动物生产中抗药性传播的鉴定和监测

前言 人类医学中抗菌药抗药性问题正日趋严重.虽然这一现象被公认为主要由人医中抗菌药的使用造成的,但是人们一直关注因在动物中使用抗菌药而产生的抗药性能否转移给人的病原菌.     

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.     

我国动物源细菌耐药状况、存在问题和对策

动物源细菌耐药性问题不仅关系到动物的用药安全,也与公共卫生安全密切相关,日益引起各国的关注。中国兽医药品监察所从事动物源细菌耐药性检测工作10余年,对我国动物源细菌的耐药性状况进行了系统的调查。本文从动物源细菌耐药性监测工作的重要性、我国动物源细菌的耐药性状况、存在的问题以及应对策略四个方面进行了综述,以期对我国的动物源细菌耐药性监测工作起一定的参考作用。     

国家动物源细菌耐药性监测工作的探讨和建议

介绍了国外动物源细菌耐药性监测工作的情况及目标,对我国的动物源细菌耐药性监测工作需考虑的许多因素进行了介绍和讨论,包括动物品种、食品、采样方法、样本的收集、细菌品种、抗菌药物、标准药敏试验法、质控、结果记录和数据库设计、报告和结果分析等,并对今后的动物源细菌耐药性监测工作提出了建议。     

International trends impacting antimicrobial stewardship in animal health

The Tripartite collaboration (World Health Organization, the Food and Agriculture Organisation of the United Nations, and the World Organisation for Animal Health) produced two documents for consultation with Member Countries in 2017 ‐ Monitoring and Evaluation of the Global Action Plan on Antimicrobial Resistance: Proposed approach and the Global Framework for Development & Stewardship to Combat Antimicrobial Resistance: Draft Roadmap. These documents intend to support a strategic whole‐of‐system approach towards the World Health Organization's Global Action Plan on Antimicrobial Resistance. This paper outlines the recent thinking in antimicrobial stewardship being developed by the major international organisations involved with mitigating global antimicrobial resistance. The directions being set in key frameworks will need to be considered by Australian stakeholders as their own antimicrobial stewardship approaches and activities are formulated.     

Antimicrobial resistance in bacteria from horses: Epidemiology of antimicrobial resistance

Antimicrobial resistance poses a significant threat to the continued successful use of antimicrobial agents for the treatment of bacterial infections. While the epidemiology of antimicrobial resistance in bacteria from man has been studied extensively, less work has been undertaken in companion animals, particularly horses. Methicillin‐resistant Staphylococcus aureus has been identified as a cause of infections, with a low prevalence of nasal carriage by horses in the community but higher for hospitalised horses. Molecular characterisation has shown methicillin‐resistant Staphylococcus aureus strains either to be predominantly of types associated with horses or of sequence type ST398. Antimicrobial‐resistant Escherichia coli (including multidrug‐resistant and extended spectrum β‐lactamase‐producing isolates) have caused infections and been documented in faecal carriage by horses, with many significant resistance mechanisms identified. More sporadic reports and molecular characterisation exist for resistance in other bacteria such as enterococci, Salmonella, Acinetobacter and Pseudomonas species. Limited work has been undertaken evaluating risk factors and much of the epidemiology of antimicrobial resistance in bacteria from horses remains to be determined.     

External quality assurance system for antibiotic resistance in bacteria of animal origin in Europe (ARBAO-II), 2003

Initiated in 2003 by the European Union, ARBAO-II aims to establish a monitoring of antimicrobial susceptibility among the veterinary laboratories in all European countries based on validated methodologies. This includes an external quality control system for the most important bacterial pathogens. In 2003 two trials were performed. The first on Salmonella and Escherichia coli involved 31 laboratories in 18 countries and the second on Staphylococcus and Streptococcus included 22 laboratories in 15 countries. For the E. coli strains, 92.8% of the results complied with the reference MICs, for Salmonella 93.7%, for Streptococcus 80.4% and for Staphylococcus 93.1%. Most problems were observed when testing florfenicol (79.2% correct), gentamicin (84.2%) and amoxicillin + cl (84.9%) in E. coli; streptomycin in Salmonella (62.5%); gentamicin (56.7%), lincomycin (71.4%), clindamycin (75.4%), TMP + sulfonamides (75.7%) and chloramphenicol (78.5%) in Streptococcus; erythromycin (81.5%) and oxacillin (78.2.5%) in Staphylococcus. A few laboratories caused most deviations. However, there was no correlation between good performance for one bacterial group and good performance for other groups. This study showed that most laboratories are capable of performing correct susceptibility testing for E. coli and Salmonella, even though performance of some laboratories can be improved, and that some problems exist for Staphylococcus and Streptococcus. This clearly shows the need for continuous harmonisation of methodologies within the EU.     

