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Robé C, Projahn M, Boll K, Blasse A, Merle R, Roesler U, Friese A. Survival of highly related ESBL- and pAmpC- producing Escherichia coli in broiler farms identified before and after cleaning and disinfection using cgMLST. BMC Microbiol 2024; 24:143. [PMID: 38664628 PMCID: PMC11044539 DOI: 10.1186/s12866-024-03292-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 04/04/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Broiler chickens are frequently colonized with Extended-Spectrum Beta-Lactamase- (ESBL-) and plasmid mediated AmpC Beta-Lactamase- (pAmpC-) producing Enterobacterales, and we are confronted with the potential spread of these resistant bacteria in the food chain, in the environment, and to humans. Research focused on identifying of transmission routes and investigating potential intervention measures against ESBL- and pAmpC- producing bacteria in the broiler production chain. However, few data are available on the effects of cleaning and disinfection (C&D) procedures in broiler stables on ESBL- and pAmpC- producing bacteria. RESULTS We systematically investigated five broiler stables before and after C&D and identified potential ESBL- and pAmpC- colonization sites after C&D in the broiler stables, including the anteroom and the nearby surrounding environment of the broiler stables. Phenotypically resistant E. coli isolates grown on MacConkey agar with cefotaxime were further analyzed for their beta-lactam resistance genes and phylogenetic groups, as well as the relation of isolates from the investigated stables before and after C&D by whole genome sequencing. Survival of ESBL- and pAmpC- producing E. coli is highly likely at sites where C&D was not performed or where insufficient cleaning was performed prior to disinfection. For the first time, we showed highly related ESBL-/pAmpC- producing E. coli isolates detected before and after C&D in four of five broiler stables examined with cgMLST. Survival of resistant isolates in investigated broiler stables as well as transmission of resistant isolates from broiler stables to the anteroom and surrounding environment and between broiler farms was shown. In addition, enterococci (frequently utilized to detect fecal contamination and for C&D control) can be used as an indicator bacterium for the detection of ESBL-/pAmpC- E. coli after C&D. CONCLUSION We conclude that C&D can reduce ESBL-/pAmpC- producing E. coli in conventional broiler stables, but complete ESBL- and pAmpC- elimination does not seem to be possible in practice as several factors influence the C&D outcome (e.g. broiler stable condition, ESBL-/pAmpC- status prior to C&D, C&D procedures used, and biosecurity measures on the farm). A multifactorial approach, combining various hygiene- and management measures, is needed to reduce ESBL-/pAmpC- E. coli in broiler farms.
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Affiliation(s)
- Caroline Robé
- Institute for Animal Hygiene and Environmental Health, Freie Universität Berlin, Berlin, Germany.
| | - Michaela Projahn
- Institute for Animal Hygiene and Environmental Health, Freie Universität Berlin, Berlin, Germany
- Department of Biological Safety, German Federal Institute for Risk Assessment, Berlin, Germany
| | - Katrin Boll
- Institute for Animal Hygiene and Environmental Health, Freie Universität Berlin, Berlin, Germany
- Department Food Safety, Federal Office of Consumer Protection and Food Safety, Berlin, Germany
| | - Anja Blasse
- Institute for Animal Hygiene and Environmental Health, Freie Universität Berlin, Berlin, Germany
- Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Roswitha Merle
- Institute for Veterinary Epidemiology and Biostatistics, Freie Universität Berlin, Berlin, Germany
| | - Uwe Roesler
- Institute for Animal Hygiene and Environmental Health, Freie Universität Berlin, Berlin, Germany
| | - Anika Friese
- Institute for Animal Hygiene and Environmental Health, Freie Universität Berlin, Berlin, Germany
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Anderer S. Drug-Resistant E coli in Pet Dogs Could Pose Risk to People. JAMA 2024; 331:1081. [PMID: 38477946 DOI: 10.1001/jama.2024.2070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
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Aworh MK, Ekeng E, Nilsson P, Egyir B, Owusu-Nyantakyi C, Hendriksen RS. Extended-Spectrum ß-Lactamase-Producing Escherichia coli Among Humans, Beef Cattle, and Abattoir Environments in Nigeria. Front Cell Infect Microbiol 2022; 12:869314. [PMID: 35463650 PMCID: PMC9021871 DOI: 10.3389/fcimb.2022.869314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/11/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Beef cattle, one of the food-producing animals, are linked to humans through a shared environment and the food chain as a major source of animal protein. Antimicrobial drugs are readily accessible for use in food animal production in Nigeria. Beef cattle and abattoir environments harbor pathogenic bacteria such as Escherichia coli (E. coli) which have developed resistance to antimicrobial agents used for prophylaxis or treatment. This study investigated the zoonotic transmission of extended-spectrum beta-lactamase-producing E. coli (ESBL-EC) among humans, beef cattle, and abattoir environments in Abuja and Lagos, Nigeria. Materials and Methods We conducted a cross-sectional study among abattoir workers, beef cattle, and abattoir environments in Abuja and Lagos. Stool, cecal, and environmental samples were collected from apparently healthy workers, slaughtered cattle, and abattoir environments from May to December 2020. Data were collected electronically using open data kit app installed on a mobile phone. Antimicrobial susceptibility patterns were determined using the Kirby–Bauer disk diffusion method against a panel of 16 antimicrobial agents. Phenotypic and genotypic characterizations of the isolates were conducted. Data were analyzed with descriptive statistics. Results From 21.7% (n = 97) of 448 samples, ESBL-EC were isolated and further characterized. Prevalence of ESBL-EC was highest in cattle (45.4%; n = 44), abattoir workers (41.2%; n = 40), and abattoir environment (13.4%; n = 13). Whole-genome sequencing of ESBL-EC showed dissemination of blaCTX-M-15 (90.7%; n = 88); blaCTX-M-14 (5.2%; n = 5); and blaCTX-M-55 (2.1%; n = 2) genes. The blaCTX-M-15 coexisted with blaCTX-M-14 and blaTEM-1 genes in 2.1% (n = 2) and 39.2% (n = 38) of the isolates, respectively. The presence of blaCTX-M-14 and blaCTX-M-15 genes was significantly associated with isolates originating from abattoir workers when compared with beef cattle isolates (p = 0.05; p < 0.01). The most prevalent sequence types (ST) were ST10 (n = 11), ST215 (n = 7), ST4684 (n = 7), and ST2178 (n = 6). ESBL-EC strain (ST205/B1) harbored mcr-1.1 and blaCTX-M15 and was isolated from a worker at Lagos abattoir. In 91 ESBL-EC isolates, 219 mobile genetic elements (MGEs) harbored resistance genes out of which β-lactam genes were carried on 64 different MGEs. Isolates showed equal distribution of insertion sequences and miniature inverted repeats although only a few composite transposons were detected (humans n = 12; cattle n = 9; environment n = 4). Two isolates of human and cattle origin (ST46/A) harboring ESBL genes and carried by MGEs were clonally related. Conclusions This is the first report of blaCTX-M-55 gene in humans and cattle in Nigeria. This study demonstrates the horizontal transfer of ESBL genes possibly by MGEs and buttresses the importance of genomic surveillance. Healthcare workers should be sensitized that people working closely with cattle or in abattoir environments are a high-risk group for fecal carriage of ESBL-EC when compared with the general population.
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Affiliation(s)
- Mabel Kamweli Aworh
- Department of Veterinary and Pest Control Services, Federal Ministry of Agriculture and Rural Development, Abuja, Nigeria
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
- *Correspondence: Mabel Kamweli Aworh,
| | - Eme Ekeng
- National Reference Laboratory, Nigeria Center for Disease Control, Abuja, Nigeria
| | - Pernille Nilsson
- Technical University of Denmark, National Food Institute, WHO Collaborating Centre (WHO CC) for Antimicrobial Resistance in Foodborne Pathogens and Genomics, FAO Reference Laboratory (FAO RL) for Antimicrobial Resistance, Europea Union Reference Laboratory for Antimicrobial Resistance (EURL-AMR), Kongens Lyngby, Denmark
| | - Beverly Egyir
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Christian Owusu-Nyantakyi
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Rene S. Hendriksen
- Technical University of Denmark, National Food Institute, WHO Collaborating Centre (WHO CC) for Antimicrobial Resistance in Foodborne Pathogens and Genomics, FAO Reference Laboratory (FAO RL) for Antimicrobial Resistance, Europea Union Reference Laboratory for Antimicrobial Resistance (EURL-AMR), Kongens Lyngby, Denmark
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Ramlal PS, Lin J, Buckley CA, Stenström TA, Amoah ID. An assessment of the health risks associated with shared sanitation: a case study of the community ablution blocks in Durban, South Africa. Environ Monit Assess 2022; 194:166. [PMID: 35142880 PMCID: PMC9035208 DOI: 10.1007/s10661-022-09815-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 01/22/2022] [Indexed: 06/14/2023]
Abstract
Shared sanitation facilities have been hailed as an innovative approach to solve the challenge with sanitation access. However, these facilities may act as hotspots for disease transmission due to unhygienic conditions. In this study we used quantitative (based on Escherichia coli contamination) techniques to assess the health risks associated with the use of community ablution blocks (CABs). The most contaminated surfaces were the cistern handle (5.7 Log10 cfu/cm2) and internal pull latch (5.8 Log10 cfu/cm2). Based on the E. coli contamination, at least two people out of 100 CAB users might be potentially infected when they touch "hot" surfaces. These risks were modelled assuming transfer of potentially pathogenic E. coli from these surfaces to the mouth. The incorporation of risk-reduction measures, such as wiping of these surfaces or washing of hands, could potentially result in significant reduction of infection risks. The most significant risk-reduction intervention was determined to be wiping of the contact surfaces, especially twice prior to contact. A combination of risk-reduction interventions could further reduce the risks. This study shows that contamination of contact surfaces within shared CABs could lead to increased risks of infections, requiring measures aimed at reducing the associated risks. The risk assessment framework used in this study could therefore be applied in similar settings to estimate associated health risks with the use of such facilities.
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Affiliation(s)
- Preshod S Ramlal
- eThekwini Municipality Health Department, 9 Archie Gumede Place, 4001, Durban, South Africa.
- School of Life Sciences, University of KwaZulu-Natal, KwaZulu-Natal, 4001, Durban, South Africa.
| | - Johnson Lin
- School of Life Sciences, University of KwaZulu-Natal, KwaZulu-Natal, 4001, Durban, South Africa
| | - Christopher A Buckley
- WASH Research and Development Centre, University of KwaZulu-Natal, KwaZulu-Natal, 4001, Durban, South Africa
| | - Thor Axel Stenström
- Institute for Water and Wastewater Technology, Durban University of Technology, KwaZulu-Natal, Durban, South Africa
| | - Isaac D Amoah
- Institute for Water and Wastewater Technology, Durban University of Technology, KwaZulu-Natal, Durban, South Africa
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Yuan Y, Liang B, Jiang BW, Zhu LW, Wang TC, Li YG, Liu J, Guo XJ, Ji X, Sun Y. Migratory wild birds carrying multidrug-resistant Escherichia coli as potential transmitters of antimicrobial resistance in China. PLoS One 2021; 16:e0261444. [PMID: 34910771 PMCID: PMC8673662 DOI: 10.1371/journal.pone.0261444] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 12/01/2021] [Indexed: 11/20/2022] Open
Abstract
Migratory birds play an important role in the spread of multidrug-resistant (MDR) bacteria. To investigate the prevalence of MDR Escherichia coli in migratory birds in China and potential relationships with the environment, a total of 1387 samples (fecal samples, cloacal swabs, or throat swabs) were collected from migratory birds from three different river basins in China. The collected samples were processed and subjected to bacteriological examinations. Antimicrobial susceptibility testing of the recovered isolates was performed using the E-test for the detection of minimum inhibitory concentrations (MICs). Some antibiotic resistance genes were detected and the PCR products were confirmed by sequencing. In total, 478 (34.7%) E. coli isolates were recovered. The results showed that the drug-resistant E. coli isolates were highly resistant to β-lactams (43.7%) and tetracycline (22.6%), and 73 (15.3%) were MDR, including eight that were extended spectrum β-lactamase-positive. The retrieved strains harbored the blaCTX-M, blaTEM-1, tet(A), tet(B), tet(M), sul1, sul2, sul3, cmlA, floR, and intI1 genes with a prevalence of 5.9%, 36.4%, 80.5%, 11.9%, 6.8%, 6.8%, 47.5%, 12.7%, 50.8%, 37.3%, and 61.0%, respectively. The drug resistance rate of the isolates from southern China was higher than those from northern China. The E. coli samples collected for migratory birds in the Pearl River Basin had the highest proportion (46.7%) MDR isolates. Furthermore, MDR bacteria carried by migratory birds were closely related to the antibiotic content in the basin, which confirms that MDR bacteria carried by migratory birds are likely acquired from the environment. This study also confirmed that migratory birds are potential transmitters of MDR bacteria, demonstrating the need to reduce the use and emission of antibiotics and further in-depth studies on the mechanisms underlying drug resistance of bacteria.
