Increase of bacterial resistance in human medicine by resistance genes of bacteria from meat supplying animals

Two different groups of bacteria carrying genes encoding for resistance to antibiotics may be transmitted from animals to humans via food products: a.) obligate infectious agents (enteric pathogens, e.g. Salmonella enterica spp., Campylobacter spp., EHEC) and b) facultative pathogenic species (e.g. E. coli, enterococci). Thus far, it is unknown whether genes encoding for resistance to antibiotics from these bacteria may be transferred to bacteria in normal flora of the host. The transfers of genes encoding for resistance to vancomycin from animal sources to the mucosa of humans has been suggested. Thus, there is a threat that these plasmid-encoded resistance genes may also be transferred to other gram-positive organisms present in the human flora. Vancomycin is the antibiotic in reserve for treatment of infections caused by oxacillin (methicillin) resistant strains of S. aureus and by strains of pneumococcus resistant to penicillin.     

Veterinary use of antimicrobials and emergence of resistance in zoonotic and sentinel bacteria in the EU

Antimicrobials are essential for treatment of sick animals, but even if used correctly, may eventually lead to antimicrobial resistance. While this represents a potential hazard to humans, the great majority of resistant human pathogens, especially the more important ones, are unrelated to animal sources. A survey of informed medical opinion suggested that of the human antimicrobial resistance problem, <4% was seen as potentially linked to animal sources. This proportion related largely to zoonotic bacteria which by definition have the capacity to carry resistance between species, although the evidence for resulting harm remains limited. A recent study compared resistance among chicken, pig and cattle isolates of Salmonella spp., Campylobacter spp. and Escherichia coli from a series of EU countries. When tested against antimicrobial agents, this survey showed variation of resistance between countries, between hosts and between organisms. Such variation may give insight into preferred methods of antimicrobial administration or disease control, but it is clear that the epidemiology of antimicrobial resistance induction and dissemination in animals remains complex and is yet to be fully understood.     

beta-Lactam resistance and beta-lactamases in bacteria of animal origin

beta-Lactams are among the most clinically important antimicrobials in both human and veterinary medicine. Bacterial resistance to beta-lactams has been increasingly observed in bacteria, including those of animal origin. The mechanisms of beta-lactam resistance include inaccessibility of the drugs to their target, target alterations and/or inactivation of the drugs by beta-lactamases. The latter contributes predominantly to beta-lactam resistance in Gram-negative bacteria. A variety of beta-lactamases have been identified in bacteria derived from food-producing and companion animals and may further serve as a reservoir for beta-lactamase-producing bacteria in humans. While this review mainly describes beta-lactamases from animal-derived Escherichia coli and Salmonella spp., beta-lactamases from animal-derived Campylobacter spp., Enterococcus spp., Staphylococcus spp. and other pathogens are also discussed. Of particular concern are the increasingly-isolated plasmid-encoded AmpC-type CMY and extended-spectrum CTX-M beta-lactamases, which mediate acquired resistance to extended-spectrum beta-lactams. The genes encoding these enzymes often coexist with other antimicrobial resistance determinants and can also be associated with transposons/integrons, increasing the potential enrichment of multidrug resistant bacteria by multiple antimicrobial agents as well as dissemination of the resistance determinants among bacterial species. Characterization of beta-lactam-resistant animal-derived bacteria warrants further investigation of the type and distribution of beta-lactamases in bacteria of animal origin and their potential impact on human medicine.     

Prevalence and diversity of Arcobacter spp. isolated from the internal organs of spontaneous porcine abortions in Denmark

