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Ramatla T, Mafokwane T, Lekota K, Monyama M, Khasapane G, Serage N, Nkhebenyane J, Bezuidenhout C, Thekisoe O. "One Health" perspective on prevalence of co-existing extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae: a comprehensive systematic review and meta-analysis. Ann Clin Microbiol Antimicrob 2023; 22:88. [PMID: 37740207 PMCID: PMC10517531 DOI: 10.1186/s12941-023-00638-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 09/12/2023] [Indexed: 09/24/2023] Open
Abstract
BACKGROUND The Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) bacterial isolates that produce extended-spectrum β-lactamases (ESBLs) contribute to global life-threatening infections. This study conducted a systematic review and meta-analysis on the global prevalence of ESBLs in co-existing E. coli and K. pneumoniae isolated from humans, animals and the environment. METHODS The systematic review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) [ID no: CRD42023394360]. This study was carried out following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. One hundred and twenty-six eligible studies published on co-existing antibiotic resistance in E. coli and K. pneumoniae between 1990 and 2022 were included. RESULTS The pooled prevalence of ESBL-producing E. coli and K. pneumoniae was 33.0% and 32.7% for humans, 33.5% and 19.4% for animals, 56.9% and 24.2% for environment, 26.8% and 6.7% for animals/environment, respectively. Furthermore, the three types of resistance genes that encode ESBLs, namely blaSHVblaCTX-M,blaOXA, and blaTEM, were all detected in humans, animals and the environment. CONCLUSIONS The concept of "One-Health" surveillance is critical to tracking the source of antimicrobial resistance and preventing its spread. The emerging state and national surveillance systems should include bacteria containing ESBLs. A well-planned, -implemented, and -researched alternative treatment for antimicrobial drug resistance needs to be formulated.
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Affiliation(s)
- Tsepo Ramatla
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom, 2520, South Africa.
| | - Tshepo Mafokwane
- Department of Life and Consumer Sciences, University of South Africa, Florida, 1710, South Africa
| | - Kgaugelo Lekota
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom, 2520, South Africa
| | - Maropeng Monyama
- Department of Life and Consumer Sciences, University of South Africa, Florida, 1710, South Africa
| | - George Khasapane
- Department of Life Sciences, Central University of Technology, Bloemfontein, 9300, South Africa
| | - Naledi Serage
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom, 2520, South Africa
| | - Jane Nkhebenyane
- Department of Life Sciences, Central University of Technology, Bloemfontein, 9300, South Africa
| | - Carlos Bezuidenhout
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom, 2520, South Africa
| | - Oriel Thekisoe
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom, 2520, South Africa
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Thomson P, García P, del Río C, Castro R, Núñez A, Miranda C. Antimicrobial Resistance and Extended-Spectrum Beta-Lactamase Genes in Enterobacterales, Pseudomonas and Acinetobacter Isolates from the Uterus of Healthy Mares. Pathogens 2023; 12:1145. [PMID: 37764953 PMCID: PMC10535638 DOI: 10.3390/pathogens12091145] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/31/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
Antibiotic-resistant bacteria are a growing concern for human and animal health. The objective of this study was to determine the antimicrobial resistance and extended-spectrum beta-lactamase genes in Enterobacterales, Pseudomonas spp. and Acinetobacter spp. isolates from the uterus of healthy mares. For this purpose, 21 mares were swabbed for samples, which were later seeded on blood agar and MacConkey agar. The isolates were identified using MALDI-TOF and the antimicrobial susceptibility test was performed using the Kirby-Bauer technique. To characterize the resistance genes, a polymerase chain reaction (PCR) scheme was performed. Of the isolates identified as Gram-negative, 68.8% were Enterobacterales, represented by E. coli, Enterobacter cloacae, Citrobacter spp., and Klebsiella pneumoniae; 28.1% belonged to the genus Acinetobacter spp.; and 3.1% to Pseudomonas aeruginosa. A 9.3% of the isolates were multidrug-resistant (MDR), presenting resistance to antibiotics from three different classes, while 18.8% presented resistance to two or more classes of different antibiotics. The diversity of three genes that code for ESBL (blaTEM, blaCTX-M and blaSHV) was detected in 12.5% of the strains. The most frequent was blaSHV, while blaTEM and blaCTX-M were present in Citrobacter spp. and Klebsiella pneumoniae. These results are an alarm call for veterinarians and their environment and suggest taking measures to prevent the spread of these microorganisms.
