Association between antimicrobial usage in livestock and antimicrobial resistance in Escherichia coli isolates from human urinary tract infections in the Netherlands, 2009–2020
Authors: Meijs Anouk P , Chanamé-Pinedo Linda E , Deng Huifang , Veldman Kees T , Brouwer Michael S M , van den Beld Maaike J C , Dierikx Cindy M , Sanders Pim , Wullings Bart , de Greeff Sabine C , van Duijkeren Engeline , Franz Eelco , Pijnacker Roan , Mughini-Gras Lapo ,   ISIS-AR study group, Cohen Stuart J W T , Melles D C , van Dijk K , Alzubaidy A , Scholing M , Kuil S D , Blaauw G J , Altorf—van der Kuil W , Bierman S M , de Greeff S C , Groenendijk S R , Hertroys R , Monen J C M , Notermans D W , Polman J , van den Reek W J , Schneeberger-van der Linden C , Schoffelen A F , Velthuis F , Wielders C C H , de Wit B J , Zoetigheid R E , van den Bijllaardt W , Kraan E M , Haeseker M B , da Silva J M , de Jong E , Maraha B , van Griethuysen A J , Wintermans B B , van Trijp M J C A , Muller A E , Wong M , Ott A , Bathoorn E , Lokate M , Sinnige J , Melles D C , Plantinga N , Renders N H , Dorigo-Zetsma J W , Bakker L J , Ang W , Waar K , van der Beek M T , Leversteijn-van Hall M A , van Mens S P , Schaftenaar E , Nabuurs-Franssen M H , Maat I , Sturm P D J , Diederen B M W , Bode L G M , Ong D S Y , van Rijn M , Dinant S , den Reijer M , van Dam D W , de Brauwer E I G B , Bentvelsen R G , Buiting A G M , Vlek A L M , de Graaf M , Troelstra A , Jansz A R , van Meer M P A , de Vries J , Machiels J D 
Published: August 2024

Abstract

Background
In the last decade, veterinary antimicrobial usage (AMU) and antimicrobial resistance (AMR) among indicator bacteria in livestock have decreased substantially in the Netherlands. The extent to which this decrease has affected AMR levels among human infections remains unclear.

Objectives
To assess the association between AMU in livestock and AMR in Escherichia coli isolates from human urinary tract infections (UTIs).

Methods
Data on AMR and AMU between 2009 and 2020 from Dutch national surveillance programmes for humans and livestock were used. Associations between AMU in four major livestock sectors and AMR in humans were assessed for 10 antimicrobial classes and the ESBL resistance profile, using logistic regression analysis. Associations between AMU and AMR in livestock, between AMR in livestock and in humans, and between AMU and AMR in humans were also assessed.

Results
Statistical significance was reached for 16/31 of the tested associations between AMU in livestock and AMR in human E. coli UTIs. Of the significant associations, 11 were positive (OR 1.01–1.24), whereas 5 were negative (OR 0.96–0.99). All associations between human AMU and AMR in E. coli isolates from UTIs were positive and statistically significant. Weak but significant positive correlations were also observed between livestock AMR and human AMR.

Conclusions
Although several significant associations between AMU in livestock and AMR in human UTIs caused by E. coli were observed, the associations between AMU and AMR were generally stronger within the human and animal populations. This indicates that potential zoonotic spread of AMR in E. coli causing human UTIs from livestock sources is limited.