Surveillance Open Access
Like 0



International organisations are calling for One Health approaches to tackle antimicrobial resistance. In France, getting an overview of the current surveillance system and its level of integration is difficult due to the diversity of surveillance programmes.


This study aimed to map and describe all French surveillance programmes for antibiotic resistance (ABR), antibiotic use (ABU) and antibiotic residues, in humans, animals, food and the environment, in 2021. Another objective was to identify integration points, gaps and overlaps in the system.


We reviewed the literature for surveillance programmes and their descriptions. To further characterise programmes found, semi-directed interviews were conducted with their coordinators.


In total 48 programmes in the human (n = 35), animal (n = 12), food (n = 3) and/or the environment (n = 1) sectors were identified; 35 programmes focused on ABR, 14 on ABU and two on antibiotic residues. Two programmes were cross-sectoral. Among the 35 ABR programmes, 23 collected bacterial isolates. Bacteria most targeted were (n = 17 programmes), (n = 13), and (n = 12). Extended-spectrum beta-lactamase-producing was monitored by most ABR programmes (15 of 35) in humans, animals and food, and is a good candidate for integrated analyses. ABU indicators were highly variable. Areas poorly covered were the environmental sector, overseas territories, antibiotic-resistant-bacterial colonisation in humans and ABU in companion animals.


The French surveillance system appears extensive but has gaps and is highly fragmented. We believe our mapping will interest policymakers and surveillance stakeholders. Our methodology may inspire other countries considering One Health surveillance of ABR.


Article metrics loading...

Loading full text...

Full text loading...