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Affiliation(s)
- Pamela Thomson
- Laboratorio de Microbiología Clínica y Microbioma, Escuela de Medicina Veterinaria, Facultad de Ciencias de la Vida, Universidad Andrés Bello, Santiago 8370134, Chile;
| | - Patricia García
- Departamento de Laboratorios Clínicos, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8940000, Chile;
| | - Camila del Río
- Laboratorio de Microbiología Clínica y Microbioma, Escuela de Medicina Veterinaria, Facultad de Ciencias de la Vida, Universidad Andrés Bello, Santiago 8370134, Chile;
| | - Rodrigo Castro
- Escuela de Medicina Veterinaria, Facultad de Recursos Naturales y Medicina Veterinaria, Universidad Santo Tomás, Talca 3473620, Chile
| | - Andrea Núñez
- Escuela de Medicina Veterinaria, Facultad de Ciencias Agrarias y Forestales, Universidad Católica del Maule, Curicó 3340000, Chile
- Facultad de Medicina Veterinaria y Agronomía, Universidad de las Américas, Santiago 7500975, Chile
| | - Carolina Miranda
- Laboratorio de Microbiología Red de Salud UC-CHRISTUS, Pontificia Universidad Católica, Santiago 8940000, Chile;
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Wang S, Xie H, Chen Y, Liu L, Fang M, Sun D, Xu L, Bi Z, Sun G, Li Y, Yu X, Zhang H, Kou Z, Zheng B. Intestinal colonization with ESBL-producing Klebsiella pneumoniae in healthy rural villager: A genomic surveillance study in China, 2015-2017. Front Public Health 2022; 10:1017050. [PMID: 36589964 PMCID: PMC9798286 DOI: 10.3389/fpubh.2022.1017050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022] Open
Abstract
Background The worldwide emergence and diffusion of extended-spectrum β-lactamase-K. pneumoniae (ESBL-KP) is of particular concern. Although ESBL-KP can inhabit the human gut asymptomatically, colonization with ESBL-KP is associated with an increased risk of ESBL-KP infection and mortality. In this study, we investigated the prevalence and characteristics of ESBL-KP in fecal samples from healthy persons in 12 villages in Shandong Province, China. Methods Screening for ESBL-KP in fecal samples was performed by selective cultivation. The bacterial species were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and 16S rDNA sequence analysis. Minimum inhibitory concentrations (MICs) of 16 antibiotics were determined by the agar dilution method. Plasmid replicons, antimicrobial resistance genes and Sequence types (STs) of the isolates were determined by whole-genome sequencing (WGS). Genetic relatedness of ESBL-KP isolates was determined by the single nucleotide polymorphisms (SNP). The S1 nuclease-pulsed-field gel electrophoresis (S1-PFGE) was used to characterize the plasmids carried by ESBL-KP isolates. Conjugation assays was used to verify the transferability of bla CTX - M. Results ESBL-KP prevalence rates increased from 12.0% in 2015 to 27.5% in 2017. The experimental results showed that 97% of isolates had multi-drug resistance. Multiple ESBL resistance genotypes were commonly detected in the isolates. STs among the ESBL-KP isolates were diverse. All 69 bla CTX-M-3-positive isolates were located on plasmids, and these genes could be transferred with plasmids between different strains. Phylogenetic analysis showed the possibility of transmission among some isolates. Conclusion This study obtained the drug resistance patterns, the drug resistance phenotype and molecular characteristics of fecal-derived ESBL-KP in rural communities in Shandong Province, China. We report a rapid increase in occurrence of ESBL-KP among fecal samples collected from healthy rural residents of Shandong Province from 2015 to 2017. The carriage rate of multidrug-resistant bacteria in healthy residents is increasing. Thus, a need for further monitoring and possible interventions of ESBL-KP in this region is warranted.
