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Werner G, Abu Sin M, Bahrs C, Brogden S, Feßler AT, Hagel S, Kaspar H, Köck R, Kreienbrock L, Krüger-Haker H, Maechler F, Noll I, Pletz MW, Tenhagen BA, Schwarz S, Walther B, Mielke M. [Therapy-relevant antibiotic resistances in a One Health context]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023:10.1007/s00103-023-03713-4. [PMID: 37184673 DOI: 10.1007/s00103-023-03713-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/28/2023] [Indexed: 05/16/2023]
Abstract
One Health refers to a concept that links human, animal, and environmental health. In Germany, there is extensive data on antibiotic resistance (AMR) and multidrug-resistant (micro)organisms (MDRO) in human and veterinary medicine, as well as from studies in various environmental compartments (soil, water, wastewater). All these activities are conducted according to different specifications and standards, which makes it difficult to compare data. A focus on AMR and MDRO of human therapeutic importance is helpful to provide some guidance. Most data are available across sectors on methicillin-resistant Staphylococcus aureus (MRSA) and multiresistant Enterobacterales such as Escherichia coli and Klebsiella pneumoniae. Here, the trends of resistance are heterogeneous. Antibiotic use leads to MRE selection, which is well documented. Success in minimizing antibiotic use has also been demonstrated in recent years in several sectors and could be correlated with success in containing AMR and MDRO (e.g., decrease in MRSA in human medicine). Sector-specific measures to reduce the burden of MDRO and AMR are also necessary, as not all resistance problems are linked to other sectors. Carbapenem resistance is still rare, but most apparent in human pathogens. Colistin resistance occurs in different sectors but shows different mechanisms in each. Resistance to antibiotics of last resort such as linezolid is rare in Germany, but shows a specific One Health correlation. Efforts to harmonize methods, for example in the field of antimicrobial susceptibility testing and genome-based pathogen and AMR surveillance, are an important first step towards a better comparability of the different data collections.
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Affiliation(s)
- Guido Werner
- Robert Koch Institut, Berlin, Deutschland.
- Abt. Infektionskrankheiten, Fachgebiet Nosokomiale Infektionserreger und Antibiotikaresistenzen, Robert Koch-Institut, Außenstelle Wernigerode, Burgstr. 37, 38855, Wernigerode, Deutschland.
| | - Muna Abu Sin
- Robert Koch Institut, Berlin, Deutschland
- WHO Collaborating Centre for Antimicrobial Resistance, Consumption and Healthcare-Associated Infections, Berlin, Deutschland
| | - Christina Bahrs
- Institut für Infektionsmedizin und Krankenhaushygiene, Universitätsklinikum Jena, Jena, Deutschland
| | - Sandra Brogden
- Institut für Biometrie, Epidemiologie und Informationsverarbeitung, Stiftung Tierärztliche Hochschule Hannover, Hannover, Deutschland
- WHO Collaborating Centre for Research and Training for Health at the Human-Animal-Environment Interface, Hannover, Deutschland
| | - Andrea T Feßler
- Institut für Mikrobiologie und Tierseuchen, Fachbereich Veterinärmedizin, Freie Universität Berlin, Berlin, Deutschland
- Tiermedizinisches Zentrum für Resistenzforschung (TZR), Fachbereich Veterinärmedizin, Freie Universität Berlin, Berlin, Deutschland
| | - Stefan Hagel
- Institut für Infektionsmedizin und Krankenhaushygiene, Universitätsklinikum Jena, Jena, Deutschland
| | - Heike Kaspar
- Bundesamt für Verbraucherschutz und Lebensmittelsicherheit, Berlin, Deutschland
| | - Robin Köck
- Bereich Hygiene und Umweltmedizin, Universitätsmedizin Essen, Essen, Deutschland
- Institut für Hygiene, Universitätsklinikum Münster, Münster, Deutschland
| | - Lothar Kreienbrock
- Institut für Biometrie, Epidemiologie und Informationsverarbeitung, Stiftung Tierärztliche Hochschule Hannover, Hannover, Deutschland
- WHO Collaborating Centre for Research and Training for Health at the Human-Animal-Environment Interface, Hannover, Deutschland
| | - Henrike Krüger-Haker
- Institut für Mikrobiologie und Tierseuchen, Fachbereich Veterinärmedizin, Freie Universität Berlin, Berlin, Deutschland
- Tiermedizinisches Zentrum für Resistenzforschung (TZR), Fachbereich Veterinärmedizin, Freie Universität Berlin, Berlin, Deutschland
| | - Frederike Maechler
- Institut für Hygiene und Umweltmedizin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Ines Noll
- Robert Koch Institut, Berlin, Deutschland
- WHO Collaborating Centre for Antimicrobial Resistance, Consumption and Healthcare-Associated Infections, Berlin, Deutschland
| | - Mathias W Pletz
- Institut für Infektionsmedizin und Krankenhaushygiene, Universitätsklinikum Jena, Jena, Deutschland
| | - Bernd-Alois Tenhagen
- Fachbereich Epidemiologie, Zoonosen und Antibiotikaresistenz, Abteilung Biologische Sicherheit, Bundesinstitut für Risikobewertung BfR, Berlin, Deutschland
| | - Stefan Schwarz
- Institut für Mikrobiologie und Tierseuchen, Fachbereich Veterinärmedizin, Freie Universität Berlin, Berlin, Deutschland
- Tiermedizinisches Zentrum für Resistenzforschung (TZR), Fachbereich Veterinärmedizin, Freie Universität Berlin, Berlin, Deutschland
| | - Birgit Walther
- Robert Koch Institut, Berlin, Deutschland
- Fachgebiet Mikrobiologische Risiken, Abteilung Umwelthygiene, Umweltbundesamt, Berlin, Deutschland
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2
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Khairullah AR, Sudjarwo SA, Effendi MH, Ramandinianto SC, Gelolodo MA, Widodo A, Riwu KHP, Kurniawati DA. Pet animals as reservoirs for spreading methicillin-resistant Staphylococcus aureus to human health. J Adv Vet Anim Res 2023; 10:1-13. [PMID: 37155545 PMCID: PMC10122942 DOI: 10.5455/javar.2023.j641] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 11/08/2022] [Accepted: 11/15/2022] [Indexed: 05/10/2023] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a strain of pathogenic bacteria that is a major problem in the world's health. Due to their frequent interaction with humans, pets are one of the main risk factors for the spread of MRSA. The possibility for zoonotic transmission exists since frequently kept dogs and cats are prone to contract MRSA and act as reservoirs for spreading MRSA. The mouth, nose, and perineum are the primary locations of MRSA colonization, according to the findings of MRSA identification tests conducted on pets. The types of MRSA clones identified in cats and dogs correlated with MRSA clones infecting humans living in the same geographic area. A significant risk factor for the colonization or transmission of MRSA is human-pet contact. An essential step in preventing the spread of MRSA from humans to animals and from animals to humans is to keep hands, clothing, and floor surfaces clean.
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Affiliation(s)
- Aswin Rafif Khairullah
- Doctoral Program in Veterinary Science, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Sri Agus Sudjarwo
- Department of Veterinary Pharmacology, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Mustofa Helmi Effendi
- Department of Veterinary Public Health, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia
| | | | - Maria Aega Gelolodo
- Department of Animal Infectious Diseases and Veterinary Public Health, Faculty of Medicine and Veterinary Medicine, Universitas Nusa Cendana, Kupang, Indonesia
| | - Agus Widodo
- Doctoral Program in Veterinary Science, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia
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3
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Pattis I, Weaver L, Burgess S, Ussher JE, Dyet K. Antimicrobial Resistance in New Zealand-A One Health Perspective. Antibiotics (Basel) 2022; 11:antibiotics11060778. [PMID: 35740184 PMCID: PMC9220317 DOI: 10.3390/antibiotics11060778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/27/2022] [Accepted: 06/01/2022] [Indexed: 11/16/2022] Open
Abstract
Antimicrobial resistance (AMR) is an increasing global threat that affects human, animal and, often less acknowledged, environmental health. This complex issue requires a multisectoral One Health approach to address the interconnectedness of humans, animals and the natural environment. The prevalence of AMR in these reservoirs varies widely among countries and thus often requires a country-specific approach. In New Zealand (NZ), AMR and antimicrobial usage in humans are relatively well-monitored and -understood, with high human use of antimicrobials and the frequency of resistant pathogens increasing in hospitals and the community. In contrast, on average, NZ is a low user of antimicrobials in animal husbandry systems with low rates of AMR in food-producing animals. AMR in New Zealand’s environment is little understood, and the role of the natural environment in AMR transmission is unclear. Here, we aimed to provide a summary of the current knowledge on AMR in NZ, addressing all three components of the One Health triad with a particular focus on environmental AMR. We aimed to identify knowledge gaps to help develop research strategies, especially towards mitigating AMR in the environment, the often-neglected part of the One Health triad.
