•MRSA and ESBL-Enterobacteriaceae were found on 96% and 61% of German pig farms.•Nasal MRSA carriage was detected in 84.7% of all pig farmers.•Rectal carriage of ESBL-Escherichia coli was detected in ...6% of the pig farmers.•Molecular typing showed exchange of ESBL-isolates between farmers and environment.
Methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum β-lactamase (ESBL) producing enterobacteria (ESBL-E) have emerged in livestock. This study prospectively investigates the prevalence of MRSA and ESBL-E on pig farms and in nasal and stool samples from farmers and compares molecular characteristics of these ESBL-E isolates.
In 2014, samples were derived at 51 pig farms in Germany. Per farm, five dust and five fecal samples were collected; one nasal and one stool sample were retrieved from farmers. ESBL-E isolates from humans and environmental isolates from the respective farms were characterized using whole genome sequencing for classical multilocus sequence typing (MLST), determination of ESBL-encoding genes and an ad hoc core genome MLST (cgMLST) analysis.
MRSA and ESBL-E were detected on 49 (96%) and 31 (61%) of the farms, respectively; in most cases (59%) simultaneously. Nasal MRSA carriage was detected in 72 of 85 (84.7%) farmers and five of 84 (6.0%) farmers carried ESBL-E. ESBL-Escherichia coli isolates from farmers belonged to MLST STs/ESBL-genes ST10/CTX-M-1, ST196/TEM-52, ST278/TEM-52, ST410/CTX-M-15 and ST453/CTX-M-1. In one case, the human ESBL-E isolate was clonally identical to isolates from the farm environment; in the other four cases typing results indicated potential exchange of resistance determinants between human and environmental isolates, but, comparing the isolates within a minimum spanning tree indicated differences in cgMLST-patterns between the farms (p=0.076).
This study demonstrated rectal ESBL-E carriage rates among farmers, which were similar to those in the general population. Molecular typing suggested that cross-transmission between the farmers and the farm environment is possible.
Clostridium difficile infections (CDI) in humans range from asymptomatic carriage to life-threatening intestinal disease. Findings on C. difficile in various animal species and an overlap in ...ribotypes (RTs) suggest potential zoonotic transmission. However, the impact of animals for human CDI remains unclear.
In a large-scale survey we collected 1,447 fecal samples to determine the occurrence of C. difficile in small companion animals (dogs and cats) and their owners and to assess potential epidemiological links within the community. The Germany-wide survey was conducted from July 2012-August 2013. PCR ribotyping, Multilocus VNTR Analysis (MLVA) and PCR detection of toxin genes were used to characterize isolated C. difficile strains. A database was defined and logistic regression used to identify putative factors associated with fecal shedding of C. difficile.
In total, 1,418 samples met the inclusion criteria. The isolation rates for small companion animals and their owners within the community were similarly low with 3.0% (25/840) and 2.9% (17/578), respectively. PCR ribotyping revealed eight and twelve different RTs in animals and humans, respectively, whereas three RTs were isolated in both, humans and animals. RT 014/0, a well-known human hospital-associated lineage, was predominantly detected in animal samples. Moreover, the potentially highly pathogenic RTs 027 and 078 were isolated from dogs. Even though, C. difficile did not occur simultaneously in animals and humans sharing the same household. The results of the epidemiological analysis of factors associated with fecal shedding of C. difficile support the hypothesis of a zoonotic potential.
Molecular characterization and epidemiological analysis revealed that the zoonotic risk for C. difficile associated with dogs and cats within the community is low but cannot be excluded.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Highlights • Fluoroquinolone-resistant CTX-M-15-producing Escherichia coli from human and animal populations were studied. • ST410 is the most frequent sequence type, harbouring five different ...clades. • Two clades (B and C) harbour chromosomally inserted CTX-M-15. • ST410 clones circulate in animals, humans and the environment in Germany.