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Affiliation(s)
- Shuang Wang
- Infection Disease Control of Institute, Shandong Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Hengjie Xie
- Department of Supervise Sampling, Shandong Institute for Food and Drug Control, Jinan, Shandong, China
| | - Yuzhen Chen
- Infection Disease Control of Institute, Shandong Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Lu Liu
- Infection Disease Control of Institute, Shandong Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Ming Fang
- Infection Disease Control of Institute, Shandong Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Dapeng Sun
- Infection Disease Control of Institute, Shandong Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Liuchen Xu
- Infection Disease Control of Institute, Shandong Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Zhenqiang Bi
- Infection Disease Control of Institute, Shandong Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Gaoxiang Sun
- Infection Disease Control of Institute, Shandong Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Yan Li
- Infection Disease Control of Institute, Shandong Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Xiaolin Yu
- Infection Disease Control of Institute, Shandong Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Huaning Zhang
- Infection Disease Control of Institute, Shandong Center for Disease Control and Prevention, Jinan, Shandong, China,*Correspondence: Huaning Zhang ✉
| | - Zengqiang Kou
- Infection Disease Control of Institute, Shandong Center for Disease Control and Prevention, Jinan, Shandong, China,Zengqiang Kou ✉
| | - Beiwen Zheng
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China,Jinan Microecological Biomedicine Shandong Laboratory, Department of Structure and Morphology, Jinan, Shandong, China,Research Units of Infectious Diseases and Microecology, Chinese Academy of Medical Sciences, Beijing, China,Beiwen Zheng ✉
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Bello Gonzalez TD, Kant A, Dijkstra Q, Marcato F, van Reenen K, Veldman KT, Brouwer MSM. Changes in Fecal Carriage of Extended-Spectrum β-Lactamase Producing Enterobacterales in Dutch Veal Calves by Clonal Spread of Klebsiella pneumoniae. Front Microbiol 2022; 13:866674. [PMID: 35814663 PMCID: PMC9260047 DOI: 10.3389/fmicb.2022.866674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/31/2022] [Indexed: 01/14/2023] Open
Abstract
This study aimed to characterize the changes in fecal carriage of Extended-Spectrum β-Lactamase (ESBL) producing Enterobacterales (ESBL-PE) in a single Dutch veal calves. During the rearing period at the Dutch veal farm, a decrease in fecal carriage of cefotaxime-resistant Escherichia coli isolates was observed after 2 weeks at the veal farm, while an increase of cefotaxime-resistant Klebsiella pneumoniae isolates was demonstrated. E. coli and K. pneumoniae were isolated from rectal swabs collected from 110 veal calves in week 2, 6, 10, 18, and 24 after their arrival at the farm. ESBL-PE isolates were selectively cultured and identified by MALDI-TOF. ESBL genes were characterized by RT-PCR, PCRs, and amplicon sequencing. A total of 80 E. coli and 174 K. pneumoniae strains were isolated from 104 out of 110 veal calves. The prevalence of ESBL-E. coli decreased from week 2 (61%) to week 6 (7%), while an unexpected increase in ESBL-K. pneumoniae colonization was detected in week 6 (80%). The predominant ESBL genes detected in E. coli isolates were blaCTX-M-15 and the non-ESBL gene blaTEM-1a, while in K. pneumoniae blaCTX-M-14 gene was detected in all isolates. Four cefotaxime-resistant K. pneumoniae isolates were randomly selected and characterized in deep by transformation, PCR-based replicon typing, and whole-genome sequencing (WGS). The clonal relatedness of a subgroup of nine animals carrying K. pneumoniae ESBL genes was investigated by Multi Locus sequence typing (MLST). In four ESBL-K. pneumoniae isolates, blaCTX-M-14 was located on IncFIIK and IncFIINK plasmid replicons and the isolates were multi-drug resistant (MDR). MLST demonstrated a clonal spread of ESBL-K. pneumoniae ST107. To the best of our knowledge, this is the first study to report a change in fecal carriage of ESBL-PE over time in the same veal calf during the rearing period.