A study was conducted to determine the prevalence and possible significance of campylobacteria in pig abortions in Denmark. Surface-cauterised liver and kidney samples from 55 aborted pig fetuses submitted to the Danish Veterinary Laboratory were taken and a sensitive isolation procedure used to examine pooled tissue samples for Campylobacter, Arcobacter and Helicobacter spp. Routine microbiological, immunological, and histopathological examinations were also performed to identify concurrent infections or histopathological changes. The abortions tested negative for established abortifacient pathogens (Brucella, Leptospira, PPV, PRRSV), but Arcobacter spp. were recovered from 23/55 abortions. Co-infections with Streptococcus suis, Escherichia coli, and haemolytic streptococci were observed in 7/23 Arcobacter-positive fetuses, and in 4/32 Arcobacter-negative fetuses. Histopathological analyses identified placentitis, pneumonia, hepatitis and encephalitis among the study group. However, no obvious pathologic features were solely associated with Arcobacter-positive cases, nor were Arcobacter-like bacteria observed in tissue samples. Protein profile analyses of the 27 Arcobacter isolates identified 11 as A. cryaerophilus and 10 as A. skirrowii. Six strains could not be classified into any existing species and were phenotypically distinct, thus, potentially representing at least one new species. The identification results showed that multiple taxa could be found in a single fetus, and in distinct aborted fetuses from a single sow. The high prevalence of arcobacters in Danish pig abortions may account for at least some of the >90% of cases in which no established abortifacient agent is detected, but further studies are needed to define the role of each species, especially where co-infections with other bacteria are present.     

Emerging enterohaemorrhagic Escherichia coli, causes and effects of the rise of a human pathogen

Shiga toxin (Stx) [Verotoxin (VT)]-producing Escherichia coli (STEC), also called enterohaemorrhagic E. coli or VTEC are emerging zoonotic agents and became most important as human pathogens, particularly in the industrialized countries. Production of cytotoxins, also called Stx or VT, is the major pathogenicity determinant of STEC, which can cause life-threatening haemorrhagic diseases in humans. The spectrum of STEC phenotypes is diverse and domestic and wildlife animals constitute important reservoirs for these bacteria. STEC are spread from animal faeces to the environment, water and food. Ingestion of contaminated foodstuff and water, as well as contact with the environment, STEC-excreting animals or humans are the major sources of human infection. Economical changes in animal and food production, alteration of consumer habits and lack of specific immune response, particularly in urbanized populations, have contributed to the recent spread of STEC as a zoonotic agent. Supranational surveillance networks as well as national reference laboratories as sentinels play an important role in the prevention and control of STEC infections in humans. Development of new vaccines and probiotics may serve as future tools to control the spread of STEC in animals and humans.     

Examination of Australian backyard poultry for Salmonella,Campylobacter and Shigella spp., and related risk factors

Worldwide, foodborne illness is a significant public health issue in both developed and developing countries. Salmonellosis, campylobacteriosis and shigellosis are common foodborne gastrointestinal illnesses caused by the bacteria Salmonella spp., Campylobacter spp. and Shigella spp. respectively. These zoonotic diseases are frequently linked to eggs and poultry products. The aim of this study was to investigate the presence of these pathogens in Australian backyard poultry flocks and to determine risk factors for these pathogens. Poultry faeces samples were collected from 82 backyards and screened for Salmonella spp., Campylobacter spp. and Shigella spp. using qPCR. A questionnaire was administered to the backyard poultry owners to assess their knowledge regarding management of poultry and eggs and to identify potential risk factors that may contribute to the presence of zoonotic pathogens in the flocks. One composite faecal sample was collected from each backyard (82 samples). Composite sampling here means taking one or more grab samples from a backyard to make up approximately 10 grams. Four per cent of samples, that is 4% backyards tested, were positive for Salmonella spp., 10% were positive for Campylobacter spp. and none were positive for Shigella spp. A higher infection rate was seen in multi-aged flocks (24%) compared with the single-aged flocks (3%). The survey found that many participants were engaging in risky food safety behaviours with 46% of participants responding that they washed their eggs with running water or still water instead of wiping the dirt off with a damp cloth to clean the eggs and 19% stored their eggs at room temperature. This study demonstrated that backyard poultry may pose a potential risk for salmonellosis and campylobacteriosis. Additionally, Australian public health and food safety regulations should be modified and effectively implemented to address the risks associated with backyard poultry husbandry.     

