ESBL/pAmpC-producing Escherichia coli and Klebsiella pneumoniae carriage among veterinary healthcare workers in the Netherlands

Abstract

Background Animals are a reservoir for ESBL/pAmpC-producing Escherichia coli/Klebsiella pneumoniae (ESBL-E/K). We investigated the association between occupational contact with different types of animals and the prevalence of ESBL-E/K carriage among veterinary healthcare workers, assessed molecular characteristics of ESBL-E/K, and followed-up on the ESBL-E/K carriage status of participants and their household members. Methods Participants completed a questionnaire about their contact with animals at work and at home, health status, travel behaviour and hygiene, and sent in a faecal sample which was tested for the presence of ESBL-E/K. Resistance genes were typed using PCR and sequencing. ESBL-E/K positive participants and their household members were followed up after 6 months. Risk factors were analysed using multivariable logistic regression methods. Results The prevalence of ESBL-E/K carriage was 9.8% (47/482; 95%CI 7.4–12.7). The most frequently occurring ESBL genes were blaCTX-M-15, blaCTX-M-14 and blaDHA-1. The predominant sequence type was ST131. None of the occupation related factors, such as contact with specific animal species, were significantly associated with ESBL-E/K carriage, whereas travel to Africa, Asia or Latin America in the past 6 months (OR 4.4), and stomach/bowel complaints in the past 4 weeks (OR 2.2) were. Sixteen of 33 initially ESBL-E/K positive participants (48.5%) tested positive again 6 months later, in 14 persons the same ESBL gene and E. coli ST was found. Four of 23 (17.4%) household members carried ESBL-E/K, in three persons this was the same ESBL gene and E. coli ST as in the veterinary healthcare worker. Conclusions Despite the absence of specific occupation related risk factors, ESBL-E/K carriage in veterinary healthcare workers was high compared to the prevalence in the general Dutch population (5%). This indicates that occupational contact with animals is a potential source of ESBL-E/K for the population at large.

A Review of Current Bacterial Resistance to Antibiotics in Food Animals

“…Several studies have demonstrated that farm animals are a reservoir of ARB (such as E. coli , K. pneumonia , Salmonella , S. aureus , etc.) and ARGs ( Table 1 ), and people can be infected with ARB through close contact with farm animals ( Tomley and Shirley, 2009 ; Dierikx et al, 2013 ; McDaniel et al, 2014 ; Saliu et al, 2017 ; Founou et al, 2021 ; Meijs et al, 2021 ).…”

“…The occurrence and prevalence of extended-spectrum β-lactamase (ESBL)- and AmpC β-lactamase (AmpC)-producing E. coli and K. pneumoniae in farmworkers and household members in Netherlands were investigated by Meijs et al (2021) . PCR and sequencing results showed that ESBL-producing E. coli and K. pneumoniae in workers accounted for 9.8%, higher than that in the Dutch population (5%), which may be related to direct contact with animals.…”

“…Additionally, 17.4% of household members had ESBL-producing E. coli and K. pneumonia and 13% of members carried the same ESBL gene as workers. The data indicated that direct or indirect contact with animals is a potential source of ARB and ARGs ( Meijs et al, 2021 ).…”

“…Workers on farms may have an increased risk of acquiring ARB and ARGs due to their direct contact with animals and transferring between persons, except for exposure to antibiotics in their daily practice environment ( Meijs et al, 2021 ).…”

Changes in Fecal Carriage of Extended-Spectrum β-Lactamase Producing Enterobacterales in Dutch Veal Calves by Clonal Spread of Klebsiella pneumoniae

“…The World Health Organization (WHO) has included third-generation cephalosporin-resistant E. coli and K. pneumoniae into the group of “critical pathogens” due to the increasing challenges for infection treatment, highlighting the importance of the monitoring and prevention of infections in humans and animals. In humans, Meijs et al (2021) have recently reported a high prevalence of fecal carriage of ESBL- E. coli and ESBL- K. pneumoniae in veterinary healthcare workers in the Netherlands compared to the general Dutch population (9.8% and 5%, respectively) ( Meijs et al, 2021 ). Likewise, in Dutch hospitals, the prevalence of ESBL- K. pneumoniae in 2020 increased up to 15% compared to 2019 (12%) ( NETMAP_MARAN, 2021 ).…”