Last week, I published 13 (!!) papers in the EFSA Journal on how to assess concentrations of antibiotics that could select for antibiotic resistance in animal feed (1-13). Or, well, you could also look at it as that the EFSA Biohaz panel that I have been a part of for more than two years published our final 13-part report.

Regardless of how you view it, this set of papers have two main takeaways:

  1. We present a method to establish Predicted Minimal Selective Concentrations (PMSCs) for antibiotics. This method uses a combination of Dan Andersson’s approach to MSCs (14) and the method I published with Joakim Larsson around five years ago to establish predicted no-effect concentrations (PNECs) for antibiotics based on MIC data (15). The combination is a powerful (but very cautious) tool to estimate minimal selective concentrations for antibiotics (1), and we have subsequently applied this method to animal feed contamination with antibiotics, but…
  2. There is way too little data to establish PMSCs for most antibiotics with any certainty. Really, the lack of data is so bad that for many of the antibiotic classes we could not make a reasonable assessment. Thus the main conclusion might be that we need a lot more data on how low concentrations of antibiotics that select for antibiotic resistance, both in laboratory systems and in more realistic settings.

References

  1. EFSA Panel on Biological Hazards (BIOHAZ)*, Allende A, Koutsoumanis K, Alvarez-Ordóñez A, Bolton D, Bover-Cid S, Chemaly M, Davies R, De Cesare A, Herman L, Hilbert F, Lindqvist R, Nauta M, Ru G, Simmons M, Skandamis P, Suffredini E, Andersson DI, Bampidis V, Bengtsson-Palme J, Bouchard D, Ferran A, Kouba M, López Puente S, López-Alonso M, Saxmose Nielsen S, Pechová A, Petkova M, Girault S, Broglia A, Guerra B, Lorenzo Innocenti M, Liébana E, López-Gálvez G, Manini P, Stella P, Peixe L: Maximum levels of cross-contamination for 24 antimicrobial active substances in non-target feed. Part 1: Methodology, general data gaps and uncertainties. EFSA Journal, 19, 10 (2021). doi: 10.2903/j.efsa.2021.6852 [Paper link]
  2. EFSA Panel on Biological Hazards (BIOHAZ)*, Allende A, Koutsoumanis K, Alvarez-Ordóñez A, Bolton D, Bover-Cid S, Chemaly M, Davies R, De Cesare A, Herman L, Hilbert F, Lindqvist R, Nauta M, Ru G, Simmons M, Skandamis P, Suffredini E, Andersson DI, Bampidis V, Bengtsson-Palme J, Bouchard D, Ferran A, Kouba M, López Puente S, López-Alonso M, Saxmose Nielsen S, Pechová A, Petkova M, Girault S, Broglia A, Guerra B, Lorenzo Innocenti M, Liébana E, López-Gálvez G, Manini P, Stella P, Peixe L: Maximum levels of cross-contamination for 24 antimicrobial active substances in non-target feed. Part 2: Aminoglycosides/aminocyclitols: apramycin, paromomycin, neomycin and spectinomycin. EFSA Journal, 19, 10 (2021). doi: 10.2903/j.efsa.2021.6853 [Paper link]
  3. EFSA Panel on Biological Hazards (BIOHAZ)*, Allende A, Koutsoumanis K, Alvarez-Ordóñez A, Bolton D, Bover-Cid S, Chemaly M, Davies R, De Cesare A, Herman L, Hilbert F, Lindqvist R, Nauta M, Ru G, Simmons M, Skandamis P, Suffredini E, Andersson DI, Bampidis V, Bengtsson-Palme J, Bouchard D, Ferran A, Kouba M, López Puente S, López-Alonso M, Saxmose Nielsen S, Pechová A, Petkova M, Girault S, Broglia A, Guerra B, Lorenzo Innocenti M, Liébana E, López-Gálvez G, Manini P, Stella P, Peixe L: Maximum levels of cross-contamination for 24 antimicrobial active substances in non-target feed. Part 3: Amprolium. EFSA Journal, 19, 10 (2021). doi: 10.2903/j.efsa.2021.6854 [Paper link]
