Multiresistant extended-spectrum β-lactamase-producing Enterobacteriaceae from humans, companion animals and horses in central Hesse, Germany - PubMed (original) (raw)

Comparative Study

Multiresistant extended-spectrum β-lactamase-producing Enterobacteriaceae from humans, companion animals and horses in central Hesse, Germany

Judith Schmiedel et al. BMC Microbiol. 2014.

Abstract

Background: Multiresistant Gram-negative bacteria producing extended-spectrum β-lactamases (ESBLs) are an emerging problem in human and veterinary medicine. This study focused on comparative molecular characterization of β-lactamase and ESBL-producing Enterobacteriaceae isolates from central Hesse in Germany. Isolates originated from humans, companion animals (dogs and cats) and horses.

Results: In this study 153 (83.6%) of the human isolates (n = 183) and 163 (91.6%) of the animal isolates (n = 178) were confirmed as ESBL producers by PCR and subsequent sequencing of the PCR amplicons. Predominant ESBL subtypes in human and animal samples were CTX-M-15 (49.3%) and CTX-M-1 (25.8%) respectively. Subtype blaCTX-M-2 was found almost exclusively in equine and was absent from human isolates. The carbapenemase OXA-48 was detected in 19 ertapenem-resistant companion animal isolates in this study. The Plasmid-encoded quinolone resistance (PMQR) gene aac('6)-Ib-cr was the most frequently detected antibiotic- resistance gene present in 27.9% of the human and 36.9% of the animal ciprofloxacin-resistant isolates. Combinations of two or up to six different resistance genes (penicillinases, ESBLs and PMQR) were detected in 70% of all isolates investigated. The most frequent species in this study was Escherichia coli (74%), followed by Klebsiella pneumoniae (17.5%), and Enterobacter cloacae (4.2%). Investigation of Escherichia coli phylogenetic groups revealed underrepresentation of group B2 within the animal isolates.

Conclusions: Isolates from human, companion animals and horses shared several characteristics regarding presence of ESBL, PMQR and combination of different resistance genes. The results indicate active transmission and dissemination of multi-resistant Enterobacteriaceae among human and animal populations.

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Figures

Figure 1

Figure 1

Heat maps generated from identified resistance genes and bacterial species among human and animal isolates. Identified resistance genes and bacterial species are listed according to frequency (except for CTX-M-1 and CTX-M-15) on the right and left side of the figures. Source = origin of isolates (outpatients, inpatients, dogs, cats, horses). Not included are isolates without detectable resistance gene (n = 28). The term “Other species” includes Enterobacter cloacae (n = 12), Klebsiella oxytoca (n = 9), Enterobacter intermedius (n = 2), Enterobacter gergoviae (n = 1), Citrobacter freundii (n = 1) and Proteus mirabilis (n = 1). A is focussing on the origin of isolates whereas the B emphasizes the involved bacterial species.

Figure 2

Figure 2

Distribution of E. coli phylogenetic groups among human and animal ESBL-producing isolates. A total of 267 isolates from human (n = 141) and animal (n = 126) sources were assigned to E. coli phylogenetic groups A, B1, B2 and D.

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