Extended-spectrum cephalosporin-resistant gram-negative organisms in livestock: An emerging problem for human health?

Abstract Escherichia coli , Salmonella spp. and Acinetobacter spp. are important human pathogens. Serious infections due to these organisms are usually treated with extended-spectrum cephalosporins (ESCs). However, in the past two decades we have faced a rapid increasing of infections and colonizati...

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Bibliographic Details
Published in:Drug resistance updates 2013-02, Vol.16 (1), p.22-45
Main Authors: Seiffert, Salome N, Hilty, Markus, Perreten, Vincent, Endimiani, Andrea
Format: Article
Language:English
Subjects:
Acinetobacter
AmpC
Animals
Anti-Bacterial Agents - pharmacology
beta-Lactam Resistance - drug effects
beta-Lactam Resistance - genetics
beta-Lactamases - genetics
beta-Lactamases - metabolism
Cattle
Cephalosporins - pharmacology
Disease Reservoirs - microbiology
Disease Reservoirs - veterinary
E. coli
ESBL
Europe - epidemiology
Gene Transfer, Horizontal
Gram-Negative Bacteria - drug effects
Gram-Negative Bacteria - enzymology
Gram-Negative Bacteria - genetics
Gram-Negative Bacterial Infections - drug therapy
Gram-Negative Bacterial Infections - epidemiology
Gram-Negative Bacterial Infections - transmission
Gram-Negative Bacterial Infections - veterinary
Hematology, Oncology and Palliative Medicine
Humans
Infectious Disease
Pig
Poultry
Poultry - microbiology
Prevalence
Salmonella
Swine - microbiology
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Summary:Abstract Escherichia coli , Salmonella spp. and Acinetobacter spp. are important human pathogens. Serious infections due to these organisms are usually treated with extended-spectrum cephalosporins (ESCs). However, in the past two decades we have faced a rapid increasing of infections and colonization caused by ESC-resistant (ESC-R) isolates due to production of extended-spectrum-β-lactamases (ESBLs), plasmid-mediated AmpCs (pAmpCs) and/or carbapenemase enzymes. This situation limits drastically our therapeutic armamentarium and puts under peril the human health. Animals are considered as potential reservoirs of multidrug-resistant (MDR) Gram-negative organisms. The massive and indiscriminate use of antibiotics in veterinary medicine has contributed to the selection of ESC-R E. coli , ESC-R Salmonella spp. and, to less extent, MDR Acinetobacter spp. among animals, food, and environment. This complex scenario is responsible for the expansion of these MDR organisms which may have life-threatening clinical significance. Nowadays, the prevalence of food-producing animals carrying ESC-R E. coli and ESC-R Salmonella (especially those producing CTX-M-type ESBLs and the CMY-2 pAmpC) has reached worryingly high values. More recently, the appearance of carbapenem-resistant isolates (i.e., VIM-1-producing Enterobacteriaceae and NDM-1 or OXA-23-producing Acinetobacter spp.) in livestock has even drawn greater concerns. In this review, we describe the aspects related to the spread of the above MDR organisms among pigs, cattle, and poultry, focusing on epidemiology, molecular mechanisms of resistance, impact of antibiotic use, and strategies to contain the overall problem. The link and the impact of ESC-R organisms of livestock origin for the human scenario are also discussed.
ISSN:1368-7646
1532-2084
DOI:10.1016/j.drup.2012.12.001