phan thi van- [email protected] build up capacity on amu and amr o systematic baseline survey on amu...
TRANSCRIPT
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CHALLENGE ON ANTIMICROBIAL USE AND
ANTIMICROBIAL RESISTANCE IN AQUACULTURE: AN
EXPERIENCE FROM VIETNAM
Phan Thi Van- [email protected] AMR Workshop 1: 10-11 April 2017, Mangalore, India
FMM/RAS/298: Strengthening capacities, policies and national action plans on
prudent and responsible use of antimicrobials in fisheries
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CONTENT
1. Aquaculture in Vietnam
2. The main sources of antimicrobials in aquaculture
system
3. Impact of AMU and AMR
4. Regulations on AMU, AMR and its implimentation
5. Recommendations
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1. AQUACULTURE IN VIETNAM
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0
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3500
4000
Pro
du
cti
on
(‘0
00
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)
Year
Aquaculture production of Vietnam
Source: D-Fish
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Area of aquaculture in Vietnam
Source: D-Fish
0
200
400
600
800
1000
1200
1400
20002001200220032004200520062007200820092010201120122013201420152016
000 Ha
Year
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1000
2000
3000
4000
5000
6000
7000
8000
9000
1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Th
ou
sa
nd
US
D
Year
Value of the Vietnamese seafood export
Source: D-Fish
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The challenges
• Many aquaculture species
• Large area of aquaculture
• Many aquaculture systems
• Tropical and subtropical climates
• Many levels of investment: large-, medium- and
small-scale
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2. THE MAIN SOURCES OF ANTIMICROBIALS IN
AQUACULTURE SYSTEM
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From direct use of antimicrobials
• Disease prevention
• Disease treatment
• Seed
• Feed
• Postharvest
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From other uses of antimicrobials
• Residues from other users
• Holding water for seed transportation
• Human waste
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Antimicrobial products in aquaculture
• To date, Vietnam has 814 products (drug, chemical and
vitamin) registered of which:
o 12.9% products from import
o 216 products contain antimicrobials (DAH,2017)
• In 2012, there were 223 products contain antimicrobial
(Mai 2012)
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The challenges
• Too many sources of antimicrobial in aquaculture system
• Uncontrolled sources of antimicrobial residues in
aquaculture environment
• Too many products containing antimicrobials
• Irresponsible use of antimicrobials
• Antimicrobials appear in all stages of aquaculture
production: from seed to post harvest
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3. REGULATIONS ON AMU, AMR AND ITS IMPLEMENTATION
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Existing regulations
• Fisheries law
• Veterinary law
• 2 Decrees on AMU and AMR
• 11 Circulars of MARD on disease control, AMU & AMR
• 20 official letters by MARD to direct and enforce
controlling of AMU & AMR
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Existing regulation
• National Steering Committees for AMU and AMR, MARD
• “Multi-stakeholder Engagement to combat AMR in
Vietnam’ by MoH, MARD and MONRE
• Banned list of antibiotic use in aquaculture (24 antibiotics)
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The implementation
Diferent level of following regulations:
• Big companies vs small scale farmers
• GoV companies/hatcheries vs private companies/hatcheries
• Foreigner invested farms/hatcheries vs Domestic
farms/hatcheries
• Exporting farm vs domestic farm
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Antimicrobial use in aquaculture in Hai phong
and Nghe an provinces in 2015
45
65
76.6
30
0
10
20
30
40
50
60
70
80
90
Farm
use a
nti
mic
rob
ial (%
)
Hải Phòng Nghệ An
Prevention Treatment
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Antimicrobial use in aquaculture in Hai phong and
Nghe an provinces in 2015
Applied method Effectiveness
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Antimicrobial use in aquaculture in Hai phong
and Nghe an provinces in 2015
• Dosage:
o Following drug company (**)
o Following own experience (***)
o Following Vet/aquatic animal health officer (*)
o Using antimicrobial at difference dosage for the same
disease: Doxycycline, Tetracycline, Oxytetracycline, Enrofloxcin
were used at 2kg/1000m3 or 1kg/1000m3 or 0,5kg/1000m3 to
spray to shrimp pond.
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The challenges
• Too many regulations
• Long regulations
• No recommended/allowed list used for animals
• Very easy to access chemicals even human
antimicrobials.
• No standard on dosage, applied methods
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4. THE IMPACT OF AMU AND AMR
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Overall impact of AMU and AMREnvironment
Human
Animal
AMU
AMR
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Impact on public health
The exact public health impact of AMR in Vietnam is unknown
but…...
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Impact on public health
• High level of AMR, is increasing over time (GARP, 2010;
Nguyen et al., 2013)
• 43.8% ESBL (extended-spectrum beta-lactamase)
producing bacteria amongst hospitalized patients
• 81% ESBL amongst Enterobacteriaceae in intensive care
units in HoChiMinh city(Kiratisin et al., 2012).
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Impact on public health
• Resistance to fluoroquinolones in Salmonella typhi isolates
increased from 4% to 97% during 1993-2005 (Chau et al.,
2007).
• Increase in tetracycline and chloramphenicol resistance
• Occurrence of multi-drug resistance seen in Streptococcus
suis from 1997-2008 associated with agricultural
antimicrobial use (Hoa et al., 2011).
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The impact on seafood export
Reason for Vietnam seafood shipments rejected by importers in 2016
Antibiotic26%
Bacteria conta.20%
Other54%
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Impact on seafood export
Antibiotic EU Korea Japan Australia USA Total
Total 10 2 32 3 11 58
CAP 5(Sq, F) 11 (S) 16
AOZ 2 (S) 08 (S) 10
SEM 3(P) 3
Enrofloxacin 14 (S) 3(F, S) 17
Tetracycline gr 4 (S) 4
Doxycycline 2 (S) 2
Sulfamid 5 (S) 5
Azithromycin 1(F) 1
Vietnam seafood shipments rejected by importers due to antibiotic residue in
2016 (NAFIQUAD)
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AMR of Vibrio alginolyticus
0
0.5
1
1.5
2
2.5
3
3.5Erythromycin
Rifamycin
Sufamethoxazole+Trimethoprim
Tetracyclin
Oxytetracyclin
2004 2005 2006 2013 2014
Inhibition zone diameter
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0
0.5
1
1.5
2
2.5
3Rifamycin
Doxycycline
OxytetracyclinTetracyclin
Erythomycin
2013 2015 2016 2017
AMR of Aeromonas hydrophila
Inhibition zone diameter
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5. RECOMMENDATIONS
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Recommendation on regulations
• Summary of regulations on AMU and AMR into a specific format
that is short and easy to understand by the farmers
• The use of recommended/allowed list of antimicrobials in
aquaculture
• Regulation on that use of antimicrobials needs a pharmaceutical
prescription by an authorized and educated professional both for
human and animal purpose
• National Action Plan inplace and implimented
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o Farmer awareness on antimicrobial use and resistance
o Build up capacity on AMU and AMR
o Systematic baseline survey on AMU and AMR for better
surveillance, mornitoring and control
o Apply VietGAP standard.
o Alternative to antimicrobials such as herbal, probiotic use
o Multi-displine work
Recommendation on awareness and techinical issue
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ACKNOWLEDGEMENT
• FAO
• NITTE University
• MARD
• Vietnam country delegate
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THANK YOU FOR YOUR ATTENTION