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Background:The rapidly increasing dissemination of carbapenem-resistant Enterobacteriaceae (CRE) in both humans and animals poses a global threat to public health. However, the transmission of CRE between humans and animals has not yet been well studied.Objectives:We investigated the prevalence, risk factors, and drivers of CRE transmission between humans and their backyard animals in rural China.Methods:We conducted a comprehensive sampling strategy in 12 villages in Shandong, China. Using the household [residents and their backyard animals (farm and companion animals)] as a single surveillance unit, we assessed the prevalence of CRE at the household level and examined the factors associated with CRE carriage through a detailed questionnaire. Genetic relationships among human- and animal-derived CRE were assessed using whole-genome sequencing–based molecular methods.Results:A total of 88 New Delhi metallo-β-lactamases–type carbapenem-resistant Escherichia coli (NDM-EC), including 17 from humans, 44 from pigs, 12 from chickens, 1 from cattle, and 2 from dogs, were isolated from 65 of the 746 households examined. The remaining 12 NDM-EC were from flies in the immediate backyard environment. The NDM-EC colonization in households was significantly associated with a) the number of species of backyard animals raised/kept in the same household, and b) the use of human and/or animal feces as fertilizer. Discriminant analysis of principal components (DAPC) revealed that a large proportion of the core genomes of the NDM-EC belonged to strains from hosts other than their own, and several human isolates shared closely related core single-nucleotide polymorphisms and blaNDM genetic contexts with isolates from backyard animals.Conclusions:To our knowledge, we are the first to report evidence of direct transmission of NDM-EC between humans and animals. Given the rise of NDM-EC in community and hospital infections, combating NDM-EC transmission in backyard farm systems is needed. https://doi.org/10.1289/EHP5251

Muscle tissue represents an abundant, accessible, and replenishable source of adult stem cells for cell-based tissue and genetic engineering. A population of cells isolated from muscle exhibits both multipotentiality and self-renewal capabilities. Satellite cells, referred to by many investigators as muscle stem cells, are myogenic precursors that are capable of regenerating muscle and that demonstrate self-renewal properties; however, they are considered to be committed to the myogenic lineage. Muscle-derived stem cells (MDSCs), which may represent a predecessor of the satellite cell, are considered to possess a higher regeneration capacity and to exhibit better cell survival and a broader range of multilineage capabilities. Remarkably, MDSCs are not only able to differentiate into mesodermal cell types including the myogenic, adipogenic, osteogenic, chondrogenic, endothelial, and hematopoietic lineages, but also possess the potential to break germ layer commitment and differentiate into ectodermal lineages including neuron-like cells under certain conditions. This article reviews the current preclinical studies and potential clinical applications of MDSC-mediated gene therapy and tissue-engineering and methods for MDSC isolation, differentiation, and molecular characterization.

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