis werken, kwamen veel infectieziekten die van mens op mens overdraagbaar zijn minder vaak voor. Ook gingen er minder mensen naar een huisarts. In ziekenhuizen bleef de totale hoeveelheid gebruikte antibiotica in 2019 ongeveer stabiel. De gegevens over het gebruik in ziekenhuizen in 2020 zijn nog niet bekend.
De maatregelen die in Nederland zijn genomen om antibioticaresistentie te bestrijden, reiken verder dan de gezondheidszorg. Resistente bacteriën komen namelijk ook voor bij dieren, in voeding en in het milieu (One Health-aanpak).
De laatste tien jaar zijn bij varkens, koeien en kippen die voor de voedselproductie worden gehouden (landbouwhuisdieren) de aanwezige darmbacteriën steeds minder resistent geworden. Ten opzichte van 2019 is de antibioticaresistentie in de verschillende diersectoren ongeveer gelijk gebleven. ESBLproducerende darmbacteriën in vleeskuikens en op kippenvlees kwamen in 2020 minder vaak voor. In de andere diersectoren zijn deze resistente bacteriën ongeveer even vaak aangetroffen als in 2019. ESBL zijn enzymen die veelgebruikte antibiotica kunnen afbreken, zoals penicillines. In 2020 zijn voor landbouwhuisdieren iets meer antibiotica verkocht dan in 2019. Ten opzichte van 2009, het referentiejaar, is de
verkoop met bijna 70 procent verminderd. Voor landbouwhuisdieren zijn de afgelopen jaren bijna geen antibiotica gebruikt die van cruciaal belang zijn om infecties bij de mens te behandelen.
Dit blijkt uit de jaarlijkse rapportage NethMap/MARAN 2021. Hierin presenteren diverse organisaties samen de gegevens over het antibioticagebruik en -resistentie in Nederland, voor mensen en dieren.
The outbreak of Covid 19 (the coronavirus) has put the health care sector in the Netherlands under extreme pressure. Many more people were admitted to intensive care, and the regular care activities were downscaled. Nevertheless, it does not seem that more bacteria developed resistance to antibiotics in 2020. For some types of bacteria, resistance even seems to have diminished in comparison to previous years. In addition, the number of bacteria that are resistant to various antibiotics at the same time, making it more difficult to treat them, remained the same. The long-term effects of the corona outbreak on antibiotic resistance are not yet clear. Over the entire world, we are seeing increasing numbers of infections caused by bacteria with resistance to antibiotics. This problem is less severe in the Netherlands than in many other countries. However, due to the global situation, it remains important to be on the alert in the Netherlands. If the problem of resistance does increase, it will then be easier to detect it in time. To prevent antibiotic resistance from developing, it is important to use antibiotics properly and only when necessary. General practitioners prescribed approximately 10% fewer courses of antibiotics in the past year compared to previous years. Due to the Covid 19 measures, such as social distancing and working from home, many infectious diseases that are spread by social contacts occurred less frequently. In addition, fewer people visited their general practitioner. The total quantity of antibiotics used in hospitals in 2019 remained fairly stable. The data on their use in hospitals in 2020 is not yet available. The scope of the measures implemented in the Netherlands to combat antibiotic resistance extend further than the health care sector. After all, resistant bacteria also occur in animals, food and in the environment (One Health approach). Over the last decade, the intestinal bacteria in pigs, cows, and chickens kept for food production (farm animals) have become less resistant. The level of antibiotic resistance in the various animal sectors remained approximately the same in comparison to 2019. ESBL producing intestinal bacteria in broiler chickens and on chicken meat were less prevalent in 2020. In the other animal sectors, the prevalence of these resistant bacteria was the same as in 2019. ESBLs are enzymes that can break down commonly used antibiotics such as penicillins. The quantity of antibiotics sold in 2020 for farm animals increased somewhat compared to 2019. In comparison to 2009, the reference year, the sale of antibiotics decreased by almost 70%. Almost no antibiotics that are crucial for treating infections in humans have been used for farm animals in recent years. This is shown in the annual report NethMap/MARAN 2021, in which various organisations jointly present data on antibiotic use and resistance in the Netherlands, for both humans and animals.
The outbreak of Covid 19 (the coronavirus) has put the health care sector in the Netherlands under extreme pressure. Many more people were admitted to intensive care, and the regular care activities were downscaled. Nevertheless, it does not seem that more bacteria developed resistance to antibiotics in 2020. For some types of bacteria, resistance even seems to have diminished in comparison to previous years. In addition, the number of bacteria that are resistant to various antibiotics at the same time, making it more difficult to treat them, remained the same. The long-term effects of the corona outbreak on antibiotic resistance are not yet clear. Over the entire world, we are seeing increasing numbers of infections caused by bacteria with resistance to antibiotics. This problem is less severe in the Netherlands than in many other countries. However, due to the global situation, it remains important to be on the alert in the Netherlands. If the problem of resistance does increase, it will then be easier to detect it in time. To prevent antibiotic resistance from developing, it is important to use antibiotics properly and only when necessary. General practitioners prescribed approximately 10% fewer courses of antibiotics in the past year compared to previous years. Due to the Covid 19 measures, such as social distancing and working from home, many infectious diseases that are spread by social contacts occurred less frequently. In addition, fewer people visited their general practitioner. The total quantity of antibiotics used in hospitals in 2019 remained fairly stable. The data on their use in hospitals in 2020 is not yet available. The scope of the measures implemented in the Netherlands to combat antibiotic resistance extend further than the health care sector. After all, resistant bacteria also occur in animals, food and in the environment (One Health approach). Over the last decade, the intestinal bacteria in pigs, cows, and chickens kept for food production (farm animals) have become less resistant. The level of antibiotic resistance in the various animal sectors remained approximately the same in comparison to 2019. ESBL producing intestinal bacteria in broiler chickens and on chicken meat were less prevalent in 2020. In the other animal sectors, the prevalence of these resistant bacteria was the same as in 2019. ESBLs are enzymes that can break down commonly used antibiotics such as penicillins. The quantity of antibiotics sold in 2020 for farm animals increased somewhat compared to 2019. In comparison to 2009, the reference year, the sale of antibiotics decreased by almost 70%. Almost no antibiotics that are crucial for treating infections in humans have been used for farm animals in recent years. This is shown in the annual report NethMap/MARAN 2021, in which various organisations jointly present data on antibiotic use and resistance in the Netherlands, for both humans and animals.
Description
Publisher
Rijksinstituut voor Volksgezondheid en Milieu RIVM
Sponsors
Ministerie van VWS