Public health and policy

Antimicrobial agent usage data are essential for focusing efforts to reduce misuse and overuse of antimicrobial agents in food producing animals because these practices may select for resistance in bacteria of animals. Transfer of resistant bacteria from animals to humans can lead to human infection caused by resistant pathogens. Resistant infections can lead to treatment failures, resulting in prolonged or more severe illness. Multiple World Health Organization (WHO) reports have concluded that both antimicrobial resistance and antimicrobial usage should be monitored on the national level. The system for collecting antimicrobial usage data should be clear and transparent to facilitate trend analysis and comparison within and among countries. Therapeutic, prophylactic and growth promotion use should be recorded, along with route of administration and animal species and/or production class treated. The usage data should be compared to resistance data, and the comparison should be made available in a timely manner. In the United States, surveillance of antimicrobial resistance in foodborne bacteria is performed by the National Antimicrobial Resistance Monitoring System (NARMS) for enteric bacteria, however, the United States still lacks a mechanism for collecting antimicrobial usage data. Combined with antimicrobial resistance information from NARMS, antimicrobial usage data will help to direct education efforts and policy decisions, minimizing the risk that people will develop antimicrobial resistant infections as a result of eating food of animal origin. Ultimately mitigation strategies guided by usage data will be more effective in maintaining antimicrobial drugs for appropriate veterinary use and in protecting human health.     

Isolation of various Arcobacter species from domestic geese (Anser anser)

In this study, the prevalence and distribution of various Arcobacter spp. were investigated in samples taken from the cloacae of healthy domestic geese raised in Turkey. A membrane filtration technique with a non-selective blood agar was employed after enrichment in Arcobacter enrichment broth (AEB) to isolate a wide range of Arcobacter spp. In addition, the isolates were characterized phenotypically and identified at species level using a multiplex-PCR assay. A total of 90 cloacal swab samples taken from geese, collected on three farms (18, 25, 47 samples, respectively), were examined. Of the samples examined, 16 (18%) were found positive for Arcobacter. One Arcobacter species was isolated from each bird. Of the 16 Arcobacter isolates, 7 (44%), 7 (44%) and 2 (12.5%) were identified by m-PCR as A. cryaerophilus, A. skirrowii and A. butzleri, respectively. The present study indicates that domestic geese can harbour a variety of Arcobacter spp. in their cloacae. The presence of Arcobacter in geese may be of significance as reservoirs in their dissemination. Detailed research is needed for better understanding of the epidemiology and zoonotic potential of this emerging pathogen.     

Global Distribution and Prevalence of Arcobacter in Food and Water

The emerging foodborne and waterborne pathogen, Arcobacter, has been linked to various gastrointestinal diseases. Currently, 19 species are established or proposed; consequently, there has been an increase in the number of publications regarding Arcobacter since it was first introduced in 1991. To better understand the potential public health risks posed by Arcobacter, this review summarizes the current knowledge concerning the global distribution and the prevalence of Arcobacter in food and water. Arcobacter spp. were identified in food animals, food‐processing environments and a variety of foods, including vegetables, poultry, beef, dairy products, seafood, pork, lamb and rabbit. A wide range of waterbodies has been reported to be contaminated with Arcobacter spp., such as wastewater, seawater, lake and river water, drinking water, groundwater and recreational water. In addition, Arcobacter has also been isolated from pets, domestic birds, wildlife, zoo and farm animals. It is expected that advancements in molecular techniques will facilitate better detection worldwide and aid in understanding the pathogenicity of Arcobacter. However, more extensive and rigorous surveillance systems are needed to better understand the occurrence of Arcobacter in food and water in various regions of the world, as well as uncover other potential public health risks, that is antibiotic resistance and disinfection efficiency, to reduce the possibility of foodborne and waterborne infections.     

Hepatitis E virus as an emerging zoonotic pathogen

Hepatitis E outbreaks are a serious public health concern in developing countries. The disease causes acute infections, primarily in young adults. The mortality rate is approximately 2%; however, it can exceed 20% in pregnant women in some regions in India. The causative agent, hepatitis E virus (HEV), has been isolated from several animal species, including pigs. HEV genotypes 3 and 4 have been isolated from both humans and animals, and are recognized as zoonotic pathogens. Seroprevalence studies in animals and humans indirectly suggest that HEV infections occur worldwide. The virus is primarily transmitted to humans via undercooked animal meats in developed countries. Moreover, transfusion- and transplantation-mediated HEV infections have recently been reported. This review summarizes the general characteristics of hepatitis E, HEV infection status in animals and humans, the zoonotic transmission modes of HEV, and HEV vaccine development status.     