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Affiliation(s)
- Teresita d.J. Bello Gonzalez
- Department of Bacteriology, Host-Pathogen Interaction, and Diagnostics Development, Wageningen Bioveterinary Research, Lelystad, Netherlands
- *Correspondence: Teresita d.J. Bello Gonzalez,
| | - Arie Kant
- Department of Bacteriology, Host-Pathogen Interaction, and Diagnostics Development, Wageningen Bioveterinary Research, Lelystad, Netherlands
| | - Quillan Dijkstra
- Department of Bacteriology, Host-Pathogen Interaction, and Diagnostics Development, Wageningen Bioveterinary Research, Lelystad, Netherlands
| | - Francesca Marcato
- Wageningen Livestock Research, Wageningen University and Research, Wageningen, Netherlands
| | - Kees van Reenen
- Wageningen Livestock Research, Wageningen University and Research, Wageningen, Netherlands
| | - Kees T. Veldman
- Department of Bacteriology, Host-Pathogen Interaction, and Diagnostics Development, Wageningen Bioveterinary Research, Lelystad, Netherlands
| | - Michael S. M. Brouwer
- Department of Bacteriology, Host-Pathogen Interaction, and Diagnostics Development, Wageningen Bioveterinary Research, Lelystad, Netherlands
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Xu C, Kong L, Gao H, Cheng X, Wang X. A Review of Current Bacterial Resistance to Antibiotics in Food Animals. Front Microbiol 2022; 13:822689. [PMID: 35633728 PMCID: PMC9133924 DOI: 10.3389/fmicb.2022.822689] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 04/04/2022] [Indexed: 12/29/2022] Open
Abstract
The overuse of antibiotics in food animals has led to the development of bacterial resistance and the widespread of resistant bacteria in the world. Antibiotic-resistant bacteria (ARB) and antibiotic-resistant genes (ARGs) in food animals are currently considered emerging contaminants, which are a serious threat to public health globally. The current situation of ARB and ARGs from food animal farms, manure, and the wastewater was firstly covered in this review. Potential risks to public health were also highlighted, as well as strategies (including novel technologies, alternatives, and administration) to fight against bacterial resistance. This review can provide an avenue for further research, development, and application of novel antibacterial agents to reduce the adverse effects of antibiotic resistance in food animal farms.
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Affiliation(s)
- Chunming Xu
- School of Light Industry, Beijing Technology and Business University, Beijing, China
- Key Laboratory of Cleaner Production and Integrated Resource Utilization of China National Light Industry, Beijing Technology and Business University, Beijing, China
| | - Lingqiang Kong
- School of Light Industry, Beijing Technology and Business University, Beijing, China
| | - Hanfang Gao
- School of Light Industry, Beijing Technology and Business University, Beijing, China
| | - Xiyu Cheng
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing, China
| | - Xiumin Wang
- Key Laboratory of Feed Biotechnology, Ministry of Agriculture and Rural Affairs, Beijing, China
- Feed Research Institute, Chinese Academy of Agricultural Sciences, Beijing, China
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Savin M, Bierbaum G, Mutters NT, Schmithausen RM, Kreyenschmidt J, García-Meniño I, Schmoger S, Käsbohrer A, Hammerl JA. Genetic Characterization of Carbapenem-Resistant Klebsiella spp. from Municipal and Slaughterhouse Wastewater. Antibiotics (Basel) 2022; 11:antibiotics11040435. [PMID: 35453187 PMCID: PMC9027467 DOI: 10.3390/antibiotics11040435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/16/2022] [Accepted: 03/22/2022] [Indexed: 12/18/2022] Open
Abstract