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Affiliation(s)
- Yue Yuan
- Engineering Research Center of Glycoconjugates, Ministry of Education, School of Life Sciences, Northeast Normal University, Changchun, China
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
| | - Bing Liang
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Changchun, China
| | - Bo-wen Jiang
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Changchun, China
| | - Ling-wei Zhu
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Changchun, China
| | - Tie-cheng Wang
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Changchun, China
| | - Yuan-guo Li
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Changchun, China
| | - Jun Liu
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Changchun, China
| | - Xue-jun Guo
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Changchun, China
| | - Xue Ji
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Changchun, China
- * E-mail: (YS); (XJ)
| | - Yang Sun
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Changchun, China
- * E-mail: (YS); (XJ)
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Burgess SA, Cookson AL, Brousse L, Ortolani E, Benschop J, Akhter R, Brightwell G, McDougall S. The epidemiology of AmpC-producing Escherichia coli isolated from dairy cattle faeces on pasture-fed farms. J Med Microbiol 2021; 70:001447. [PMID: 34672922 PMCID: PMC8604167 DOI: 10.1099/jmm.0.001447] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 09/28/2021] [Indexed: 12/16/2022] Open
Abstract
Introduction. Antibiotic use, particularly amoxicillin-clavulanic acid in dairy farming, has been associated with an increased incidence of AmpC-hyperproducing Escherichia coli.Gap statement. There is limited information on the incidence of AmpC-hyperproducing E. coli from seasonal pasture-fed dairy farms.Aim. We undertook a New Zealand wide cross-sectional study to determine the prevalence of AmpC-producing E. coli carried by dairy cattle.Methodology. Paddock faeces were sampled from twenty-six dairy farms and were processed for the selective growth of both extended-spectrum beta-lactamase (ESBL)- and AmpC-producing E. coli. Whole genome sequence analysis was carried out on 35 AmpC-producing E. coli.Results. No ESBL- or plasmid mediated AmpC-producing E. coli were detected, but seven farms were positive for chromosomal mediated AmpC-hyperproducing E. coli. These seven farms were associated with a higher usage of injectable amoxicillin antibiotics. Whole genome sequence analysis of the AmpC-producing E. coli demonstrated that the same strain (<3 SNPs difference) of E. coli ST5729 was shared between cows on a single farm. Similarly, the same strain (≤15 SNPs difference) of E. coli ST8977 was shared across two farms (separated by approximately 425 km).Conclusion. These results infer that both cow-to-cow and farm-to-farm transmission of AmpC-producing E. coli has occurred.
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Affiliation(s)
- Sara A. Burgess
- School of Veterinary Science, Massey University, Palmerston North, New Zealand
- Food System Integrity, Hopkirk Research Institute, AgResearch Ltd, Palmerston North, New Zealand
| | - Adrian L. Cookson
- School of Veterinary Science, Massey University, Palmerston North, New Zealand
- Food System Integrity, Hopkirk Research Institute, AgResearch Ltd, Palmerston North, New Zealand
| | - Lisa Brousse
- School of Veterinary Science, Massey University, Palmerston North, New Zealand
- Present address: Lisa Brousse, BioMerieux, Grenoble, France
| | - Enrico Ortolani
- School of Veterinary Science, Massey University, Palmerston North, New Zealand
- Ministry of Agriculture, Livestock and Food Supply, Brazil
| | - Jackie Benschop
- School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - Rukhshana Akhter
- School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - Gale Brightwell
- Food System Integrity, Hopkirk Research Institute, AgResearch Ltd, Palmerston North, New Zealand
- New Zealand Food Safety Science and Research Centre, Massey University, Palmerston North, New Zealand
| | - Scott McDougall
- School of Veterinary Science, Massey University, Palmerston North, New Zealand
- Cognosco Limited, Anexa Veterinary Services, Morrinsville, New Zealand
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Glaize A, Young M, Harden L, Gutierrez-Rodriguez E, Thakur S. The effect of vegetation barriers at reducing the transmission of Salmonella and Escherichia coli from animal operations to fresh produce. Int J Food Microbiol 2021; 347:109196. [PMID: 33906045 DOI: 10.1016/j.ijfoodmicro.2021.109196] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/03/2021] [Accepted: 04/05/2021] [Indexed: 02/08/2023]
Abstract
Due to the recent outbreaks of Salmonella and Escherichia coli in fresh produce in the United States, the transfer of foodborne pathogens between animal feeding operations and fresh produce continues to be a considerable risk. The purpose of this study was to determine if the establishment of a vegetation barrier (VB) on small-scale sustainable farms could prevent the transmission of Salmonella and E. coli to nearby fresh produce fields. A 5-layer VB (31 × 49 m) was constructed between a dairy farm, a poultry farm, and a nearby produce field. Fresh produce (i.e., romaine lettuce and tomato), animal feces, and environmental (i.e., air, soil, and barrier) samples were collected for 15 months from 2018 to 2019. Four replicates of soil and fresh produce samples were taken from three plots located 10 m, 61 m, and 122 m away from the respective animal locations and processed for Salmonella and E. coli. Air and vegetative strip samples were sampled at 15-day intervals. Multiple colonies were processed from each positive sample, and a total of 143 positive Salmonella (n = 15) and E. coli (n = 128) isolates were retrieved from the soil, produce, air, and fecal samples. Interestingly, 18.2% of the Salmonella and E. coli isolates (n = 26) were recovered from fresh produce (n = 9) samples. Surprisingly, Salmonella isolates (n = 9) were only found in fecal (n = 3) samples collected from the dairy pasture. Data analysis suggests that the VB is an effective tool at reducing the transmission of E. coli and Salmonella from animal farms to fresh produce fields. However, based on phenotypic and genotypic testing, it is clear that fecal samples from animal farms are not the only source of pathogen contamination. This indicates that the environment (e.g., soil and wind), as well as the initial setup of the farm (e.g., proximity to service roads and produce plot placement), can contribute to the contamination of fresh produce. Our study recommends the need for more effective bioremediation and prevention control measures to use in conjunction with VBs to reduce pathogen transmission.
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Affiliation(s)
- Ayanna Glaize
- Department of Population Health & Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607, USA
| | - Morgan Young
- Department of Population Health & Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607, USA
| | - Lyndy Harden
- Department of Population Health & Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607, USA
| | - Eduardo Gutierrez-Rodriguez
- Department of Horticulture and Landscape Architecture College of Agricultural Sciences, Colorado State University, USA
| | - Siddhartha Thakur
- Department of Population Health & Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607, USA.
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Rapp D, Ross CM, Maclean P, Cave VM, Brightwell G. Investigation of On-Farm Transmission Routes for Contamination of Dairy Cows with Top 7 Escherichia coli O-Serogroups. Microb Ecol 2021; 81:67-77. [PMID: 32561945 DOI: 10.1007/s00248-020-01542-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 06/10/2020] [Indexed: 06/11/2023]
Abstract
Shiga toxin-producing Escherichia coli (STEC) are foodborne bacterial pathogens, with cattle a significant reservoir for human infection. This study evaluated environmental reservoirs, intermediate hosts and key pathways that could drive the presence of Top 7 STEC (O157:H7, O26, O45, O103, O111, O121 and O145) on pasture-based dairy herds, using molecular and culture-based methods. A total of 235 composite environmental samples (including soil, bedding, pasture, stock drinking water, bird droppings and flies and faecal samples of dairy animals) were collected from two dairy farms, with four sampling events on each farm. Molecular detection revealed O26, O45, O103 and O121 as the most common O-serogroups, with the greatest occurrence in dairy animal faeces (> 91%), environments freshly contaminated with faeces (> 73%) and birds and flies (> 71%). STEC (79 isolates) were a minor population within the target O-serogroups in all sample types but were widespread in the farm environment in the summer samplings. Phylogenetic analysis of whole genome sequence data targeting single nucleotide polymorphisms revealed the presence of several clonal strains on a farm; a single STEC clonal strain could be found in several sample types concurrently, indicating the existence of more than one possible route for transmission to dairy animals and a high rate of transmission of STEC between dairy animals and wildlife. Overall, the findings improved the understanding of the ecology of the Top 7 STEC in open farm environments, which is required to develop on-farm intervention strategies controlling these zoonoses.
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Affiliation(s)
- D Rapp
- Food & Bio-based Products, AgResearch, Hopkirk Research Institute, Palmerston North, 4442, New Zealand.
| | - C M Ross
- Food & Bio-based Products, AgResearch, Hopkirk Research Institute, Palmerston North, 4442, New Zealand
| | - P Maclean
- Bioinformatics & Statistics, AgResearch, Grasslands Research Centre, Palmerston North, 4410, New Zealand
| | - V M Cave
- Bioinformatics & Statistics, AgResearch, Ruakura Agricultural Centre, Hamilton, 3214, New Zealand
| | - G Brightwell
- Food & Bio-based Products, AgResearch, Hopkirk Research Institute, Palmerston North, 4442, New Zealand
- New Zealand Food Safety Science & Research Centre, Hopkirk Research Institute, Palmerston North, 4442, New Zealand
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Findlay J, Mounsey O, Lee WWY, Newbold N, Morley K, Schubert H, Gould VC, Cogan TA, Reyher KK, Avison MB. Molecular Epidemiology of Escherichia coli Producing CTX-M and pAmpC β-Lactamases from Dairy Farms Identifies a Dominant Plasmid Encoding CTX-M-32 but No Evidence for Transmission to Humans in the Same Geographical Region. Appl Environ Microbiol 2020; 87:e01842-20. [PMID: 33067197 PMCID: PMC7755243 DOI: 10.1128/aem.01842-20] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 10/08/2020] [Indexed: 12/28/2022] Open
Abstract
Third-generation cephalosporin resistance (3GC-R) in Escherichia coli is a rising problem in human and farmed-animal populations. We conducted whole-genome sequencing analysis of 138 representative 3GC-R isolates previously collected from dairy farms in southwest England and confirmed by PCR to carry acquired 3GC-R genes. This analysis identified blaCTX-M (131 isolates encoding CTX-M-1, -14, -15, -and 32 and the novel variant CTX-M-214), blaCMY-2 (6 isolates), and blaDHA-1 (1 isolate). A highly conserved plasmid was identified in 73 isolates, representing 27 E. coli sequence types. This novel ∼220-kb IncHI2 plasmid carrying blaCTX-M-32 was sequenced to closure and designated pMOO-32. It was found experimentally to be stable in cattle and human transconjugant E. coli even in the absence of selective pressure and was found by multiplex PCR to be present on 26 study farms representing a remarkable range of transmission over 1,500 square kilometers. However, the plasmid was not found among human urinary E. coli isolates we recently characterized from people living in the same geographical location, collected in parallel with farm sampling. There were close relatives of two blaCTX-M plasmids circulating among eight human and two cattle isolates, and a closely related blaCMY-2 plasmid was found in one cattle and one human isolate. However, phylogenetic evidence of recent sharing of 3GC-R strains between farms and humans in the same region was not found.IMPORTANCE Third-generation cephalosporins (3GCs) are critically important antibacterials, and 3GC resistance (3GC-R) threatens human health, particularly in the context of opportunistic pathogens such as Escherichia coli There is some evidence for zoonotic transmission of 3GC-R E. coli through food, but little work has been done examining possible transmission via interaction of people with the local near-farm environment. We characterized acquired 3GC-R E. coli found on dairy farms in a geographically restricted region of the United Kingdom and compared these with E. coli from people living in the same region, collected in parallel. While there is strong evidence for recent farm-to-farm transmission of 3GC-R strains and plasmids-including one epidemic plasmid that has a remarkable capacity to be transmitted-there was no evidence that 3GC-R E. coli found on study farms had a significant impact on circulating 3GC-R E. coli strains or plasmids in the local human population.
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Affiliation(s)
- Jacqueline Findlay
- School of Cellular & Molecular Medicine, Biomedical Sciences Building, University of Bristol, Bristol, United Kingdom
| | - Oliver Mounsey
- School of Cellular & Molecular Medicine, Biomedical Sciences Building, University of Bristol, Bristol, United Kingdom
| | - Winnie W Y Lee
- School of Cellular & Molecular Medicine, Biomedical Sciences Building, University of Bristol, Bristol, United Kingdom
| | - Nerissa Newbold
- School of Cellular & Molecular Medicine, Biomedical Sciences Building, University of Bristol, Bristol, United Kingdom
- Bristol Veterinary School, University of Bristol, Langford, United Kingdom
| | - Katy Morley
- Bristol Veterinary School, University of Bristol, Langford, United Kingdom
| | - Hannah Schubert
- Bristol Veterinary School, University of Bristol, Langford, United Kingdom
| | - Virginia C Gould
- School of Cellular & Molecular Medicine, Biomedical Sciences Building, University of Bristol, Bristol, United Kingdom
- Bristol Veterinary School, University of Bristol, Langford, United Kingdom
| | - Tristan A Cogan
- Bristol Veterinary School, University of Bristol, Langford, United Kingdom
| | - Kristen K Reyher
- Bristol Veterinary School, University of Bristol, Langford, United Kingdom
| | - Matthew B Avison
- School of Cellular & Molecular Medicine, Biomedical Sciences Building, University of Bristol, Bristol, United Kingdom
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10
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Otero Fernandez M, Thomas RJ, Oswin H, Haddrell AE, Reid JP. Transformative Approach To Investigate the Microphysical Factors Influencing Airborne Transmission of Pathogens. Appl Environ Microbiol 2020; 86:e01543-20. [PMID: 32978136 PMCID: PMC7657628 DOI: 10.1128/aem.01543-20] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 09/17/2020] [Indexed: 01/06/2023] Open
Abstract
Emerging outbreaks of airborne pathogenic infections worldwide, such as the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, have raised the need to understand parameters affecting the airborne survival of microbes in order to develop measures for effective infection control. We report a novel experimental strategy, TAMBAS (tandem approach for microphysical and biological assessment of airborne microorganism survival), to explore the synergistic interactions between the physicochemical and biological processes that impact airborne microbe survival in aerosol droplets. This innovative approach provides a unique and detailed understanding of the processes taking place from aerosol droplet generation through to equilibration and viability decay in the local environment, elucidating decay mechanisms not previously described. The impact of evaporation kinetics, solute hygroscopicity and concentration, particle morphology, and equilibrium particle size on airborne survival are reported, using Escherichia coli MRE162 as a benchmark system. For this system, we report that (i) particle crystallization does not directly impact microbe longevity, (ii) bacteria act as crystallization nuclei during droplet drying and equilibration, and (iii) the kinetics of size and compositional change appear to have a larger effect on microbe longevity than the equilibrium solute concentration.IMPORTANCE A transformative approach to identify the physicochemical processes that impact the biological decay rates of bacteria in aerosol droplets is described. It is shown that the evaporation process and changes in the phase and morphology of the aerosol particle during evaporation impact microorganism viability. The equilibrium droplet size was found to affect airborne bacterial viability. Furthermore, the presence of Escherichia coli MRE162 in a droplet does not affect aerosol growth/evaporation but influences the dynamic behavior of the aerosol by processing the culture medium prior to aerosolization, affecting the hygroscopicity of the culture medium; this highlights the importance of the inorganic and organic chemical composition within the aerosolized droplets that impact hygroscopicity. Bacteria also act as crystallization nuclei. The novel approach and data have implications for increased mechanistic understanding of aerosol survival and infectivity in bioaerosol studies spanning the medical, veterinary, farming, and agricultural fields, including the role of microorganisms in atmospheric processing and cloud formation.
