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    NethMap 2022. Consumption of antimicrobial agents and antimicrobial resistance among medically important bacteria in the Netherlands in 2021 / MARAN 2022. Monitoring of Antimicrobial Resistance and Antibiotic Usage in Animals in the Netherlands in 2021

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    Authors
    de Greeff, SC
    Kolwijck, E
    Schoffelen, AF
    Verduin, CM
    Series/Report no.
    RIVM rapport 2022-0057
    Type
    Report
    Language
    en
    
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    Title
    NethMap 2022. Consumption of antimicrobial agents and antimicrobial resistance among medically important bacteria in the Netherlands in 2021 / MARAN 2022. Monitoring of Antimicrobial Resistance and Antibiotic Usage in Animals in the Netherlands in 2021
    Translated Title
    NethMap 2022. Consumption of antimicrobial agents and antimicrobial resistance among medically important bacteria in the Netherlands in 2021 / MARAN 2022. Monitoring of Antimicrobial Resistance and Antibiotic Usage in Animals in the Netherlands in 2021
    Publiekssamenvatting
    The coronavirus pandemic still impacted heavily on the healthcare system in the Netherlands in 2021. More people ended up in intensive care units and fewer people were able to get appointments in regular healthcare. Despite these changes the number of antibiotic-resistant bacteria has remained the same over the past couple of years. Resistance has even decreased in some strains of bacteria compared to previous years. Furthermore, the number of bacteria that are resistant to various types of antibiotics simultaneously, which makes treatment more difficult, has not changed. In recent years, there has been an increase in antibiotic resistance in some strains of bacteria that usually cause mild infections such as of the skin. Hospitals and care homes for the elderly have reported fewer outbreaks caused by resistant bacteria since the start of the pandemic in 2020. It is unclear what the effects of the pandemic will be on antibiotic resistance on the long-term. The overall quantity of antibiotics prescribed by GPs and hospitals fell during the pandemic. That said, more antibiotics per patient were prescribed. This is due to the fact that many patients with Covid-19 had to be treated for longer and more intensively in hospital. Infections caused by antibiotic-resistant bacteria are becoming increasingly common throughout the world. This problem is not quite so acute in the Netherlands as it is in many other countries as antibiotics are only prescribed if it is absolutely necessary to do so. Still, we do need to remain vigilant in the Netherlands. That entails keeping a close eye on antibiotic use and antibiotic resistance. Monitoring these will enable us to implement measures in a timely fashion to prevent the problem of antibiotic resistance from getting worse. The measures currently in place in the Netherlands to combat antibiotic resistance extend beyond the healthcare sphere. After all, resistant bacteria are also found in animals, in food and in the environment (One Health approach). Over the past decade there has been a fall in resistance in gut bacteria in pigs, cows and chickens kept for food production (farmed animals). A lower quantity of antibiotics was sold and used for farmed animals in 2021 than in 2020. Compared to 2009, the reference year, the drop in sales is over 70%. Since 2015, the antibiotics that are crucial to treat infections in people have only been used on farmed animals in highly exceptional circumstances. This is shown in the annual report NethMap/MARAN 2022, in which various organisations collectively present the data on antibiotic use and antibiotic resistance in the Netherlands, for humans and animals.
    Ook in 2021 heeft de uitbraak van het coronavirus de gezondheidszorg in Nederland nog erg belast. Er hebben meer mensen op de IC gelegen en minder mensen konden terecht in de reguliere zorg. Toch is het aantal bacteriën dat resistent is tegen antibiotica afgelopen twee jaar gelijk gebleven. Bij sommige bacteriesoorten is de resistentie zelfs afgenomen ten opzichte van de jaren ervoor. Ook is het aantal bacteri?n dat resistent is tegen verschillende antibiotica tegelijk, waardoor ze moeilijker te behandelen zijn, gelijk gebleven. Wel is de laatste jaren de resistentie toegenomen bij sommige soorten bacteriën die veelal milde infecties van onder andere de huid veroorzaken. Sinds het begin van de coronapandemie in 2020 hebben ziekenhuizen en verpleeghuizen minder uitbraken door resistente bacteriën gemeld. Het is niet duidelijk wat de effecten van de coronapandemie op de antibioticaresistentie op de langere termijn zijn. Tijdens de coronapandemie hebben huisartsen en ziekenhuizen in totaal minder antibiotica voorgeschreven. Wel is er gemiddeld per patiënt meer antibiotica gegeven. Dit komt doordat veel patiënten met COVID-19 langer en intensiever moesten worden behandeld in het ziekenhuis. Wereldwijd komt het steeds vaker voor dat infecties worden veroorzaakt door bacteriën die resistent zijn tegen antibiotica. In Nederland is dit probleem minder groot dan in veel andere landen omdat antibiotica alleen wordt voorgeschreven als het echt nodig is. Toch is het belangrijk dat Nederland waakzaam blijft. Dat gebeurt onder andere door antibioticaresistentie en antibioticagebruik in de gaten te houden. Dan kunnen op tijd maatregelen worden genomen om te voorkomen dat het resistentieprobleem groter wordt. De maatregelen die nu al 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 darmbacteri?n in varkens, koeien en kippen die voor de voedselproductie worden gehouden (landbouwhuisdieren) steeds minder resistent geworden. In 2021 zijn minder antibiotica verkocht en gebruikt voor landbouwhuisdieren dan in 2020. Ten opzichte van 2009, het referentiejaar, is de verkoop met ruim 70 procent gedaald. Sinds 2015 worden de antibiotica die cruciaal zijn om infecties bij de mens te behandelen, alleen nog bij hoge uitzondering gebruikt voor landbouwhuisdieren. Dit blijkt uit de jaarlijkse rapportage NethMap/MARAN 2022. Hierin presenteren diverse organisaties samen de gegevens over het antibioticagebruik en -resistentie in Nederland, voor mensen en dieren.
    Publisher
    Rijksinstituut voor Volksgezondheid en Milieu RIVM
    DOI
    10.21945/RIVM-2022-0057
    URI
    http://hdl.handle.net/10029/625885
    ae974a485f413a2113503eed53cd6c53
    10.21945/RIVM-2022-0057
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