Detection and identification of food-borne pathogens of the genera Campylobacter, Arcobacter and Helicobacter by multiplex PCR in poultry and poultry products

The objective of this study was to develop a multiplex polymerase chain reaction (PCR) to detect and differentiate food-borne pathogens of the three genera Campylobacter, Arcobacter and Helicobacter in a single step procedure. One common reverse primer and three genus-specific forward primers were designed by hybridizing to the 16S rRNA of selected reference strains. Besides the species with significance as food-borne pathogens isolated from poultry meat--Campylobacter jejuni, Campylobacter coli, Arcobacter butzleri and Helicobacter pullorum--several other members of these genera were tested to determine the specificity of the designed multiplex PCR. In total, 20 ATCC and NCTC reference strains of Campyobacter, Arcobacter and Helicobacter were used to evaluate the PCR. Specific amplificates were obtained from all thermophilic species of Campylobacter as well as from species of Arcobacter and Helicobacter. No amplification product was obtained from the non-thermophilic Campylobacter, C. hyointestinalis and C. fetus. Furthermore, a total of 43 field strains of the three genera isolated from poultry, pigs, cattle and humans were investigated using this PCR. To confirm the classification of 10 H. pullorum strains the 16S rRNAs were sequenced. The developed PCR is a helpful diagnostic tool to detect and differentiate Campylobacter, Arcobacter and Helicobacter isolated from poultry and poultry products.     

Prevalence of gastrointestinal bacterial pathogens in a population of zoo animals

Faecal prevalence of gastrointestinal bacterial pathogens, including Campylobacter, Escherichia coli O157:H7, Salmonella, Shigella, Yersinia, as well as Arcobacter, were examined in 317 faecal specimens from 44 animal species in Belfast Zoological Gardens, during July-September 2006. Thermophilic campylobacters including Campylobacter jejuni, Campylobacter coli and Campylobacter lari, were the most frequently isolated pathogens, where members of this genus were isolated from 11 animal species (11 of 44; 25%). Yersinia spp. were isolated from seven animal species (seven of 44; 15.9%) and included, Yersinia enterocolitica (five of seven isolates; 71.4%) and one isolate each of Yersinia frederiksenii and Yersinia kristensenii. Only one isolate of Salmonella was obtained throughout the entire study, which was an isolate of Salmonella dublin (O 1,9,12: H g, p), originating from tiger faeces after enrichment. None of the animal species found in public contact areas of the zoo were positive for any gastrointestinal bacterial pathogens. Also, water from the lake in the centre of the grounds, was examined for the same bacterial pathogens and was found to contain C. jejuni. This study is the first report on the isolation of a number of important bacterial pathogens from a variety of novel host species, C. jejuni from the red kangaroo (Macropus rufus), C. lari from a maned wolf (Chrysocyon brachyurus), Y. kristensenii from a vicugna (Vicugna vicugna) and Y. enterocolitica from a maned wolf and red panda (Ailurus fulgens). In conclusion, this study demonstrated that the faeces of animals in public contact areas of the zoo were not positive for the bacterial gastrointestinal pathogens examined. This is reassuring for the public health of visitors, particularly children, who enjoy this educational and recreational resource.     

Recovery of Arcobacter spp. from nonlivestock species

The genus Arcobacter encompasses campylobacter-like organisms that grow in air at 25 degrees C. Arcobacter has been detected or isolated from clinically healthy livestock as well as aborted fetuses and has been presumptively identified as either Campylobacter or Leptospira, based on its growth in selective semisolid media. Because reports from nonlivestock species are limited, this study examined nine presumptive isolates of Arcobacter spp. from an alpaca (Vicugna pacos), black rhinoceros (Diceros bicornis), white rhinoceros (Ceratotherium simum), gorilla (Troglodytes gorilla), gazelle (Eudorcas thomsoni), rhea (Rhea americana), and aborted equine fetuses. Seven of these nine phenotypically identified isolates of Arcobacter were confirmed by a multiplex polymerase chain reaction assay. The remaining two isolates were subsequently identified as Arcobacter skirrowii (Case 5) and Campylobacter jejuni (Case 6) by sequence analysis of a 527-base pair fragment of the 16S rRNA gene. Together, these cases underscore the challenges to a clinical laboratory of identifying Arcobacter in cases which mimic vibrionic abortion or leptospirosis.     

