Un avis1 de l’Agence nationale de sécurité sanitaire de l’alimentation, de l’environnement et du travail (Anses) publié en juin 2023, analyse le rôle des animaux dans la transmission de l’antibiorésistance en France et recommande des mesures de gestion. Les experts ont ainsi identifié 11 couples bactérie/famille d’antibiotiques présents dans le secteur animal et jugés préoccupants pour la santé publique, parmi lesquels cinq sont jugés très préoccupants et classés dans un groupe « hautement prioritaires ». Sur la base de cette liste, l’Agence recommande plus particulièrement un renforcement de la surveillance des souches d’Enterobacterales2 résistantes aux carbapénèmes, aux céphalosporines de 3ème et 4ème générations, aux fluoroquinolones et polymyxines ainsi que des souches de Staphylococcus aureus résistantes à la méticilline) par des mesures de dépistage et par le séquençage du génome entier des souches résistantes pour identifier d’éventuels liens épidémiologiques entre les souches isolées des populations animales, humaines, et de l’environnement.
Certaines situations de contacts (directs avec un animal de production ou de compagnie ou indirects à travers la voie alimentaire) constituent des voies de transmission privilégiées de l’antibiorésistance entre le secteur animal et le secteur humain. Cependant, au vu des données actuelles, la transmission en France des résistances bactériennes entre le secteur animal et le secteur humain apparaît limitée et/ou sont souvent maîtrisée (par exemple : mesures de biosécurité dans les élevages, bonnes pratiques d’hygiène au sein des cliniques vétérinaires, cuisson des aliments, etc.). Néanmoins, avec la mondialisation et l’intensification des échanges entre les zones géographiques, les pathogènes résistants aux antibiotiques peuvent être disséminés très rapidement. Aussi, l’Agence appelle à renforcer la surveillance des denrées alimentaires et des animaux vivants en provenance de pays hors de l’UE, qui présentent des niveaux particulièrement élevés de résistance. En effet, de telles importations favoriseraient l’introduction, sur le territoire français, de bactéries portant de nouveaux gènes de résistance à des antibiotiques voire même de bactéries multirésistantes, qui constituent un danger majeur pour la santé publique compte tenu des impasses thérapeutiques auxquelles elles peuvent conduire.
La maîtrise de l’antibiorésistance dans le secteur animal est une composante indispensable de la maîtrise de l’antibiorésistance en général. Elle est emblématique de l’interdépendance de la santé humaine, de la santé animale et de celle des écosystèmes. À ce titre, ces travaux s’inscrivent totalement dans une approche intégrative « Une seule santé ».
1 https://www.anses.fr/fr/system/files/SABA2020SA0066Ra.pdf
2 Les Enterobacterales sont un ordre de bactéries Gram-négatives, non sporulées, anaérobies facultatives, en forme de bâtonnet, appartenant à la classe des gammaprotéobactéries. On y retrouvent diverses espèces bactériennes comme Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae.
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