Fluoroquinolone sales in food animals and quinolone resistance in non-typhoidal Salmonella from retail meats: United States, 2009–2018

Objectives: Antimicrobial-resistant non-typhoidal Salmonella (NTS) infections are associated with worse health outcomes compared to antimicrobial-susceptible infections. Misuse of antimicrobials in food animals can amplify the emergence of antimicrobial resistance. The objective of this study was to examine the association between fluoroquinolone sales in food animals and the prevalence of quinolone-resistant NTS isolated from retail meats. Methods: We reviewed data for 4318 NTS isolates from retail meat samples collected from 2009 to 2018 through the FDA National Antimicrobial Resistance Monitoring System programs. The Pearson's correlation was used to examine the correlation between the prevalence of quinolone-resistant NTS and standardised fluoroquinolone sales. Results: After adjusting for the increase in beef and pork production, fluoroquinolone sales increased by 41.67% from 2013 to 2018. The prevalence of quinolone-resistant NTS from retail ground beef increased from 5% in 2014 to 11% in 2018. The increase of quinolone-resistant isolates in retail meats since 2016 was mostly related to Salmonella Infantis and Salmonella enteritidis. Conclusion: One Health integrated surveillance for NTS isolates from food of animal origin and human sources is necessary to elucidate trends in resistance to critical drugs. The study also underscores the need for judicious use of antimicrobials in agricultural settings.