  4. EFSA Panel on Biological Hazards (BIOHAZ)*, Allende A, Koutsoumanis K, Alvarez-Ordóñez A, Bolton D, Bover-Cid S, Chemaly M, Davies R, De Cesare A, Herman L, Hilbert F, Lindqvist R, Nauta M, Ru G, Simmons M, Skandamis P, Suffredini E, Andersson DI, Bampidis V, Bengtsson-Palme J, Bouchard D, Ferran A, Kouba M, López Puente S, López-Alonso M, Saxmose Nielsen S, Pechová A, Petkova M, Girault S, Broglia A, Guerra B, Lorenzo Innocenti M, Liébana E, López-Gálvez G, Manini P, Stella P, Peixe L: Maximum levels of cross-contamination for 24 antimicrobial active substances in non-target feed. Part 4: ß-Lactams: amoxicillin and penicillin. EFSA Journal, 19, 10 (2021). doi: 10.2903/j.efsa.2021.6855 [Paper link]
  5. EFSA Panel on Biological Hazards (BIOHAZ)*, Allende A, Koutsoumanis K, Alvarez-Ordóñez A, Bolton D, Bover-Cid S, Chemaly M, Davies R, De Cesare A, Herman L, Hilbert F, Lindqvist R, Nauta M, Ru G, Simmons M, Skandamis P, Suffredini E, Andersson DI, Bampidis V, Bengtsson-Palme J, Bouchard D, Ferran A, Kouba M, López Puente S, López-Alonso M, Saxmose Nielsen S, Pechová A, Petkova M, Girault S, Broglia A, Guerra B, Lorenzo Innocenti M, Liébana E, López-Gálvez G, Manini P, Stella P, Peixe L: Maximum levels of cross-contamination for 24 antimicrobial active substances in non-target feed. Part 5: Lincosamides: lincomycin. EFSA Journal, 19, 10 (2021). doi: 10.2903/j.efsa.2021.6856 [Paper link]
  6. EFSA Panel on Biological Hazards (BIOHAZ)*, Allende A, Koutsoumanis K, Alvarez-Ordóñez A, Bolton D, Bover-Cid S, Chemaly M, Davies R, De Cesare A, Herman L, Hilbert F, Lindqvist R, Nauta M, Ru G, Simmons M, Skandamis P, Suffredini E, Andersson DI, Bampidis V, Bengtsson-Palme J, Bouchard D, Ferran A, Kouba M, López Puente S, López-Alonso M, Saxmose Nielsen S, Pechová A, Petkova M, Girault S, Broglia A, Guerra B, Lorenzo Innocenti M, Liébana E, López-Gálvez G, Manini P, Stella P, Peixe L: Maximum levels of cross-contamination for 24 antimicrobial active substances in non-target feed. Part 6: Macrolides: tilmicosin, tylosin and tylvalosin. EFSA Journal, 19, 10 (2021). doi: 10.2903/j.efsa.2021.6858 [Paper link]
  7. EFSA Panel on Biological Hazards (BIOHAZ)*, Allende A, Koutsoumanis K, Alvarez-Ordóñez A, Bolton D, Bover-Cid S, Chemaly M, Davies R, De Cesare A, Herman L, Hilbert F, Lindqvist R, Nauta M, Ru G, Simmons M, Skandamis P, Suffredini E, Andersson DI, Bampidis V, Bengtsson-Palme J, Bouchard D, Ferran A, Kouba M, López Puente S, López-Alonso M, Saxmose Nielsen S, Pechová A, Petkova M, Girault S, Broglia A, Guerra B, Lorenzo Innocenti M, Liébana E, López-Gálvez G, Manini P, Stella P, Peixe L: Maximum levels of cross-contamination for 24 antimicrobial active substances in non-target feed. Part 7: Amphenicols: florfenicol and thiamphenicol. EFSA Journal, 19, 10 (2021). doi: 10.2903/j.efsa.2021.6859 [Paper link]
  8. EFSA Panel on Biological Hazards (BIOHAZ)*, Allende A, Koutsoumanis K, Alvarez-Ordóñez A, Bolton D, Bover-Cid S, Chemaly M, Davies R, De Cesare A, Herman L, Hilbert F, Lindqvist R, Nauta M, Ru G, Simmons M, Skandamis P, Suffredini E, Andersson DI, Bampidis V, Bengtsson-Palme J, Bouchard D, Ferran A, Kouba M, López Puente S, López-Alonso M, Saxmose Nielsen S, Pechová A, Petkova M, Girault S, Broglia A, Guerra B, Lorenzo Innocenti M, Liébana E, López-Gálvez G, Manini P, Stella P, Peixe L: Maximum levels of cross-contamination for 24 antimicrobial active substances in non-target feed. Part 8: Pleuromutilins: tiamulin and valnemulin. EFSA Journal, 19, 10 (2021). doi: 10.2903/j.efsa.2021.6860 [Paper link]