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Affiliation(s)
| | - Richard J Thomas
- Defence Science Technology Laboratory (DSTL), Porton Down, Salisbury, United Kingdom
| | - Henry Oswin
- School of Chemistry, University of Bristol, Bristol, United Kingdom
| | - Allen E Haddrell
- School of Chemistry, University of Bristol, Bristol, United Kingdom
| | - Jonathan P Reid
- School of Chemistry, University of Bristol, Bristol, United Kingdom
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11
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Syahrul F, Wahyuni CU, Notobroto HB, Wasito EB, Adi AC, Dwirahmadi F. Transmission Media of Foodborne Diseases as an Index Prediction of Diarrheagenic Escherichia coli: Study at Elementary School, Surabaya, Indonesia. Int J Environ Res Public Health 2020; 17:E8227. [PMID: 33171702 PMCID: PMC7664320 DOI: 10.3390/ijerph17218227] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 10/30/2020] [Accepted: 11/03/2020] [Indexed: 12/21/2022]
Abstract
Foodborne diseases (FBDs) have a large disease burden among children. The major type of FBD in children is diarrhea, caused mainly by contaminated food. One of the diarrhea pathogens is Diarrheagenic Escherichia coli (DEC). The aim of this study was to establish a model of microbial prediction (DEC) in stool, caused by the transmission of FBDs in elementary schoolchildren. An observational analytic study was conducted, with a nested case-control study design. In Stage I, the study population was children in a selected elementary school at Surabaya. The sample size for Stage I was 218 children. In Stage II, the case sample was all children with a positive test for DEC (15 children), and the control sample was all children who had tested negative for DEC (60 children). The result of the laboratory tests showed that the proportion of DEC in children was 6.88% (15 of 218 children) and the proportion of Escherichia coli O157:H7 in children was only 0.46%. The most significant mode of transmission included in the model was the snacking frequency at school and the risk classification of food that was often purchased at school. The formulation of the predicting model of DEC in stool can be used as an early warning against the incidence of FBDs in elementary schoolchildren.
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Affiliation(s)
- Fariani Syahrul
- Department of Epidemiology, Faculty of Public Health, Universitas Airlangga, Surabaya 60115, Indonesia;
| | - Chatarina U. Wahyuni
- Department of Epidemiology, Faculty of Public Health, Universitas Airlangga, Surabaya 60115, Indonesia;
| | - Hari B. Notobroto
- Department of Biostatistic, Faculty of Public Health Universitas Airlangga, Surabaya 60115, Indonesia;
| | - Eddy B. Wasito
- Department of Microbiology, Faculty of Medicine Universitas Airlangga, Surabaya 60115, Indonesia;
| | - Annis C. Adi
- Department of Nutrition, Faculty of Public Health Universitas Airlangga, Surabaya 60115, Indonesia;
| | - Febi Dwirahmadi
- Center for Environment and Population Health, School of Medicine, Griffith University, Queensland 4215, Australia;
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12
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Daniel S, Goldlust K, Quebre V, Shen M, Lesterlin C, Bouet JY, Yamaichi Y. Vertical and Horizontal Transmission of ESBL Plasmid from Escherichia coli O104:H4. Genes (Basel) 2020; 11:genes11101207. [PMID: 33081159 PMCID: PMC7602700 DOI: 10.3390/genes11101207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/05/2020] [Accepted: 10/13/2020] [Indexed: 12/16/2022] Open
Abstract
Multidrug resistance (MDR) often results from the acquisition of mobile genetic elements (MGEs) that encode MDR gene(s), such as conjugative plasmids. The spread of MDR plasmids is founded on their ability of horizontal transference, as well as their faithful inheritance in progeny cells. Here, we investigated the genetic factors involved in the prevalence of the IncI conjugative plasmid pESBL, which was isolated from the Escherichia coli O104:H4 outbreak strain in Germany in 2011. Using transposon-insertion sequencing, we identified the pESBL partitioning locus (par). Genetic, biochemical and microscopic approaches allowed pESBL to be characterized as a new member of the Type Ib partitioning system. Inactivation of par caused mis-segregation of pESBL followed by post-segregational killing (PSK), resulting in a great fitness disadvantage but apparent plasmid stability in the population of viable cells. We constructed a variety of pESBL derivatives with different combinations of mutations in par, conjugational transfer (oriT) and pnd toxin-antitoxin (TA) genes. Only the triple mutant exhibited plasmid-free cells in viable cell populations. Time-lapse tracking of plasmid dynamics in microfluidics indicated that inactivation of pnd improved the survival of plasmid-free cells and allowed oriT-dependent re-acquisition of the plasmid. Altogether, the three factors—active partitioning, toxin-antitoxin and conjugational transfer—are all involved in the prevalence of pESBL in the E. coli population.
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Affiliation(s)
- Sandra Daniel
- Institute for Integrative Biology of the Cell (I2BC), Université Paris-Saclay, CEA, CNRS, 91198 Gif-sur-Yvette, France; (S.D.); (M.S.)
| | - Kelly Goldlust
- Microbiologie Moléculaire et Biochimie Structurale (MMSB), Université Lyon 1, CNRS, Inserm, UMR5086, 69007 Lyon, France; (K.G.); (C.L.)
| | - Valentin Quebre
- Laboratoire de Microbiologie et de Génétique Moléculaires (LMGM), CBI, CNRS, Université de Toulouse, UPS, 31062 Toulouse, France; (V.Q.); (J.-Y.B.)
| | - Minjia Shen
- Institute for Integrative Biology of the Cell (I2BC), Université Paris-Saclay, CEA, CNRS, 91198 Gif-sur-Yvette, France; (S.D.); (M.S.)
- Graduate School of Structure and Dynamics of Living Systems, Université Paris-Saclay, CEA, CNRS, 91198 Gif-sur-Yvette, France
| | - Christian Lesterlin
- Microbiologie Moléculaire et Biochimie Structurale (MMSB), Université Lyon 1, CNRS, Inserm, UMR5086, 69007 Lyon, France; (K.G.); (C.L.)
| | - Jean-Yves Bouet
- Laboratoire de Microbiologie et de Génétique Moléculaires (LMGM), CBI, CNRS, Université de Toulouse, UPS, 31062 Toulouse, France; (V.Q.); (J.-Y.B.)
| | - Yoshiharu Yamaichi
- Institute for Integrative Biology of the Cell (I2BC), Université Paris-Saclay, CEA, CNRS, 91198 Gif-sur-Yvette, France; (S.D.); (M.S.)
- Correspondence:
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13
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Abstract
Many cattle are persistently colonized with Shiga toxin-producing Escherichia coli (STEC) and represent a major source of human infections with human-pathogenic STEC strains (syn. enterohemorrhagic E. coli (EHEC)). Intervention strategies most effectively protecting humans best aim at the limitation of bovine STEC shedding. Mechanisms enabling STEC to persist in cattle are only partialy understood. Cattle were long believed to resist the detrimental effects of Shiga toxins (Stxs), potent cytotoxins acting as principal virulence factors in the pathogenesis of human EHEC-associated diseases. However, work by different groups, summarized in this review, has provided substantial evidence that different types of target cells for Stxs exist in cattle. Peripheral and intestinal lymphocytes express the Stx receptor globotriaosylceramide (Gb3syn. CD77) in vitro and in vivo in an activation-dependent fashion with Stx-binding isoforms expressed predominantly at early stages of the activation process. Subpopulations of colonic epithelial cells and macrophage-like cells, residing in the bovine mucosa in proximity to STEC colonies, are also targeted by Stxs. STEC-inoculated calves are depressed in mounting appropriate cellular immune responses which can be overcome by vaccination of the animals against Stxs early in life before encountering STEC. Considering Stx target cells and the resulting effects of Stxs in cattle, which significantly differ from effects implicated in human disease, may open promising opportunities to improve existing yet insufficient measures to limit STEC carriage and shedding by the principal reservoir host.
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Affiliation(s)
- Christian Menge
- Friedrich-Loeffler-Institut/Federal Research Institute for Animal Health, Institute of Molecular Pathogenesis, D-07743 Jena, Germany
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14
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Ramay BM, Caudell MA, Cordón-Rosales C, Archila LD, Palmer GH, Jarquin C, Moreno P, McCracken JP, Rosenkrantz L, Amram O, Omulo S, Call DR. Antibiotic use and hygiene interact to influence the distribution of antimicrobial-resistant bacteria in low-income communities in Guatemala. Sci Rep 2020; 10:13767. [PMID: 32792543 PMCID: PMC7426860 DOI: 10.1038/s41598-020-70741-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 07/30/2020] [Indexed: 11/09/2022] Open
Abstract
To examine the effects of poor sanitation and hygiene on the prevalence of antimicrobial-resistant bacteria, we surveyed households in two rural and two urban communities in Guatemala (N = 196 randomly selected households). One adult (≥ 18-years old) and, when available, one child (≤ 5 years-old) provided a stool sample. Up to 48 presumptive Escherichia coli isolates were collected from each stool sample (n = 21,256 total) and were subjected to breakpoint assays for ten antibiotics. Mixed-effects logistic models were used to identify potential factors influencing the likelihood of harboring antibiotic-resistant bacteria. For nine out of ten antibiotics, the odds of detecting resistant bacteria decreased by ~ 32% (odds ratios, OR 0.53-0.8, P < 0.001) for every unit of improvement of a hygiene scale. Hygiene differences between households had a greater impact on prevalence compared to antibiotic use differences. The likelihood of detecting resistant isolates was lower for five antibiotics among households that boiled raw milk before consumption (OR 0.31-0.69), and higher for nine antibiotics in urban households (OR > 1.89-9.6). Poor hygiene conditions likely obscure effects of individual antibiotic use, presumably due to enhanced microbial transmission. Consequently, efforts to improve antibiotic stewardship should be coupled with improving hygiene conditions.
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Affiliation(s)
- Brooke M Ramay
- Center for Health Studies, Universidad del Valle de Guatemala, 181 Avenida 11-95, Guatemala City, 01015, Guatemala
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA, 99164, USA
| | - Mark A Caudell
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA, 99164, USA
- Food and Agriculture Organization of the United Nations, United Nations Complex, UN Avenue, Gigiri, PO Box: 30470, Nairobi, 00100, Kenya
| | - Celia Cordón-Rosales
- Center for Health Studies, Universidad del Valle de Guatemala, 181 Avenida 11-95, Guatemala City, 01015, Guatemala.
| | - L Diego Archila
- Center for Health Studies, Universidad del Valle de Guatemala, 181 Avenida 11-95, Guatemala City, 01015, Guatemala
| | - Guy H Palmer
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA, 99164, USA
- Nelson Mandela African Institution of Science and Technology, P.O.BOX 447, Arusha, Tanzania
| | - Claudia Jarquin
- Center for Health Studies, Universidad del Valle de Guatemala, 181 Avenida 11-95, Guatemala City, 01015, Guatemala
| | - Purificación Moreno
- Center for Health Studies, Universidad del Valle de Guatemala, 181 Avenida 11-95, Guatemala City, 01015, Guatemala
| | - John P McCracken
- Center for Health Studies, Universidad del Valle de Guatemala, 181 Avenida 11-95, Guatemala City, 01015, Guatemala
| | - Leah Rosenkrantz
- Department of Geography, Simon Fraser University, Burnaby, BC, V5A 1S6, Canada
| | - Ofer Amram
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA, 99164, USA
- Elson S. Floyd College of Medicine, Washington State University, PO Box 1495, Spokane, WA, USA
| | - Sylvia Omulo
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA, 99164, USA
| | - Douglas R Call
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA, 99164, USA
- Nelson Mandela African Institution of Science and Technology, P.O.BOX 447, Arusha, Tanzania
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15
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Awofisayo-Okuyelu A, Brainard J, Hall I, McCarthy N. Incubation Period of Shiga Toxin-Producing Escherichia coli. Epidemiol Rev 2020; 41:121-129. [PMID: 31616910 PMCID: PMC7108491 DOI: 10.1093/epirev/mxz001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 03/20/2019] [Accepted: 05/08/2019] [Indexed: 01/21/2023] Open
Abstract
Shiga toxin–producing Escherichia coli are pathogenic bacteria found in the gastrointestinal tract of humans. Severe infections could lead to life-threatening complications, especially in young children and the elderly. Understanding the distribution of the incubation period, which is currently inconsistent and ambiguous, can help in controlling the burden of disease. We conducted a systematic review of outbreak investigation reports, extracted individual incubation data and summary estimates, tested for heterogeneity, classified studies into subgroups with limited heterogeneity, and undertook a meta-analysis to identify factors that may contribute to the distribution of the pathogen’s incubation period. Twenty-eight studies were identified for inclusion in the review (1 of which included information on 2 outbreaks), and the resulting I2 value was 77%, indicating high heterogeneity. Studies were classified into 5 subgroups, with the mean incubation period ranging from 3.5 to 8.1 days. The length of the incubation period increased with patient age and decreased by 7.2 hours with every 10% increase in attack rate.
