{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T23:48:03Z","timestamp":1770335283926,"version":"3.49.0"},"reference-count":14,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Federal Public Service (FPS) of health, Food chain safety and Environment","award":["2024\/EMAMR-OH\/01"],"award-info":[{"award-number":["2024\/EMAMR-OH\/01"]}]},{"name":"M. Filippitzi"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background\/Objectives: As part of the European Union\u2019s harmonized monitoring framework, Belgium conducts antimicrobial resistance (AMR) monitoring in commensal bacteria from livestock. The aim of this study was to conduct a cost analysis of the national AMR monitoring in livestock, and to explore sampling size scenarios in relation to their associated costs and statistical performance (power and confidence) of monitoring. Methods: To our knowledge, this is the first published cost evaluation using unit cost aggregation of a national AMR monitoring program in animals. Results: The testing of the different sample size scenarios showed that if the sample size increases, the costs increase linearly. A sample size increase of 10 samples\/isolates (e.g., from 170 to 180) can increase the yearly total costs per animal species by 5.2%. Moreover, the testing of the different scenarios showed that if the sample size increases, the power and the confidence level also increase, providing a higher level of trust in the results of the monitoring program. The highest total monitoring costs per animal category were estimated for fattening pigs, broilers and veal calves (over 18% of total costs each, using 2024 data). Among the various monitoring activities, antimicrobial susceptibility testing emerged as the costliest component, representing 50.2% of the total monitoring costs. Conclusions: The approach presented allows it to be used by other countries aiming to estimate the cost of their national AMR monitoring in animals or other similar activities. This economic and scenario testing analysis can be used to suggest informed suggestions to improve AMR monitoring in animals.<\/jats:p>","DOI":"10.3390\/antibiotics15020172","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T10:35:37Z","timestamp":1770287737000},"page":"172","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cost Analysis of the Belgian National Antimicrobial Resistance Monitoring in Livestock: Effects on Sampling Design and Statistical Performance"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9287-698X","authenticated-orcid":false,"given":"Maria Eleni","family":"Filippitzi","sequence":"first","affiliation":[{"name":"Laboratory of Animal Production Economics, Faculty of Veterinary Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6460-5602","authenticated-orcid":false,"given":"Adrien","family":"de Fraipont","sequence":"additional","affiliation":[{"name":"Coordination of Veterinary Activities and Veterinary Epidemiology Service, Infectious Diseases in Animals Department, Sciensano, 1050 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7490-7903","authenticated-orcid":false,"given":"Micka\u00ebl","family":"Cargnel","sequence":"additional","affiliation":[{"name":"Coordination of Veterinary Activities and Veterinary Epidemiology Service, Infectious Diseases in Animals Department, Sciensano, 1050 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u00e9line","family":"Guillaume","sequence":"additional","affiliation":[{"name":"Coordination of Veterinary Activities and Veterinary Epidemiology Service, Infectious Diseases in Animals Department, Sciensano, 1050 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7504-9138","authenticated-orcid":false,"given":"Jean Baptiste","family":"Hanon","sequence":"additional","affiliation":[{"name":"Coordination of Veterinary Activities and Veterinary Epidemiology Service, Infectious Diseases in Animals Department, Sciensano, 1050 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"European Food Safety Authority (EFSA) (2008). Report from the Task Force on Zoonoses Data Collection including guidance for harmonized monitoring and reporting of antimicrobial resistance in commensal Eschericia coli and Enterococcus spp. from food animals. EFSA J., 141, 1\u201344.","DOI":"10.2903\/j.efsa.2008.141r"},{"key":"ref_2","unstructured":"Sciensano (2024). Antimicrobial Resistance in Commensal Escherichia coli from Livestock in Belgium: Trend Analysis 2011\u20132023, Sciensano."