Occurrence and spread of carbapenemase-producing Enterobacterales (CPE) in the food chain in the EU/EFTA. Part 1: 2025 update

Abstract

Carbapenemase-producing Enterobacterales (CPE) have been reported in the food chain in 14 out of 30 EU/EFTA countries. Commonly reported genes are blaVIM-1, blaOXA-48 and blaOXA-181, followed by blaNDM-5 and blaIMI-1. Escherichia coli, target of most of the studies, Enterobacter cloacae complex, Klebsiella pneumoniae complex and Salmonella Infantis are the most frequent CPE. E. coli isolates show a high clonal diversity. IncHI2 (blaVIM-1 and blaOXA-162), IncC (blaVIM-1 and blaNDM-1), IncX3 (blaNDM-5 and blaOXA-181), IncI and IncL (blaOXA-48) plasmids are frequently reported. Most reports are from terrestrial food-producing animals and their environments – mainly pigs, followed by bovines and poultry and with occasional reports of meat thereof (targets of the EU monitoring and follow up trace back investigations). Few studies have investigated foods of aquatic animal origin and of non-animal origin, finding a great CPE diversity. A notable increase in the number of CPE detections has been observed, predominantly from pigs, with a surge in certain countries in 2021 (blaOXA-181, Italy) and 2023 (blaOXA-48, Spain; blaOXA-181, blaOXA-48, blaOXA-244 and blaNDM-5, Portugal). Very few data points to circumstantial evidence of CPE transmission, clonal and/or horizontal gene spread within the food chain and from/to humans. Various methods are used in the EU/EFTA countries to detect and characterise CPE in the food chain. Improvement of their sensitivity should be investigated. Ten out of 30 EU/EFTA countries have specific contingency plans for CPE control, being epidemiological investigations (e.g. trace-back) a common action included in those plans. Overall, data remain scarce for the bacterial species and sources beyond those systematically monitored. Recommendations to fill data gaps on other bacterial species and sources, dissemination pathways and optimisation of detection methods are given. A One Health approach to address the drivers of CPE spread in the food chain is needed.