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Affiliation(s)
- Adedoyin Awofisayo-Okuyelu
- Correspondence to Adedoyin Awofisayo-Okuyelu, Department of Zoology, University of Oxford, Peter Medawar Building for Pathogen Research, South Parks Road, Oxford, United Kingdom OX1 3SY ()
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16
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Blakiston MR, Freeman JT. Population-level exposures associated with MRSA and ESBL-E. coli infection across district health boards in Aotearoa New Zealand: an ecological study. N Z Med J 2020; 133:62-69. [PMID: 32078602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
AIMS National responses to antimicrobial resistance (AMR) require an understanding of the factors driving its development and spread. Research to date has primarily focused on determining individual-level risk factors for AMR-associated infections. However, additional insights may be gained by investigating exposures associated with AMR variation at the population level. METHODS We used an ecological study design to describe the association between the incidence rate of methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum β-lactamase producing Escherichia coli (ESBL-E. coli) infection and population-level variables among 18 geographically distinct populations, defined by district health boards, in Aotearoa New Zealand. Associations were described using Spearman's correlational analysis. RESULTS Positive correlations were found between the incidence of both MRSA and ESBL-E. coli infection and household crowding and community antimicrobial use. Positive correlations were also observed between MRSA and socioeconomic deprivation; age <5 years; Māori ethnicity; and Pacific ethnicity. For ESBL-E. coli, positive correlations were also observed with Asian ethnicity; Pacific ethnicity; and overseas-born new arrivals. European ethnicity was negatively correlated with both MRSA and ESBL-E. coli infection. CONCLUSIONS These findings provide insight into the potential contribution of population-level exposures to MRSA and ESBL-E. coli infection in New Zealand. Exposures such as household crowding, community antimicrobial use and socioeconomic deprivation, are in principle modifiable and may present potentially novel opportunities to reduce the burden of AMR.
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Affiliation(s)
- Matthew R Blakiston
- Clinical Microbiologist, Microbiology Department, LabPLUS, Auckland District Health Board, Auckland
| | - Joshua T Freeman
- Clinical Microbiologist, Microbiology Department, Canterbury Health Laboratories, Canterbury District Health Board, Christchurch
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17
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Joseph A, Cointe A, Mariani Kurkdjian P, Rafat C, Hertig A. Shiga Toxin-Associated Hemolytic Uremic Syndrome: A Narrative Review. Toxins (Basel) 2020; 12:E67. [PMID: 31973203 PMCID: PMC7076748 DOI: 10.3390/toxins12020067] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 01/13/2020] [Accepted: 01/17/2020] [Indexed: 01/28/2023] Open
Abstract
The severity of human infection by one of the many Shiga toxin-producing Escherichia coli (STEC) is determined by a number of factors: the bacterial genome, the capacity of human societies to prevent foodborne epidemics, the medical condition of infected patients (in particular their hydration status, often compromised by severe diarrhea), and by our capacity to devise new therapeutic approaches, most specifically to combat the bacterial virulence factors, as opposed to our current strategies that essentially aim to palliate organ deficiencies. The last major outbreak in 2011 in Germany, which killed more than 50 people in Europe, was evidence that an effective treatment was still lacking. Herein, we review the current knowledge of STEC virulence, how societies organize the prevention of human disease, and how physicians treat (and, hopefully, will treat) its potentially fatal complications. In particular, we focus on STEC-induced hemolytic and uremic syndrome (HUS), where the intrusion of toxins inside endothelial cells results in massive cell death, activation of the coagulation within capillaries, and eventually organ failure.
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Affiliation(s)
- Adrien Joseph
- Department of Nephrology, AP-HP, Hôpital Tenon, F-75020 Paris, France; (A.J.); (C.R.)
| | - Aurélie Cointe
- Department of Microbiology, AP-HP, Hôpital Robert Debré, F-75019 Paris, France; (A.C.); (P.M.K.)
| | | | - Cédric Rafat
- Department of Nephrology, AP-HP, Hôpital Tenon, F-75020 Paris, France; (A.J.); (C.R.)
| | - Alexandre Hertig
- Department of Renal Transplantation, Sorbonne Université, AP-HP, Hôpital Pitié Salpêtrière, F-75013 Paris, France
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18
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Montealegre MC, Talavera Rodríguez A, Roy S, Hossain MI, Islam MA, Lanza VF, Julian TR. High Genomic Diversity and Heterogenous Origins of Pathogenic and Antibiotic-Resistant Escherichia coli in Household Settings Represent a Challenge to Reducing Transmission in Low-Income Settings. mSphere 2020; 5:e00704-19. [PMID: 31941809 PMCID: PMC6968650 DOI: 10.1128/msphere.00704-19] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 12/14/2019] [Indexed: 11/25/2022] Open
Abstract
Escherichia coli is present in multiple hosts and environmental compartments as a normal inhabitant, temporary or persistent colonizer, and as a pathogen. Transmission of E. coli between hosts and with the environment is considered to occur more often in areas with poor sanitation. We performed whole-genome comparative analyses on 60 E. coli isolates from soils and fecal sources (cattle, chickens, and humans) in households in rural Bangladesh. Isolates from household soils were in multiple branches of the reconstructed phylogeny, intermixed with isolates from fecal sources. Pairwise differences between all strain pairs were large (minimum, 189 single nucleotide polymorphisms [SNPs]), suggesting high diversity and heterogeneous origins of the isolates. The presence of multiple virulence and antibiotic resistance genes is indicative of the risk that E. coli from soil and feces represent for the transmission of variants that pose potential harm to people. Analysis of the accessory genomes of the Bangladeshi E. coli relative to E. coli genomes available in NCBI identified a common pool of accessory genes shared among E. coli isolates in this geographic area. Together, these findings indicate that in rural Bangladesh, a high level of E. coli in soil is likely driven by contributions from multiple and diverse E. coli sources (human and animal) that share an accessory gene pool relatively unique to previously published E. coli genomes. Thus, interventions to reduce environmental pathogen or antimicrobial resistance transmission should adopt integrated One Health approaches that consider heterogeneous origins and high diversity to improve effectiveness and reduce prevalence and transmission.IMPORTANCEEscherichia coli is reported in high levels in household soil in low-income settings. When E. coli reaches a soil environment, different mechanisms, including survival, clonal expansion, and genetic exchange, have the potential to either maintain or generate E. coli variants with capabilities of causing harm to people. In this study, we used whole-genome sequencing to identify that E. coli isolates collected from rural Bangladeshi household soils, including pathogenic and antibiotic-resistant variants, are diverse and likely originated from multiple diverse sources. In addition, we observed specialization of the accessory genome of this Bangladeshi E. coli compared to E. coli genomes available in current sequence databases. Thus, to address the high level of pathogenic and antibiotic-resistant E. coli transmission in low-income settings, interventions should focus on addressing the heterogeneous origins and high diversity.
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Affiliation(s)
| | | | - Subarna Roy
- Food Microbiology Laboratory, Laboratory Sciences and Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Muhammed Iqbal Hossain
- Food Microbiology Laboratory, Laboratory Sciences and Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Mohammad Aminul Islam
- Food Microbiology Laboratory, Laboratory Sciences and Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, Washington, USA
| | - Val F Lanza
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain
| | - Timothy R Julian
- Eawag, Swiss Federal Institute of Science and Technology, Dübendorf, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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19
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Abstract
Infections caused by extra-intestinal pathogenic Escherichia coli (ExPEC) are a serious public health problem worldwide. The most troublesome are urinary tract infections, severe neonatal meningitis, serious intraabdominal infections, and more rarely, pneumonia, intravascular-device infections, osteomyelitis, soft-tissue infections or sometimes bacteraemia. These strains are also able cause significant economic losses in animal husbandry. A thorough understanding of ExPEC ecology, reservoirs, chains and dynamics of transmission can greatly contribute to a reduction in the burden of ExPEC-associated disease. The ability of E. coli (including ExPEC) to exist and survive in various ecological niches impedes the precise recognition and indication of transmission routes most important for individual infections cases. Among many identified ExPEC reservoirs, animal companion and animals providing food seem to be important sources of infection for human; however, the real level of risk connected with potential transmission of these bacteria remains unclear. Food is indicated as one of potential ways of transmission. Despite a quite high number of reports, many of the uncertainties are expected to be reliably elucidated. This review presents most important data on the current state of knowledge concerning the potential role of food in ExPEC transmission. The possible consequences of ExPEC infections in human and animals are briefly described.
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Affiliation(s)
- Bernard Wasiński
- Department of Microbiology, National Veterinary Research Institute, Puławy, Poland
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20
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Affiliation(s)
- Grant R. Whitmer
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Ganga Moorthy
- Department of Pediatrics, Duke University, Durham, North Carolina, United States of America
| | - Mehreen Arshad
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
- Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, United States of America
- * E-mail:
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21
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Browne AS, Biggs PJ, Wilkinson DA, Cookson AL, Midwinter AC, Bloomfield SJ, Hranac CR, Rogers LE, Marshall JC, Benschop J, Withers H, Hathaway S, George T, Jaros P, Irshad H, Fong Y, Dufour M, Karki N, Winkleman T, French NP. Use of Genomics to Investigate Historical Importation of Shiga Toxin-Producing Escherichia coli Serogroup O26 and Nontoxigenic Variants into New Zealand. Emerg Infect Dis 2019; 25:489-500. [PMID: 30789138 PMCID: PMC6390770 DOI: 10.3201/eid2503.180899] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Shiga toxin-producing Escherichia coli serogroup O26 is an important public health pathogen. Phylogenetic bacterial lineages in a country can be associated with the level and timing of international imports of live cattle, the main reservoir. We sequenced the genomes of 152 E. coli O26 isolates from New Zealand and compared them with 252 E. coli O26 genomes from 14 other countries. Gene variation among isolates from humans, animals, and food was strongly associated with country of origin and stx toxin profile but not isolation source. Time of origin estimates indicate serogroup O26 sequence type 21 was introduced at least 3 times into New Zealand from the 1920s to the 1980s, whereas nonvirulent O26 sequence type 29 strains were introduced during the early 2000s. New Zealand's remarkably fewer introductions of Shiga toxin-producing Escherichia coli O26 compared with other countries (such as Japan) might be related to patterns of trade in live cattle.
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22
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MacFadden DR, Fisman DN, Hanage WP, Lipsitch M. The Relative Impact of Community and Hospital Antibiotic Use on the Selection of Extended-spectrum Beta-lactamase-producing Escherichia coli. Clin Infect Dis 2019; 69:182-188. [PMID: 30462185 PMCID: PMC6771767 DOI: 10.1093/cid/ciy978] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 11/16/2018] [Indexed: 01/13/2023] Open
Abstract
Antibiotic stewardship programs have traditionally focused on reducing hospital antibiotic use. However, reducing community antibiotic prescribing could have substantial impacts in both hospital and community settings. We developed a deterministic model of transmission of extended-spectrum beta-lactamase-producing Escherichia coli in both the community and hospitals. We fit the model to existing, national-level antibiotic use and resistance prevalence data from Sweden. Across a range of conditions, a given relative change in antibiotic use in the community had a greater impact on resistance prevalence in both the community and hospitals than an equivalent relative change in hospital use. However, on a per prescription basis, changes in antibiotic use in hospitals had the greatest impact. The magnitude of changes in prevalence were modest, even with large changes in antimicrobial use. These data support the expansion of stewardship programs/interventions beyond the walls of hospitals, but also suggest that such efforts would benefit hospitals themselves.
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Affiliation(s)
- Derek R MacFadden
- Harvard TH Chan School of Public Health, Boston, Massachusetts
- Division of Infectious Diseases, Department of Medicine, University of Toronto, Ontario, Canada
| | - David N Fisman
- Division of Infectious Diseases, Department of Medicine, University of Toronto, Ontario, Canada
| | | | - Marc Lipsitch
- Harvard TH Chan School of Public Health, Boston, Massachusetts
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Terveer EM, Fallon M, Kraakman MEM, Ormond A, Fitzpatrick M, Caljouw MAA, Martin A, van Dorp SM, Wong MC, Kuijper EJ, Fitzpatrick F. Spread of ESBL-producing Escherichia coli in nursing home residents in Ireland and the Netherlands may reflect infrastructural differences. J Hosp Infect 2019; 103:160-164. [PMID: 31077778 DOI: 10.1016/j.jhin.2019.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 05/01/2019] [Indexed: 12/29/2022]
Abstract
A prevalence study in two nursing homes (one each in the Netherlands and Ireland) found four (11%) Dutch and six (9%) Irish residents colonized with 11 extended-spectrum beta-lactamase-producing Escherichia coli, 10 of which contained CTX-M-15. Four Dutch isolates, from three residents of the same ward, belonged to E. coli O25:H4, sequence type (ST) 131 and were part of the same cluster type by whole-genome sequencing. Four Irish residents on three different wards were colonized with an identical E. coli O89:H9, ST131, complex type 1478. Cross-transmission between three Irish wards may reflect differences in nursing home infrastructure, specifically communal areas and multi-bedded resident rooms.
