The debate relationship on the role of animal antibiotics to resistance in humans is protracted, particularly in the United States, where action lags far behind that of the European Union, where the “precautionary principle,” is a guiding tenet of public health, even though the Swann report [8] from the UK showed in the 1960s a clear link between antibiotic use in food animals and human disease CX-5461 mw and deaths and made many important recommendation to curb antibiotic use in food animals. Things might however be changing [9]. Recent studies and evidence is best focussed on (i) frequency of enterobacteria producing extended spectrum beta-lactamases (E-ESBL) or resistant to fluoroquinolones

(both major threat for humans) in food chain animals (FCA), (ii) role of density of fecal E-ESBL in terms see more of risks, (iii) evidences for transfer

between animals and humans, and (iv) characteristics of organic FCA in terms of resistance. E. coli causes not only very common community infections such as urinary tract infections (UTI), but yearly also millions of severe and life threatening infections such as blood stream infections. In Australia, fluoroquinolones have been used in people for over 30 years but the use of fluoroquinolones is banned in food production animals. Levels of fluoroquinolone resistance in both community and healthcare acquired E. coli infections are low (~5%) in contrast to nearly all other countries where fluoroquinolone resistance rates are often very much higher. This is despite the overall use of antibiotics per capita being relatively high in

Australia [10]. Also, there is also almost no fluoroquinolone resistance in food-borne infections with salmonella and campylobacter acquired domestically. In Europe there is a clear association between the levels of antibiotic resistant E. coli causing blood stream infections in different countries and the levels of resistance in poultry and pig E. coli isolates [11]. Colonization of food chain animals by E. coli-ESBL is quite high and increasing. In Switzerland in 2011, it was of 15% in pigs, which is over that of the local human population [12] and as high a 25% in calves and 63% in chicken which might be in relation with specific usage of cephalosporins in these DOK2 animals. The widespread practice of injecting 3rd generation cephalosporin (e.g. ceftiofur) into eggs just before they hatch appears to be the major contributor to this problem [13]. In Germany, 38% of the chicken were colonized with a variety of ESBL genes and retail chicken meat might be a reservoir for strains or ESBL genes for humans [14]. In Spain the prevalence of E. coli-ESBL in poultry meat increased from 62.5% in 2007 to 93.3% in 2010. Consumption of retail meat by women is associated with a threefold risks that strain are resistant in case of UTI [15].