},{"key":"ref_3","unstructured":"Garcia-Graells, C., Bricteux, F., Van Damme, I., Boland, C., Fretin, D., and Van Hoorde, K. (2023). Antimicrobial Resistance in ESBL and Indicator E. coli, Campylobacter spp., Salmonella spp., Methicillin-Resistant Staphylococcus aureus (MRSA) and Enterococcus faecalis and faecium Isolated from Food and Food-Producing Animals (Primary Production) in 2023; National Reference Laboratory for Antimicrobial Resistance, Sciensano. Available online: https:\/\/favv-afsca.be\/sites\/default\/files\/pro\/amr\/rapport\/sciensano\/2023_Rapport_AMR_Sciensano.pdf?utm_source=chatgpt.com."},{"key":"ref_4","unstructured":"BELMAP (2024). One Health Report of Antimicrobial Consumption and Resistance in Belgium, BELMAP. Available online: https:\/\/www.health.belgium.be\/sites\/default\/files\/uploads\/fields\/fpshealth_theme_file\/belmap2024_report.pdf."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1186\/s13756-023-01265-5","article-title":"A systematic literature review of economic evaluation studies of interventions impacting antimicrobial resistance","volume":"12","author":"Painter","year":"2023","journal-title":"Antimicrob. Resist. Infect. Control."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Gunarathna, S., Hwang, Y., and Lee, J.-S. (2025). Existing Evidence from Economic Evaluations of Antimicrobial Resistance\u2014A Systematic Literature Review. Antibiotics, 14.","DOI":"10.3390\/antibiotics14111072"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"42","DOI":"10.20506\/rst.42.3347","article-title":"Economic evaluation of antimicrobial usage surveillance in livestock","volume":"42","author":"Strang","year":"2023","journal-title":"Sci. Tech. Rev."},{"key":"ref_8","unstructured":"Bricteux, F., Garcia-Graells, C., Boland, C., Kowalewicz, C., Degives, N., Cargnel, M., Hanon, J.-B., Fretin, D., and Van Hoorde, K. (2024). Sciensano National Reference Laboratory (NRL) for Antimicrobial Resistance. Antimicrobial Resistance in ESBL and Indicator E. coli, Campylobacter spp., Salmonella spp., Methicillin-Resistant Staphylococcus aureus (MRSA) and Enterococcus faecalis and Faecium Isolated from Food and Food-Producing Animals (Primary Production) in 2024, Sciensano. Available online: https:\/\/favv-afsca.be\/sites\/default\/files\/pro\/amr\/rapport\/sciensano\/2024_Rapport_AMR_Sciensano.pdf."},{"key":"ref_9","unstructured":"DANMAP (2024). Use of Antimicrobial Agents and Occurrence of Antimicrobial Resistance in Bacteria from Food Animals, Food and Humans in Denmark, DANMAP. Available online: https:\/\/www.danmap.org\/reports\/2023."},{"key":"ref_10","unstructured":"NethMap\/MARAN (2024). Consumption of Antimicrobial Agents and Antimicrobial Resistance Among Medically Important Bacteria in the Netherlands, NethMap\/MARAN. Available online: https:\/\/www.rivm.nl\/publicaties\/nethmap-2024-consumption-of-antimicrobial-agents-and-antimicrobial-resistance."},{"key":"ref_11","unstructured":"NARMS (2026, January 04). National Antimicrobial Resistance Monitoring System (NARMS) Integrated Report, Available online: https:\/\/www.fda.gov\/animal-veterinary\/antimicrobial-resistance\/national-antimicrobial-resistance-monitoring-system."},{"key":"ref_12","unstructured":"Drummond, M.F., Sculpher, M.J., Claxton, K., Stoddart, G.L., and Torrance, G.W. (2015). Methods for the Economic Evaluation of Health Care Programmes, Oxford University Press. [4th ed.]."},{"key":"ref_13","unstructured":"Sciensano (2024). Proposed Action for the One Health National Action Plan on Antimicrobial Resistance (NAP AMR) 2025\u20132029, Sciensano."},{"key":"ref_14","unstructured":"D\u2019Agostino, R.B., Sullivan, L., and Massaro, J. (2007). Sample Size Calculation for Comparing Proportions, Wiley Encyclopedia of Clinical Trials."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/15\/2\/172\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T11:00:11Z","timestamp":1770289211000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/15\/2\/172"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,5]]},"references-count":14,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["antibiotics15020172"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics15020172","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,5]]}}}