Susceptibility of Clostridium perfringens of animal origin to fifteen antimicrobial agents

The minimal inhibitory concentrations of fifteen antibacterial agents were determined by agar-dilution method against 121 strains of Clostridium perfringens isolated from pigs, cattle and poultry. All strains, regardless of host of origin, were susceptible to avoparcin, furazolidone, monensin, nitrovin, penicillin G, ronidazole and tiamulin and resistant to flavomycin. Poultry strains were also susceptible to carbadox, chloramphenicol, erythromycin and virginiamycin. Bacitracin-resistant poultry strains were susceptible to all tested antibacterial agents except tetracycline, but the bacitracin-resistant cattle strains were polyresistant. Porcine strains were susceptible to bacitracin and bovine strains to carbadox. Carbadox-resistant porcine strains were resistant to erythromycin, lincomycin and tetracycline and susceptible to chloramphenicol. Resistance to erythromycin was associated with resistance to lincomycin. High level erythromycin-lincomycin-resistant strains were susceptible to virginiamycin, but the intermediate level erythromycin-lincomycin-resistant cattle strains were resistant to virginiamycin. Resistance to chloramphenicol or erythromycin-lincomycin was always associated with resistance to tetracycline but the reverse was not always true.     

浅析动物源细菌抗生素耐药性的现状与对策

抗生素的滥用使细菌耐性问题日趋恶化,从细菌耐药性的定义、耐药机理及危害出发,简要阐述和分析了动物源细菌抗菌药物耐药性的现状及对策,并简述我国动物源细菌耐药性研究进展。     

Usage of antimicrobials and occurrence of antimicrobial resistance among bacteria from mink

The usage of antimicrobials for treatment of mink and the occurrence of antimicrobial resistance among the most important bacterial pathogens in mink was investigated. The aim of the study was to provide data, which may serve as a basis for the formulation of recommendations for prudent use of antimicrobials for mink. A total of 164 haemolytic staphylococci, 49 haemolytic streptococci, 39 Pseudomonas aeruginosa, 13 Pasteurella multocida, and 1093 Escherichia coli isolates from Danish mink were included in the study. A high frequency of resistance among S. intermedius was found for tetracyclines (54.7%), followed by penicillin (21.7%), lincosamides (20.4%), macrolides (19.1%), and spectinomycin (18.5%). Very low frequencies of resistance were recorded for other antimicrobials. The highest frequency among the E. coli isolates was recorded for ampicillin, streptomycin, sulphonamides, and tetracyclines, whereas resistance to other antimicrobials was rare. All P. aeruginosa were sensitive to gentamicin and colistin and sensitive or intermediate to enrofloxacin, whereas most isolates were resistant to all other antimicrobials. All P. multocida and haemolytic streptococci were sensitive to penicillin. There was a steady increase in the use of antimicrobials during the period 2001-2006, the majority of the prescribed amount being extended spectrum penicillins followed by aminoglycosides, sulphonamides with trimethoprim, and macrolides.     