  1. Interagency coordination group on antimicrobial resistance. No time to wait: securing the future from drug-resistant infections - report to the Secretary-General of the United Nations 2019. New York: United Nations; 2019. Available from: https://news.un.org/en/story/2019/04/1037471
  2. Antimicrobial Resistance Collaborators. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet. 2022;399(10325):629-55.  https://doi.org/10.1016/S0140-6736(21)02724-0  PMID: 35065702 
  3. World Health Organization (WHO). Global action plan on antimicrobial resistance. Geneva: WHO; 2015. Available from: https://www.who.int/publications/i/item/9789241509763
  4. European commission. A European One Health Action Plan against Antimicrobial Resistance (AMR). Brussels: European commission; 2023. Available from: https://health.ec.europa.eu/antimicrobial-resistance/eu-action-antimicrobial-resistance_en
  5. European Centre for Disease Prevention and Control (ECDC). Antimicrobial resistance in the EU/EEA (EARS-Net) - Annual Epidemiological Report 2021. Stockholm: ECDC; 2022. Available from: https://www.ecdc.europa.eu/en/publications-data/surveillance-antimicrobial-resistance-europe-2021
  6. Schrijver R, Stijntjes M, Rodríguez-Baño J, Tacconelli E, Babu Rajendran N, Voss A. Review of antimicrobial resistance surveillance programmes in livestock and meat in EU with focus on humans. Clin Microbiol Infect. 2018;24(6):577-90.  https://doi.org/10.1016/j.cmi.2017.09.013  PMID: 28970159 
  7. European Centre for Disease Prevention and Control (ECDC)/European Food Safety Authority (EFSA)/European Medicines Agency (EMA) Interagency report. Antimicrobial consumption and resistance in bacteria from humans and animals, JIACRA III, 2016-2018. Stockholm, Parma, Amsterdam: ECDC, EFSA, EMA; 2021. Available from: https://www.ecdc.europa.eu/en/publications-data/third-joint-interagency-antimicrobial-consumption-and-resistance-analysis-report
  8. Interministerial committee on health. Interministerial roadmap for controlling antimicrobial resistance. 2021. Available from: https://sante.gouv.fr/IMG/pdf/interministerial_amr_roadmap_en.docx.pdf
  9. French Ministry of Solidarity and Health. Stratégie nationale 2022-2055 de prévention des infections et de l'antibiorésistance [2022-2055 national strategy for preventing infections and antibiotic resistance]. 2022. Available from: https://sante.gouv.fr/IMG/pdf/national_strategy_for_preventing_infections_and_antibiotic_resistance_2022-2025_.pdf
  10. French Ministry of Agriculture and Food Sovereignty. Ecoantibio2: the French national plan for the reduction of the risks of antimicrobial resistance in veterinary medicine 2017-2021. French Ministry of Agriculture and Food Sovereignty; 2022. Available from: https://agriculture.gouv.fr/telecharger/119352
  11. Ministry of Ecological Transition and French Ministry of Solidarity and Health. Un environnement, une santé - 4e plan national santé environnement (PNSE4). [2020-2024 National Environmental Health Plan (PNSE4)]. Ministry of Ecological Transition and French Ministry of Solidarity and Health; 2022. Available from: https://www.ecologie.gouv.fr/environnement-sante-decouvrez-4e-plan-national-sante-environnement
  12. Hoinville LJ, Alban L, Drewe JA, Gibbens JC, Gustafson L, Häsler B, et al. Proposed terms and concepts for describing and evaluating animal-health surveillance systems. Prev Vet Med. 2013;112(1-2):1-12.  https://doi.org/10.1016/j.prevetmed.2013.06.006  PMID: 23906392 
  13. Bordier M, Delavenne C, Nguyen DTT, Goutard FL, Hendrikx P. One Health Surveillance: A Matrix to Evaluate Multisectoral Collaboration. Front Vet Sci. 2019;6:109.  https://doi.org/10.3389/fvets.2019.00109  PMID: 31106210 
  14. Réseau de Prévention des Infections Associées aux Soins. [Network for prevention of healthcare associated infections]. [Accessed Mar 2022]. French. Available from: https://www.preventioninfection.fr/
  15. Observatoire National de l'Epidémiologie de la Résistance Bactérienne aux Antibiotiques (ONERBA) [French National Observatory for Epidemiology of Bacterial Resistance to Antimicrobials (ONERBA)]. [Accessed Mar 2022]. French. Available from: http://onerba.org/
  16. Collineau L, Belloc C, Stärk KD, Hémonic A, Postma M, Dewulf J, et al. Guidance on the Selection of Appropriate Indicators for Quantification of Antimicrobial Usage in Humans and Animals. Zoonoses Public Health. 2017;64(3):165-84.  https://doi.org/10.1111/zph.12298  PMID: 27592024 
  17. Council of the European Union. Council directive 96/23/EC of 29 April 1996 on measures to monitor certain substances and residues thereof in live animals and animal products and repealing Directives 85/358/EEC and 86/469/EEC and Decisions 89/187/EEC and 91/664/EEC. Official Journal of the European Union. Luxembourg: Publications Office of the European Union; 1996. Available from: https://eur-lex.europa.eu/legal-content/en/ALL/?uri=CELEX:31996L0023
  18. European Commission. Commission implementing decision (eu) 2020/1161 of 4 august 2020 establishing a watch list of substances for union-wide monitoring in the field of water policy pursuant to directive 2008/105/ec of the European parliament and of the council. Official Journal of the European Union. (C/2020/5205). Luxembourg: Publications Office of the European Union; 2020. Available from: https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=uriserv:OJ.L_.2020.257.01.0032.01.ENG
  19. Mader R, Damborg P, Amat JP, Bengtsson B, Bourély C, Broens EM, et al. , EU-JAMRAI. Building the European Antimicrobial Resistance Surveillance network in veterinary medicine (EARS-Vet). Euro Surveill. 2021;26(4):2001359.  https://doi.org/10.2807/1560-7917.ES.2021.26.4.2001359  PMID: 33509339 
  20. Bennani H, Cornelsen L, Stärk KDC, Häsler B. Characterisation and mapping of the surveillance system for antimicrobial resistance and antimicrobial use in the United Kingdom. Vet Rec. 2021;188(7):e10.  https://doi.org/10.1002/vetr.10  PMID: 33835538 