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Affiliation(s)
- Isabelle Pattis
- Institute of Environmental Science and Research Ltd., Christchurch 8041, New Zealand
| | - Louise Weaver
- Institute of Environmental Science and Research Ltd., Christchurch 8041, New Zealand
| | - Sara Burgess
- School of Veterinary Science, Massey University, Palmerston North 4442, New Zealand
| | - James E Ussher
- Department of Microbiology and Immunology, University of Otago, Dunedin 9054, New Zealand
| | - Kristin Dyet
- Institute of Environmental Science and Research Ltd., Porirua 5022, New Zealand
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Nielsen SS, Bicout DJ, Calistri P, Canali E, Drewe JA, Garin‐Bastuji B, Gonzales Rojas JL, Gortázar C, Herskin M, Michel V, Miranda Chueca MÁ, Padalino B, Pasquali P, Roberts HC, Spoolder H, Ståhl K, Velarde A, Viltrop A, Winckler C, Baldinelli F, Broglia A, Kohnle L, Alvarez J. Assessment of listing and categorisation of animal diseases within the framework of the Animal Health Law (Regulation (EU) No 2016/429): antimicrobial-resistant Staphylococcus aureus in cattle and horses. EFSA J 2022; 20:e07312. [PMID: 35582361 PMCID: PMC9087474 DOI: 10.2903/j.efsa.2022.7312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Staphylococcus aureus (S. aureus) was identified among the most relevant antimicrobial-resistant (AMR) bacteria in the EU for cattle and horses in previous scientific opinions. Thus, it has been assessed according to the criteria of the Animal Health Law (AHL), in particular criteria of Article 7 on disease profile and impacts, Article 5 on its eligibility to be listed, Annex IV for its categorisation according to disease prevention and control rules as in Article 9, and Article 8 for listing animal species related to the bacterium. The assessment has been performed following a methodology previously published. The outcome is the median of the probability ranges provided by the experts, which indicates whether each criterion is fulfilled (lower bound ≥ 66%) or not (upper bound ≤ 33%), or whether there is uncertainty about fulfilment. Reasoning points are reported for criteria with uncertain outcome. According to the assessment here performed, it is uncertain whether AMR S. aureus can be considered eligible to be listed for Union intervention according to Article 5 of the AHL (60-90% probability). According to the criteria in Annex IV, for the purpose of categorisation related to the level of prevention and control as in Article 9 of the AHL, the AHAW Panel concluded that the bacterium does not meet the criteria in Sections 1, 2 and 4 (Categories A, B and D; 1-5%, 5-10% and 10-33% probability of meeting the criteria, respectively) and the AHAW Panel was uncertain whether it meets the criteria in Sections 3 and 5 (Categories C and E, 33-90% and 60-90% probability of meeting the criteria, respectively). The animal species to be listed for AMR S. aureus according to Article 8 criteria include mainly mammals, birds, reptiles and fish.
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MRSA Colonization in Workers from Different Occupational Environments—A One Health Approach Perspective. ATMOSPHERE 2022. [DOI: 10.3390/atmos13050658] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Staphylococcus aureus and particularly methicillin-resistant S. aureus (MRSA) infections are currently associated with extremely high morbidity and mortality rates worldwide. The global escalation in the development of antibiotic-resistant human pathogens and S. aureus ability in developing new clones with the capacity to invade community settings, leads to an urgent need to develop accurate and efficient assessments of S. aureus colonization in occupational settings, particularly those with increased risk of human and animal colonization and food contamination. Here we present cross-sectional studies with the aim to assemble crucial information regarding MRSA prevalence in workers from five different Portuguese occupational environments (bakeries, swineries (humans and animals), ambulance crews, veterinary clinics and healthcare facilities). Our data demonstrated high prevalence of S. aureus asymptomatic carriers among bakery workers (40%; 75% MSSA and 25% MRSA), swinery workers (54%; 8% MSSA and 46% MRSA), firefighters (48.5%; 24% MSSA and 21% MRSA) and healthcare workers (Study 1: 42.2%; 18.4% MSSA and 23.7% MRSA, Study 2: 43.3% MRSA). S. aureus prevalence in veterinary staff was 7.1% (MSSA), lower than the results obtained in control groups (33.3% S. aureus; MRSA 4% to 10%). The present study sustains the urge to develop accurate and efficient assessment of S. aureus human and animal colonization, particularly in high risk occupational settings, with proper guidelines and validated procedures in order to avoid potential hazardous health outcomes associated with bioaerosol exposure and associated infectious diseases.
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Farfalla A, Achutan C. Exposure Assessment at a Pullet Barn - A Case Study. J Agromedicine 2021; 27:339-345. [PMID: 34511041 DOI: 10.1080/1059924x.2021.1979154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Poultry production is an integral part of agriculture and of the U.S. economy, accounting for millions of eggs and chicken products consumed annually. Most ubiquitous to the poultry industry from farm production to research are broiler and layer poultry operations, with pullet operations at the forefront. Although essential to the cycles of production, there is a dearth of evidence regarding the occupational exposure risks of pullet production. The aim of this case study was to measure total dust and ammonia levels during the growth cycle of pullets. Ammonia and total dust concentrations were measured as single day measurements at three different points of time during the 16.5-week growth cycle of pullet flocks using two fixed sampling stations configured to represent the breathing zone height of poultry workers. As birds grew from chicks to hens, concentrations of total dust and ammonia increased. Notably, from 3 weeks-of-age to 9 weeks-of-age concentrations of total dust increased from 1.1-1.2 mg/m3 to 16.0-18.0 mg/m3; and from 9 weeks-of-age to 15 weeks-of-age, dust concentrations reached 43.0-50.0 mg/m3. Concentrations of ammonia also increased from 9 weeks to 15 weeks from 1.1-2.7 ppm to 22.0-30.0 ppm. Both levels of ammonia and total dust reached levels that have the potential to induce adverse health effects among farmers raising pullets.
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Affiliation(s)
- Alexandra Farfalla
- University of Nebraska Medical Center College of Public Health, Department of Environmental, Agricultural, and Occupational Health, Omaha, USA
| | - Chandran Achutan
- University of Nebraska Medical Center College of Public Health, Department of Environmental, Agricultural, and Occupational Health, Omaha, USA
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7
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Abdullahi IN, Lozano C, Ruiz-Ripa L, Fernández-Fernández R, Zarazaga M, Torres C. Ecology and Genetic Lineages of Nasal Staphylococcus aureus and MRSA Carriage in Healthy Persons with or without Animal-Related Occupational Risks of Colonization: A Review of Global Reports. Pathogens 2021; 10:1000. [PMID: 34451464 PMCID: PMC8400700 DOI: 10.3390/pathogens10081000] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 07/30/2021] [Accepted: 08/02/2021] [Indexed: 01/16/2023] Open
Abstract
In this conceptual review, we thoroughly searched for appropriate English articles on nasal staphylococci carriage among healthy people with no reported risk of colonization (Group A), food handlers (Group B), veterinarians (Group C), and livestock farmers (Group D) published between 2000 and 2021. Random-effects analyses of proportions were performed to determine the pooled prevalence of S. aureus, MRSA, MRSA-CC398, and MSSA-CC398, as well as the prevalence of PVL-positive S. aureus from all eligible studies. A total of 166 eligible papers were evaluated for Groups A/B/C/D (n = 58/31/26/51). The pooled prevalence of S. aureus and MRSA in healthy humans of Groups A to D were 15.9, 7.8, 34.9, and 27.1%, and 0.8, 0.9, 8.6, and 13.5%, respectively. The pooled prevalence of MRSA-CC398 nasal carriage among healthy humans was as follows: Group A/B (<0.05%), Group C (1.4%), Group D (5.4%); and the following among Group D: pig farmers (8.4%) and dairy farmers (4.7%). The pooled prevalence of CC398 lineage among the MSSA and MRSA isolates from studies of the four groups were Group A (2.9 and 6.9%), B (1.5 and 0.0%), C (47.6% in MRSA), and D (11.5 and 58.8%). Moreover, MSSA-CC398 isolates of Groups A and B were mostly of spa-t571 (animal-independent clade), while those of Groups C and D were spa-t011 and t034. The MRSA-CC398 was predominately of t011 and t034 in all the groups (with few other spa-types, livestock-associated clades). The pooled prevalence of MSSA and MRSA isolates carrying the PVL encoding genes were 11.5 and 9.6% (ranges: 0.0-76.9 and 0.0-28.6%), respectively. Moreover, one PVL-positive MSSA-t011-CC398 isolate was detected in Group A. Contact with livestock and veterinary practice seems to increase the risk of carrying MRSA-CC398, but not in food handlers. Thus, this emphasizes the need for integrated molecular epidemiology of zoonotic staphylococci.
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Affiliation(s)
| | | | | | | | | | - Carmen Torres
- Area of Biochemistry and Molecular Biology, University of La Rioja, Madre de Dios 53, 26006 Logroño, Spain; (I.N.A.); (C.L.); (L.R.-R.); (R.F.-F.); (M.Z.)
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8
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Astrup LB, Hansen JE, Pedersen K. Occurrence and Survival of Livestock-Associated MRSA in Pig Manure and on Agriculture Fields. Antibiotics (Basel) 2021; 10:448. [PMID: 33923392 PMCID: PMC8071562 DOI: 10.3390/antibiotics10040448] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/11/2021] [Accepted: 04/14/2021] [Indexed: 11/16/2022] Open
Abstract
Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) is widespread in European pig production, and an increasing number of humans attract infections with this bacterium. Although most infections occur in humans with direct livestock contact, an increasing number of infections occur in humans without any established livestock contact. There have been speculations that at least some of these infections may be connected to the exposure of liquid pig manure for example spread as fertilizers. The present study therefore undertook to measure the presence of LA-MRSA in liquid pig manure and on the surface of soils fertilized with liquid manure and investigate the survival of the bacterium in manure. The results showed that LA-MRSA could be detected in 7 out of 20 liquid manure samples and in 12 out of 186 soil samples. However, the bacterium was not more frequently detected in samples collected after compared to before the spreading of liquid manure on the fields, thus suggesting that other sources of LA-MRSA on agriculture fields likely exist. The decimation time in liquid manure was >32 days at 5 °C in vitro but decreased with increasing temperature. Based on these results, liquid manure does not appear to be an important risk factor for human exposure to LA-MRSA.