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Affiliation(s)
- E M Terveer
- Department of Medical Microbiology, Leiden University Medical Centre, Leiden, the Netherlands.
| | - M Fallon
- Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - M E M Kraakman
- Department of Medical Microbiology, Leiden University Medical Centre, Leiden, the Netherlands
| | - A Ormond
- Department of Clinical Microbiology, Beaumont Hospital, Dublin, Ireland
| | - M Fitzpatrick
- Department of Clinical Microbiology, Beaumont Hospital, Dublin, Ireland
| | - M A A Caljouw
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, the Netherlands
| | - A Martin
- Department of Geriatric and Stroke Medicine, Beaumont Hospital, Dublin, Ireland; Department of Geriatric and Stroke Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - S M van Dorp
- Department of Medical Microbiology, Leiden University Medical Centre, Leiden, the Netherlands
| | - M C Wong
- Department of Medical Microbiology, Leiden University Medical Centre, Leiden, the Netherlands
| | - E J Kuijper
- Department of Medical Microbiology, Leiden University Medical Centre, Leiden, the Netherlands
| | - F Fitzpatrick
- Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland; Department of Clinical Microbiology, Beaumont Hospital, Dublin, Ireland
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24
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Bourne JA, Chong WL, Gordon DM. Genetic structure, antimicrobial resistance and frequency of human associated Escherichia coli sequence types among faecal isolates from healthy dogs and cats living in Canberra, Australia. PLoS One 2019; 14:e0212867. [PMID: 30830915 PMCID: PMC6398920 DOI: 10.1371/journal.pone.0212867] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 02/11/2019] [Indexed: 11/24/2022] Open
Abstract
Extraintestinal pathogenic Escherichia coli (ExPEC) cause clinical infections in humans. Understanding the evolution and dissemination of ExPEC strains via potential reservoirs is important due to associated morbidity, health care costs and mortality. To further understanding this survey has examined isolates recovered from the faeces of 221 healthy dogs and 427 healthy cats. The distribution of phylogroups varied with host species, and depended on whether the animal was living in a shelter or a home. The human associated STs 69, 73, 95, 131 and 127 were prevalent, with 30.5% of cat isolates and 10.3% of dog isolates representing these ExPEC sequence types. Resistance to the antibiotics ampicillin and tetracycline was common, but resistance to other antimicrobials was negligible.
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Affiliation(s)
- Judith A. Bourne
- Ecology and Evolution, Research School of Biology, the Australian National University, Acton, Australian Capital Territory, Australia
| | - Wye Li Chong
- RSPCA Veterinary Clinic, Wright, Australian Capital Territory, Australia
| | - David M. Gordon
- Ecology and Evolution, Research School of Biology, the Australian National University, Acton, Australian Capital Territory, Australia
- * E-mail:
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25
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Mourand G, Andraud M, Jouy E, Chauvin C, Le Devendec L, Paboeuf F, Kempf I. Impact of colistin administered before or after inoculation on the transmission of a mcr-1 colistin-resistant Escherichia coli strain between pigs. Vet Microbiol 2019; 230:164-170. [PMID: 30827384 DOI: 10.1016/j.vetmic.2019.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 01/17/2019] [Accepted: 02/03/2019] [Indexed: 11/19/2022]
Abstract
Colistin resistance associated with plasmidic resistance genes is a serious public health issue. We aimed at studying the transmission of an mcr-1 colistin- and rifampicin-resistant Escherichia coli strain between inoculated pigs and sentinels in different controlled conditions. Three groups of four pigs were bred in separated animal rooms and inoculated on Day 0 (D0). In each inoculated group, six contact pigs were introduced on D2. The first inoculated-and-contact group was left untreated. The ten pigs in the second inoculated-and-contact group received colistin (100 000 IU/kg) before inoculation or contact (D-7 to D-5), simulating prophylactic administration. Pigs in the third inoculated-and-contact group were treated just after inoculation or before transfer (D0 to D2), simulating metaphylactic administration. Faecal samples were regularly collected and segments of intestinal tracts were obtained at necropsy, on D20-D22. Samples were cultured on rifampicin-supplemented media, and PCR was used to detect the mcr-1 gene. The kinetics of infection, based on culture results, were analysed using an SIR model. The inoculated strain was detected in all inoculated and contact pigs. The SIR model showed that one infected pig could transmit the resistant bacteria to one susceptible individual in less than 3 h on average. Prophylactic administration significantly enhanced the transmission rate and resulted in more samples containing the mcr-1 resistance gene at necropsy. No effect of metaphylactic administration could be detected on the transmission rate, nor on the carriage of the resistant strain. Our study confirms that colistin should not be used in a prophylactic manner.
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Affiliation(s)
- Gwenaëlle Mourand
- ANSES, Laboratoire de Ploufragan-Plouzané-Niort, Ploufragan, France; Université Bretagne Loire, France
| | - Mathieu Andraud
- ANSES, Laboratoire de Ploufragan-Plouzané-Niort, Ploufragan, France; Université Bretagne Loire, France
| | - Eric Jouy
- ANSES, Laboratoire de Ploufragan-Plouzané-Niort, Ploufragan, France; Université Bretagne Loire, France
| | - Claire Chauvin
- ANSES, Laboratoire de Ploufragan-Plouzané-Niort, Ploufragan, France; Université Bretagne Loire, France
| | - Laetitia Le Devendec
- ANSES, Laboratoire de Ploufragan-Plouzané-Niort, Ploufragan, France; Université Bretagne Loire, France
| | - Frederic Paboeuf
- ANSES, Laboratoire de Ploufragan-Plouzané-Niort, Ploufragan, France; Université Bretagne Loire, France
| | - Isabelle Kempf
- ANSES, Laboratoire de Ploufragan-Plouzané-Niort, Ploufragan, France; Université Bretagne Loire, France.
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26
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Elhenawy W, Tsai CN, Coombes BK. Host-Specific Adaptive Diversification of Crohn's Disease-Associated Adherent-Invasive Escherichia coli. Cell Host Microbe 2019; 25:301-312.e5. [PMID: 30683582 DOI: 10.1016/j.chom.2018.12.010] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 10/05/2018] [Accepted: 12/13/2018] [Indexed: 12/12/2022]
Abstract
Crohn's disease (CD) is an inflammatory bowel disease influenced by bacteria. Adherent-invasive E. coli (AIEC) is associated with CD, yet the adaptations facilitating AIEC gut colonization are unknown. AIEC isolates exhibit high genetic diversity, suggesting strains evolve independently across different gut environments. We tracked the adaptive evolution of AIEC in a murine model of chronic colonization across multiple hosts and transmission events. We detected evolved lineages that outcompeted the ancestral strain in the host through independent mechanisms. One lineage was hypermotile because of a mobile insertion sequence upstream of the master flagellar regulator, flhDC, which enhanced AIEC invasion and establishment of a mucosal niche. Another lineage outcompeted the ancestral strain through improved use of acetate, a short-chain fatty acid in the gut. The presence of hypermotile and acetate-consuming lineages discriminated E. coli isolated from CD patients from healthy controls, suggesting an evolutionary trajectory that distinguishes AIEC from commensal E. coli.
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Affiliation(s)
- Wael Elhenawy
- Michael G. DeGroote Institute for Infectious Disease Research, Hamilton, ON, Canada
| | - Caressa N Tsai
- Michael G. DeGroote Institute for Infectious Disease Research, Hamilton, ON, Canada
| | - Brian K Coombes
- Michael G. DeGroote Institute for Infectious Disease Research, Hamilton, ON, Canada; Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Hamilton, ON, Canada.
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27
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Hospenthal MK, Waksman G. The Remarkable Biomechanical Properties of the Type 1 Chaperone-Usher Pilus: A Structural and Molecular Perspective. Microbiol Spectr 2019; 7. [PMID: 30681068 DOI: 10.1128/microbiolspec.psib-0010-2018] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Indexed: 01/02/2023] Open
Abstract
Chaperone-usher (CU) pili are long, supramolecular protein fibers tethered to the surface of numerous bacterial pathogens. These virulence factors function primarily in bacterial adhesion to host tissues, but they also mediate biofilm formation. Type 1 and P pili of uropathogenic Escherichia coli (UPEC) are the two best-studied CU pilus examples, and here we primarily focus on the former. UPEC can be transmitted to the urinary tract by fecal shedding. It can then ascend up the urinary tract and cause disease by invading and colonizing host tissues of the bladder, causing cystitis, and the kidneys, causing pyelonephritis. FimH is the subunit displayed at the tip of type 1 pili and mediates adhesion to mannosylated host cells via a unique catch-bond mechanism. In response to shear forces caused by urine flow, FimH can transition from a low-affinity to high-affinity binding mode. This clever allosteric mechanism allows UPEC cells to remain tightly attached during periods of urine flow, while loosening their grip to allow dissemination through the urinary tract during urine stasis. Moreover, the bulk of a CU pilus is made up of the rod, which can reversibly uncoil in response to urine flow to evenly spread the tensile forces over the entire pilus length. We here explore the novel structural and mechanistic findings relating to the type 1 pilus FimH catch-bond and rod uncoiling and explain how they function together to enable successful attachment, spread, and persistence in the hostile urinary tract.
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Affiliation(s)
- Manuela K Hospenthal
- Institute of Structural and Molecular Biology, University College London and Birkbeck, London WC1E 7HX, United Kingdom
- Institute of Molecular Biology and Biophysics, ETH Zürich, 8093 Zürich, Switzerland
| | - Gabriel Waksman
- Institute of Structural and Molecular Biology, University College London and Birkbeck, London WC1E 7HX, United Kingdom
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28
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Plaza Rodríguez C, Correia Carreira G, Käsbohrer A. A Probabilistic Transmission Model for the Spread of Extended-Spectrum-β-Lactamase and AmpC-β-Lactamase-Producing Escherichia Coli in the Broiler Production Chain. Risk Anal 2018; 38:2659-2682. [PMID: 30096222 DOI: 10.1111/risa.13145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 09/29/2017] [Accepted: 06/08/2018] [Indexed: 06/08/2023]
Abstract
Direct contact between humans and live broilers, as well as the consumption of chicken meat, have been suggested as pathways for transmission of extended-spectrum-β-lactamase (ESBL) and AmpC-β-lactamase (AmpC)-producing Escherichia coli. One approach to design intervention strategies to control the transmission of such bacteria between animals and humans is to study the transmission pathways of such bacteria between the animals themselves. The rationale is that controlling the process of the underlying source, here transmission between animals, can provide hints on how to control a higher-level process, here the transmission between animals and humans. The focus of this article is the transmission of the above-mentioned bacteria between broilers and broiler flocks in meat production with regards to the establishment of possible intervention strategies to reduce the transfer of these bacteria between animals. The objective of this work is to design a mathematical transmission model describing the effects of vertical and horizontal bacterial transmission in the broiler production chain, from the parent generation to the slaughterhouse level. To achieve this objective, an existing transmission model for Campylobacter was adapted for the case of E. coli. The model keeps track of prevalence among flocks (flock prevalence) and of prevalence among animals within one flock (animal prevalence). Flock and animal prevalences show different dynamics in the model. While flock prevalence increases mainly through horizontal transmission in hatcheries, animal prevalence increases mainly at the broiler-fattening farm. Transports have rather small effects just as the vertical transmission from parents to chicks.
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Affiliation(s)
- Carolina Plaza Rodríguez
- Bundesinstitut für Risikobewertung Standort Marienfelde, Berlin, Germany
- German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Guido Correia Carreira
- Bundesinstitut für Risikobewertung Standort Marienfelde, Berlin, Germany
- German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Annemarie Käsbohrer
- Bundesinstitut für Risikobewertung Standort Marienfelde, Berlin, Germany
- German Federal Institute for Risk Assessment (BfR), Berlin, Germany
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29
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Projahn M, Daehre K, Semmler T, Guenther S, Roesler U, Friese A. Environmental adaptation and vertical dissemination of ESBL-/pAmpC-producing Escherichia coli in an integrated broiler production chain in the absence of an antibiotic treatment. Microb Biotechnol 2018; 11:1017-1026. [PMID: 29345080 PMCID: PMC6196392 DOI: 10.1111/1751-7915.13040] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 11/22/2017] [Accepted: 11/28/2017] [Indexed: 11/30/2022] Open
Abstract
High prevalence numbers of extended-spectrum beta-lactamase- (ESBL-)/plasmid-mediated AmpC beta-lactamase- (pAmpC-) producing Escherichia coli in broiler chicken and their distribution along the broiler production chain is an ongoing problem in food production. We, therefore, investigated resistant isolates along the broiler production chain to determine whether there is a constantly occurring direct vertical transmission of the ESBL-/pAmpC-producing E. coli from the parent flocks to their offspring or not. We, furthermore, analysed the isolates concerning the occurrence of virulence factors and their ability to form biofilms to estimate their potential to effectively colonize broiler chickens and/or persist and survive in the environment of the broiler production facilities. Using whole genome sequencing, we could show that ESBL-/pAmpC-producing E. coli were likely transferred in a step-wise process along the broiler production chain but not directly from the parent flock to the fattening flock with every single batch of offspring chickens. Additionally, resistant E. coli strains showing an extraintestinal pathogenic genotype as well as high numbers of virulence-associated genes including the production of curli fibres and cellulose have high capabilities to persist and spread in the broiler production chain.