Currently, human and veterinary medicine are threatened worldwide by an increasing resistance to carbapenems, particularly present in opportunistic Enterobacterales pathogens (e.g., Klebsiella spp.). However, there is a lack of comprehensive and comparable data on their occurrence in wastewater, as well as on the phenotypic and genotypic characteristics for various countries including Germany. Thus, this study aims to characterize carbapenem-resistant Klebsiella spp. isolated from municipal wastewater treatment plants (mWWTPs) and their receiving water bodies, as well as from wastewater and process waters from poultry and pig slaughterhouses. After isolation using selective media and determination of carbapenem (i.e., ertapenem) resistance using broth microdilution to apply epidemiological breakpoints, the selected isolates (n = 30) were subjected to WGS. The vast majority of the isolates (80.0%) originated from the mWWTPs and their receiving water bodies. In addition to ertapenem, Klebsiella spp. isolates exhibited resistance to meropenem (40.0%) and imipenem (16.7%), as well as to piperacillin-tazobactam (50.0%) and ceftolozan-tazobactam (50.0%). A high diversity of antibiotic-resistance genes (n = 68), in particular those encoding β-lactamases, was revealed. However, with the exception of blaGES-5-like, no acquired carbapenemase-resistance genes were detected. Virulence factors such as siderophores (e.g., enterobactin) and fimbriae type 1 were present in almost all isolates. A wide genetic diversity was indicated by assigning 66.7% of the isolates to 12 different sequence types (STs), including clinically relevant ones (e.g., ST16, ST252, ST219, ST268, ST307, ST789, ST873, and ST2459). Our study provides information on the occurrence of carbapenem-resistant, ESBL-producing Klebsiella spp., which is of clinical importance in wastewater and surface water in Germany. These findings indicate their possible dissemination in the environment and the potential risk of colonization and/or infection of humans, livestock and wildlife associated with exposure to contaminated water sources.
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Affiliation(s)
- Mykhailo Savin
- Institute for Hygiene and Public Health, University Hospital Bonn, 53127 Bonn, Germany;
- Institute of Animal Sciences, University of Bonn, 53115 Bonn, Germany;
- Correspondence: (M.S.); (J.A.H.)
| | - Gabriele Bierbaum
- Institute for Medical Microbiology, Immunology and Parasitology, Medical Faculty, University of Bonn, 53115 Bonn, Germany;
| | - Nico T. Mutters
- Institute for Hygiene and Public Health, University Hospital Bonn, 53127 Bonn, Germany;
| | - Ricarda Maria Schmithausen
- Department of Hygiene and Environmental Medicine, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany;
| | - Judith Kreyenschmidt
- Institute of Animal Sciences, University of Bonn, 53115 Bonn, Germany;
- Department of Fresh Produce Logistics, Hochschule Geisenheim University, 65366 Geisenheim, Germany
| | - Isidro García-Meniño
- Department for Biological Safety, German Federal Institute for Risk Assessment, 10589 Berlin, Germany; (I.G.-M.); (S.S.); (A.K.)
- Laboratorio de Referencia de Escherichia coli (LREC), Departamento de Microbioloxía e Parasitoloxía, Facultade de Veterinaria, Universidade de Santiago de Compostela (USC), 27002 Lugo, Spain
| | - Silvia Schmoger
- Department for Biological Safety, German Federal Institute for Risk Assessment, 10589 Berlin, Germany; (I.G.-M.); (S.S.); (A.K.)
| | - Annemarie Käsbohrer
- Department for Biological Safety, German Federal Institute for Risk Assessment, 10589 Berlin, Germany; (I.G.-M.); (S.S.); (A.K.)
- Unit for Veterinary Public Health and Epidemiology, University of Veterinary Medicine, AT-1210 Vienna, Austria
| | - Jens Andre Hammerl
- Department for Biological Safety, German Federal Institute for Risk Assessment, 10589 Berlin, Germany; (I.G.-M.); (S.S.); (A.K.)
- Correspondence: (M.S.); (J.A.H.)
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