  21. National collaborating centre for infectious diseases (ICID). Progress on Integrated Antimicrobial Resistance and Antimicrobial Use Surveillance in Canada (2014-2019). Winnipeg: ICID; 2020. Available from: https://nccid.ca/wp-content/uploads/sites/2/2021/04/Final_IntegratedAntimicrobialResistance_Feb23.pdf
  22. Peñalva G, Crespo-Robledo P, Molvik M, López-Navas A, Kacelnik O, Cisneros JM, EU-JAMRAI WP7.4.1 group. A step forward in antibiotic use and resistance monitoring: a quarterly surveillance system pilot in 11 European Union/European Economic Area countries, September 2017 to May 2020. Euro Surveill. 2022;27(46):2200082.  https://doi.org/10.2807/1560-7917.ES.2022.27.46.2200082  PMID: 36398580 
  23. Santé publique France (SPF). Antibiotiques et résistance bactérienne: pistes d'actions pour ancrer les progrès de 2020. [Antibiotics and bacterial resistance: action points to anchor the progress of 2020]. Synthèse. Saint Maurice: SPF; Nov 2021. Available from: https://www.santepubliquefrance.fr/maladies-et-traumatismes/infections-associees-aux-soins-et-resistance-aux-antibiotiques/infections-associees-aux-soins/documents/rapport-synthese/antibiotiques-et-resistance-bacterienne-pistes-d-actions-pour-ancrer-les-progres-de-2020
  24. World Health Organization (WHO). World antimicrobial awareness week. Geneva: WHO. [Accessed 17 May 2023]. Available from: https://www.who.int/campaigns/world-antimicrobial-awareness-week
  25. Babu Rajendran N, Arieti F, Mena-Benítez CA, Galia L, Tebon M, Alvarez J, et al. , EPI-Net One Health consensus working group. EPI-Net One Health reporting guideline for antimicrobial consumption and resistance surveillance data: a Delphi approach. Lancet Reg Health Eur. 2022;26:100563.  https://doi.org/10.1016/j.lanepe.2022.100563  PMID: 36895445 
  26. World Health Organization (WHO). Global Tricycle Surveillance: WHO integrated global surveillance on ESBL-producing E. coli using a “One Health” approach, Implementation and opportunities. Geneva: WHO; 2021. Available from: https://www.who.int/publications/i/item/who-integrated-global-surveillance-on-esbl-producing-e.-coli-using-a-one-health-approach
  27. Bertrand-Krajewski J-L, Bournique R, Lecomte V, Pernin N, Wiest L, Bazin C, et al. SIPIBEL observatory: Data on usual pollutants (solids, organic matter, nutrients, ions) and micropollutants (pharmaceuticals, surfactants, metals), biological and ecotoxicity indicators in hospital and urban wastewater, in treated effluent and sludge from wastewater treatment plant, and in surface and groundwater. Data Brief. 2021;40:107726.  https://doi.org/10.1016/j.dib.2021.107726  PMID: 34993289 
  28. Haenni M, Dagot C, Chesneau O, Bibbal D, Labanowski J, Vialette M, et al. Environmental contamination in a high-income country (France) by antibiotics, antibiotic-resistant bacteria, and antibiotic resistance genes: Status and possible causes. Environ Int. 2022;159:107047.  https://doi.org/10.1016/j.envint.2021.107047  PMID: 34923370 
  29. Huijbers PMC, Flach CF, Larsson DGJ. A conceptual framework for the environmental surveillance of antibiotics and antibiotic resistance. Environ Int. 2019;130:104880.  https://doi.org/10.1016/j.envint.2019.05.074  PMID: 31220750 
  30. World Health Organization (WHO). Tripartite and UNEP support OHHLEP's definition of “One Health”. Geneva: WHO; 2021. Available from: https://www.who.int/news/item/01-12-2021-tripartite-and-unep-support-ohhlep-s-definition-of-one-health
  31. Colomb-Cotinat M, Soing-Altrach S, Leon A, Savitch Y, Poujol I, Naas T, et al. , CPIAS network. Emerging extensively drug-resistant bacteria (eXDR) in France in 2018. Med Mal Infect. 2020;50(8):715-22.  https://doi.org/10.1016/j.medmal.2020.01.011  PMID: 32113869 
  32. Mader R, Muñoz Madero C, Aasmäe B, Bourély C, Broens EM, Busani L, et al. Review and analysis of national monitoring systems for antimicrobial resistance in animal bacterial pathogens in Europe: a basis for the development of the European Antimicrobial Resistance Surveillance network in Veterinary medicine (EARS-Vet). Front Microbiol. 2022;13:838490.  https://doi.org/10.3389/fmicb.2022.838490  PMID: 35464909 
  33. Regulation (EU) 2019/6 of the European Parliament and of the Council of 11 December 2018 on veterinary medicinal products and repealing Directive 2001/82/EC. Official Journal of the European Union. Luxembourg: Publications Office of the European Union; 2019. Available from: https://eur-lex.europa.eu/eli/reg/2019/6/oj
  34. Agence nationale de sécurité sanitaire de l’alimentation, de l’environnement et du travail (ANSES). RESAPATH on line 2023. Maisons-Alfort: ANSES. [Accessed 30 Jan 2023]. Available from: https://shiny-public.anses.fr/ENresapath2/
  35. Mader R, Bourély C, Amat JP, Broens EM, Busani L, Callens B, et al. , EU-JAMRAI. Defining the scope of the European Antimicrobial Resistance Surveillance network in Veterinary medicine (EARS-Vet): a bottom-up and One Health approach. J Antimicrob Chemother. 2022;77(3):816-26.  https://doi.org/10.1093/jac/dkab462  PMID: 35022739 
  36. Institut national de la santé et de la recherche médicale (INSERM). Interface nationale ANTIBIORÉSISTANCE - Projets et actions soutenu: Action 2 – Résultats des AAP structurants du PPR Antibiorésistance, 3 projets retenus 2021. [National interface Antimicrobial resistance – Funded projects and actions – Action 2 – Results of the call from the Priority Research Programme on Antimicrobial resistance, 3 funded projects 2021]. Paris: INSERM. [Accessed Apr 2022]. Available from: https://ppr-antibioresistance.inserm.fr/fr/projets-actions-soutenus/action-2-resultats-des-aap-structurants-du-ppr-antibioresistance-3-projets-retenus/#promise

Data & Media loading...

Supplementary data

Submit comment
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error