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Affiliation(s)
- Lӕrke Boye Astrup
- National Veterinary Institute, Technical University of Denmark, Kemitorvet, DK-2800 Kongens Lyngby, Denmark; (L.B.A.); (J.E.H.)
| | - Julie Elvekjӕr Hansen
- National Veterinary Institute, Technical University of Denmark, Kemitorvet, DK-2800 Kongens Lyngby, Denmark; (L.B.A.); (J.E.H.)
| | - Karl Pedersen
- Department of Animal Health and Antimicrobial Strategies, National Veterinary Institute, 751 89 Uppsala, Sweden
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Pezzani MD, Mazzaferri F, Compri M, Galia L, Mutters NT, Kahlmeter G, Zaoutis TE, Schwaber MJ, Rodríguez-Baño J, Harbarth S, Tacconelli E. Linking antimicrobial resistance surveillance to antibiotic policy in healthcare settings: the COMBACTE-Magnet EPI-Net COACH project. J Antimicrob Chemother 2020; 75:ii2-ii19. [PMID: 33280049 PMCID: PMC7719409 DOI: 10.1093/jac/dkaa425] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To systematically summarize the evidence on how to collect, analyse and report antimicrobial resistance (AMR) surveillance data to inform antimicrobial stewardship (AMS) teams providing guidance on empirical antibiotic treatment in healthcare settings. METHODS The research group identified 10 key questions about the link between AMR surveillance and AMS using a checklist of 9 elements for good practice in health research priority settings and a modified 3D combined approach matrix, and conducted a systematic review of published original studies and guidelines on the link between AMR surveillance and AMS. RESULTS The questions identified focused on AMS team composition; minimum infrastructure requirements for AMR surveillance; organisms, samples and susceptibility patterns to report; data stratification strategies; reporting frequency; resistance thresholds to drive empirical therapy; surveillance in high-risk hospital units, long-term care, outpatient and veterinary settings; and surveillance data from other countries. Twenty guidelines and seven original studies on the implementation of AMR surveillance as part of an AMS programme were included in the literature review. CONCLUSIONS The evidence summarized in this review provides a useful basis for a more integrated process of developing procedures to report AMR surveillance data to drive AMS interventions. These procedures should be extended to settings outside the acute-care institutions, such as long-term care, outpatient and veterinary. Without proper AMR surveillance, implementation of AMS policies cannot contribute effectively to the fight against MDR pathogens and may even worsen the burden of adverse events from such interventions.
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Affiliation(s)
- Maria Diletta Pezzani
- Infectious Diseases Section, Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Fulvia Mazzaferri
- Infectious Diseases Section, Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Monica Compri
- Infectious Diseases Section, Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Liliana Galia
- Infectious Diseases Section, Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Nico T Mutters
- Bonn University Hospital, Institute for Hygiene and Public Health, Bonn, Germany
| | - Gunnar Kahlmeter
- Department of Clinical Microbiology, Växjö Central Hospital, Växjö, Sweden
| | - Theoklis E Zaoutis
- Perelman School of Medicine at the University of Pennsylvania, Infectious Diseases Division, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Mitchell J Schwaber
- National Centre for Infection Control, Israel Ministry of Health and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jesús Rodríguez-Baño
- Division of Infectious Diseases, Microbiology and Preventive Medicine, Hospital Universitario Virgen Macarena/Department of Medicine, University of Seville/Biomedicine Institute of Seville (IBiS), Seville, Spain
| | - Stephan Harbarth
- Infection Control Program, World Health Organization Collaborating Centre on Patient Safety, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Evelina Tacconelli
- Infectious Diseases Section, Department of Diagnostic and Public Health, University of Verona, Verona, Italy
- Infectious Diseases, Department of Internal Medicine I, Tübingen University Hospital, Tübingen, Germany
- German Centre for Infection Research (DZIF), Clinical Research Unit for Healthcare Associated Infections, Tübingen, Germany
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Avberšek J, Golob M, Papić B, Dermota U, Grmek Košnik I, Kušar D, Ocepek M, Zdovc I. Livestock-associated methicillin-resistant Staphylococcus aureus: Establishing links between animals and humans on livestock holdings. Transbound Emerg Dis 2020; 68:789-801. [PMID: 32687685 DOI: 10.1111/tbed.13745] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/10/2020] [Accepted: 07/15/2020] [Indexed: 12/01/2022]
Abstract
Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) represents a concern in both human and veterinary medicine. The aim of this study was to investigate potential LA-MRSA transmission between animals and humans in rural settings. To this aim, a study was designed to include 14 farms in Slovenia, which were selected on the basis of a farmer (initial patient) with confirmed LA-MRSA infection and regular animal contacts. On all farms, the initial patients, their household members, animals and barn environment were analysed for the presence of LA-MRSA. In addition, the epidemiologically linked hospital-related LA-MRSA isolates were included to investigate possible nosocomial transmissions. On five farms, LA-MRSA was discovered both in animals and in humans. In total, 49 LA-MRSA isolates of different origins underwent whole-genome sequencing, antimicrobial susceptibility testing and spa typing. All 49 isolates belonged to the sequence type 398 (ST398), spa types t011 and t034, and harboured staphylococcal chromosomal cassette mec Vc. High levels of concordance between resistance phenotypes and genotypes were observed. No transmission pairs between animals and initial patients were discovered. However, several isolates originating from farm animals and other household members formed clusters with pairwise distances of ≤14 single nucleotide polymorphisms (SNPs), indicating recent transmission events. In addition, three closely related isolates (0 SNP) form hospitalized patients were observed, indicating a possible nosocomial transmission. Two hospital-related isolates harboured the immune evasion cluster genes, which are associated with adaptation to the human host; however, these two isolates differed in >30 SNPs from the remaining isolates. Characteristics of LA-MRSA from Slovenia reflect those observed previously in other European studies. Immune evasion cluster-positive LA-MRSA ST398 suggests its re-adaptation to the human host and calls for a closer monitoring of such emerging LA-MRSA lineages, in addition to monitoring and preventing the introduction of LA-MRSA from farms to hospitals where transmission is highly plausible.
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Affiliation(s)
- Jana Avberšek
- Veterinary Faculty, Institute of Microbiology and Parasitology, University of Ljubljana, Ljubljana, Slovenia
| | - Majda Golob
- Veterinary Faculty, Institute of Microbiology and Parasitology, University of Ljubljana, Ljubljana, Slovenia
| | - Bojan Papić
- Veterinary Faculty, Institute of Microbiology and Parasitology, University of Ljubljana, Ljubljana, Slovenia
| | - Urška Dermota
- National Laboratory of Health, Environment and Food, Kranj, Slovenia
| | | | - Darja Kušar
- Veterinary Faculty, Institute of Microbiology and Parasitology, University of Ljubljana, Ljubljana, Slovenia
| | - Matjaž Ocepek
- Veterinary Faculty, Institute of Microbiology and Parasitology, University of Ljubljana, Ljubljana, Slovenia
| | - Irena Zdovc
- Veterinary Faculty, Institute of Microbiology and Parasitology, University of Ljubljana, Ljubljana, Slovenia
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11
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Köper LM, Bode C, Bender A, Reimer I, Heberer T, Wallmann J. Eight years of sales surveillance of antimicrobials for veterinary use in Germany-What are the perceptions? PLoS One 2020; 15:e0237459. [PMID: 32776971 PMCID: PMC7416935 DOI: 10.1371/journal.pone.0237459] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 07/27/2020] [Indexed: 11/18/2022] Open
Abstract
A surveillance system for sales volumes of antimicrobial agents for veterinary use was established in Germany in 2011. Since then, pharmaceutical companies and wholesalers have been legally obliged to report annual volumes of veterinary antimicrobial products sold to veterinary practices or clinics located in Germany. The evaluation of sales volumes for eight consecutive years resulted in a considerable total decrease by 58% from 1706 tons to 722 tons. During the investigation period, two legally binding measures to control the risk of antimicrobial resistance resulting from the veterinary use of antimicrobials were introduced, a) the German treatment frequencies benchmarking in 2014 and b) the obligation to conduct susceptibility testing for the use of cephalosporins of the 3rd and 4th generation and of fluoroquinolones in 2018. Both had a marked impact on sales volumes. Nonetheless, the category of Critically Important Antimicrobials as defined by the World Health Organization kept accounting for the highest share on sales volumes in Germany in 2018 with 403 tons, despite an overall reduction by 53%. Sales surveillance is considered essential for data retrieval on a global scale and inter-country comparison. However, the usability of a surveillance system based on sales data for risk management of antimicrobial resistance has limitations. The German system does not include off-label use of antimicrobial products authorized for human medicine and does not allow for identification of areas of high risk according to animal species, farm and production types and indications for treatment. For further reduction and enhanced promotion of a prudent use of antimicrobials, targeted measures would be required that could only be deducted from use data collected at farm or veterinary practice level. A surveillance system based on use data is currently lacking in Germany but will be established according to Regulation (EU) 2019/6 on veterinary medicinal products.