Methicillin-resistant Staphylococcus aureus and Staphylococcus pseudintermedius in veterinary medicine

Staphylococci are important opportunistic pathogens in most animal species. Among the most relevant species are the coagulase positive species Staphylococcus aureus and Staphylococcus pseudintermedius. Methicillin resistance has emerged as an important problem in both of these organisms, with significant concerns about animal and public health. The relative importance of these staphylococci on different animal species varies, as do the concerns about zoonotic transmission, yet it is clear that both present a challenge to veterinary medicine.     

Animal health and foodborne pathogens: enterohaemorrhagic O157:H7 strains and other pathogenic Escherichia coli virotypes (EPEC,ETEC, EIEC,EHEC)

The majority of interactions between microorganisms and animals are based on convenient relations for both of them. Symbiotic microorganisms, like intestinal microbiota, produce important vitamins for animals and protects them from putative pathogens. In general, for monogastric animals, the main contribution of intestinal microorganisms is to supply with growth factors the animal diet, and in some cases they are responsible for providing essential vitamins (e.g. vitamin K). Some particular and relatively few microbes like viruses, bacteria, fungi, protozoa and algae are responsible for animal illness. Because microorganisms are easily dispersed, display physiological diversity, and tolerate extreme conditions, they are ubiquitous and may contaminate and grow in many products, including food and raw materials. Foodborne diseases are caused by consumption of contaminated food or beverages. Many different disease-causing pathogens can contaminate food, so there are many different foodborne infections. In addition, poisonous chemicals and biological toxins can cause disease if they are present in food. To know how a particular disease is spreading is an important matter to take appropriate steps to stop it. For example Escherichia coli O157:H7 infections can spread through contaminated food (meat, vegetables, cheese, etc.), contaminated drinking water or juices, contaminated swimming water and from person to person. Among foodborne pathogens, the most frequently detected are bacteria, but also parasitic protozoa and worms, viruses, natural toxins and other pathogenic agents like prions are important agents for foodborne diseases. Particular pathogenic types of E. coli, classified by their specific pathogenic mechanisms (toxins, adhesins, invasiveness, etc.) are actually known as E. coli virotypes. Enterohaemorrhagic E. coli (EHEC), which constitute the main part of this review, were also named verotoxigenic E. coli (VTEC) or Shiga toxigenic E. coli (STEC). EHEC strains cause haemorrhagic colitis (HC), haemolytic uremic syndrome (HUS) and thrombotic thrombocytopaenic purpura (TP) in humans. They synthetize shigatoxins (verotoxins) which are potent cytotoxic substances, adherence factors and enterohaemolysin. EHEC are responsible for many outbreaks of bloody diarrhoea caused by contaminated foods: beef, milk, fruits, juice, water, etc. The most important serogroups among EHEC are O26, O111 and O157, being O157:H7 the most relevant serotype in foodborne outbreaks. The normal intestinal microflora of cattle was found to be the most relevant reservoir of EHEC strains.     

Amebae and ciliated protozoa as causal agents of waterborne zoonotic disease

The roles free-living amebae and the parasitic protozoa Entamoeba histolytica and Balantidium coli play as agents of waterborne zoonotic diseases are examined. The free-living soil and water amebae Naegleria fowleri, Acanthamoeba spp., and Balamuthia mandrillaris are recognized etiologic agents of mostly fatal amebic encephalitides in humans and other animals, with immunocompromised and immunocompetent hosts among the victims. Acanthamoeba spp. are also agents of amebic keratitis. Infection is through the respiratory tract, breaks in the skin, or by uptake of water into the nostrils, with spread to the central nervous system. E. histolytica and B. coli are parasitic protozoa that cause amebic dysentery and balantidiasis, respectively. Both intestinal infections are spread via a fecal-oral route, with cysts as the infective stage. Although the amebic encephalitides can be acquired by contact with water, they are not, strictly speaking, waterborne diseases and are not transmitted to humans from animals. Non-human primates and swine are reservoirs for E. histolytica and B. coli, and the diseases they cause are acquired from cysts, usually in sewage-contaminated water. Amebic dysentery and balantidiasis are examples of zoonotic waterborne infections, though human-to-human transmission can occur. The epidemiology of the diseases is examined, as are diagnostic procedures, anti-microbial interventions, and the influence of globalization, climate change, and technological advances on their spread.     