Zinc resistance of Staphylococcus aureus of animal origin is strongly associated with methicillin resistance

This study was conducted to determine the occurrence of zinc and copper resistances in methicillin-resistant Staphylococcus aureus (MRSA) from swine and veal calves in a global strain collection. The test population consisted of 476 porcine MRSA isolates from ten European countries, 18 porcine MRSA isolates from Canada and seven MRSA from China, 92 MRSA and 60 methicillin-susceptible S. aureus (MSSA) isolates from veal calves in the Netherlands and 88 porcine MSSA isolates from four European countries. Most porcine MRSA (n=454) and all bovine MRSA belonged to clonal complex (CC) 398 whereas 37 of the pig MRSA from Europe and the seven Chinese isolates belonged to other CCs and 3 isolates were not classified into a CC. All isolates were tested for susceptibility to zinc chloride and copper sulphate using agar dilution and tested by PCR for the czrC gene encoding zinc resistance. Phenotypic zinc resistance (MIC>2mM) was observed in 74% (n=324) and 42% (n=39) of European MRSA CC398 from pigs and veal calves, respectively, and in 44% of the Canadian isolates (n=8), but not among the Chinese isolates. Almost all (99%) zinc-resistant MRSA carried czrC. Of the 37 European non-CC398 MRSA, 62% were resistant to zinc, but only 46% of them carried czrC. The MICs of the MSSA isolates to zinc chloride ranged from 1 to 4mM and none carried czrC. The MICs of copper sulphate were associated neither with methicillin resistance nor with the detection of czrC. This study showed that zinc resistance and the czrC gene are widespread among CC398 MRSA isolates. This suggests that the use of zinc in feed might have contributed to the emergence of MRSA.     

Trends of antimicrobial resistance in bacterial isolates from a small animal referral hospital

A longitudinal, retrospective investigation was made of antimicrobial resistance in bacterial isolates obtained from clinical cases in a small animal hospital between 1989 and 1997. Isolates of Escherichia coli and Staphylococcus species were used as Gram-negative and Gram-positive indicator organisms, respectively, and the annual prevalence of antimicrobial resistance was calculated for each organism to each of nine (for E coli) and 11 (for Staphylococcus species) appropriate antimicrobials, including enrofloxacin. Using a chi-square test for trend, statistically significant, rising trends were identified in the resistance of E coli to amoxycillin (P=0.04), clavulanate-amoxycillin (P<0.01) and streptomycin (P<0.01), and in the resistance of Staphylococcus species to erythromycin (P<0.01). There was an equivocal, rising trend for the resistance of Staphylococcus species to cephalexin. No significant trends were apparent for any of the other 15 organism/drug interactions. The annual prevalence of multiple drug resistance was calculated for E coli, Proteus species, Pseudomonas species, staphylococci and streptococci, but no statistically significant trends were identified.     

应用基因芯片检测动物性食品中主要致病菌

依据16SrDNA、23SrDNA上的恒定区和可变区设计7种致病菌的通用引物和特异性寡核苷酸探针，并对探针5’端进行氨基化修饰进行基因芯片共价结合，然后优化杂交反应液、芯片点样及后处理程序，研制出一种可同时检测动物性食品中7种主要致病菌的基因芯片。结果表明，7种致病菌的基因芯片杂交检测灵敏度可达10^2cfu／g，与经典传统检测方法及分子生物学、免疫学方法相比该方法特异性强，准确率高，可同时检测动物性食品中7种致病菌。     

2022年北京市宠物源细菌耐药性监测浅析

为了解北京市宠物源细菌的抗菌药物耐药情况,2022年,笔者对北京市四个城区的四家宠物医院的犬、猫共计50份样本的肛拭子进行了研究。试验对样品中的大肠杆菌和肠球菌首先进行了分离培养和质谱鉴定,然后采用微量肉汤稀释法分析分离菌株的耐药表型。结果共分离出大肠杆菌25株、肠球菌25株（屎肠球菌14株、粪肠球菌11株）。大肠杆菌耐药率最高的2种抗菌药为四环素和氨苄西林,多重耐药菌占44%;肠球菌耐药情况较严重,粪肠球菌耐药率最高的抗菌药物为磺胺异噁唑,屎肠球菌耐药率最高的抗菌药物为磺胺异噁唑、头孢西丁和红霉素,二者多重耐药菌占分离株总数的100%。综上,北京地区宠物源大肠杆菌、肠球菌的耐药情况较为严峻,且多重耐药现象突出,需要加强对宠物抗菌药使用的监督与管理。     

Integrated surveillance of antimicrobial resistance and antimicrobial use: Evaluation of the status in Canada (2014–2019)