Abstract Escherichia (E.) coli producing extended-spectrum beta-lactamases (ESBLs) are an increasing problem for public health. The success of ESBLs may be due to spread of ESBL-producing bacterial ...clones, transfer of ESBL gene-carrying plasmids or exchange of ESBL encoding genes on mobile elements. This makes it difficult to identify transmission routes and sources for ESBL-producing bacteria. The objectives of this study were to compare the distribution of genotypic and phenotypic properties of E. coli isolates from different animal and human sources collected in studies in the scope of the national research project RESET. ESBL-producing E. coli from two longitudinal and four cross-sectional studies in broiler, swine and cattle farms, a cross-sectional and a case–control study in humans and diagnostic isolates from humans and animals were used. In the RESET consortium, all laboratories followed harmonized methodologies for antimicrobial susceptibility testing, confirmation of the ESBL phenotype, specific PCR assays for the detection of blaTEM , blaCTX , and blaSHV genes and sequence analysis of the complete ESBL gene as well as a multiplex PCR for the detection of the four major phylogenetic groups of E. coli . Most ESBL genes were found in both, human and non-human populations but quantitative differences for distinct ESBL-types were detectable. The enzymes CTX-M-1 (63.3% of all animal isolates, 29.3% of all human isolates), CTX-M-15 (17.7% vs. 48.0%) and CTX-M-14 (5.3% vs. 8.7%) were the most common ones. More than 70% of the animal isolates and more than 50% of the human isolates contained the broadly distributed ESBL genes blaCTX-M-1 , blaCTX-M-15 , or the combinations blaSHV-12 + blaTEM or blaCTX-M-1 + blaTEM . While the majority of animal isolates carried blaCTX-M-1 (37.5%) or the combination blaCTX-M-1 + blaTEM (25.8%), this was the case for only 16.7% and 12.6%, respectively, of the human isolates. In contrast, 28.2% of the human isolates carried blaCTX-M-15 compared to 10.8% of the animal isolates. When grouping data by ESBL types and phylogroups blaCTX-M-1 genes, mostly combined with phylogroup A or B1, were detected frequently in all settings. In contrast, blaCTX-M-15 genes common in human and animal populations were mainly combined with phylogroup A, but not with the more virulent phylogroup B2 with the exception of companion animals, where a few isolates were detectable. When E. coli subtype definition included ESBL types, phylogenetic grouping and antimicrobial susceptibility data, the proportion of isolates allocated to common clusters was markedly reduced. Nevertheless, relevant proportions of same subtypes were detected in isolates from the human and livestock and companion animal populations included in this study, suggesting exchange of bacteria or bacterial genes between these populations or a common reservoir. In addition, these results clearly showed that there is some similarity between ESBL genes, and bacterial properties in isolates from the different populations. Finally, our current approach provides good insight into common and population-specific clusters, which can be used as a basis for the selection of ESBL-producing isolates from interesting clusters for further detailed characterizations, e.g. by whole genome sequencing.
Two-thirds of human infectious diseases are zoonotic diseases and routine data collections exist for each sector (human, veterinary, environmental). However, these operate separately and the ...collected data are not integrated across sectors. Publicly available information on these routine data collections in terms of metadata and the information collected is sparse. The aim was to create an inventory of routine data collections in the Federal State of Lower Saxony, Germany. A systematic screening of existing routine data collections from the human and veterinary sectors on zoonotic infectious diseases was carried out on the basis of expert interviews. A standardised template was used to collect relevant metadata on data collections and pathogens they contain. The template was transferred to Research Electronic Data Capture tools. We recorded metadata for 19 veterinary, 16 human and 2 other data collections, and for 69 different zoonotic pathogens. The frequencies of a selection of metadata were analysed descriptively. The data collections, which served different purposes, differed, e.g., in underlying population and sampling strategy, export format and access to the original data. We identified challenges for integrated analyses of data from different collections, which need to be addressed to develop a One Health monitoring and surveillance system.