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Affiliation(s)
- Lydia M. Köper
- Department Veterinary Drugs, Federal Office of Consumer Protection and Food Safety (BVL), Berlin, Germany
- * E-mail:
| | - Christoph Bode
- Department Veterinary Drugs, Federal Office of Consumer Protection and Food Safety (BVL), Berlin, Germany
| | - Alice Bender
- Department Veterinary Drugs, Federal Office of Consumer Protection and Food Safety (BVL), Berlin, Germany
| | - Inke Reimer
- Department Veterinary Drugs, Federal Office of Consumer Protection and Food Safety (BVL), Berlin, Germany
| | - Thomas Heberer
- Department Veterinary Drugs, Federal Office of Consumer Protection and Food Safety (BVL), Berlin, Germany
| | - Jürgen Wallmann
- Department Veterinary Drugs, Federal Office of Consumer Protection and Food Safety (BVL), Berlin, Germany
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Sarhan SR, Hashim HO, Al-Shuhaib MBS. The Gly152Val mutation possibly confers resistance to beta-lactam antibiotics in ovine Staphylococcus aureus isolates. Open Vet J 2019; 9:339-348. [PMID: 32042657 PMCID: PMC6971359 DOI: 10.4314/ovj.v9i4.12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 11/21/2019] [Indexed: 12/30/2022] Open
Abstract
Background: The mecA gene is a key factor that allows bacterial cells to resist several antibiotics. Aim: This study was conducted to detect the mecA gene polymorphism in ovine wounds and its possible association with the structure and function of penicillin binding protein A2 (PBP2A). Methods: One genetic locus of 1,967 bp that covered the majority of the coding regions of the mecA gene within methicillin-resistant Staphylococcus aureus (MRSA) DNA sequences was designed. Results: In addition to standard microbiological tests, PCR-sequencing reactions and phylogenetic analyses confirmed the identity of the targeted MRSA bacteria. Seven novel missense SNPs, including N57T, N115Y, D120N, D139N, G152V, E189K, and F211V, were observed in the mecA amplicons. Multiple state-of-the-art in silico tools were utilized to assess the consequences of each observed SNP in terms of its effect on the corresponding PBP2A protein structure and function. It was shown that some MRSA isolates exhibited a highly PBP2A-damaging SNP, G152V, which showed an entirely deleterious effect on the PBP2A. Furthermore, G152V induced an alteration in the PBP2A interaction with its receptor, which presumably reduced its affinity to bind with the beta-lactams. Conclusion: The present report indicated a possible role for the observed deleterious G152V SNP in the reduction of PBP2A binding with beta-lactams, which has led to a remarkable increase in MRSA’s resistance to antibiotics.
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Affiliation(s)
- Sarhan R Sarhan
- Department of Pharmacology and Physiology, College of Veterinary Medicine, Wasit University, Wasit, Iraq
| | - Hayder O Hashim
- Department of Clinical Laboratory Sciences, College of Pharmacy, University of Babylon, Iraq
| | - Mohammed Baqur S Al-Shuhaib
- Department of Animal Production, College of Agriculture, Al-Qasim Green University, Al-Qasim, Babil 51001, Iraq
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Döring S, Geisthardt N, Freitag H, Kobusch I, Boelhauve M, Mergenthaler M. Animal Hygiene Indexes in Relation to Big-Five Personality Traits of German Pig Farmers Evaluated by Self- and Other-Rating. Front Vet Sci 2019; 6:379. [PMID: 31824965 PMCID: PMC6879459 DOI: 10.3389/fvets.2019.00379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 10/14/2019] [Indexed: 12/02/2022] Open
Abstract
Improving biosecurity in intensive livestock production has become an increasingly challenging task. Often, animal hygiene measures are implemented at lower levels than recommended. Therefore, veterinarians and farm advisors look for new approaches to improve their advisory process with farmers. In the current study it has been hypothesized that German pig farmers' big-five measured personality traits might correlate with farms' biosecurity level expressed by a “continuous animal hygiene index” and a “technical animal hygiene index.” Hence, comprehensive data on the implementation of more than 100 hygiene measures were collected at farm level from a specific pilot sample of 42 pig farmers from a livestock intensive region in north-western Germany. In addition, big-five personality traits (BFI-S) were measured by self- and other-rating. Inter-rater reliabilities for personality traits indicated expected positive correlations apart from agreeableness (rS = −0.101). Regarding the self-rating, neuroticism was valued lowest (x¯ = 3.88 ± 1.18) and conscientiousness highest (x¯ = 5.68 ± 0.70). The animal hygiene indexes revealed medium biosecurity levels on the participating farms. Piglet breeders had a significantly higher value for the “continuous animal hygiene index” (x¯ = 63.00 ± 9.91%). Personality traits conscientiousness and openness showed correlations with the continuous and the technical animal hygiene index. Depending on the production systems as well as the rating perspectives, correlations varied. For one of the personality traits playing a direct role in social interaction—extraversion—the advisory process might function as a mediating factor. The current results show that clustering of single hygiene measures into indexes in the evaluation of pig farms' biosecurity level might have advantages. The preliminary results from this study should be validated in larger, more representative samples. Furthermore, structured and systematic consideration of personality traits of farmers adds an additional aspect to include individuality of farmers more systematically in complex advisory processes. Interaction of personality traits with characteristics of the advisory process should be further researched and should be included in a much broader socio-political understanding of what is involved in changing practices.
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Affiliation(s)
- Susanne Döring
- Faculty of Agriculture, South Westphalia University of Applied Sciences, Soest, Germany
| | - Nicole Geisthardt
- Faculty of Agriculture, South Westphalia University of Applied Sciences, Soest, Germany
| | - Henrike Freitag
- Faculty of Agriculture, South Westphalia University of Applied Sciences, Soest, Germany
| | - Iris Kobusch
- Faculty of Agriculture, South Westphalia University of Applied Sciences, Soest, Germany
| | - Marc Boelhauve
- Faculty of Agriculture, South Westphalia University of Applied Sciences, Soest, Germany
| | - Marcus Mergenthaler
- Faculty of Agriculture, South Westphalia University of Applied Sciences, Soest, Germany
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Papadopoulos P, Angelidis AS, Papadopoulos T, Kotzamanidis C, Zdragas A, Papa A, Filioussis G, Sergelidis D. Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) in bulk tank milk, livestock and dairy-farm personnel in north-central and north-eastern Greece: Prevalence, characterization and genetic relatedness. Food Microbiol 2019; 84:103249. [PMID: 31421759 DOI: 10.1016/j.fm.2019.103249] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 06/21/2019] [Accepted: 06/21/2019] [Indexed: 10/26/2022]
Abstract
Recently, there has been an increased tendency towards raw-milk consumption, which may pose a consumer risk, due to the possible presence of human pathogenic microorganisms, such as Staphylococcus aureus and even methicillin-resistant S. aureus (MRSA). The prevalence of S. aureus and methicillin-resistant S. aureus (MRSA) was investigated in 40 dairy (cattle, sheep and goat) farms in northern Greece. S. aureus and MRSA were detected in 47.8% and 4.1% of the 387 samples (raw milk, farmers and animal samples) tested, respectively. Most (81.3%) of the MRSA isolates harbored the mecA gene, whereas the mecC or Panton-Valentine Leucocidin (PVL) genes were not detected. Seven spa types were identified, with t127 being the most prevalent. Spa type t034 (CC398) was isolated for the first time from livestock in Greece. Staphylococcal enterotoxin genes were detected in 93.8% of the MRSA isolates. The MRSA isolates were genetically diverse and were all capable of biofilm production. Our results confirm the lurking threat of MRSA in raw milk and dairy farms and suggest the need for surveillance programs starting at the farm level.
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Affiliation(s)
- Panagiotis Papadopoulos
- Laboratory of Hygiene of Foods of Animal Origin-Veterinary Public Health, School of Veterinary Medicine, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.
| | - Apostolos S Angelidis
- Laboratory of Safety and Quality of Milk and Dairy Products, School of Veterinary Medicine, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - Theofilos Papadopoulos
- Department of Epidemiology and Public Health, Sciensano, 1050, Brussels, Belgium; Veterinary Research Institute of Thessaloniki, Greek Agricultural Organization-DIMITRA, 57006, Thermi, Greece
| | - Charalampos Kotzamanidis
- Veterinary Research Institute of Thessaloniki, Greek Agricultural Organization-DIMITRA, 57006, Thermi, Greece
| | - Antonios Zdragas
- Veterinary Research Institute of Thessaloniki, Greek Agricultural Organization-DIMITRA, 57006, Thermi, Greece
| | - Anna Papa
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, 54 124, Thessaloniki, Greece
| | - George Filioussis
- Laboratory of Microbiology and Infectious Diseases, School of Veterinary Medicine, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - Daniel Sergelidis
- Laboratory of Hygiene of Foods of Animal Origin-Veterinary Public Health, School of Veterinary Medicine, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
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White JK, Nielsen JL, Madsen AM. Microbial species and biodiversity in settling dust within and between pig farms. ENVIRONMENTAL RESEARCH 2019; 171:558-567. [PMID: 30771719 DOI: 10.1016/j.envres.2019.01.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 11/30/2018] [Accepted: 01/04/2019] [Indexed: 05/14/2023]
Abstract
The airborne fungal and bacterial species present in pig farm dust have not been well characterised even though these bioaerosols are known to cause inflammation and other airway maladies. In this study, the microbial species and composition in airborne dust within and between pig farms were investigated. Passively sedimenting dust from six pig farms were collected using electrostatic dust collectors. The bacterial and fungal species were identified using matrix-assisted laser desorption-ionisation time-of-flight mass spectrometry (MALDI-TOF MS) and next generation sequencing (NGS). Dust samples taken within the same stable section revealed high resemblance and stability. Constrained statistical analysis of the microbial community compositions indicated that the types of stable did not appear to have a great effect on the bacterial and fungal β-diversity. In contrast to this, the farm from which samples were taken appeared to have the greatest effect on the bacterial β-diversity, but this trend was not observed for the fungal β-diversity. The most common bacteria and fungi according to NGS data were anaerobes typically associated with the pig intestinal tract and yeasts respectively. Bacterial sedimentation varied at a rate between 103 and 109 CFU/m2/day, with the most common species after aerobic incubation being Aerococcus viridans and Staphylococcus equorum, while Clostridium perfringens and Staphylococcus simulans were the most common species after anaerobic incubation. A total of 28 different species of bacteria and fungi were classifiable as pathogens. In conclusion, the biodiversity in pig farm dust shows a high diversity of bacterial species. However, samples from the same stable section resembled each other, but also different sections within the same farm also resembled each other, thus indicating a high degree of community stability in the dust source. In regards to fungal identification, the biodiversity was observed to be similar between samples from different stable sections and farms, indicating a higher degree of similarities in the mycobiomes found across pig farms studied.
