The European Food Safety Authority (EFSA) has produced a report on the presence, spread and risks of the hospital bacteria CPE (Carbapenemase-producing Enterobacterales) in the EU food chain. It states that EFSA does not yet know everything because many food categories are still under-sampled. Conclusions on risk are therefore preliminary and limited.
CPEs are also called hospital bacteria because they are mainly found there and are a problem there, just like MRSA. CPE stands for Carbapenemase-producing Enterobacterales - these are bacteria (like E. coli or Salmonella) that produce a special kind of enzyme called carbapenemase. That enzyme renders some of the strongest antibiotics (carbapenems) ineffective. The genes that control these enzymes (such as blaVIM-1, blaOXA-48, blaOXA-181 and blaNDM-5) are often located on plasmids, which are transferable pieces of DNA. Plasmids can be easily passed from one bacterium to another, even between different species. This means that resistance can not only spread within a farm, slaughterhouse or supermarket, but can also theoretically jump from animal to human.
A total of 380 CPE isolates have been documented within the EU since 2011, including 257 from the pig chain. Other sources: cattle, chicken, meat, fish, vegetables, herbs, and even insects (mostly from imports). So much more sampling has been done in pigs than in, say, vegetables, fish, or spices. This is because many of the CPE surveys in Europe focus on pigs and E. coli (often as indicator bacteria), as these are included in the official AMR monitoring programme. So: we simply know much less about CPE in other food categories.
Unfortunately, the monitoring data are not transparently presented by EFSA. Herewith a probability calculation per food category based on the information given in the report.
Food category | Number of samples (estimated/known) | Number of CPE-positive | Chance (%) |
Pigs (meat + environment) | approx. 8,000-10,000 (monitoring since 2011) | 257 | ~2.6-3.2% |
Cattle (meat + environment) | unknown, less than pigs | ~30 | estimated <1% |
Chicken | Unknown | several dozen | estimated <1% |
Fish/seafood | Limited number, mostly imports | ~10-15 | unknown, possibly >1% |
Vegetables/spices (import) | very limited (~dozens/year) | ~10-12 | relatively high (sometimes >5%) |
Insects (ready-to-eat) | very few samples | 2-3 (gene detection) | unattachable |
N.B. Many of these numbers are estimates or based on fragmentary EFSA monitoring data. The probability calculation may be underestimated or overestimated, depending on sampling intensity and analytical methods.
The report says: "Data remain scarce for sources beyond those systematically monitored." and "An increase in CPE reports may partially reflect an increase in testing."
In short, we do not have a complete picture of reality. We mainly know what was found where people looked. That makes any firm statement about "where the most risk is" premature.
The report therefore repeatedly stresses that monitoring focuses mainly on pigs and E. coli, data over other food categories (vegetables, fish, herbs, insects) are very limited and trends in CPE found may be due to increased sampling, not necessarily to actual increases in contamination.
Nevertheless, EFSA advocates preventing or minimising the spread of CPE in the food chain. They aim to fill knowledge gaps regarding bacterial species and sources not currently monitored, as well as transmission routes, detection methods and the types of research needed to optimise CPE detection. The report also calls for a One Health approach, which integrates human, animal and environmental health, to effectively address the causes of carbapenem resistance in the food chain worldwide.
There are reasons for vigilance. CPE can theoretically jump from animals to humans. Resistance resides on transmissible plasmids - genetic material that bacteria readily share with each other. Situations have already been described where CPE has been found in farm animals as well as workers. But at the same time, there is also no evidence that CPE through meat makes people sick on a massive scale. EFSA talks about possible risks, not proven threats.
Those who could (theoretically) be infected are mainly people working in slaughterhouses, cutting plants and butchers. Good hygiene, as always, is important, and this, of course, also applies to consumers. The bacteria are killed at a temperature of 70°C.
Although carbapenems are not used in animal husbandry, the presence of CPE in the food chain is a potential risk. Due to the transmissibility of the resistance genes and their potential to infect humans, CPE could be a problem. Only we do not yet know how big, how widespread, or how acute that risk is. In short, vigilance is good but we should not overreact to limited data.
Source: https://efsa.onlinelibrary.wiley.com/doi/epdf/10.2903/j.efsa.2025.9336