  9. EFSA Panel on Biological Hazards (BIOHAZ)*, Allende A, Koutsoumanis K, Alvarez-Ordóñez A, Bolton D, Bover-Cid S, Chemaly M, Davies R, De Cesare A, Herman L, Hilbert F, Lindqvist R, Nauta M, Ru G, Simmons M, Skandamis P, Suffredini E, Andersson DI, Bampidis V, Bengtsson-Palme J, Bouchard D, Ferran A, Kouba M, López Puente S, López-Alonso M, Saxmose Nielsen S, Pechová A, Petkova M, Girault S, Broglia A, Guerra B, Lorenzo Innocenti M, Liébana E, López-Gálvez G, Manini P, Stella P, Peixe L: Maximum levels of cross-contamination for 24 antimicrobial active substances in non-target feed. Part 9: Polymyxins: colistin. EFSA Journal, 19, 10 (2021). doi: 10.2903/j.efsa.2021.6861 [Paper link]
  10. EFSA Panel on Biological Hazards (BIOHAZ)*, Allende A, Koutsoumanis K, Alvarez-Ordóñez A, Bolton D, Bover-Cid S, Chemaly M, Davies R, De Cesare A, Herman L, Hilbert F, Lindqvist R, Nauta M, Ru G, Simmons M, Skandamis P, Suffredini E, Andersson DI, Bampidis V, Bengtsson-Palme J, Bouchard D, Ferran A, Kouba M, López Puente S, López-Alonso M, Saxmose Nielsen S, Pechová A, Petkova M, Girault S, Broglia A, Guerra B, Lorenzo Innocenti M, Liébana E, López-Gálvez G, Manini P, Stella P, Peixe L: Maximum levels of cross-contamination for 24 antimicrobial active substances in non-target feed. Part 10: Quinolones: flumequine and oxolinic acid. EFSA Journal, 19, 10 (2021). doi: 10.2903/j.efsa.2021.6862 [Paper link]
  11. EFSA Panel on Biological Hazards (BIOHAZ)*, Allende A, Koutsoumanis K, Alvarez-Ordóñez A, Bolton D, Bover-Cid S, Chemaly M, Davies R, De Cesare A, Herman L, Hilbert F, Lindqvist R, Nauta M, Ru G, Simmons M, Skandamis P, Suffredini E, Andersson DI, Bampidis V, Bengtsson-Palme J, Bouchard D, Ferran A, Kouba M, López Puente S, López-Alonso M, Saxmose Nielsen S, Pechová A, Petkova M, Girault S, Broglia A, Guerra B, Lorenzo Innocenti M, Liébana E, López-Gálvez G, Manini P, Stella P, Peixe L: Maximum levels of cross-contamination for 24 antimicrobial active substances in non-target feed. Part 11: Sulfonamides. EFSA Journal, 19, 10 (2021). doi: 10.2903/j.efsa.2021.6863 [Paper link]
  12. EFSA Panel on Biological Hazards (BIOHAZ)*, Allende A, Koutsoumanis K, Alvarez-Ordóñez A, Bolton D, Bover-Cid S, Chemaly M, Davies R, De Cesare A, Herman L, Hilbert F, Lindqvist R, Nauta M, Ru G, Simmons M, Skandamis P, Suffredini E, Andersson DI, Bampidis V, Bengtsson-Palme J, Bouchard D, Ferran A, Kouba M, López Puente S, López-Alonso M, Saxmose Nielsen S, Pechová A, Petkova M, Girault S, Broglia A, Guerra B, Lorenzo Innocenti M, Liébana E, López-Gálvez G, Manini P, Stella P, Peixe L: Maximum levels of cross-contamination for 24 antimicrobial active substances in non-target feed. Part 12: Tetracycline, chlortetracycline, oxytetracycline, and doxycycline. EFSA Journal, 19, 10 (2021). doi: 10.2903/j.efsa.2021.6864[Paper link]
  13. EFSA Panel on Biological Hazards (BIOHAZ)*, Allende A, Koutsoumanis K, Alvarez-Ordóñez A, Bolton D, Bover-Cid S, Chemaly M, Davies R, De Cesare A, Herman L, Hilbert F, Lindqvist R, Nauta M, Ru G, Simmons M, Skandamis P, Suffredini E, Andersson DI, Bampidis V, Bengtsson-Palme J, Bouchard D, Ferran A, Kouba M, López Puente S, López-Alonso M, Saxmose Nielsen S, Pechová A, Petkova M, Girault S, Broglia A, Guerra B, Lorenzo Innocenti M, Liébana E, López-Gálvez G, Manini P, Stella P, Peixe L: Maximum levels of cross-contamination for 24 antimicrobial active substances in non-target feed. Part 13: Trimethoprim. EFSA Journal, 19, 10 (2021). doi: 10.2903/j.efsa.2021.6865 [Paper link]
  14. Gullberg E, Cao S, Berg OG, Ilbäck C, Sandegren L, Hughes D, et al.: Selection of resistant bacteria at very low antibiotic concentrations. PLoS Pathogens 7, e1002158 (2011). doi: 10.1371/journal.ppat.1002158
  15. Bengtsson-Palme J, Larsson DGJ: Concentrations of antibiotics predicted to select for resistant bacteria: Proposed limits for environmental regulation. Environment International, 86, 140-149 (2016). doi: 10.1016/j.envint.2015.10.015 [Paper link]