The role of wildlife in transboundary animal diseases

This paper identifies some of the more important diseases at the wildlife-livestock interface and the role wildlife plays in disease transmission. Domestic livestock, wildlife and humans share many similar pathogens. Pathogens of wild or domestic animal origin that can cause infections in humans are known as zoonotic organisms and the converse are termed as anthroponotic organisms. Seventy-seven percent of livestock pathogens and 91% of domestic carnivore pathogens are known to infect multiple hosts, including wildlife. Understanding this group of pathogens is critical to public health safety, because they infect a wide range of hosts and are most likely to emerge as novel causes of infection in humans and domestic animals. Diseases at the wildlife-livestock interface, particularly those that are zoonotic, must be an area of focus for public health programs and surveillance for emerging infectious diseases. Additionally, understanding wildlife and their role is a vital part of understanding the epidemiology and ecology of diseases. To do this, a multi-faceted approach combining capacity building and training, wildlife disease surveillance, wildlife-livestock interface and disease ecology studies, data and information sharing and outbreak investigation are needed.     

Shedding of foodborne pathogens and microbial carcass contamination of hunted wild ruminants

To assess the shedding of selected bacterial foodborne pathogens, fecal samples from 239 hunted wild red deer, roe deer, chamois, and ibex were examined. All samples tested negative for Salmonella spp. and L. monocytogenes, but other Listeria species were occasionally found. Of the 239 fecal samples, 32.6% tested positive for stx (Shiga toxins), 6.7% for eae (intimin) and 13.8% for both stx and eae genes. Among the 56 isolated Shiga toxin-producing Escherichia coli (STEC) strains, 44.6% harbored genes for the Stx2 group, 30.4% for the Stx1 group, and 21.4% for both Stx1 and Stx2. Only two of these strains harbored eae. Hence, wild ruminants constitute a reservoir for STEC, but further characterization data of the isolated strains are required to assess their actual human pathogenicity. In addition, 328 carcasses from hunted wild red deer, roe deer, and chamois were examined for total viable counts (TVC) and Enterobacteriaceae by swabbing. For the examined animal species, average TVC (4.0-4.2 log CFU cm(-2)) and average Enterobacteriaceae counts/detection rates (2.3-2.6 log CFU cm(-2); 87.5-90%) were at comparable levels. On the other hand, the microbial status of carcasses differed between certain abattoirs by several orders of magnitude. Strict compliance with good hunting and hygiene practices during any step from shooting, through evisceration in the field, to dehiding, cooling, and processing is therefore of central importance to avoid contaminations and to prevent foodborne pathogens carried by the animals from entering the food chain.     

Public health and research perspectives on the microbial contamination of foods

Scientific advances in methodology and epidemiology have resulted in a renewed awareness of foodborne disease, and increased contact among nations of the world has stimulated rapid global distribution of foods as well as foodborne pathogens. New food vehicles are being identified for old, familiar pathogens, and new pathogens are being discovered. Current research in food microbiology has spurred development of rapid and specific methods to identify these pathogens and to assess their virulence. Organisms of recent interest, such as Bacillus, Yersinia, Campylobacter, Listeria, Sporothrix, Giardia, Cryptosporidium, and Anisakis, are the foci of new investigations, as are the more familiar foodborne pathogens, Salmonella, Shigella, Clostridium, Staphylococcus, Entamoeba and Ascaris. Some foodborne organisms, such as parasitic protozoa, serve as hosts for unique bacterial and viral symbionts but also might become infected with mammalian viruses. The remote possibility of the transmission of human immunodeficiency viruses in foodborne protozoa is discussed.