Objective Integrated surveillance of antimicrobial resistance (AMR) and antimicrobial use (AMU) across One Health sectors is critically important for effective, evidence-based policy, stewardship, and control of AMR. Our objective was to evaluate progress towards achieving comprehensive, integrated AMR/AMU surveillance in Canada.Materials and methods Based on an environmental scan, interviews of subject matter experts, and reports from the 2014 National Collaborating Centre for Infectious Diseases and the 2016 Canadian Council of Chief Veterinary Officers, we identified 8 core surveillance requirements and their specific components; the latter were assessed using a 2-way classification matrix, with 7 common elements ranked according to development stage.Results Components that mapped to requirements of a comprehensive, fully integrated AMR/AMU surveillance system were mostly in the lowest stages of development (Exploration or Program Adoption). However, both the establishment of the Canadian AMR Surveillance System integrated reporting and expansion of existing components under the Canadian Nosocomial Infection Surveillance Program and the Canadian Integrated Program for AMR Surveillance are improvements. Regardless, obvious gaps in Canadian AMR/AMU surveillance prevent this from being a comprehensive and integrated One Health program.Conclusion Action is needed in 3 crucial areas: i) development of a complete, integrated AMR/AMU surveillance program, based on current success; ii) changes in Federal/Provincial/Territorial policies to require standardized AMR/AMU reporting; and iii) more resources for AMR/AMU surveillance (dedicated persons, funding, and enabling structures and policy). There is an urgent need for prioritization by Federal/Provincial/Territorial governments to address governance, leadership, and funding to create surveillance systems that inform stewardship and policy.     

Towards the establishment and standardization of a veterinary antimicrobial resistance surveillance and monitoring programme in South Africa

The objective of this study was to establish a repeatable, standardized laboratory procedure for monitoring the development of antimicrobial resistance in bacteria isolated from animals and food of animal origin in South Africa, with reagents prepared in-house. The emergence of resistance and the spread of resistant bacteria can be limited by implementing a veterinary antimicrobial drug policy, in which inter alia systematic monitoring and prudent use play essential roles. The bacteria included in this study represented three different categories, namely zoonotic bacteria (Salmonella), indicator bacteria (Escherichia coli, Enterococcus faecalis and Enterococcus faecium) and veterinary pathogens (Mannheimia haemolytica). Thirty isolates of each species were collected with the aim of standardizing the laboratory methodology for a future national veterinary surveillance and monitoring programme. Susceptibility to ten selected antimicrobial drugs was determined by means of minimum inhibitory concentrations (MICs) using the microdilution method. The method according to the National Committee for Clinical Laboratory Standards was used as the standard. Multi-well plates containing varying dilutions of antimicrobial drugs and prepared in-house for MIC determinations, yielded repeatable results. Storage of plates for 2 months at -70 degrees C did not influence results meaningfully. Within this limited sample of bacteria, MIC results did not indicate meaningful resistance against any of the ten selected antimicrobial drugs. The findings of the study will be used to establish a national veterinary antimicrobial resistance surveillance and monitoring programme in South Africa. To allow for international comparison of data, harmonisation of the surveillance and monitoring programme in accordance with global trends is encouraged. Ideally it should be combined with a programme monitoring the quantities of antimicrobial drugs used. The aim is to contribute to slowing down the emergence of resistance and the problems associated with this phenomenon by means of the rational use of antimicrobial drugs.     

Organic livestock production in Europe: aims,rules and trends with special emphasis on animal health and welfare

Organic farming in Europe has increased during the last decade but the market share is still relatively low with less than 3% of farmed arable land and an even smaller proportion of farm animal species raised in organic livestock production systems. In many aspects, the biological and ethological needs of animals in organic farming systems are better met than on conventional farms. Emphasis is placed on high standards in product quality, animal health and welfare. However, limitations due to the strict organic rules place high demands on management qualifications. Practical experience shows that organic livestock production is certainly no guarantee of good animal health and welfare. It is suggested to develop quality assurance programmes for process quality assessment to ensure a certain level of management standard. Epidemiological studies are needed to evaluate health risk factors for health and welfare problems in organic livestock production. The concept of organic animal farming can only fulfil the criteria for sustainability, if all requirements on animal health and welfare, together with product quality and ecological soundness, are strongly considered and controlled.