Swiss Antibiotic Resistance Report

The Swiss Antibiotic Resistance Report (SARR) is the national report on the antibiotic resistance situation in Switzerland. The report not only focuses on antibiotic consumption and resistance in human and veterinary medicine, but also on the impacts in the environment (One Health approach).

Antibiotic resistance occurs when bacteria become immune or less sensitive to antibiotics. Such resistant bacteria can make it more difficult or even impossible to treat infections. This is why the Swiss Antibiotic Resistance Strategy was launched in 2015. One part of the strategy involves monitoring antibiotic resistance and antibiotic consumption in humans, livestock and domestic animals, and in the environment. The results of this monitoring and surveillance have been published every two years since 2016 in the Swiss Antibiotic Resistance Report.

SARR 2022

Find out about the most important figures and results from the SARR 2022 here.

Interview with Andreas Kronenberg, Project Manager at the Swiss Centre for Antibiotic Resistance ANRESIS

Antibiotic consumption

Every time antibiotics are used, resistant bacteria can develop. It is therefore crucial that these medicines are taken properly. The guiding principles are «as much as necessary, as little as possible» and «use wisely, take precisely». Surveillance of antibiotic use in human and veterinary medicine is therefore key.

Veterinary medicine

In veterinary medicine antibiotic consumption has further declined

Some 28 tonnes of antibiotics were used to treat animals in 2021 – a decline of around 6% compared with 2019. Since 2012, antibiotic use in veterinary medicine has been reduced by around half. In addition, the use of critically important antibiotics, which are particularly important in human medicine, continued to decline between 2019 and 2021, and has decreased by 46% since 2016. In domestic animals, antibiotic consumption has decreased by 19% in the last 10 years. Only 3% of the antibiotics used are exclusively authorised for domestic animals.

The rollout of the antibiotic consumption information system (IS ABV database) in 2019 means it is now possible to present detailed data on antibiotic use in animals. These data are provided by vets who have been required to electronically record all treatments and prescriptions of antibiotics for livestock and domestic animals since October 2019.
This information was published for the first time in the SARR 2022 report. Due to a lack of comparison data, it is not yet possible to study the evolution of prescribing practice in animals. Such analyses will be conducted in the next few years.

In 2020, 23 tonnes (rounded) of antibiotics were used to treat livestock and 1.7 tonnes (rounded) to treat domestic animals. In proportional terms, most of the antibiotics used in livestock were for cattle and the majority of antibiotics used in domestic animals were for horses (chart).

SARR22 Grafik AB Verbrauch Vet EN
Source: SARR22; Data: IS ABV

Antibiotic resistance

If the bacteria that cause an infection are resistant to certain antibiotics, the infection becomes difficult or even impossible to treat. The data collected on humans since 2004 and on animals since 2006 reveal a mixed picture: while antibiotic resistance has significantly increased in some bacteria, it has remained stable or decreased in others. Resistance rates have stabilised in recent years.

Veterinary medicine

Indicator bacteria collected from healthy animals show a mixed picture regarding antibiotic resistance

The monitoring of antibiotic resistance in indicator bacteria from healthy slaughter animals is designed to provide information on the type of resistance found in intestinal bacteria of animal origin. These bacteria do not usually cause disease themselves, but can pass on resistance to other bacteria, including those that can cause disease in humans. Every time antibiotics are used in animals, it can result in selective pressure, giving rise to resistant bacteria in the intestinal flora of the animals concerned. Consequently, E. coli as indicator bacteria are a useful instrument with which to observe changes in resistance and to track the spread of resistance.

The resistance rates of E. coli in the intestines of broiler chickens, fattening pigs and veal calves evolved differently between 2019 and 2021. While resistance fell in broiler chickens, rates remained more or less stable in fattening pigs and veal calves.

Proportion of resistant E. coli in broilers

SARR22 Grafik AB Resistenz Poulet EN
Source: SARR22

Proportion of resistant E. coli in fattening pigs

SARR22 Grafik Schwein EN
Source: SARR22

Proportion of resistant E. coli in fattening calves

SARR22 Grafik Kalb EN
Source: SARR22

Environment

New methods allow a better understanding of the spread of antibiotic resistance

Drug-resistant bacteria can spread between humans and animals, just like non-resistant bacteria, and use many different and complex routes of transmission (see figure). As part of the National Research Programme on antimicrobial resistance (NRP 72), various projects looked at the spread of new forms of resistance using next-generation sequencing (NGS). Among other things, researchers found a high colonisation with resistant pathogens in travellers returning from certain locations. They also detected transmission of resistant pathogens from patients discharged from hospital to their relatives, and between staff working in veterinary clinics and the animals treated there. To determine the part played by these routes of transmission more accurately, NGS would need to be systematically expanded. The aim of sequencing must be to gain relevant insights for the control of resistant pathogens and to utilise these for targeted action within the framework of the StAR. 

SARR Grafik Umwelt
1) In health institutions, resistant bacteria can be transmitted through contact between patients, between patients and their visitors, by the nursing staff or through contaminated surfaces and medical devices (during a medical procedure).
2) Resistant bacteria that occur after antibiotic treatment can be transferred from a human to an animal, or vice versa.
3) Bacteria can also infect raw meat during slaughter and cause foodborne infections. They can also contaminate dairy products, eggs, fish and seafood, vegetables and fruit.
4) Tourism and food imports are the fastest way of spreading resistant bacterial strains across national borders.
5) Resistant bacteria can get into rivers, lakes and groundwater reserves, although treatment plants eliminate 99% of them in treated wastewater before they discharge the water into the natural environment.
6) The spreading of manure (slurry) on cultivated fields can also lead to the spread of bacteria, which can multiply on plants, seep into groundwater or be washed into rivers and lakes.

Last modification 24.11.2022

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