The European Food Safety Authority (EFSA) is sounding the alarm: bacteria previously classified as hospital-associated are increasingly being found in food products. These bacteria are resistant to carbapenems, a critical class of antibiotics used in human medicine.

Carbapenemase-Producing Enterobacterales

The group of bacteria in question is the carbapenemase-producing Enterobacterales (CPE). These bacteria are resistant to carbapenems—antibiotics typically reserved as a last resort when other treatments have failed. As a result, CPE bacteria pose a serious threat in hospitals. The most common CPE bacteria are E. coli, Enterobacter, Klebsiella, and Salmonella.

EFSA now reports that in recent years, CPE bacteria have also been found in pigs, cattle, and poultry. They have even been detected, to a lesser extent, in meat and other animal products [1,2].

The Danger

There is currently no conclusive evidence that CPE is transmitted to humans through food. However, some bacterial strains found in animals are genetically identical to those found in humans, suggesting the possibility of cross-transmission. This can occur through food or direct contact [1].

Because CPE bacteria are resistant to antibiotics, they pose a particular risk to people with weakened immune systems. Resistance can prevent certain surgeries or treatments from being effective. In severe cases, infection can be fatal [3]. The spread of CPE bacteria contributes to rising antibiotic resistance, making an effective response essential.

Preventing Resistance

The growing issue of antimicrobial resistance calls for an integrated approach. Excessive and improper use of antibiotics promotes the development of resistant bacteria. Moreover, some bacteria can transfer their resistance to others [3]. EFSA emphasizes the importance of the One Health approach, which links human health, animal health, and food safety [1]. Key measures include:

Healthcare

Preventing unnecessary use of antibiotics is crucial. Infection prevention—through vaccination and proper hygiene—plays a vital role [3]. Innovative disinfection technologies, such as in situ (on-site) generated hypochlorous acid (HOCl) by Watter, can enhance overall hygiene. HOCl is used to disinfect surfaces and is effective against a broad range of microorganisms, including CPE. The in situ technology ensures a constant supply of fresh disinfectant without relying on external suppliers.

Animal Health

In livestock farming, minimizing antibiotic use is also essential. Although carbapenems are not used in this sector, the use of other antibiotics may unintentionally encourage CPE [1]. In the United States, 70% of all antibiotics are intended for animals. Improving hygiene can drastically reduce this need [4]. For example, disinfecting drinking water with the Watter system can improve animal health, allowing some farms to reduce antibiotic use by up to 50%.

Food Industry

Preventing bacterial transmission during food processing is critical. Hygiene measures are central to this effort. An effective disinfection protocol can prevent contamination and the further spread of harmful microorganisms [1]. The Watter system is ideally suited for both water and surface disinfection and can also be applied via misting. HOCl has broad-spectrum effectiveness against many types of microorganisms, including CPE.

Conclusion

EFSA’s report highlights the threat of CPE in our food chain. Innovative disinfection technologies, such as Watter’s in situ generated hypochlorous acid (HOCl), can play a crucial role in managing resistance. HOCl can support hygiene and reduce the need for antibiotics across healthcare, livestock farming, and the food industry.

References

1. De Mooij, W. P. (2025, 8 april). ziekenhuisbacterie-infiltreert-voedselketen-efsa-waarschuwt-voor-antibioticaresistentie. https://www.vmt.nl/72144/ziekenhuisbacterie-infiltreert-voedselketen-efsa-waarschuwt-voor-antibioticaresistentie
2. European Food Safety Authority. (2025, 8 april). ​​Carbapenem resistance in the food chain​. European Food Safety Authority. https://www.efsa.europa.eu/en/news/carbapenem-resistance-food-chain
3. Antibioticaresistentie - MSD. (2021, 21 juli). MSD. Antibioticaresistentie - MSD.
4. The review on antimicrobial resistance, & O’NEILL, J. (2016). Tackling Drug-resistant Infections Globally: Final report and recommendations. https://amr-review.org/sites/default/files/160525_Final%20paper_with%20cover.pdf