Occurrence of Antimicrobial Resistance in the Environment in Germany, Austria, and Switzerland: A Narrative Review of Existing Evidence

[Therapy-relevant antibiotic resistances in a One Health context]

One Health refers to a concept that links human, animal, and environmental health. In Germany, there is extensive data on antibiotic resistance (AMR) and multidrug-resistant (micro)organisms (MDRO) in human and veterinary medicine, as well as from studies in various environmental compartments (soil, water, wastewater). All these activities are conducted according to different specifications and standards, which makes it difficult to compare data. A focus on AMR and MDRO of human therapeutic importance is helpful to provide some guidance. Most data are available across sectors on methicillin-resistant Staphylococcus aureus (MRSA) and multiresistant Enterobacterales such as Escherichia coli and Klebsiella pneumoniae. Here, the trends of resistance are heterogeneous. Antibiotic use leads to MRE selection, which is well documented. Success in minimizing antibiotic use has also been demonstrated in recent years in several sectors and could be correlated with success in containing AMR and MDRO (e.g., decrease in MRSA in human medicine). Sector-specific measures to reduce the burden of MDRO and AMR are also necessary, as not all resistance problems are linked to other sectors. Carbapenem resistance is still rare, but most apparent in human pathogens. Colistin resistance occurs in different sectors but shows different mechanisms in each. Resistance to antibiotics of last resort such as linezolid is rare in Germany, but shows a specific One Health correlation. Efforts to harmonize methods, for example in the field of antimicrobial susceptibility testing and genome-based pathogen and AMR surveillance, are an important first step towards a better comparability of the different data collections.

Integrated adsorption and photocatalytic degradation based removal of ciprofloxacin and sulfamethoxazole antibiotics using Fc@rGO-ZnO nanocomposite in aqueous systems

Ferrocene functionalized rGO-ZnO nanocomposite was synthesized via the facile hydrothermal method. ZnO was reduced over the 3-dimensional rGO framework (3D-Fc@rGO) using Camellia sinensis extract. The Fc@rGO-ZnO nanocomposite was employed for pharmaceutical degradation (sulfamethoxazole (SMX) and ciprofloxacin (CIP)) in an aqueous solution under UV C light. The physicochemical properties of the as-prepared photocatalyst were characterized using FTIR, XRD, FESEM, EDS mapping, HR-TEM, XPS, and DR-UV Vis. The as-synthesized Fc@rGO-ZnO photocatalyst performed remarkably against pristine ZnO, with a fivefold increase in removal efficiency. This superior activity was attributed to its improved light harvesting, charge carrier interface, and enhanced charge separation. Additionally, the photocatalyst obeyed the Lagergen model for pseudo-first-order kinetics. Congruously, the integrated approach of Fc@rGO and ZnO as oxidizing agents was proficient in removing >95% of antibiotics (CIP and SMX) within 180 min. Furthermore, the heterostructure configuration developed between Fc@rGO and ZnO helps in charge migration and generation of abundant •OH and •O₂^- radicals for photodegradation activities. The toxicity assessment of the treated solutions showed improved cell viability in the algal strains of Scenedesmus and Chlorella sp. Moreover, this novel approach for the synthesis of a photoactive nanocomposite is found to be low-cost and reusable for three cycles. The nanocomposite is environmentally sustainable paving the way for practical applications in the treatment of different classes of antibiotics.

Special Issue "Multidrug-Resistant Bacteria in the Environment, Their Resistance and Transfer Mechanisms"

Multidrug-resistant bacteria are an emerging issue which is not restricted to clinics and the health care sector, but is increasingly affecting the environment [...].

Detecting Carbapenemases in Animal and Food Samples by Droplet Digital PCR

BACKGROUND

The presence of carbapenemase-producing bacteria (CPB) in animal hosts and along the food chain may result in the development of reservoirs for human infections. Several CPB strains isolated from animals have been reported, suggesting that transmission and dissemination of the corresponding genes between humans and animals may occur. Animal and food samples have complex backgrounds that hinder the detection of CPB present in low concentrations by standard detection procedures.

METHODS

We evaluated the possibility of detecting bla_KPC, bla_VIM, and bla_OXA-48-like carbapenemases in 286 animal and food samples (faeces from farm and companion animals, raw meat, bivalve molluscs) by culture-based and standard molecular methods and by ddPCR.

RESULTS

The proposed ddPCR managed to detect the target genes, also in samples resulting negative to standard methods. While the presence of bla_KPC and bla_VIM was detected in few samples (~3%), one third of the samples (n = 94/283) carried different variants of bla_OXA-48-like genes.

CONCLUSION

A specific and sensitive method such as ddPCR could be suitable to evaluate the current veterinarian and environmental situation and to assess the dynamic transmission and persistence of CPB between animals and humans and vice versa.

Resistance towards Critically Important Antimicrobials among Enterococcus faecalis and E. faecium in Poultry Farm Environments in Selangor, Malaysia

Multidrug resistant (MDR) enterococci pose significant public health challenges. However, the extent of resistance in the environment is less explored. This study aimed to determine the antibiotic resistance in a poultry farm environment. Eighty enterococcal isolates recovered from the soil and effluent water of 28 poultry farms in Selangor state were included in the study for further bacterial identification and antibiotic susceptibility testing using a VITEK 2 system. Data were analyzed using Statistical Package for Social Science (SPSS) version 27. The resistance rate and MDR of enterococcal isolates were reported. Out of 80 isolates recovered, 72 (90%) exhibited resistance to at least one antibiotic, with 50 isolates (62.5%) being found to be MDR. All linezolid-resistant enterococci (LRE) exhibit MDR, which constituted 40% of resistance among all the isolates recovered from poultry environment. Since linezolid is listed as critically important antibiotics for clinical use by the World Health Organization (WHO), the higher resistance towards it and other critically important antibiotic for human use is a serious concern. Hence, relevant agencies need to investigate the use of clinically important antimicrobials in poultry farms paying special attention towards linezolid or any other antibiotics that can facilitate the development of LRE.

Emotive Themes from Tennessee Cattle Producers Regarding Responsible Antibiotic Use

To improve judicious antimicrobial use (AMU) in food animals in the United States, all feed additives that were medically important antimicrobials were moved from over the counter to Veterinary Feed Directive in 2017. This action required a change in behavior of producers’ AMU practices. Because emotions are important aspects of behavior, several behavioral interventions have targeted people’s emotions as means of effecting change. Hence, understanding and incorporating the emotional experiences of producers towards current AMU practices can be a starting point to making future behavioral changes that could reduce the emergence of antimicrobial resistance challenge. Between June 2017 and March 2018, seven focus group meetings of Tennessee (TN) beef and dairy cattle producers were conducted to evaluate producers’ emotional views regarding responsible AMU in TN cattle. Sixty-two TN cattle producers participated and emotively expressed the following: (1) deep connections to animals in ways that improve animal and public health; (2) pride in their quality of products; (3) distress that consumers misconceive their AMU practices as indiscriminate; and (4) recommended that producers be more transparent about their AMU practices and the public improve their awareness for detecting marketers’ deceptive product labels that take advantage of public ignorance. Knowledge of these producers’ emotions would help educators target more successful behavioral change campaigns, improving stewardship in AMU practices among producers.