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Affiliation(s)
- Michaela Projahn
- Institute for Animal Hygiene and Environmental HealthFreie Universität BerlinBerlinGermany
- Present address:
German Federal Institute for Risk Assessment, Diedersdorfer Weg 1, D‐12277BerlinGermany
| | - Katrin Daehre
- Institute for Animal Hygiene and Environmental HealthFreie Universität BerlinBerlinGermany
| | | | - Sebastian Guenther
- Institute for Animal Hygiene and Environmental HealthFreie Universität BerlinBerlinGermany
| | - Uwe Roesler
- Institute for Animal Hygiene and Environmental HealthFreie Universität BerlinBerlinGermany
| | - Anika Friese
- Institute for Animal Hygiene and Environmental HealthFreie Universität BerlinBerlinGermany
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30
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Dawson DE, Keung JH, Napoles MG, Vella MR, Chen S, Sanderson MW, Lanzas C. Investigating behavioral drivers of seasonal Shiga-Toxigenic Escherichia Coli (STEC) patterns in grazing cattle using an agent-based model. PLoS One 2018; 13:e0205418. [PMID: 30304002 PMCID: PMC6179278 DOI: 10.1371/journal.pone.0205418] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 09/25/2018] [Indexed: 11/18/2022] Open
Abstract
The causes of seasonal variability in pathogen transmission are not well understood, and have not been comprehensively investigated. In an example for enteric pathogens, incidence of Escherichia coli O157 (STEC) colonization in cattle is consistently higher during warmer months compared to cooler months in various cattle production systems. However, actual mechanisms for this seasonality remain elusive. In addition, the influence of host (cattle) behavior on this pattern has not been thoroughly considered. To that end, we constructed a spatially explicit agent-based model that accounted for the effect of temperature fluctuations on cattle behavior (direct contact among cattle and indirect between cattle and environment), as well as its effect on pathogen survival in the environment. We then simulated the model in a factorial approach to evaluate the hypothesis that temperature fluctuations can lead to seasonal STEC transmission dynamics by influencing cattle aggregation, grazing, and drinking behaviors. Simulation results showed that higher temperatures increased the frequency at which cattle aggregated under shade in pasture, resulting in increased direct contact and transmission of STEC between individual cattle, and hence higher incidence over model simulations in the warm season. In contrast, increased drinking behavior during warm season was not an important transmission pathway. Although sensitivity analyses suggested that the relative importance of direct vs. indirect (environmental) pathways depend to upon model parameterization, model simulations indicated that factors influencing cattle aggregation, such as temperature, were likely strong drivers of transmission dynamics of enteric pathogens.
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Affiliation(s)
- Daniel E. Dawson
- Department of Pathobiology and Population Health, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
- * E-mail:
| | - Jocelyn H. Keung
- National Institute for Mathematical and Biological Synthesis (NIMBioS), Knoxville, Tennessee, United States of America
| | - Monica G. Napoles
- National Institute for Mathematical and Biological Synthesis (NIMBioS), Knoxville, Tennessee, United States of America
| | - Michael R. Vella
- National Institute for Mathematical and Biological Synthesis (NIMBioS), Knoxville, Tennessee, United States of America
| | - Shi Chen
- Department of Pathobiology and Population Health, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
- Department of Public Health Sciences, College of Health and Human Services, University of North Carolina Charlotte, Charlotte, North Carolina, United States of America
| | - Michael W. Sanderson
- Center for Outcomes Research and Epidemiology, Department of Diagnostic Medicine and Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, United States of America
| | - Cristina Lanzas
- Department of Pathobiology and Population Health, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
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31
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Sandegren L, Stedt J, Lustig U, Bonnedahl J, Andersson DI, Järhult JD. Long-term carriage and rapid transmission of extended spectrum beta-lactamase-producing E. coli within a flock of Mallards in the absence of antibiotic selection. Environ Microbiol Rep 2018; 10:576-582. [PMID: 30043488 DOI: 10.1111/1758-2229.12681] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 07/19/2018] [Indexed: 05/11/2023]
Abstract
Wild birds have been suggested as transmitters and reservoirs for antibiotic resistant bacteria. We performed an experimental study investigating carriage time and interindividual transmission of extended spectrum beta-lactamase- (ESBL-)producing Escherichia coli in Mallards (Anas platyrhynchos) to assess if the birds carry the bacteria long enough to transfer them geographically during migration. Mallards were inoculated intraoesophageally with four different strains of ESBL-producing E. coli and kept together in a flock. The ESBL-strains belonged to sequence types previously shown to spread between birds and humans. Culturing from faecal samples showed presence of ESBL-producing E. coli the entire 29 day experimental period. An extensive and rapid transmission of the different ESBL-strains between individuals (including non-inoculated controls) was observed. In necropsy samples, we detected ESBL-strains in the cecum even in faeces-negative birds, indicating that this part of the intestine could function as a reservoir of resistant bacteria. We demonstrate that birds can carry ESBL-producing E. coli for long enough times to travel far during migration and the extensive interindividual transmission suggests spread between individuals in a dense bird population as a mechanism that allow persistence of resistant bacteria.
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Affiliation(s)
- Linus Sandegren
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, SE - 751 23, Sweden
| | - Johan Stedt
- Centre for Ecology and Evolution in Microbial Model Systems, School of Natural Sciences, Linnaeus University, Kalmar, SE - 391 82, Sweden
| | - Ulrika Lustig
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, SE - 751 23, Sweden
| | - Jonas Bonnedahl
- Centre for Ecology and Evolution in Microbial Model Systems, School of Natural Sciences, Linnaeus University, Kalmar, SE - 391 82, Sweden
- Department of Infectious Diseases, Kalmar County Hospital, Kalmar, SE - 391 85, Sweden
| | - Dan I Andersson
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, SE - 751 23, Sweden
| | - Josef D Järhult
- Section for Infectious Diseases, Department of Medical Sciences, Uppsala University, Uppsala, SE - 751 85, Sweden
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Abstract
The aim of this study was to identify risk factors for extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (E coli) bloodstream infection (BSI) among carriers hospitalized between March 2011 and June 2016 at the ICU of the West China Hospital.The cases were patients with at least 1 episode of ESBL-producing E coli BSI within 1 week after a positive rectal swab. Controls were selected randomly 1:2 among ESBL-producing E coli rectal carriers who did not develop BSI.Among 19,429 ICU patients, 9015 (46.4%) had a positive rectal swab for ESBL-producing E coli. Of them, 42 (0.5%) were diagnosed with ESBL-producing E coli BSI. The in-hospital mortality was higher for the BSI patients compared with controls (19.1% vs. 6.0%, P = .031). In the past 72 hours, patients in case group were more likely to use penicillin (odds ratio [OR] = 12.076; 95% confidence interval [CI]: 1.397-104.251, P = .02), cephalosporin (OR = 6.900; 95% CI: 1.493-31.852, P = .01), and carbapenem (OR = 5.422; 95% CI: 1.228-23.907, P = .03) as compared to patients in control group. Also, when compared to patients in control group, patients in case group were likely to stay for a longer time in ICU before positive rectal swab test (OR = 1.041, 95% CI: 1.009-1.075, P = .01) and have higher maximum body temperature before positive rectal swab (OR = 8.014; 95% CI: 2.408-26.620, P = .001).Bacteremia owing to ESBL-producing E coli was associated with high antimicrobial exposure, hospital stay, and maximum body temperature.
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Affiliation(s)
- Minxue Liu
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu
- Department of Laboratory Medicine, The Maternal & Child Health Hospital, The Children's hospital, The Obstetrics & Gynecology Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Mengjiao Li
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu
| | - Lijuan Wu
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu
| | - Qifei Song
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu
| | - Dan Zhao
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu
| | - Zhixing Chen
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu
| | - Mei Kang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu
| | - Yi Xie
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu
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33
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Muloi D, Ward MJ, Pedersen AB, Fèvre EM, Woolhouse ME, van Bunnik BA. Are Food Animals Responsible for Transfer of Antimicrobial-Resistant Escherichia coli or Their Resistance Determinants to Human Populations? A Systematic Review. Foodborne Pathog Dis 2018; 15:467-474. [PMID: 29708778 PMCID: PMC6103250 DOI: 10.1089/fpd.2017.2411] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The role of farm animals in the emergence and dissemination of both AMR bacteria and their resistance determinants to humans is poorly understood and controversial. Here, we systematically reviewed the current evidence that food animals are responsible for transfer of AMR to humans. We searched PubMed, Web of Science, and EMBASE for literature published between 1940 and 2016. Our results show that eight studies (18%) suggested evidence of transmission of AMR from food animals to humans, 25 studies (56%) suggested transmission between animals and humans with no direction specified and 12 studies (26%) did not support transmission. Quality of evidence was variable among the included studies; one study (2%) used high resolution typing tools, 36 (80%) used intermediate resolution typing tools, six (13%) relied on low resolution typing tools, and two (5%) based conclusions on co-occurrence of resistance. While some studies suggested to provide evidence that transmission of AMR from food animals to humans may occur, robust conclusions on the directionality of transmission cannot be drawn due to limitations in study methodologies. Our findings highlight the need to combine high resolution genomic data analysis with systematically collected epidemiological evidence to reconstruct patterns of AMR transmission between food animals and humans.
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Affiliation(s)
- Dishon Muloi
- Usher Institute of Population Health Sciences & Informatics, University of Edinburgh, Edinburgh, United Kingdom
- Centre for Immunity, Infection and Evolution, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Melissa J. Ward
- Centre for Immunity, Infection and Evolution, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Nuffield Department of Clinical Medicine, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| | - Amy B. Pedersen
- Centre for Immunity, Infection and Evolution, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Eric M. Fèvre
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
- International Livestock Research Institute, Nairobi, Kenya
| | - Mark E.J. Woolhouse
- Usher Institute of Population Health Sciences & Informatics, University of Edinburgh, Edinburgh, United Kingdom
- Centre for Immunity, Infection and Evolution, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Bram A.D. van Bunnik
- Usher Institute of Population Health Sciences & Informatics, University of Edinburgh, Edinburgh, United Kingdom
- Centre for Immunity, Infection and Evolution, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
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Abstract
The mcr-1 (mobile colistin resistance 1) gene, which encodes phosphoethanolamine transferase, has been recently identified as a source of acquired resistance to polymyxins in Escherichia coli. Using the SuperPolymyxin selective medium, we prospectively screened 100 pigs at 2 farms in Portugal for polymyxin-resistant Enterobacteriaceae and recovered 98 plasmid-mediated MCR-1–producing isolates. Most isolates corresponded to nonclonally related E. coli belonging to many sequence types; we also found 2 Klebsiella pneumoniae sequence types. The mcr-1 gene was carried on IncHI2 or IncP plasmid backbones. Our finding of a high rate of MCR-1 producers on 2 pig farms in Portugal highlights the diffusion of that colistin-resistance determinant at the farm level. The fact that the pigs received colistin as metaphylaxis in their feed during the 6 weeks before sampling suggests selective pressure.
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Schutz K, Cowley LA, Shaaban S, Carroll A, McNamara E, Gally DL, Godbole G, Jenkins C, Dallman TJ. Evolutionary Context of Non-Sorbitol-Fermenting Shiga Toxin-Producing Escherichia coli O55:H7. Emerg Infect Dis 2018; 23:1966-1973. [PMID: 29148397 PMCID: PMC5708253 DOI: 10.3201/eid2312.170628] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
In July 2014, an outbreak of Shiga toxin–producing Escherichia coli (STEC) O55:H7 in England involved 31 patients, 13 (42%) of whom had hemolytic uremic syndrome. Isolates were sequenced, and the sequences were compared with publicly available sequences of E. coli O55:H7 and O157:H7. A core-genome phylogeny of the evolutionary history of the STEC O55:H7 outbreak strain revealed that the most parsimonious model was a progenitor enteropathogenic O55:H7 sorbitol-fermenting strain, lysogenized by a Shiga toxin (Stx) 2a–encoding phage, followed by loss of the ability to ferment sorbitol because of a non-sense mutation in srlA. The parallel, convergent evolutionary histories of STEC O157:H7 and STEC O55:H7 may indicate a common driver in the evolutionary process. Because emergence of STEC O157:H7 as a clinically significant pathogen was associated with acquisition of the Stx2a-encoding phage, the emergence of STEC O55:H7 harboring the stx2a gene is of public health concern.
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Mylius M, Dreesman J, Pulz M, Pallasch G, Beyrer K, Claußen K, Allerberger F, Fruth A, Lang C, Prager R, Flieger A, Schlager S, Kalhöfer D, Mertens E. Shiga toxin-producing Escherichia coli O103:H2 outbreak in Germany after school trip to Austria due to raw cow milk, 2017 - The important role of international collaboration for outbreak investigations. Int J Med Microbiol 2018; 308:539-544. [PMID: 29884330 DOI: 10.1016/j.ijmm.2018.05.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 05/18/2018] [Accepted: 05/28/2018] [Indexed: 11/17/2022] Open
Abstract
Following a school ski-trip to Austria from 10 to 18/02/2017, nine of 25 participants of the group from Lower Saxony (Germany) developed gastroenteritis. The students and teachers (17-41 years) shared meals in a hotel. Active case finding revealed further cases among German school groups from North Rhine-Westphalia and Schleswig-Holstein, staying at the same hotel in February 2017. We conducted two retrospective cohort studies using self-administered questionnaires on clinical symptoms and food consumption. We defined a case as a trip participant in February 2017, staying at the aforementioned hotel and developing diarrhoea, vomiting or abdominal pain during or within ten days after the trip and/or who had a stool sample tested positive for STEC within four weeks after the trip. During the outbreak investigation, Austrian authorities detected that unlabeled raw cow milk delivered by a dairy farm had been offered at the hotel for breakfast during January and February 2017. Stool samples of participants, samples of milk served in the hotel and fecal samples of various animals kept at the milk-delivering farm were examined by culture and polymerase chain reaction. STEC isolates were typed using Pulsed-field Gel Electrophoresis (PFGE) and Whole-Genome Sequencing (WGS). All 25 participants from Lower Saxony completed the questionnaire on symptoms and milk consumption; 14 were cases (56%). Thirteen of 20 participants who had consumed cold milk fell ill (risk ratio (RR): 3.25; 95%-confidence interval (CI): 0.55-19.32). Of 159 trip participants from North Rhine-Westphalia, 81 completed the questionnaire (51%), 25 were cases (31%); RR for cold milk was 2.11 (CI: 0.89-5.03). The combined RR for cold milk in both groups was 2.49 (CI: 1.16-5.35). Shiga toxin 1a-gene and eaeA-gene positive STEC O103:H2 were detected in nine of 32 patients' stool samples and in two of 18 dairy farm cattle. Nine isolates from human stool samples and two isolates from cattle fecal samples yielded the same strain with an almost identical PFGE-pattern and WGS-profile. Microbiological and epidemiological evidence identified raw cow milk as the vehicle. Results may have been compromised by misclassification of cases due to a recall bias and mild symptoms. As a result of this outbreak investigation, the Austrian authorities enforced Austrian law in the hotel, to provide milk only when pasteurized. We recommend re-emphasizing the risk of raw milk consumption to providers.