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Affiliation(s)
- John Kerr White
- Department of Chemistry and Bioscience, Aalborg University, Fredrik Bajers Vej 7 H, 9220 Aalborg Ø, Denmark; The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark.
| | - Jeppe Lund Nielsen
- Department of Chemistry and Bioscience, Aalborg University, Fredrik Bajers Vej 7 H, 9220 Aalborg Ø, Denmark.
| | - Anne Mette Madsen
- The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark.
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Madsen AM, Markouch A, Frederiksen MW, Tendal K. Measurement of dust-borne MRSA in pig farms using different approaches. J Appl Microbiol 2019; 126:1580-1593. [PMID: 30614172 DOI: 10.1111/jam.14198] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 12/14/2018] [Accepted: 01/04/2019] [Indexed: 11/30/2022]
Abstract
AIMS To obtain knowledge about (i) how to sample airborne methicillin-resistant Staphylococcus aureus (MRSA) and dust in the pig farm environment including effects of sampler on (a) measured exposure, (b) MRSA survival and (c) spatial and temporal variation in exposure, and (ii) the association between exposure to MRSA, dust and optical density OD. METHODS AND RESULTS Airborne dust was sampled on five pig farms using five active and one passive samplers. Staphylococcus aureus and MRSA (as a subset of S. aureus) were quantified using selective agar media and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. The Andersen sampler, electrostatic dust collectors (EDC), and Gesamtstaubprobenahme (GSP) and Institute of Occupational Medicine samplers with polycarbonate or Teflon filters were applicable for sampling airborne MRSA. The half-life of MRSA was not reduced by active sampling. A significant correlation was found between dust and S. aureus exposure within, but not between, farm section and farms. A significant spatial and temporal variation in dust and MRSA exposure was found within a stable. The dust sampling rate and the concentration of MRSA in the sampled dust decreased after 5 days of sampling. CONCLUSION Sampling using the GSP can be performed for 1 h without affecting the following half-life of MRSA. Sampling for MRSA using the EDC should not exceed 3 days due to overloading and the die-off of MRSA. The measurement of OD may be used as a proxy measure for dust exposure. To obtain knowledge about potential exposure, samples should be taken repeatedly and in different areas within a stable section. SIGNIFICANCE AND IMPACT OF THE STUDY Sampling method, sampling time and number of samples taken, but not force of airflow on the filter, influence the measured potential exposure to MRSA and dust.
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Affiliation(s)
- A M Madsen
- The National Research Centre for the Working Environment, Copenhagen Ø, Denmark
| | - A Markouch
- The National Research Centre for the Working Environment, Copenhagen Ø, Denmark
| | - M W Frederiksen
- The National Research Centre for the Working Environment, Copenhagen Ø, Denmark
| | - K Tendal
- The National Research Centre for the Working Environment, Copenhagen Ø, Denmark
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Franceschini G, Bottino M, Millet I, Martello E, Zaltron F, Favretto AR, Vonesch N, Tomao P, Mannelli A. Assessment of the Exposure of Turkey Farmers to Antimicrobial Resistance Associated with Working Practices. Vet Sci 2019; 6:E13. [PMID: 30717204 PMCID: PMC6466403 DOI: 10.3390/vetsci6010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 01/24/2019] [Accepted: 01/29/2019] [Indexed: 11/17/2022] Open
Abstract
The objective of the present study was the identification of farming practices in the production of turkeys for human consumption, and their ranking in terms of the occupational probability of exposure to antimicrobial resistant (AMR) bacteria, for farm workers. We gathered evidence and data from scientific literature, on risk factors for AMR in farmers, and on the prevalence of those hazards across farming phases. We administered semi-structured interviews to public and private veterinarians in Northern Italy, to obtain detailed information on turkey farming phases, and on working practices. Data were then integrated into a semi-quantitative Failure Modes and Effect Analysis (FMEA). Those working practices, which are characterized by direct contact with numerous animals, and which are carried out frequently, with rare use of personal protection devices resulted as associated with the greatest probability of exposure to AMR. For methicillin resistant Staphylococcus aureus (MRSA), these included vaccination and administration of any individual therapy, and removal and milling of litter, given the exposure of farmers to high dust level. Indeed, levels of occupational exposure to MRSA are enhanced by its transmission routes, which include direct contact with animal, as well as airborne transmission. Level of exposure to extended spectrum beta lactamase (ESBL) is more strictly associated with direct contact and the oral-fecal route. Consequently, exposure to ESBL resulted and associated with the routinely tipping over of poults turned on their back, and with the individual administration of therapies.
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Affiliation(s)
| | - Marta Bottino
- Department of Veterinary Sciences, University of Turin, 10124 Turin, Italy.
| | - Ilary Millet
- Department of Veterinary Sciences, University of Turin, 10124 Turin, Italy.
| | - Elisa Martello
- Department of Veterinary Sciences, University of Turin, 10124 Turin, Italy.
| | - Francesca Zaltron
- Department of Law and Political, Economic and Social Sciences, University of Eastern Piedmont, 15121 Alessandria, Italy.
| | - Anna Rosa Favretto
- Department of Law and Political, Economic and Social Sciences, University of Eastern Piedmont, 15121 Alessandria, Italy.
| | - Nicoletta Vonesch
- Department of Medicine, Epidemiology, Occupational Hygiene and the Environment, National Institute for Insurance against Accidents at Work (INAIL), 00078 Monte Porzio Catone (Rome), Italy.
| | - Paola Tomao
- Department of Medicine, Epidemiology, Occupational Hygiene and the Environment, National Institute for Insurance against Accidents at Work (INAIL), 00078 Monte Porzio Catone (Rome), Italy.
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Kramer TS, Schröder C, Behnke M, Aghdassi SJ, Geffers C, Gastmeier P, Remschmidt C. Decrease of methicillin resistance in Staphylococcus aureus in nosocomial infections in Germany-a prospective analysis over 10 years. J Infect 2019; 78:215-219. [PMID: 30658080 DOI: 10.1016/j.jinf.2018.12.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 12/04/2018] [Accepted: 12/12/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Methicillin resistant Staphylococcus aureus (MRSA) remains an important cause of healthcare-associated infections. Here, we describe the development of methicillin-resistant isolates among nosocomial Staphylococcus aureus (SA) infections in Germany between 2007 and 2016. METHODS We analyzed data from the voluntary German national nosocomial Infection Surveillance System. Data on bloodstream infections (BSI) and lower respiratory tract infections (LRTI) were derived from intensive care units (ICU), whereas data on surgical site infections (SSI) were collected from surgical departments (SD). Univariate analysis was performed on trend of proportion, while multivariable logistic regression was performed to identify risk factors for MRSA-infections. RESULTS Data of 1218 ICU and 1,556 SD were included. Overall, a decrease in the proportion of MRSA among all nosocomial SA-infections from 32.8% to 20.0% was noted. MRSA decreased from 37.1% to 21.8% (p = 0.01) for BSI, from 38.7% to 19.2% for LTRI (p < 0.01) and. from 21.1% to 7.4% (p < 0.01) in SSI. Logistic regression revealed that SA-infections in Mecklenburg Western-Pomerania were more likely caused by MRSA (Odds ratio (OR): 2.5; 95% CI: 1.7, 3.6). CONCLUSION We observed a significant reduction of the proportion of nosocomial Staphylococcus aureus infections due to MRSA in Germany over the course of the last 10 years.
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Affiliation(s)
- T S Kramer
- Institute of Hygiene and Environmental Medicine, Charité - University Medicine Berlin, Hindenburgdamm 27, 12203 Berlin, Germany; German National Reference Centre for Surveillance of Nosocomial Infections, Hindenburgdamm 27, 12203 Berlin, Germany.
