In 2023 WHO renewed its cooperation with the Collaborating Centre for Antimicrobial Resistance in Foodborne Pathogens and Genomics based at the Technical University of Denmark (DTU) in Kongens Lyngby. The renewal of the collaboration, which stretches back to 2002, highlights a joint commitment to strengthening global understanding and response to antimicrobial resistance (AMR) in food.
The Centre, known as the DTU National Food Institute, has led One Health AMR surveillance to quantify AMR in genetic contexts as well as contexts where the genotype and the environment interact, and has worked to implement research and build capacity. Its research lays the foundation for new policies that mandate AMR mitigation and prevention across the globe, saving hundreds of thousands of lives.
“The burden of AMR in foodborne disease is a growing threat to human, animal and environmental health globally,” said Dr Danilo Lo Fo Wong, WHO/Europe’s Regional Adviser for Control of AMR. “Strong partnerships with collaborating centres like the DTU National Food Institute are vital, giving WHO the evidence it needs to guide Member States in making policies and formulating strategies to control AMR in foodborne diseases. The DTU National Food Institute also makes a valued contribution towards building capacity to improve surveillance in countries.”
The WHO Collaborating Centre’s contribution to reducing AMR
Conducting proper surveillance on resistant pathogens helps scientists understand where they started, what they are resistant to and how they are potentially spreading. The DTU National Food Institute’s research, surveillance, scientific studies and global awareness-raising efforts are of critical importance in controlling foodborne AMR.
The Centre has supported WHO since 1999 with the inception of the WHO Global Foodborne Infections Network (GFN), formerly known as Global Salm-Surv (GSS), through various capacity-building activities. These have included the development of laboratory protocols and guidance, and training activities to strengthen countries’ surveillance and response systems for foodborne diseases and AMR.
In addition, the Centre supports WHO to improve the capacity of international, national and regional laboratories that participate in the WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS). It assists in increasing knowledge and implementing guidance on AMR and foodborne disease surveillance.
Whole genome sequencing for AMR surveillance
The Centre uses whole genome sequencing to analyse the millions of units (base pairs) that make up the DNA of the germs that can be present in food and cause disease. Complementing existing foodborne disease surveillance with whole genome sequencing enables scientists to more accurately determine the source and transmission of pathogens and learn more about the genes and mutations that are causing resistance to antimicrobial medicines.
Because of the unparalleled level of resolution it provides, whole genome sequencing is radically changing how scientists detect and monitor microbial hazards within the food chain, improving the detection of disease outbreaks, informing outbreak response and guiding a One Health approach.
The DTU National Food Institute has been instrumental in providing technical support to countries implementing the Tricycle project for integrated One Health surveillance of drug-resistant E. coli in multiple sectors, including human health, animal health and agriculture. Whole genome sequencing will help to define the linkages between the E. coli causing disease in humans and those found in food and in the environment.
“We look forward to our continuing partnership with WHO/Europe in the future, and to help build support for AMR surveillance globally,” explained Professor Rene Hendriksen, Head of the Collaborating Centre.
The global AMR threat
AMR is one of the top global health threats, placing both human and animal health at risk. It is associated with the deaths of 4.95 million people per year around the world. AMR occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines, making infections harder to treat and increasing the risk of disease spread, severe illness and death. As medicines become ineffective, infections persist in the body and increase the risk of spread to others.
AMR is a potential risk for everyone, especially when common causes of foodborne illness such as Salmonella, Giardia, Campylobacter and E. coli become resistant to treatment.
Resistant pathogens can spread to people in a variety of ways, such as via contamination during the slaughter and processing of animals for meat, contaminated fruits and vegetables, and unsanitary or inadequate food preparation. Cases of disease caused by resistant foodborne pathogens are steadily rising around the world, with almost 1 in 10 people falling ill every year from eating contaminated food. Controlling AMR in foodborne disease is a public health priority.
AMR is being driven globally by the inappropriate use of antimicrobial medicines and extensive use of antibiotics in livestock and poultry production systems. Today, resistant pathogens are spreading ever more rapidly because of factors such as environmental pollution and global travel and trade.