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Affiliation(s)
- Maren Mylius
- Governmental Institute of Public Health of Lower Saxony (Niedersächsisches Landesgesundheitsamt, NLGA), Hanover, Germany; Postgraduate Training for Applied Epidemiology (PAE), Robert Koch Institute, Berlin, Germany; affiliated with the European Programme for Intervention Epidemiology Training, ECDC, Sweden.
| | - Johannes Dreesman
- Governmental Institute of Public Health of Lower Saxony (Niedersächsisches Landesgesundheitsamt, NLGA), Hanover, Germany.
| | - Matthias Pulz
- Governmental Institute of Public Health of Lower Saxony (Niedersächsisches Landesgesundheitsamt, NLGA), Hanover, Germany.
| | | | - Konrad Beyrer
- Governmental Institute of Public Health of Lower Saxony (Niedersächsisches Landesgesundheitsamt, NLGA), Hanover, Germany.
| | - Katja Claußen
- Governmental Institute of Public Health of Lower Saxony (Niedersächsisches Landesgesundheitsamt, NLGA), Hanover, Germany.
| | | | - Angelika Fruth
- National Reference Centre for Salmonella and other Bacterial Enteritic Pathogens, Division of Enteropathogenic Bacteria and Legionella (FG11), Robert Koch Institute, Wernigerode, Germany.
| | - Christina Lang
- National Reference Centre for Salmonella and other Bacterial Enteritic Pathogens, Division of Enteropathogenic Bacteria and Legionella (FG11), Robert Koch Institute, Wernigerode, Germany
| | - Rita Prager
- National Reference Centre for Salmonella and other Bacterial Enteritic Pathogens, Division of Enteropathogenic Bacteria and Legionella (FG11), Robert Koch Institute, Wernigerode, Germany
| | - Antje Flieger
- National Reference Centre for Salmonella and other Bacterial Enteritic Pathogens, Division of Enteropathogenic Bacteria and Legionella (FG11), Robert Koch Institute, Wernigerode, Germany
| | - Sabine Schlager
- Austrian Agency for Health and Food Safety (AGES), Graz, Austria.
| | | | - Elke Mertens
- Governmental Institute of Public Health of Lower Saxony (Niedersächsisches Landesgesundheitsamt, NLGA), Hanover, Germany.
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Abd El Ghany M, Alsomali M, Almasri M, Regalado EP, Naeem R, Tukestani A, Asiri A, Hill-Cawthorne GA, Pain A, Memish ZA. Enteric Infections Circulating during Hajj Seasons, 2011-2013. Emerg Infect Dis 2018; 23. [PMID: 28930004 PMCID: PMC5621540 DOI: 10.3201/eid2310.161642] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Foodborne-associated bacteria with increased incidence of antimicrobial drug resistance were the most common cause. Hajj, the annual Muslim pilgrimage to Mecca, Saudi Arabia, is a unique mass gathering event that raises public health concerns in the host country and globally. Although gastroenteritis and diarrhea are common among Hajj pilgrims, the microbial etiologies of these infections are unknown. We collected 544 fecal samples from pilgrims with medically attended diarrheal illness from 40 countries during the 2011–2013 Hajj seasons and screened the samples for 16 pathogens commonly associated with diarrheal infections. Bacteria were the main agents detected, in 82.9% of the 228 positive samples, followed by viral (6.1%) and parasitic (5.3%) agents. Salmonella spp., Shigella/enteroinvasive Escherichia coli, and enterotoxigenic E. coli were the main pathogens associated with severe symptoms. We identified genes associated with resistance to third-generation cephalosporins ≈40% of Salmonella- and E. coli–positive samples. Hajj-associated foodborne infections pose a major public health risk through the emergence and transmission of antimicrobial drug–resistant bacteria.
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Abstract
In May 2016, an outbreak of Shiga toxin-producing Escherichia coli O157 infections occurred among children who had played in a stream flowing through a park. Analysis of E. coli isolates from the patients, stream water, and deer and coyote scat showed that feces from deer were the most likely source of contamination.
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Andreu Ruiz A, Argente Del Castillo TR, Moya Sánchez J. Acute infectious purpura fulminans secondary to a dog bite. Emergencias 2018; 30:67. [PMID: 29437318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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40
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Payne M, Croxen MA, Lee TD, Mayson B, Champagne S, Leung V, Bariso S, Hoang L, Lowe C. mcr-1-Positive Colistin-Resistant Escherichia coli in Traveler Returning to Canada from China. Emerg Infect Dis 2018; 22:1673-5. [PMID: 27533019 PMCID: PMC4994352 DOI: 10.3201/eid2209.160177] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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41
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Chapman B, Pintar K, Smith BA. Multi-Exposure Pathway Model to Compare Escherichia coli O157 Risks and Interventions. Risk Anal 2018; 38:392-409. [PMID: 28471504 DOI: 10.1111/risa.12826] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 03/09/2017] [Accepted: 03/14/2017] [Indexed: 06/07/2023]
Abstract
The relative contributions of exposure pathways associated with cattle-manure-borne Escherichia coli O157:H7 on public health have yet to be fully characterized. A stochastic, quantitative microbial risk assessment (QMRA) model was developed to describe a hypothetical cattle farm in order to compare the relative importance of five routes of exposure, including aquatic recreation downstream of the farm, consumption of contaminated ground beef processed with limited interventions, consumption of leafy greens, direct animal contact, and the recreational use of a cattle pasture. To accommodate diverse environmental and hydrological pathways, existing QMRAs were integrated with novel and simplistic climate and field-level submodels. The model indicated that direct animal contact presents the greatest risk of illness per exposure event during the high pathogen shedding period. However, when accounting for the frequency of exposure, using a high-risk exposure-receptor profile, consumption of ground beef was associated with the greatest risk of illness. Additionally, the model was used to evaluate the efficacy of hypothetical interventions affecting one or more exposure routes; concurrent evaluation of multiple routes allowed for the assessment of the combined effect of preharvest interventions across exposure pathways-which may have been previously underestimated-as well as the assessment of the effect of additional downstream interventions. This analysis represents a step towards a full evaluation of the risks associated with multiple exposure pathways; future incorporation of variability associated with environmental parameters and human behaviors would allow for a comprehensive assessment of the relative contribution of exposure pathways at the population level.
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Affiliation(s)
- B Chapman
- Public Health Agency of Canada, Guelph, ON, Canada
- University of Guelph, Guelph, ON, Canada
| | - K Pintar
- Public Health Agency of Canada, Guelph, ON, Canada
| | - B A Smith
- Public Health Agency of Canada, Guelph, ON, Canada
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Abstract
To evaluate the potential public health risk caused by secondary Shiga toxin-producing Escherichia coli (STEC) infections in Japan, we investigated the prevalence and characteristics of STEC isolated from healthy adults during 2010-2012. Although prevalence among healthy adults was high, most STEC organisms displayed characteristics rarely found in isolates from symptomatic patients.
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Tschudin-Sutter S, Frei R, Schwahn F, Tomic M, Conzelmann M, Stranden A, Widmer AF. Prospective Validation of Cessation of Contact Precautions for Extended-Spectrum β-Lactamase-Producing Escherichia coli(1). Emerg Infect Dis 2018; 22:1094-7. [PMID: 27191171 PMCID: PMC4880108 DOI: 10.3201/eid2206.150554] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
After contact precautions were discontinued, we determined nosocomial transmission of extended-spectrum β-lactamase (ESBL)–producing Escherichia coli by screening hospital patients who shared rooms with ESBL-producing E. coli–infected or –colonized patients. Transmission rates were 2.6% and 8.8% at an acute-care and a geriatric/rehabilitation hospital, respectively. Prolonged contact was associated with increased transmission.
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Tijet N, Faccone D, Rapoport M, Seah C, Pasterán F, Ceriana P, Albornoz E, Corso A, Petroni A, Melano RG. Molecular characteristics of mcr-1-carrying plasmids and new mcr-1 variant recovered from polyclonal clinical Escherichia coli from Argentina and Canada. PLoS One 2017; 12:e0180347. [PMID: 28678874 PMCID: PMC5498056 DOI: 10.1371/journal.pone.0180347] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 06/14/2017] [Indexed: 11/18/2022] Open
Abstract
We have characterized nine mcr-1-harboring plasmids from clinical Escherichia coli isolates previously described in Argentina and Canada. Three of these plasmids carried a mcr-1-variant called here mcr-1.5. All these E. coli isolates were not clonally related and were recovered in different years and locations. However, their mcr-1-harboring plasmids showed high identity among them and to others characterized in other countries, which strongly suggests that this plasmid-type is playing an important role in spreading this mechanism of resistance to polymyxins.
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Affiliation(s)
- Nathalie Tijet
- Public Health Ontario Laboratory, Toronto, Ontario, Canada
| | - Diego Faccone
- Servicio Antimicrobianos, National and Regional Reference Laboratory in Antimicrobial Resistance, Instituto Nacional de Enfermedades Infecciosas (INEI)-ANLIS “Dr. C. Malbran”, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Melina Rapoport
- Servicio Antimicrobianos, National and Regional Reference Laboratory in Antimicrobial Resistance, Instituto Nacional de Enfermedades Infecciosas (INEI)-ANLIS “Dr. C. Malbran”, Buenos Aires, Argentina
| | - Christine Seah
- Public Health Ontario Laboratory, Toronto, Ontario, Canada
| | - Fernando Pasterán
- Servicio Antimicrobianos, National and Regional Reference Laboratory in Antimicrobial Resistance, Instituto Nacional de Enfermedades Infecciosas (INEI)-ANLIS “Dr. C. Malbran”, Buenos Aires, Argentina
| | - Paola Ceriana
- Servicio Antimicrobianos, National and Regional Reference Laboratory in Antimicrobial Resistance, Instituto Nacional de Enfermedades Infecciosas (INEI)-ANLIS “Dr. C. Malbran”, Buenos Aires, Argentina
| | - Ezequiel Albornoz
- Servicio Antimicrobianos, National and Regional Reference Laboratory in Antimicrobial Resistance, Instituto Nacional de Enfermedades Infecciosas (INEI)-ANLIS “Dr. C. Malbran”, Buenos Aires, Argentina
| | - Alejandra Corso
- Servicio Antimicrobianos, National and Regional Reference Laboratory in Antimicrobial Resistance, Instituto Nacional de Enfermedades Infecciosas (INEI)-ANLIS “Dr. C. Malbran”, Buenos Aires, Argentina
| | - Alejandro Petroni
- Servicio Antimicrobianos, National and Regional Reference Laboratory in Antimicrobial Resistance, Instituto Nacional de Enfermedades Infecciosas (INEI)-ANLIS “Dr. C. Malbran”, Buenos Aires, Argentina
| | - Roberto G. Melano
- Public Health Ontario Laboratory, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- * E-mail:
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45
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Stromberg ZR, Johnson JR, Fairbrother JM, Kilbourne J, Van Goor A, Curtiss R, Mellata M. Evaluation of Escherichia coli isolates from healthy chickens to determine their potential risk to poultry and human health. PLoS One 2017; 12:e0180599. [PMID: 28671990 PMCID: PMC5495491 DOI: 10.1371/journal.pone.0180599] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 06/16/2017] [Indexed: 11/18/2022] Open
Abstract
Extraintestinal pathogenic Escherichia coli (ExPEC) strains are important pathogens that cause diverse diseases in humans and poultry. Some E. coli isolates from chicken feces contain ExPEC-associated virulence genes, so appear potentially pathogenic; they conceivably could be transmitted to humans through handling and/or consumption of contaminated meat. However, the actual extraintestinal virulence potential of chicken-source fecal E. coli is poorly understood. Here, we assessed whether fecal E. coli isolates from healthy production chickens could cause diseases in a chicken model of avian colibacillosis and three rodent models of ExPEC-associated human infections. From 304 E. coli isolates from chicken fecal samples, 175 E. coli isolates were screened by PCR for virulence genes associated with human-source ExPEC or avian pathogenic E. coli (APEC), an ExPEC subset that causes extraintestinal infections in poultry. Selected isolates genetically identified as ExPEC and non-ExPEC isolates were assessed in vitro for virulence-associated phenotypes, and in vivo for disease-causing ability in animal models of colibacillosis, sepsis, meningitis, and urinary tract infection. Among the study isolates, 13% (40/304) were identified as ExPEC; the majority of these were classified as APEC and uropathogenic E. coli, but none as neonatal meningitis E. coli. Multiple chicken-source fecal ExPEC isolates resembled avian and human clinical ExPEC isolates in causing one or more ExPEC-associated illnesses in experimental animal infection models. Additionally, some isolates that were classified as non-ExPEC were able to cause ExPEC-associated illnesses in animal models, and thus future studies are needed to elucidate their mechanisms of virulence. These findings show that E. coli isolates from chicken feces contain ExPEC-associated genes, exhibit ExPEC-associated in vitro phenotypes, and can cause ExPEC-associated infections in animal models, and thus may pose a health threat to poultry and consumers.
