Molecular relatedness of ESBL/AmpC-producing Escherichia coli from humans, animals, food and the environment: a pooled analysis

Dorado-García, Alejandro; Smid, Joost; Pelt, Wilfrid van; Bonten, Marc J. M.; Fluit, Ad C.; Bunt, Gerrita van den; Wagenaar, Jaap A.; Hordijk, Joost; Dierikx, Cindy; Veldman, Kees; Koeijer, Aline de; Dohmen, Wietske; Schmitt, Heike; Liakopoulos, Apostolos; Pacholewicz, Ewa; Lam, T.J.G.M.; Velthuis, A.G.J.; Heuvelink, Annet; Gonggrijp, Maaike; Duijkeren, Engeline van; Hoek, Angela H.A.M. van; Husman, Ana Maria de Roda; Blaak, Hetty; Havelaar, Arie H.; Mevius, Dik; Heederik, Dick

doi:10.1093/jac/dkx397

Cited by 158 publications

(151 citation statements)

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“…There appears to be limited overlap between extended‐spectrum cephalosporinase E. coli recovered from animals (or derived foods) and the general human population (Börjesson et al., ; Day et al., ; Nguyen et al., ; Wu et al., ). However, human–animal sharing of closely related strains or plasmid types has been observed, especially in farmers (Dorado‐García et al., ; van Hoek, Stalenhoef, van Duijkeren, & Franz, ), and consequently there is a particular focus around the licensing and use of these antibiotic classes in agriculture.…”

Section: Introductionmentioning

confidence: 99%

Antimicrobial Resistance on Farms: A Review Including Biosecurity and the Potential Role of Disinfectants in Resistance Selection

Davies

Wales

2019

Comp Rev Food Sci Food Safe

124

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Resistance to therapeutic antimicrobial agents is recognized as a growing problem for both human and veterinary medicine, and the need to address the issue in both of these linked domains is a current priority in public policy. Efforts to limit antimicrobial resistance (AMR) on farms have so far focused on control of the supply and use of antimicrobial drugs, plus husbandry measures to reduce infectious disease. In the United Kingdom and some other countries, substantial progress has been made recently against targets on agricultural antimicrobial drug use. However, evidence suggests that resistant pathogenic and commensal bacteria can persist and spread within and between premises despite declining or zero antimicrobial drug use. Reasons for this are likely complex and varied but may include: bacterial adaptations to ameliorate fitness costs associated with maintenance and replication of resistance genes and associated proteins, horizontal transmission of genetic resistance determinants between bacteria, physical transfer of bacteria via movement (of animals, workers, and equipment), ineffective cleaning and disinfection, and co‐selection of resistance to certain drugs by use of other antimicrobials, heavy metals, or biocides. Areas of particular concern for public health include extended‐spectrum cephalosporinases and fluoroquinolone resistance among Enterobacteriaceae, livestock‐associated methicillin‐resistant Staphylococcus aureus, and the emergence of transmissible colistin resistance. Aspects of biosecurity have repeatedly been identified as risk factors for the presence of AMR on farm premises, but there are large gaps in our understanding of the most important risk factors and the most effective interventions. The present review aims to summarize the present state of knowledge in this area, from a European perspective.

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Section: Introductionmentioning

confidence: 99%

Antimicrobial Resistance on Farms: A Review Including Biosecurity and the Potential Role of Disinfectants in Resistance Selection

Davies

Wales

2019

Comp Rev Food Sci Food Safe

124

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“…E. coli are the most reported ESBL/AmpC-producing enterobacteria worldwide, with increasing frequency from animals, food, environmental sources and humans. In recent years, CR- E. coli transmission has been reported in different hosts, demonstrating a close human-animal ESBL/AmpC gene similarity between livestock (broilers and pigs) and personnel working at the farms [10]. Additionally, similar CR genes have been reported between isolates from the community and those from human clinical settings, sewage water and wild birds [10].…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, CR- E. coli transmission has been reported in different hosts, demonstrating a close human-animal ESBL/AmpC gene similarity between livestock (broilers and pigs) and personnel working at the farms [10]. Additionally, similar CR genes have been reported between isolates from the community and those from human clinical settings, sewage water and wild birds [10]. Although ESBL transmission has been studied extensively in Enterobacteriaceae from humans and livestock, data on antimicrobial resistance in the environment is still limited [2].…”