| | - C Schröder
- Institute of Hygiene and Environmental Medicine, Charité - University Medicine Berlin, Hindenburgdamm 27, 12203 Berlin, Germany; German National Reference Centre for Surveillance of Nosocomial Infections, Hindenburgdamm 27, 12203 Berlin, Germany
| | - M Behnke
- Institute of Hygiene and Environmental Medicine, Charité - University Medicine Berlin, Hindenburgdamm 27, 12203 Berlin, Germany; German National Reference Centre for Surveillance of Nosocomial Infections, Hindenburgdamm 27, 12203 Berlin, Germany
| | - S J Aghdassi
- Institute of Hygiene and Environmental Medicine, Charité - University Medicine Berlin, Hindenburgdamm 27, 12203 Berlin, Germany; German National Reference Centre for Surveillance of Nosocomial Infections, Hindenburgdamm 27, 12203 Berlin, Germany
| | - C Geffers
- Institute of Hygiene and Environmental Medicine, Charité - University Medicine Berlin, Hindenburgdamm 27, 12203 Berlin, Germany; German National Reference Centre for Surveillance of Nosocomial Infections, Hindenburgdamm 27, 12203 Berlin, Germany
| | - P Gastmeier
- Institute of Hygiene and Environmental Medicine, Charité - University Medicine Berlin, Hindenburgdamm 27, 12203 Berlin, Germany; German National Reference Centre for Surveillance of Nosocomial Infections, Hindenburgdamm 27, 12203 Berlin, Germany
| | - C Remschmidt
- Institute of Hygiene and Environmental Medicine, Charité - University Medicine Berlin, Hindenburgdamm 27, 12203 Berlin, Germany; German National Reference Centre for Surveillance of Nosocomial Infections, Hindenburgdamm 27, 12203 Berlin, Germany
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Madsen AM, Kurdi I, Feld L, Tendal K. Airborne MRSA and Total Staphylococcus aureus as Associated With Particles of Different Sizes on Pig Farms. Ann Work Expo Health 2018; 62:966-977. [PMID: 30060058 PMCID: PMC6188509 DOI: 10.1093/annweh/wxy065] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 06/28/2018] [Indexed: 11/29/2022] Open
Abstract
Airborne methicillin-resistant Staphylococcus aureus (MRSA) have previously been found on pig farms, which may lead to nasal deposition of MRSA in humans via inhalation. The anterior nares are the main niche for S. aureus, and S. aureus can cause, e.g. wound infection and pneumonia. The aim of this study was to acquire knowledge about the potential deposition of airborne MRSA, specifically, and of total S. aureus (including both methicillin-sensitive S. aureus and MRSA, in the following called S. aureus) in the different parts of the airways during occupancy on pig farms. Measurements of airborne MRSA and S. aureus were performed on four pig farms using a six and a three-stage sampler during different work tasks, such as high-pressure cleaning and everyday inspection. MRSA were quantified using MRSA-selective agar, and S. aureus were quantified using Staphylococcus selective agar. The identity of the bacteria were confirmed using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. The geometric mean (GM) concentrations of MRSA and S. aureus were 447 cfu/m3 air and 1.8 × 103 cfu/m3 air, respectively. The highest concentrations of MRSA and S. aureus were found among pigs in a weaner stable and during high-pressure cleaning of an empty stable, respectively. The lowest concentrations of MRSA and S. aureus were found in a stable with sick pigs and in feed-storages, respectively. Most MRSA and S. aureus were associated with particles between 7 and 12 µm. On average, the particle size fractions potentially depositing in the upper airways constituted 70%, in the primary and secondary bronchi 22%, and in the terminal bronchi and alveoli 8% of the inhalable MRSA and S. aureus concentration. Across the sampled areas, the geometric mean diameter (Dg) of particles with MRSA and S. aureus were 7.2 and 6.4 µm, respectively, and no significant difference was found between these Dgs. The Dg of the airborne particles with the studied bacterium was significantly associated with the different locations on the farms. The largest Dgs were found in the air samples from the aisles and on the fence to the pens, while the smallest Dgs were found in samples from the pens among the pigs and in samples taken at greater distances from the pigs: in the hallway, feed-storage, and entry room. In conclusion, airborne MRSA and S. aureus were found in sample fractions potentially depositing in all six parts of the airways. However, the majority was found to potentially deposit in the upper airways. The concentration of airborne MRSA and S. aureus and MRSA, as well as the fraction potentially depositing in the different parts of the airways, depended on the specific work task being performed and the location on the farm.
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Affiliation(s)
- Anne Mette Madsen
- The National Research Centre for the Working Environment, Lersø Parkallé, Copenhagen Ø, Denmark
| | - Iman Kurdi
- The National Research Centre for the Working Environment, Lersø Parkallé, Copenhagen Ø, Denmark
| | - Louise Feld
- The National Research Centre for the Working Environment, Lersø Parkallé, Copenhagen Ø, Denmark
| | - Kira Tendal
- The National Research Centre for the Working Environment, Lersø Parkallé, Copenhagen Ø, Denmark
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20
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Feld L, Bay H, Angen Ø, Larsen AR, Madsen AM. Survival of LA-MRSA in Dust from Swine Farms. Ann Work Expo Health 2018; 62:147-156. [PMID: 29365048 PMCID: PMC6788576 DOI: 10.1093/annweh/wxx108] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 10/30/2017] [Accepted: 12/07/2017] [Indexed: 11/24/2022] Open
Abstract
Dust is suspected to be an important factor in transmission of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) between pigs and pig farmers and their families. The aim of this study was to determine the rate of decay for Staphylococcus aureus and LA-MRSA in dust from swine farms. Electrostatic dust fall collectors (EDCs) were used for passive sampling of settling airborne dust in 11 stable sections from six swine farms. Extraction, plating, identification, and enumeration of cultivable S. aureus and LA-MRSA from the EDCs were performed after storage for 0-30 days postsampling. The survival of S. aureus was measured in 196 dust samples from all farms, and data were used to estimate the decay constant λ according to a model for exponential decay: N(t) = N0 × e-λt. The number of S. aureus colonies was up to 600-fold higher than the number of LA-MRSA colonies on MRSA selective agar. The data showed a good fit to the model (λ = 0.13, r2 = 0.86) even with a large difference in initial concentrations of S. aureus between stables. The loads of S. aureus and LA-MRSA in the dust were significantly reduced by storage time, and the half-life was 5 days for both S. aureus and LA-MRSA. In dust samples with high initial concentrations, LA-MRSA and S. aureus could still be cultivated 30 days after sampling. On all farms MRSA isolates belonged to the clonal complex (CC) 398, and at one farm some isolates also belonged to CC30. A screening for other Staphylococcus species in the farm dust revealed 13 different species numerically dominated by Staphylococcus equorum. Based on the exponential decay model, S. equorum had a half-life of 4 days. In conclusion, the presence of MRSA in airborne dust from five of six farms indicates that dust might be an important vehicle for transmission of LA-MRSA. LA-MRSA and S. aureus was found to survive well in farm dust with half-lives of 5 days, and dependent on the initial concentration they could be found in farm dust for weeks. The 99.9% die-off rate was 66 days for LA-MRSA. Thus, farm dust can pose an exposure risk for humans in the farm environment, but also when transported to other environments. On the other hand, the risk will decrease by time. These results provide important knowledge to diminish spread from farm environments to other environments on, e.g., tools or clothing, and in relation to cleaning of emptied LA-MRSA-positive stables.
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Affiliation(s)
- Louise Feld
- The National Research Center for the Working Environment, Copenhagen Ø, Denmark
| | - Hans Bay
- The National Research Center for the Working Environment, Copenhagen Ø, Denmark
| | | | | | - Anne Mette Madsen
- The National Research Center for the Working Environment, Copenhagen Ø, Denmark
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Prevalence of Staphylococcus aureus and of methicillin-resistant S. aureus (MRSA) along the production chain of dairy products in north-western Greece. Food Microbiol 2018; 69:43-50. [DOI: 10.1016/j.fm.2017.07.016] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 07/20/2017] [Accepted: 07/24/2017] [Indexed: 11/22/2022]
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22
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Agunos A, Pierson FW, Lungu B, Dunn PA, Tablante N. Review of Nonfoodborne Zoonotic and Potentially Zoonotic Poultry Diseases. Avian Dis 2017; 60:553-75. [PMID: 27610715 DOI: 10.1637/11413-032416-review.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Emerging and re-emerging diseases are continuously diagnosed in poultry species. A few of these diseases are known to cross the species barrier, thus posing a public health risk and an economic burden. We identified and synthesized global evidence for poultry nonfoodborne zoonoses to better understand these diseases in people who were exposed to different poultry-related characteristics (e.g., occupational or nonoccupational, operational types, poultry species, outbreak conditions, health status of flocks). This review builds on current knowledge on poultry zoonoses/potentially zoonotic agents transmitted via the nonfoodborne route. It also identifies research gaps and potential intervention points within the poultry industry to reduce zoonotic transmission by using various knowledge synthesis tools such as systematic review (SR) and qualitative (descriptive) and quantitative synthesis methods (i.e., meta-analysis). Overall, 1663 abstracts were screened and 156 relevant articles were selected for further review. Full articles (in English) were retrieved and critically appraised using routine SR methods. In total, eight known zoonotic diseases were reviewed: avian influenza (AI) virus (n = 85 articles), Newcastle disease virus (n = 8), West Nile virus (WNV, n = 2), avian Chlamydia (n = 24), Erysipelothrix rhusiopathiae (n = 3), methicillin-resistant Staphylococcus aureus (MRSA, n = 15), Ornithonyssus sylvarium (n = 4), and Microsporum gallinae (n = 3). In addition, articles on other viral poultry pathogens (n = 5) and poultry respiratory allergens derived from mites and fungi (n = 7) were reviewed. The level of investigations (e.g., exposure history, risk factor, clinical disease in epidemiologically linked poultry, molecular studies) to establish zoonotic linkages varied across disease agents and across studies. Based on the multiple outcome measures captured in this review, AI virus seems to be the poultry zoonotic pathogen that may have considerable and significant public health consequences; however, epidemiologic reports have only documented severe human cases clustered in Asia and not in North America. In contrast, avian Chlamydia and MRSA reports clustered mainly in Europe and less so in North America and other regions. Knowledge gaps in other zoonoses or other agents were identified, including potential direct (i.e., nonmosquito-borne) transmission of WNV from flocks to poultry workers, the public health and clinical significance of poultry-derived (livestock-associated) MRSA, the zoonotic significance of other viruses, and the role of poultry allergens in the pathophysiology of respiratory diseases of poultry workers. Across all pathogens reviewed, the use of personal protective equipment was commonly cited as the most important preventive measure to reduce the zoonotic spread of these diseases and the use of biosecurity measures to reduce horizontal transmission in flock populations. The studies also emphasized the need for flock monitoring and an integrated approach to prevention (i.e., veterinary-public health coordination with regard to diagnosis, and knowledge translation and education in the general population) to reduce zoonotic transmission.