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Affiliation(s)
- Zachary R Stromberg
- Department of Food Science and Human Nutrition, Iowa State University, Ames, Iowa, United States of America
| | - James R Johnson
- Veterans Affairs Medical Center and University of Minnesota, Minneapolis, Minnesota, United States of America
| | - John M Fairbrother
- OIE Reference Laboratory for Escherichia coli, Faculty of Veterinary Medicine, Université de Montréal, St-Hyacinthe, Québec, Canada
| | - Jacquelyn Kilbourne
- The Biodesign Institute, Arizona State University, Tempe, Arizona, United States of America
| | - Angelica Van Goor
- Department of Food Science and Human Nutrition, Iowa State University, Ames, Iowa, United States of America
| | - Roy Curtiss
- The Biodesign Institute, Arizona State University, Tempe, Arizona, United States of America
- School of Life Sciences, Arizona State University, Tempe, Arizona, United States of America
| | - Melha Mellata
- Department of Food Science and Human Nutrition, Iowa State University, Ames, Iowa, United States of America
- The Biodesign Institute, Arizona State University, Tempe, Arizona, United States of America
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Todorović D, Velhner M, Grego E, Vidanović D, Milanov D, Krnjaić D, Kehrenberg C. Molecular Characterization of Multidrug-Resistant Escherichia coli Isolates from Bovine Clinical Mastitis and Pigs in the Vojvodina Province, Serbia. Microb Drug Resist 2017; 24:95-103. [PMID: 28520501 DOI: 10.1089/mdr.2017.0016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The aim of the study was to characterize multidrug-resistant (MDR) Escherichia coli isolates collected in Serbia from bovine clinical mastitis cases and diseased pigs, mainly with molecular methods. A total of 48 E. coli isolates was collected during the years 2013-2014, of which 22 were MDR and were included in further analysis. Phylogenetic typing showed that 17 isolates belonged to group A, while two isolates were classified in group B1 and a single one in group D. All isolates showed unique macrorestriction patterns. Phenotypic susceptibility testing revealed resistances of the isolates against up to 13 antimicrobial agents, including resistance to fluoroquinolones. A wide variety of resistance genes was detected by PCR amplification and sequencing of amplicons. Sequence analysis of the quinolone resistance determining regions of topoisomerase genes revealed mutations in gyrA, parC, and/or parE. Plasmid-mediated quinolone resistance genes were detected in two porcine (aac-6'-Ib-cr and qnrS, respectively) isolates and a single bovine (aac-6'-Ib-cr) isolate. Resistance genes were found to be located on conjugative plasmids in 16 cases, many of which conferred a multidrug resistance phenotype. In conclusion, the plentitude of resistance genes located on conjugative plasmids and integrons in E. coli from cows and pigs in Vojvodina, Serbia, pose a high risk for horizontal gene transfer in bacteria from livestock husbandry.
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Affiliation(s)
| | - Maja Velhner
- 1 Scientific Veterinary Institute "Novi Sad," Novi Sad, Serbia
| | - Edita Grego
- 2 Public Health Institute of Serbia , "Dr Milan Jovanović Batut," Belgrade, Serbia
| | | | | | - Dejan Krnjaić
- 4 Faculty of Veterinary Medicine, University of Belgrade , Belgrade, Serbia
| | - Corinna Kehrenberg
- 5 Institute for Food Quality and Food Safety, University of Veterinary Medicine Hannover , Foundation, Hannover, Germany
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Blakiston M, Roberts SA, Freeman JT, Heffernan H. Household transmission of NDM-producing E. coli in New Zealand. N Z Med J 2017; 130:63-65. [PMID: 28337042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This report describes the introduction of an extensively antibiotic-resistant carbapenemase-producing Escherichia coli into a hospital in Auckland, New Zealand, by a patient who was a household contact of recent travellers to the Indian subcontinent. The carbapenemase was identified as New Delhi metallo-β-lactamase (NDM) and reflects probable household transmission in the context of a recent upsurge in NDM-producing Enterobacteriaceae isolation in New Zealand. The observations in this report suggest that hospital screening practices to identify carbapenemase-producing Enterobacteriaceae (CPE) colonised patients may need to be extended to include travellers to high-risk countries who were not hospitalised during their trip, and possibly also their close contacts.
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Affiliation(s)
| | - Sally A Roberts
- Microbiology Department, LabPlus, Auckland City Hospital, Auckland
| | - Joshua T Freeman
- Microbiology Department, LabPlus, Auckland City Hospital, Auckland
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48
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Castellanos LR, Donado-Godoy P, León M, Clavijo V, Arevalo A, Bernal JF, Timmerman AJ, Mevius DJ, Wagenaar JA, Hordijk J. High Heterogeneity of Escherichia coli Sequence Types Harbouring ESBL/AmpC Genes on IncI1 Plasmids in the Colombian Poultry Chain. PLoS One 2017; 12:e0170777. [PMID: 28125687 PMCID: PMC5268450 DOI: 10.1371/journal.pone.0170777] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Accepted: 01/10/2017] [Indexed: 11/19/2022] Open
Abstract
Background Escherichia coli producing ESBL/AmpC enzymes are unwanted in animal production chains as they may pose a risk to human and animal health. Molecular characterization of plasmids and strains carrying genes that encode these enzymes is essential to understand their local and global spread. Objectives To investigate the diversity of genes, plasmids and strains in ESBL/AmpC-producing E. coli from the Colombian poultry chain isolated within the Colombian Integrated Program for Antimicrobial Resistance Surveillance (Coipars). Methods A total of 541 non-clinical E. coli strains from epidemiologically independent samples and randomly isolated between 2008 and 2013 within the Coipars program were tested for antimicrobial susceptibility. Poultry isolates resistant to cefotaxime (MIC ≥ 4 mg/L) were screened for ESBL/AmpC genes including blaCTX-M, blaSHV, blaTEM, blaCMY and blaOXA. Plasmid and strain characterization was performed for a selection of the ESBL/AmpC-producing isolates. Plasmids were purified and transformed into E. coli DH10B cells or transferred by conjugation to E. coli W3110. When applicable, PCR Based Replicon Typing (PBRT), plasmid Multi Locus Sequence Typing (pMLST), plasmid Double Locus Sequence Typing (pDLST) and/or plasmid Replicon Sequence Typing (pRST) was performed on resulting transformants and conjugants. Multi Locus Sequence Typing (MLST) was used for strain characterization. Results In total, 132 of 541 isolates were resistant to cefotaxime and 122 were found to carry ESBL/AmpC genes. Ninety-two harboured blaCMY-2 (75%), fourteen blaSHV-12 (11%), three blaSHV-5 (2%), five blaCTX-M-2 (4%), one blaCTX-M-15 (1%), one blaCTX-M-8 (1%), four a combination of blaCMY-2 and blaSHV-12 (4%) and two a combination of blaCMY-2 and blaSHV-5 (2%). A selection of 39 ESBL/AmpC-producing isolates was characterized at the plasmid and strain level. ESBL/AmpC genes from 36 isolates were transferable by transformation or conjugation of which 22 were located on IncI1 plasmids. These IncI1 plasmids harboured predominantly blaCMY-2 (16/22), and to a lesser extend blaSHV-12 (5/22) and blaCTX-M-8 (1/22). Other plasmid families associated with ESBL/AmpC-genes were IncK (4/33), IncHI2 (3/33), IncA/C (2/33), IncΒ/O (1/33) and a non-typeable replicon (1/33). Subtyping of IncI1 and IncHI2 demonstrated IncI1/ST12 was predominantly associated with blaCMY-2 (12/16) and IncHI2/ST7 with blaCTX-M-2 (2/3). Finally, 31 different STs were detected among the 39 selected isolates. Conclusions Resistance to extended spectrum cephalosporins in E. coli from Colombian poultry is mainly caused by blaCMY-2 and blaSHV-12. The high diversity of strain Sequence Types and the dissemination of homogeneous IncI1/ST12 plasmids suggest that spread of the resistance is mainly mediated by horizontal gene transfer.
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Affiliation(s)
- Luis Ricardo Castellanos
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
- Colombian Integrated Program for Antimicrobial Resistance Surveillance – Coipars, Corporación Colombiana de Investigación Agropecuaria - Corpoica, Cundinamarca, Colombia
| | - Pilar Donado-Godoy
- Colombian Integrated Program for Antimicrobial Resistance Surveillance – Coipars, Corporación Colombiana de Investigación Agropecuaria - Corpoica, Cundinamarca, Colombia
| | - Maribel León
- Instituto Colombiano Agropecuario - ICA, Bogotá, Colombia
| | - Viviana Clavijo
- Colombian Integrated Program for Antimicrobial Resistance Surveillance – Coipars, Corporación Colombiana de Investigación Agropecuaria - Corpoica, Cundinamarca, Colombia
- Department of Biological Sciences, Los Andes University, Bogotá, Colombia
| | - Alejandra Arevalo
- Colombian Integrated Program for Antimicrobial Resistance Surveillance – Coipars, Corporación Colombiana de Investigación Agropecuaria - Corpoica, Cundinamarca, Colombia
| | - Johan F. Bernal
- Colombian Integrated Program for Antimicrobial Resistance Surveillance – Coipars, Corporación Colombiana de Investigación Agropecuaria - Corpoica, Cundinamarca, Colombia
| | - Arjen J. Timmerman
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - Dik J. Mevius
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
- Wageningen Bioveterinary Research, Lelystad, the Netherlands
| | - Jaap A. Wagenaar
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
- Wageningen Bioveterinary Research, Lelystad, the Netherlands
| | - Joost Hordijk
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
- * E-mail:
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Park SY, Kang CI, Wi YM, Chung DR, Peck KR, Lee NY, Song JH. Risk factors and molecular epidemiology of community-onset, multidrug resistance extended-spectrum β-lactamase-producing Escherichia coli infections. Korean J Intern Med 2017; 32:146-157. [PMID: 27093979 PMCID: PMC5214718 DOI: 10.3904/kjim.2015.113] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 01/15/2016] [Accepted: 01/22/2016] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS Although multidrug resistance (MDR) among extended-spectrum β-lactamase-producing Escherichia coli (ESBL-EC) poses significant therapeutic challenges, little is known regarding the risk factors and epidemiology of community-onset MDR-ESBL-EC infections. We performed this study to investigate risk factors and the molecular epidemiology of community-onset MDR-ESBL-EC infections. METHODS We conducted a case-control-control study of community-onset infections. MDR-ESBL-EC was defined as ESBL-EC that demonstrated in vitro resistance to trimethoprim-sulfamethoxazole, fluoroquinolones (FQs), and gentamicin. Patients with MDR-ESBL-EC infections were designated as case patients. A control group I (CG I) patient was defined as a person whose clinical sample yielded ESBL-EC that did not meet the criteria for MDR. A control group II (CG II) patient was defined as a patient with a non-ESBL-EC infection. RESULTS Of 108 patients with ESBL-EC infections, 30 cases (27.8%) were due to MDR-ESBL-EC. Compared with CG I, prior use of FQs (odds ratio [OR], 3.16; 95% confidence interval [CI], 1.11 to 8.98) and immunosuppressant use (OR, 10.47; 95% CI, 1.07 to 102.57) were significantly associated with MDR-ESBL-EC. Compared with CG II, prior use of FQs (OR, 15.53; 95% CI, 2.86 to 84.27) and healthcare-associated infection (OR, 5.98; 95% CI, 2.26 to 15.86) were significantly associated with MDR-ESBL-EC. CTX-M-15 was the most common in MDR-ESBL-EC infections (59.1% [13/22]), while CTX-M-14 was the most common in non-MDR-ESBL-EC infections (41.6% [32/77]). CTX-M-15 was significantly associated with MDR-ESBL-EC (59.1% vs. 32.5%, p = 0.028). Pulsed-field gel electrophoresis showed clonal diversity of MDR-ESBL-EC isolates. CONCLUSIONS The emergence of strains of MDR-ESBL-EC in the community poses an important new public health threat. More information on the emergence and transmission of these strains will be necessary in order to prevent their spread.
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Affiliation(s)
- So Yeon Park
- Division of Infectious Diseases, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Cheol-In Kang
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Correspondence to Cheol-In Kang, M.D. Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnamgu, Seoul 06351, Korea Tel: +82-2-3410-0324 Fax: +82-2-3410-0064 E-mail:
| | - Yu Mi Wi
- Division of Infectious Diseases, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Doo Ryeon Chung
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyong Ran Peck
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Nam-Yong Lee
- Department of Laboratory Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Hoon Song
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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50
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Adams NL, Byrne L, Smith GA, Elson R, Harris JP, Salmon R, Smith R, O'Brien SJ, Adak GK, Jenkins C. Shiga Toxin-Producing Escherichia coli O157, England and Wales, 1983-2012. Emerg Infect Dis 2016; 22:590-7. [PMID: 26982243 PMCID: PMC4806951 DOI: 10.3201/eid2204.151485] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Although incidence remained constant, outbreaks from contaminated meat and milk declined and those from petting farms and schools and nurseries increased. We evaluated clinical Shiga toxin–producing Escherichia coli O157 infections in England and Wales during 1983–2012 to describe changes in microbiological and surveillance methods. A strain replacement event was captured; phage type (PT) 2 decreased to account for just 3% of cases by 2012, whereas PT8 and PT21/28 strains concurrently emerged, constituting almost two thirds of cases by 2012. Despite interventions to control and reduce transmission, incidence remained constant. However, sources of infection changed over time; outbreaks caused by contaminated meat and milk declined, suggesting that interventions aimed at reducing meat cross-contamination were effective. Petting farm and school and nursery outbreaks increased, suggesting the emergence of other modes of transmission and potentially contributing to the sustained incidence over time. Studies assessing interventions and consideration of policies and guidance should be undertaken to reduce Shiga toxin–producing E. coli O157 infections in England and Wales in line with the latest epidemiologic findings.
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