Section: Discussionmentioning

confidence: 99%

“…The dissemination of CR has been studied widely in Enterobacteriaceae from humans and livestock, whereas studies concerning the environment, including wildlife, are still lacking [2]. In recent years, an important increase of CR Escherichia coli has been reported in different epidemiological settings such as humans, pets, livestock, retail meat and the environment [5-10]. The study of wildlife as sentinel of the AMR environmental contamination has recently acquired more consideration worldwide [11].…”

Section: Introductionmentioning

confidence: 99%

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High prevalence and diversity of Extended-Spectrum β-Lactamase and emergence of Carbapenemase producingEnterobacteriaceaespp in wildlife in Catalonia

Darwich

Vidal

Seminati

et al. 2019

Preprint

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19In wildlife, most of the studies focused on antimicrobial resistance (AMR) describe 20 Escherichia coli as the principal indicator of the selective pressure. In the present study, 21 new species of Enterobacteriaceae with a large panel of cephalosporin resistant (CR) 22 genes have been isolated from wildlife in Catalonia. A total of 307 wild animals were 23 examined to determine CR enterobacteria prevalence, AMR phenotypes and common 24 carbapenem and CR gene expression. The overall prevalence of CR-phenotype was 25 13% (40/307): 17.3% in wild mammals (18/104) and 11.5% in wild birds (22/191) 26 (p<0.01)). Hedgehogs presented the largest prevalence with 13.5% (14/104) of the 27 mammal specimens, followed by raptors with 7.3% (14/191) of the total bird specimens. 28Although CR E. coli was obtained most frequently (45%), other CR- 29Enterobacteriaceae spp like Klebsiella pneumoniae (20%), Citrobacter freundii (15%), 30 Enterobacter cloacae (5%), Proteus mirabilis (5%), Providencia spp (5%) and Serratia 31 marcescens (2.5%) were isolated. A high diversity of CR genes was identified among 32 the isolates, with 50% yielding blaCMY-2, 23% blaSHV-12, 20% blaCMY-1 and 18% 33 blaCTX-M-15. Additionally, new CR-gene variants and resistance to carbapenems 34 associated to OXA-48 were found. Most of the CR isolates, principally K. pneumoniae 35 and C. freundii, were multiresistant with co-resistance to fluoroquinolones, tetracycline, 36 sulphonamides and aminoglycosides. This study describes for the first time in wildlife a 37 high prevalence of Enterobacteriaceae spp harbouring a large variety of carbapenem 38 and CR genes frequently associated to nosocomial human infections. Implementation of 39 control measures to reduce the impact of anthropogenic pressure in the environment is 40 urgently needed. 41 In the last decades, the prevalence of opportunistic and antimicrobial resistant (AMR) 44 bacteria associated with nosocomial infections has suffered an important increase in 45 hospital settings. The overuse of antibiotics in human and veterinary medicine have led 46 to the spread of AMR pathogens, becoming a global health problem [1]. 47 Extended-spectrum β-lactamases (ESBLs) and plasmid-mediated AmpC-type β-48 lactamases (pAmpC) are the most common enzymes that confer resistance to broad-49 spectrum cephalosporins among members of the family Enterobacteriaceae. These β-50 lactamases have extensively diversified in response to the clinical use of new generation 51 drugs: cephalosporins, carbapenems and monobactams [2]. These enzymes are mostly 52 encoded by genes located in plasmids that can be horizontally transferred to different 53 bacteria genera [1]. Carbapenems are last-line beta-lactam antibiotics with the broadest 54 spectrum of activity. Unfortunately, carbapenems nowadays are commonly used in 55 hospital settings for the treatment of life-threatening infections caused by cephalosporin 56 resistant (CR) Enterobacteriaceae. However, the emergence of resistance to 57 carbapenems mediated by the produ...