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Affiliation(s)
- Agnes Agunos
- A Public Health Agency of Canada, Guelph, Ontario, Canada N1G5B2
| | - F William Pierson
- B Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061
| | - Bwalya Lungu
- C Department of Food Science and Technology, University of California, Davis, CA 95616
| | - Patricia A Dunn
- D Animal Diagnostic Laboratory (PADLS-PSU), Pennsylvania State University, University Park, PA 16802
| | - Nathaniel Tablante
- E Virginia-Maryland College of Veterinary Medicine, University of Maryland, College Park, MD 20740
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Sahibzada S, Abraham S, Coombs GW, Pang S, Hernández-Jover M, Jordan D, Heller J. Transmission of highly virulent community-associated MRSA ST93 and livestock-associated MRSA ST398 between humans and pigs in Australia. Sci Rep 2017; 7:5273. [PMID: 28706213 PMCID: PMC5509732 DOI: 10.1038/s41598-017-04789-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 05/19/2017] [Indexed: 12/13/2022] Open
Abstract
Pigs have been recognised as a reservoir of livestock associated methicillin-resistant Staphylococcus aureus (LA-MRSA) in Europe, Asia and North America. However, little is known about the presence and distribution of MRSA in the Australian pig population and pig industry. This study describes the presence, distribution and molecular characteristics of the human adapted Australian CA-MRSA ST93 isolated from pigs, people, and the environment within a piggery. Isolates were subjected to antibiotic susceptibility testing, DNA microarray, whole genome sequencing, multi locus sequence typing, virulence and resistance gene characterization and phylogenetic analysis. MRSA were isolated from 60% (n = 52) of farm workers where 84% of isolates returned ST93 and the rest ST398. Of the thirty-one pig isolates tested further, an equal number of ST398 and ST93 (15 each) and one as ST30-V were identified. Four of six environmental isolates were identified as ST93 and two as ST398. This study has identified for the first time in Australia the occurrence of CA-MRSA ST93 and LA-MRSA ST398 amongst farm workers, pigs, and the farm environment. Comparative genome analysis indicates that ST398 is likely to have been introduced into Australia from Europe or North America. This study also reports the first linezolid resistant MRSA isolated in Australia.
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Affiliation(s)
- S Sahibzada
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW 2678, Australia
- Graham Centre for Agricultural Innovation, Wagga Wagga, Australia
| | - S Abraham
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, Australia
| | - G W Coombs
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, Australia
- PathWest Laboratory Medicine - WA, Fiona Stanley Hospital, Murdoch, Australia
| | - S Pang
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, Australia
- PathWest Laboratory Medicine - WA, Fiona Stanley Hospital, Murdoch, Australia
| | - M Hernández-Jover
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW 2678, Australia
- Graham Centre for Agricultural Innovation, Wagga Wagga, Australia
| | - D Jordan
- Department of Primary Industries, Wollongbar, NSW 2478, Australia
| | - J Heller
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW 2678, Australia.
- Graham Centre for Agricultural Innovation, Wagga Wagga, Australia.
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Mroczkowska A, Żmudzki J, Marszałek N, Orczykowska-Kotyna M, Komorowska I, Nowak A, Grzesiak A, Czyżewska-Dors E, Dors A, Pejsak Z, Hryniewicz W, Wyszomirski T, Empel J. Livestock-associated Staphylococcus aureus on Polish pig farms. PLoS One 2017; 12:e0170745. [PMID: 28151984 PMCID: PMC5289463 DOI: 10.1371/journal.pone.0170745] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 01/10/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Livestock-associated Staphylococcus aureus (LA-SA) draws increasing attention due to its particular ability to colonize farm animals and be transmitted to people, which in turn leads to its spread in the environment. The aim of the study was to determine the dissemination of LA-SA on pig farms selected throughout Poland, characterize the population structure of identified S. aureus, and assess the prevalence of LA-SA carriage amongst farmers and veterinarians being in contact with pigs. METHODS AND FINDINGS The study was conducted on 123 pig farms (89 farrow-to-finish and 34 nucleus herds), located in 15 out of 16 provinces of Poland. Human and pig nasal swabs, as well as dust samples were analyzed. S. aureus was detected on 79 (64.2%) farms from 14 provinces. Amongst these farms LA-SA-positive farms dominated (71/79, 89.9%, 95% CI [81.0%, 95.5%]). The prevalence of LA-MRSA-positive farms was lower than LA-MSSA-positive (36.6% of LA-SA-positive farms, 95% CI [25.5%, 48.9%] vs. 74.6%, 95% CI [62.9%, 84.2%]). In total, 190 S. aureus isolates were identified: 72 (38%) MRSA and 118 (62%) methicillin-susceptible S. aureus (MSSA), of which 174 (92%) isolates were classified to three livestock-associated lineages: CC398 (73%), CC9 (13%), and CC30/ST433 (6%). All CC398 isolates belonged to the animal clade. Four LA-MRSA clones were detected: ST433-IVa(2B) clone (n = 8, 11%), described to the best of our knowledge for the first time, and three ST398 clones (n = 64, 89%) with the most prevalent being ST398-V(5C2&5)c, followed by ST398-V(5C2), and ST398-IVa(2B). Nasal carriage of LA-SA by pig farmers was estimated at 13.2% (38/283), CC398 carriage at 12.7% (36/283) and ST398-MRSA carriage at 3.2% (9/283), whereas by veterinarians at 21.1% (8/38), 18.4% (7/38) and 10.5% (4/38), respectively. CONCLUSIONS The prevalence of LA-MRSA-positive pig farms in Poland has increased considerably since 2008, when the first MRSA EU baseline survey was conducted in Europe. On Polish pig farms CC398 of the animal clade predominates, this being also reflected in the prevalence of CC398 nasal carriage in farmers and veterinarians. However, finding a new ST433-IVa(2B) clone provides evidence for the continuing evolution of LA-MRSA and argues for further monitoring of S. aureus in farm animals.
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Affiliation(s)
- Aneta Mroczkowska
- Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland
| | - Jacek Żmudzki
- Department of Swine Diseases, National Veterinary Research Institute, Puławy, Poland
| | - Natalia Marszałek
- Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland
| | | | - Iga Komorowska
- Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland
| | - Agnieszka Nowak
- Department of Swine Diseases, National Veterinary Research Institute, Puławy, Poland
| | - Anna Grzesiak
- Department of Swine Diseases, National Veterinary Research Institute, Puławy, Poland
| | | | - Arkadiusz Dors
- Department of Swine Diseases, National Veterinary Research Institute, Puławy, Poland
| | - Zygmunt Pejsak
- Department of Swine Diseases, National Veterinary Research Institute, Puławy, Poland
| | - Waleria Hryniewicz
- Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland
- Centre of Quality Control in Microbiology, Warsaw, Poland
| | - Tomasz Wyszomirski
- Faculty of Biology, Biological and Chemical Research Centre, University of Warsaw, Warsaw, Poland
| | - Joanna Empel
- Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland
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25
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[Multidrug-resistant bacteria in Germany. The impact of sources outside healthcare facilities]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2017; 59:113-23. [PMID: 26446586 DOI: 10.1007/s00103-015-2261-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Currently, there is an ongoing discussion about the question whether the emergence of multidrug-resistant microorganisms (MDRO) among humans is due to transfer of these bacteria from animals. OBJECTIVES This review summarizes data on the occurrence of methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum beta-lactamase (ESBL) producing enterobacteria in animals and humans, and describes knowledge about transmission pathways. MATERIAL AND METHODS After a scientific literature analysis, relevant articles were identified by screening of titles and abstracts, amended by publications of infection control authorities and the respective reference lists. RESULTS MDRO are both transmitted in the nosocomial setting and are increasingly detected as sources of infection outside healthcare facilities. CONCLUSIONS Due to new transmission pathways of MDRO an inter-disciplinary approach towards prevention is necessary, involving medical, pharmaceutical and veterinary expertise.
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Reynaga E, Navarro M, Vilamala A, Roure P, Quintana M, Garcia-Nuñez M, Figueras R, Torres C, Lucchetti G, Sabrià M. Prevalence of colonization by methicillin-resistant Staphylococcus aureus ST398 in pigs and pig farm workers in an area of Catalonia, Spain. BMC Infect Dis 2016; 16:716. [PMID: 27894267 PMCID: PMC5127002 DOI: 10.1186/s12879-016-2050-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 11/21/2016] [Indexed: 11/30/2022] Open
Abstract
Background A livestock-associated clonal lineage (ST398) of methicillin-resistant Staphylococcus aureus (MRSA) has been identified causing colonization or infection in farm workers. The aim of the study was to analyze the prevalence of MRSA-ST398 colonization in pigs and in pig farmers in an area with a high pig population (Osona, Barcelona province, Catalonia, Spain). Methods We performed a cross-sectional prevalence study in Osona (Catalonia, Spain), from June 2014 to June 2015. All pig farm workers from 83 farms were studied. Twenty of these farms were randomly selected for the study of both pigs and farmers: 9 fattening and 11 farrow-to-finish farms. All workers over the age of 18 who agreed to participate were included. Samples were analyzed to identify MRSA-ST398 and their spa type. Results Eighty-one of the 140 pig farm workers analyzed (57.9% (95% IC: 50.0–66.4%)) were MRSA-positive, all of them ST398. The mean number of years worked on farms was 17.5 ± 12.6 (range:1–50), without significant differences between positive and negative MRSA results (p = 0.763). Over 75% of MRSA-ST398 carriers worked on farms with more than 1250 pigs (p < 0.001). At least one worker tested positive for MRSA-ST398 on all 20 selected pig farms. Ninety-two (46.0% (95% IC: 39.0–53.0%)) of the nasal swabs from 200 pigs from these 20 farms were MRSA-positive, with 50.5% of sows and 41.4% of fattening pigs (p = 0.198) giving MRSA-positive results. All the isolates were tetracycline-resistant, and were identified as MRSA-ST398. The spa type identified most frequently was t011 (62%). Similar spa types and phenotypes of antibiotic resistance were identified in pigs and farmers of 19/20 tested farms. Conclusions The prevalence of MRSA-ST398 among pig farm workers and pigs on farms in the studied region is very high, and the size of the farm seems to correlate with the frequency of colonization of farmers. The similar spa-types and phenotypes of resistance detected in pigs and workers in most of the farms studied suggest animal-to-human transmission.
