Mini-review: Epidemiology and zoonotic potential of multiresistant bacteria and Clostridium difficile in livestock and food
- PMID: 25285265
- PMCID: PMC4184042
- DOI: 10.3205/dgkh000241
Mini-review: Epidemiology and zoonotic potential of multiresistant bacteria and Clostridium difficile in livestock and food
Abstract
Aim: Information on the epidemiology of multiresistant bacteria (MRB) with zoonotic potential is growing but still remains quite incomplete. This narrative mini-review provides a general overview of the epidemiology of the most important zoonotic MRB in cattle, swine and poultry in Europe.
Methods: A literature search was conducted mainly on the PubMed website including articles published until April 2012.
Results: Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) especially poses a zoonotic risk to people working in close contact with livestock. These people may become carriers themselves and the hazard of transmission into health-care facilities needs surveillance. Extended-spectrum beta-lactamases (ESBL) producing bacteria are widely spread in both humans and livestock, sharing similar genotypes, especially of the CTX-M-group, which makes a zoonotic transfer very likely. Identical strains of vancomycin-resistant enterococci (VRE) were found both in humans and animals, after ingestion of animal strains transient colonization of the human gut may be possible. Only a few data are available on the transmission of methicillin-resistant coagulase-negative staphylococci (MR-CoNS) between humans and animals. Direct contact to colonized animals may be a risk factor as well as the exchange of resistance genes between human and animal staphylococci. Clostridium difficile (C. difficile) ribotype 078 emerges in livestock and humans and a zoonotic transmission seems probable as genotypes and diseases resemble each other.
Conclusion: All discussed MRB and C. difficile are important nosocomial agents which also occur in livestock and were found in foods of animal origin. Further analysis is needed to reveal the exact transmission routes and to perform a reliable risk assessment.
Zielsetzung: Die Intention des vorliegenden narrativen Mini-Reviews ist es, dem Leser einen Überblick über die Prävalenz und Epidemiologie multiresistenter Bakterien in Europa bei Rindern, Schweinen und Geflügel zu geben und deren zoonotisches Potential zu beleuchten. Methode: Es wurde eine PubMed-Literaturrecherche unter Einschluss bis April 2012 publizierter Artikel durchgeführt.Ergebnisse: Der livestock-associated Methicillin-resistente Staphylococcus aureus (LA-MRSA) ist nicht nur bei Nutztieren, sondern auch häufig bei engen Kontaktpersonen nachweisbar. Dem Eintrag durch kolonisierte und infizierte Personen ins Gesundheitswesen muss deshalb Beachtung geschenkt werden. Bakterien, die die Fähigkeit besitzen, β-Laktamasen mit einem erweitertem Wirkspektrum (ESBL) zu bilden, sind ebenfalls bei Mensch und Nutztier zu finden. Insbesondere die ESBL vom Typ CTX-M stehen im Verdacht, zwischen Mensch und Tier übertragen zu werden. Einige Studien legen nahe, dass eine Transmission von Vancomycin-resistenten Enterokokken (VRE), z.B. nach oraler Aufnahme kontaminierter tierischen Lebensmitteln, auf den Menschen möglich ist. Bezüglich des zoonotischen Potentials von multiresistenten Koagulase-negativen Staphylokokken (MR-CoNS) existieren hingegen nur wenige Publikationen. Es gibt jedoch erste Hinweise, dass eine zoonotische Übertragung möglich sein könnte und auch der Austausch von Resistenzgenen zwischen humanen und tierischen Bakterien scheint prinzipiell möglich. Die Nachweisrate von Clostridium difficile (C. difficile), v.a. des Ribotyps 078, hat bei Mensch und Tier gleichermaßen zugenommen. Nicht nur die Genotypen, auch die verursachten Infektionen weisen unabhängig von der betroffenen Spezies Gemeinsamkeiten auf. Schlussfolgerung: Alle betrachteten multiresistenten Erreger sowie C. difficile spielen eine erhebliche Rolle bei nosokomialen Infektionen in der Humanmedizin und sind ebenfalls bei Nutztieren und Lebensmitteln tierischen Ursprungs zu finden. Weitere Studien sind nötig, um die exakten Transmissionsrouten zu identifizieren und eine valide Risikobeurteilung durchzuführen.
Keywords: Clostridium difficile; E. coli; ESBL; MRSA; VRE; livestock; multiresistant; vancomycin; zoonoses.
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