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“…In Tanzania, for example, genotypic similarity has been documented between resistant enteric bacteria in people, animals (both livestock and wildlife) and the environment (i.e., waters sources) [8,9] Similar patterns were found in Salmonella isolates from people and animals in Uganda [10]. In contrast, genotypic studies from high-income countries have largely shown distinguishable epidemics of AMR in livestock and the general population [11–13]. These patterns within HICs are consistent with limited contact between the general population and livestock and with the more developed health, sanitation, and regulatory infrastructures that limit transmission events [11–15].…”

Section: Introductionmentioning

confidence: 99%

Towards a bottom-up understanding of antimicrobial use and resistance on the farm: A knowledge, attitudes, and practices survey across livestock systems in five African countries

Caudell¹,

Dorado-García

Eckford

et al. 2019

Preprint

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47The nutritional and economic potentials of livestock systems are compromised by the 48 emergence and spread of antimicrobial resistance. A major driver of resistance is the misuse and 49 abuse of antimicrobial drugs. The likelihood of misuse may be elevated in low-and middle-50 income countries where limited professional veterinary services and laissez faire access to drugs 51 are assumed to promote non-prudent practices (e.g., self-administration of drugs). The extent of 52 these practices, as well as the knowledge and attitudes motivating them, are largely unknown 53 within most agricultural communities in low-and middle-income countries. The main objective 54 of this study was to document dimensions of knowledge, attitudes and practices related to 55 antimicrobial use and antimicrobial resistance in livestock systems and identify the livelihood 56 factors associated with these dimensions. A mixed-methods ethnographic approach was used to 57 survey households keeping layers in Ghana (N=110) and Kenya (N=76), pastoralists keeping 58 cattle, sheep, and goats in Tanzania (N=195), and broiler farmers in Zambia (N=198), and 59 Zimbabwe (N=298). Across countries, we find that it is individuals who live or work at the farm 60 who draw upon their knowledge and experiences to make decisions regarding antimicrobial use 61 and related practices. Input from animal health professionals is rare and antimicrobials are 62 sourced at local, privately owned agrovet drug shops. We also find that knowledge, attitudes, and 63 particularly practices significantly varied across countries, with poultry farmers holding more 64 knowledge, desirable attitudes, and prudent practices compared to pastoralists households. 65 Multivariate models showed that variation is related to several factors, including education, 66 disease dynamics on the farm, and sources of animal health information. Study results emphasize 67 that interventions to limit antimicrobial resistance must be founded upon a bottom-up 68 understanding of antimicrobial use at the farm-level given limited input from animal health 4 69 professionals and under-resourced regulatory capacities within most low-and middle-income 70 countries. Establishing this bottom-up understanding across cultures and production systems will 71 inform the development and implementation of the behavioral change interventions to combat 72 AMR globally. 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 5 95 96 97 Antimicrobial drugs are essential to maintain animal health within livestock production 98 systems but their misuse and/or abuse increases selection for the emergence, transmission, and 99 persistence of antimicrobial resistance (AMR) [1-3]. AMR results in therapeutic failures and 100 increases lengths and/or cycles of treatment, thereby producing downstream impacts on animal 101 welfare, food security, and public health. AMR in animals may impact prevalence in people as 102 resistant microorganisms (e.g., bacteria, viruses, parasites) can be transmitted across the human...

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Molecular relatedness of ESBL/AmpC-producing Escherichia coli from humans, animals, food and the environment: a pooled analysis

Cited by 158 publications

References 56 publications

Antimicrobial Resistance on Farms: A Review Including Biosecurity and the Potential Role of Disinfectants in Resistance Selection

Antimicrobial Resistance on Farms: A Review Including Biosecurity and the Potential Role of Disinfectants in Resistance Selection

High prevalence and diversity of Extended-Spectrum β-Lactamase and emergence of Carbapenemase producingEnterobacteriaceaespp in wildlife in Catalonia

Towards a bottom-up understanding of antimicrobial use and resistance on the farm: A knowledge, attitudes, and practices survey across livestock systems in five African countries

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