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Affiliation(s)
- Esteban Reynaga
- Department of Internal Medicine, Hospital Universitari de Vic, Barcelona, Spain. .,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Marian Navarro
- Microbiology Department, Hospital Universitari de Vic, Barcelona, Spain
| | - Anna Vilamala
- Microbiology Department, Hospital Universitari de Vic, Barcelona, Spain
| | - Pere Roure
- Epidemiology Department, Hospital Universitari de Vic, Barcelona, Spain
| | - Manuel Quintana
- Epidemiology Department Hospital Vall d'Hebron, Barcelona, Spain
| | - Marian Garcia-Nuñez
- Infectious Diseases Unit, Health Sciences Research Institute of the Germans Trias i Pujol Foundation, Badalona, Barcelona, Spain.,CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Raül Figueras
- Veterinary, Associació Tecnicosanitària del Porcí (ASSAPORC), Vic, Barcelona, Spain
| | - Carmen Torres
- Area de Bioquímica y Biología Molecular, Universidad de La Rioja, Logroño, Spain
| | - Gianni Lucchetti
- Department of Internal Medicine, Hospital Universitari de Vic, Barcelona, Spain
| | - Miquel Sabrià
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Infectious Diseases Unit, Health Sciences Research Institute of the Germans Trias i Pujol Foundation, Badalona, Barcelona, Spain.,CIBER de Enfermedades Respiratorias, Madrid, Spain.,Infectious Diseases Department, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
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27
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Brennan GI, Abbott Y, Burns A, Leonard F, McManus BA, O’Connell B, Coleman DC, Shore AC. The Emergence and Spread of Multiple Livestock-Associated Clonal Complex 398 Methicillin-Resistant and Methicillin-Susceptible Staphylococcus aureus Strains among Animals and Humans in the Republic of Ireland, 2010-2014. PLoS One 2016; 11:e0149396. [PMID: 26886749 PMCID: PMC4757405 DOI: 10.1371/journal.pone.0149396] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 02/01/2016] [Indexed: 11/23/2022] Open
Abstract
Clonal complex (CC) 398 methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) are associated with carriage and infection among animals and humans but only a single case of CC398 MRSA has been reported in the Republic of Ireland (ROI). The present study investigated the molecular epidemiology of CC398 MRSA (n = 22) and MSSA (n = 10) from animals and humans in the ROI from 2010-2014. Isolates underwent antimicrobial susceptibility testing, spa typing, DNA microarray profiling and PCR for CC398-associated resistance genes. All MRSA underwent SCCmec IV or V subtyping. Four distinct CC398-MRSA incidents were identified from (i) a man in a nursing home (spa type t011-SCCmec IVa, immune evasion complex (IEC) negative), (ii) a horse and veterinarian who had recently travelled to Belgium (t011-IVa, IEC positive), (iii) pigs (n = 9) and farm workers (n = 9) on two farms, one which had been restocked with German gilts and the other which was a finisher farm (t034-VT, IEC negative, 3/9 pigs; t011-VT, IEC negative, 6/9 pigs & 9/9 farm workers), and (iv) a child who had worked on a pig farm in the UK (t034-VT, IEC negative). Isolates also carried different combinations of multiple resistance genes including erm(A), erm(B), tet(K), tet(M) & tet(L), fexA, spc, dfrG, dfrK aacA-aphD and aadD further highlighting the presence of multiple CC398-MRSA strains. CC398 MSSA were recovered from pigs (n = 8) and humans (n = 2). CC398 MSSA transmission was identified among pigs but zoonotic transmission was not detected with animal and human isolates exhibiting clade-specific traits. This study highlights the importation and zoonotic spread of CC398 MRSA in the ROI and the spread of CC398 MSSA among pigs. Increased surveillance is warranted to prevent further CC398 MRSA importation and spread in a country that was considered CC398 MRSA free.
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Affiliation(s)
- Gráinne I. Brennan
- National MRSA Reference Laboratory, St. James’s Hospital, James’s St., Dublin 8, Ireland
- Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital, University of Dublin, Trinity College Dublin, Dublin 2, Ireland
| | - Yvonne Abbott
- Pathobiology, School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - Aisling Burns
- Pathobiology, School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - Finola Leonard
- Pathobiology, School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - Brenda A. McManus
- National MRSA Reference Laboratory, St. James’s Hospital, James’s St., Dublin 8, Ireland
| | - Brian O’Connell
- National MRSA Reference Laboratory, St. James’s Hospital, James’s St., Dublin 8, Ireland
- Department of Clinical Microbiology, University of Dublin, Trinity College, St. James’s Hospital, James’s St., Dublin 8, Ireland
| | - David C. Coleman
- Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital, University of Dublin, Trinity College Dublin, Dublin 2, Ireland
| | - Anna C. Shore
- Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital, University of Dublin, Trinity College Dublin, Dublin 2, Ireland
- Department of Clinical Microbiology, University of Dublin, Trinity College, St. James’s Hospital, James’s St., Dublin 8, Ireland
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Goerge T, Lorenz MB, van Alen S, Hübner NO, Becker K, Köck R. MRSA colonization and infection among persons with occupational livestock exposure in Europe: Prevalence, preventive options and evidence. Vet Microbiol 2015; 200:6-12. [PMID: 26658156 DOI: 10.1016/j.vetmic.2015.10.027] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 10/19/2015] [Accepted: 10/27/2015] [Indexed: 12/31/2022]
Abstract
Colonization with livestock-associated Methicillin-resistant Staphylococcusaureus (LA-MRSA) among persons occupationally exposed to pigs, cattle or poultry is very frequent. In Europe, LA-MRSA mostly belong to the clonal lineage CC398. Since colonized persons have an increased risk of developing MRSA infections, defining the burden of work-related infection caused by LA-MRSA CC398 is of interest to exposed personnel, insurance companies and infection control staff. This review summarizes data on the types of occupation-related infections caused by LA-MRSA CC398, the incidence of such infections as well as potential preventive strategies. We identified twelve case reports on infections among livestock-exposed persons. Overall, there is a lack of data describing the incidence of occupation-related infections due to MRSA CC398. Currently, no specific guidance towards the prevention of LA-MRSA CC398 colonization of persons with routine exposure exists. In vitro, MRSA CC398 strains are susceptible (>95%) to mupirocin. Single reports have described effective decolonization of persons carrying LA-MRSA CC398, but long-term success rates are low in case of continuous livestock contact. Overall, the occupational health risk due to LA-MRSA CC398 is not well understood. Currently, prevention of human LA-MRSA CC398 infection is mostly based on the recommendation to perform screening and decolonization therapies prior to elective medical interventions in order to avoid nosocomial infections, but there is no conclusive evidence to perform specific measures aiming to forestall community-acquired infections.
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Affiliation(s)
- Tobias Goerge
- University Hospital Münster, Department of Dermatology, Von-Esmarch-Str. 58, 48149 Münster, Germany
| | - Marthe Barbara Lorenz
- University Hospital Münster, Department of Dermatology, Von-Esmarch-Str. 58, 48149 Münster, Germany
| | - Sarah van Alen
- University Hospital Münster, Institute of Medical Microbiology, Domagkstr. 10, 48149 Münster, Germany
| | - Nils-Olaf Hübner
- Institute of Medical Diagnostics (IMD), Vitus-Bering-Straße 27a, 17493 Greifswald, Germany
| | - Karsten Becker
- University Hospital Münster, Institute of Medical Microbiology, Domagkstr. 10, 48149 Münster, Germany
| | - Robin Köck
- University Hospital Münster, Institute of Medical Microbiology, Domagkstr. 10, 48149 Münster, Germany,.
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Characteristics of Methicillin Resistant Staphylococcus aureus Strains Isolated From Poultry in Iran. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2015. [DOI: 10.5812/archcid.30885] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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30
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Morcillo A, Castro B, Rodríguez-Alvarez C, Abreu R, Aguirre-Jaime A, Arias A. Descriptive analysis of antibiotic-resistant patterns of methicillin-resistant Staphylococcus aureus (MRSA) st398 isolated from healthy swine. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:611-22. [PMID: 25588155 PMCID: PMC4306882 DOI: 10.3390/ijerph120100611] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 01/04/2015] [Indexed: 12/18/2022]
Abstract
BACKGROUND Livestock-associated methicillin-resistant Staphylococcus aureus (MRSA) such as the MRSA ST398 strain has spread all over the world and the most worrying aspect of this fact appears to be its capacity to easily spread to humans. The excessive use of antibiotics has made swine a reservoir of MRSA. The aim of the present study was to determine the antibiotic resistance profile of MRSA samples isolated from healthy swine of the island of Tenerife (Spain). METHODS A total of 256 MRSA isolates from swine samples and five MRSA isolates from pig worker samples were investigated for MRSA antibiotic resistant patterns. RESULTS Analysis of the susceptibility status of MRSA pig isolates revealed that 39 isolates were resistant to one antibiotic, 71 isolates were resistant to two antibiotics and 96 isolates were resistant to three or more antibiotics. SCCmec typing revealed the presence of types IV and V. Isolates having SCCmec IV had an increased resistance to the antimicrobial agents tested than those having SCCmec V. We observed significant differences when comparing the most common resistance patterns and SCCmec type. CONCLUSIONS MRSA isolated from humans showed similar resistance to those isolated from pigs, excepting erythromycin, since all the workers' isolates were sensitive to this antibiotic. The evolution of new MRSA clones has emphasized the need for infection control practices in animals and humans in close contact.
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Affiliation(s)
- Ana Morcillo
- Department of Preventive Medicine and Public Health, University of La Laguna, Canary Islands 38071, Spain.
| | - Beatriz Castro
- University Hospital of the Canary Islands, San Cristóbal de La Laguna, Tenerife, Canary Islands 38320, Spain.
| | | | - Rossana Abreu
- Department of Preventive Medicine and Public Health, University of La Laguna, Canary Islands 38071, Spain.
| | - Armando Aguirre-Jaime
- Nuestra Señora de la Candelaria University Hospital, Santa Cruz de Tenerife 38010, Spain.
| | - Angeles Arias
- Department of Preventive Medicine and Public Health, University of La Laguna, Canary Islands 38071, Spain.
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