Extended spectrum beta-lactamase (ESBL)-producing
are an emerging problem in veterinary and human medicine. Our study concentrated on the estimation of the prevalence and factors associated with the ...carriage of ESBL-producing
in dogs who visited a veterinary clinic in northern Germany in 2017. For this reason, 1000 patients (healthy and sick dogs) were tested, resulting in 1000 samples originating from rectal swabs. Additional data were collected using a self-reported questionnaire that was completed by the dog owner. Factors associated with ESBL carriage were considered for further modeling if
< 0.05 using a two-sided Fisher test. Using a backward elimination procedure, the variables for the final multivariable logistic regression model were identified. In total, 8.9% of the dogs tested were positive for carriage of ESBL-producing
. Seven factors were associated with the colonization of dogs with ESBL-
within the multivariable model, namely husbandry system (
= 0.0019, OR = 3.00; 95% CI: 1.50-6.00), contact with puppies (
= 0.0044, OR = 2.43; 95% CI: 1.32-4.46), feeding of raw meat (
= 0.011, OR = 2.28; 95% CI: 1.21-4.31), food residues (
= 0.0151, OR = 2.31; 95% CI: 1.18-4.53) and food supplements (
= 0.0487, OR = 0.426; 95% CI: 0.18-0.96), and antibiotic treatments of dogs (
= 0.0005, OR = 3.030; 95% CI: 1.62-5.68) or owners (
= 0.041, OR = 2.74; 95% CI: 1.04-7.19) prior to the study. These factors refer to the animals themselves as well as to the owners and their habits or medical treatments. Although the causality and direction of transmission from owners to their dogs cannot be proven, the factor of antibiotic treatment of the owner is clearly associated with the dog's status.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Locally, the introduction of measures during times of a pandemic emergency is embodied in a pandemic containment plan created by the Robert Koch Institute in 2017. In addition to central indicators ...such as incidence rates and number of deaths, various indicators are used at the local level to assess the pandemic situation. So far, there hasn't been analyses of the availability and perceived relevance of the surveillance indicators used to manage the SARS-CoV-2 pandemic by the local German pandemic task forces.
This study examined whether local decision-makers had access to surveillance-related indicators in a way that they could be used to make informed decisions in response to the pandemic situation.
A cross sectional study was conducted, using an online questionnaire developed by experts of The Public Health Agency of Lower Saxony and The University Medical Center Göttingen (UMG). All local COVID-19 task forces of the German state of Lower-Saxony were enrolled in the study.
The surveillance indicators assessed by survey respondents as most available and relevant are included under the German Infection Protection Act (IfSG). In contrast, the indicators that are not bound by the IfSG have a significantly lower availability and an inconsistent assessment of relevance.
Against the background of efficiency, it seems central to be able to reliably provide the highly weighted surveillance indicators. Nevertheless, the relevance assessment gap between the indicators embedded in the IfSG and the ones that are not may be explained by cognitive processes such as anchoring bias. The collection and use of indicators to assess the pandemic situation and to evaluate measures should be the subject of continuous multidisciplinary discussions.
Antimicrobial resistance in livestock is a matter of general concern. To develop hygiene measures and methods for resistance prevention and control, epidemiological studies on a population level are ...needed to detect factors associated with antimicrobial resistance in livestock holdings. In general, regression models are used to describe these relationships between environmental factors and resistance outcome. Besides the study design, the correlation structures of the different outcomes of antibiotic resistance and structural zero measurements on the resistance outcome as well as on the exposure side are challenges for the epidemiological model building process. The use of appropriate regression models that acknowledge these complexities is essential to assure valid epidemiological interpretations. The aims of this paper are (i) to explain the model building process comparing several competing models for count data (negative binomial model, quasi-Poisson model, zero-inflated model, and hurdle model) and (ii) to compare these models using data from a cross-sectional study on antibiotic resistance in animal husbandry. These goals are essential to evaluate which model is most suitable to identify potential prevention measures. The dataset used as an example in our analyses was generated initially to study the prevalence and associated factors for the appearance of cefotaxime-resistant
in 48 German fattening pig farms. For each farm, the outcome was the count of samples with resistant bacteria. There was almost no overdispersion and only moderate evidence of excess zeros in the data. Our analyses show that it is essential to evaluate regression models in studies analyzing the relationship between environmental factors and antibiotic resistances in livestock. After model comparison based on evaluation of model predictions, Akaike information criterion, and Pearson residuals, here the hurdle model was judged to be the most appropriate model.
