Our 'One Health' approach provides an integrated evaluation of the molecular relatedness of ESBL/AmpC-EC from numerous sources. The analysis showed distinguishable ESBL/AmpC-EC transmission cycles in different hosts and failed to demonstrate a close epidemiological linkage of ESBL/AmpC genes and plasmid replicon types between livestock farms and people in the general population.
A cross-sectional study was conducted to evaluate the prevalence of extended-spectrum β-lactamase (ESBL)- and plasmid-mediated AmpC-producing Escherichia coli and associated risk factors in dairy herds. One hundred dairy herds were randomly selected and sampled to study the presence of ESBL- and AmpC-producing E. coli in slurry samples. The sensitivity of testing slurry samples for ESBL/AmpC herd status is less than 100%, especially for detecting herds with a low ESBL/AmpC prevalence. Therefore, whereas herds that tested positive for ESBL/AmpC-producing E. coli in slurry were defined as positive herds, herds with negative slurry samples were defined as unsuspected. Isolates of ESBL- and AmpC-producing E. coli were further characterized by detection and typing of their ESBL/AmpC gene. At the initial sampling, a comprehensive questionnaire was conducted at the participating farms. The farmers were asked questions about management practices potentially associated with the ESBL/AMPC herd status. Also, data on antimicrobial purchases during 2011 were acquired to evaluate whether the animal-defined daily dose of antimicrobials per year at farm level was associated with the ESBL/AmpC herd status. Multivariable logistic regression models were used to determine the association between management practices and the ESBL/AmpC herd status. Six months after the initial slurry sampling, 10 positive herds and 10 herds that had an unsuspected ESBL/AmpC herd status during the first visit were resampled. At each farm, slurry samples and feces from 24 individual cows were collected to evaluate within herd dynamics. During the first sampling, ESBL/AmpC-producing E. coli were isolated from the slurry samples collected at 41% of the herds. In total, 37 isolates were further characterized, revealing 7 different ESBL genes (bla and bla), 1 plasmid-encoded AmpC gene (bla), and 1 chromosomally encoded ampC gene (ampC type 3). The total animal-defined daily dose of antimicrobials per year at farm level was not significantly different between ESBL/AmpC-positive and unsuspected dairy herds. The use of third- and fourth-generation cephalosporins, however, was found to be associated with ESBL/AmpC status, with higher use of these antimicrobials resulting in a significant higher odds to be ESBL/AmpC-positive. Management factors that were associated with a higher odds of being ESBL/AmpC-positive were treatment of all cases of clinical mastitis with antimicrobials, a higher proportion of calves treated with antimicrobials, not applying teat sealants in all cows at dry off, and the use of a floor scraper. This last association, however, was considered a methodological effect rather than a true risk factor. On 5 of the 10 initially positive farms, no ESBL/AmpC-producing E. coli were cultured from the slurry or any of the individual cow samples collected during the second sampling. In 4 of the initially unsuspected farms, slurry or individual cow samples tested positive during the second sampling. In conclusion, ESBL/AmpC could frequently be cultured...
Extended-spectrum β-lactamase and AmpC-producing Escherichia coli (ESBL/AmpC) are an emerging problem and are hypothesized to be associated with antimicrobial use (AMU), and more specifically with the use of third- and fourth-generation cephalosporins. Whether ESBL/AmpC also occur in organic dairy herds, which have restricted AMU, is not known. Additionally, it is unknown whether, in addition to restricted AMU, other factors in organic herd management are associated with ESBL/AmpC herd status. The aim of this study was to estimate the prevalence of ESBL/AmpC in organic dairy herds in the Netherlands. Subsequently, the relationships between the ESBL/AmpC herd status and AMU and between ESBL/AmpC herd status and farmers' management were assessed in organic dairy herds. For this study, 90 randomly selected, officially registered organic dairy herds were included. The ESBL/AmpC herd status was determined based on the bacteriological culture result of a slurry sample. The sensitivity of testing slurry samples for ESBL/AmpC herd status is less than 100% for detecting herds with a low ESBL/AmpC prevalence. For that reason, herds that tested positive for ESBL/AmpC in slurry were defined as positive and herds with negative slurry samples were defined as unsuspected. A comprehensive questionnaire on management practices was conducted and records on specified antimicrobials that were provided to these herds by the veterinary service providers were obtained. From the data on antimicrobial supplies by the veterinarian, the animal daily defined dose of antimicrobials per farm per year (DDDA) was calculated. Descriptive statistics were used to describe the relation between the ESBL/AmpC herd status and DDDA. Multivariable logistic regression models were used to evaluate management factors associated with the ESBL/AmpC herd status. We found ESBL/AmpC in 12 of the 90 (13%; 95% confidence interval=7-22%) slurry samples from organic dairy herds. The median DDDA in organic dairy herds was 0.5, which was not significantly different between ESBL/AmpC-positive and unsuspected dairy herds. No association could be found between the use of different types of antimicrobials, such as third- and fourth-generation cephalosporins, and ESBL/AmpC herd status. Factors that were associated with higher odds of being ESBL/AmpC-positive were pig farms located within a 2-km radius of the barn, applying parental treatment for clinical mastitis, and providing milk replacer to the female calves after colostrum intake. The prevalence of ESBL/AmpC in organic dairy herds appeared lower than the prevalence in previous studies conducted in conventional dairy herds. Apparently, ESBL/AmpC are also present in herds with low AMU; this indicates that other factors than AMU are also associated with ESBL/AmpC herd status.
We aimed to characterize and target drug-tolerant BRCA1-deficient tumor cells that cause residual disease and subsequent tumor relapse. We studied responses to various mono- and bifunctional alkylating agents in a genetically engineered mouse model for -mutant breast cancer. Because of the large intragenic deletion of the gene, no restoration of BRCA1 function is possible, and therefore, no BRCA1-dependent acquired resistance occurs. To characterize the cell-cycle stage from which mammary tumors arise after cisplatin treatment, we introduced the fluorescent ubiquitination-based cell-cycle indicator (FUCCI) construct into the tumor cells. Despite repeated sensitivity to the MTD of platinum drugs, the -mutated mammary tumors are not eradicated, not even by a frequent dosing schedule. We show that relapse comes from single-nucleated cells delaying entry into the S-phase. Such slowly cycling cells, which are present within the drug-naïve tumors, are enriched in tumor remnants. Using the FUCCI construct, we identified nonfluorescent G-like cells as the population most tolerant to platinum drugs. Intriguingly, these cells are more sensitive to the DNA-crosslinking agent nimustine, resulting in an increased number of multinucleated cells that lack clonogenicity. This is consistent with our finding that the nimustine MTD, among several alkylating agents, is the most effective in eradicating-mutated mouse mammary tumors. Our data show that targeting G-like cells is crucial for the eradication of BRCA1/p53-deficient tumor cells. This can be achieved with selected alkylating agents such as nimustine. .
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