•Prevalence of ESBL/pAmpC-producing E. coli is highest in chicken meat.•Characteristics of isolates from turkey meat are significantly different to those from chicken.•Prevalence of CTX-M group among ...the ESBL/pAmpC producing E. coli isolates was highest in turkey (26.0%) and chicken (24.0 %).•Minced meat from beef or pork is contaminated at higher frequency than beef or pork.•Vegetables are contaminated only at a very low level in Germany.
The spread of extended-spectrum β-lactamases (ESBLs) in Escherichia coli is a major public health issue and ESBL-producing bacteria are frequently reported in livestock. For the assessment of the role of the foodborne transmission pathway in Germany, detailed data on the prevalence and characteristics of isolates of food origin are necessary. The objective of this study was to describe the prevalence of cefotaxime resistant E. coli as well as ESBL/pAmpC-producing E. coli and their characteristics in foods in Germany.
Out of 2256 food samples, the highest prevalence of cefotaxime resistant E. coli was observed in chicken meat (74.9%), followed by turkey meat (40.1%). Prevalence in beef, pork and minced meat was considerably lower (4.2–15.3%). Whereas 18.0% of the raw milk samples, collected at farm level were positive, this was true only for few cheese samples (1.3%). In one out of 399 vegetable samples a cefotaxime-resistant E. coli was isolated.
ESBL resistance genes of the CTX-M-group (10.1% of all samples) were most frequently detected, followed by genes of the pAmpC (2.6%), SHV (2.0%) and TEM (0.8%) families. Distribution of ESBL/AmpC-encoding E. coli resistance genes and E. coli phylogroups was significantly different between the chicken related food samples and all other food items.
Our study results reflect that consumers might get exposed to ESBL/pAmpC-producing E. coli through several food chains. These results together with those collected at primary production and in the human population in other studies will allow more detailed analysis of the foodborne pathways, considering transmission from livestock populations to food at retail and to consumers in Germany.
•48 fattening pig farms in Germany were investigated.•216 mixed bacterial cultures were tested for the presence of the mcr-1 colistin–resistance gene.•Escherichia coli carrying the mcr-1 gene was ...isolated from 26 mixed bacterial cultures.•Factors associated with occurrence of mcr-1 gene: number of pigs, hygiene, change of housing of all pigs during fattening.•There was no statistically significant association between antimicrobial use and the occurrence of the mcr-1 gene.
Within the scope of a cross-sectional investigation on fattening pig farms conducted in 2011 and 2012, 48 fattening farms in different agricultural regions of Germany were sampled. Primary cultures of boot swabs and collective faecal samples were stored at −80 °C and screened for the presence of the mcr-1 colistin–resistance gene. The laboratory results were linked to farm–related data collected via questionnaire. Logistic regression models were used to investigate the association between occurrence of mcr-1 and farm–related data. Escherichia coli carrying the mcr-1 gene were isolated from 26 of 216 (12.0%) mixed bacterial cultures originating from 12 of 48 (25.0%) farms. Results of the logistic regression analyses indicate that the transmission between pigs or their direct environment is crucial for the occurrence of these resistant bacteria. However, there was no statistically significant association between antimicrobial use and the occurrence of the mcr-1 gene.
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