Spatial Trends in Mercury Exposure, its Dietary Sources and Clinical Health Effects in Finnish White-Tailed Eagle Nestlings

Despite the current increasing population trend, white-tailed eagles are still prone to many anthropogenic stressors. Mercury (Hg) is a very persistent naturally occurring element and apex predators as well as birds feeding on aquatic ecosystems are usually exposed to higher levels of Hg. Since global Hg emissions are still increasing, Hg remains as a topical health issue. The effects of mercury on wildlife have been studied extensively. Blood clinical-chemical parameters (BCCPs) can potentially be useful as biomarker endpoints for contaminant exposure. However, the effects of Hg on blood chemistry and metabolism are still poorly described. Mercury concentrations and stable isotope composition can be measured from the feathers of nestlings and the nestlings represents well the geographical area of interest. Stable isotope analyses can be used to investigate the potential dietary sources of mercury. In the experimental part we investigated the regional differences in stable isotope values, Hg concentration and BCCPs, as well as the interactions between stable isotope values and Hg exposure. We also investigated possible effects of Hg exposure on the health of WTE nestlings in three populations in Finland perceived by BCCPs. Blood and feather samples were collected from WTE nestlings in Finland during the years 2015 and 2016 in three different locations. Blood plasma was analysed for 16 different BCCPs. Feathers were analysed for total Hg concentration as well as for stable nitrogen (δ15N) and carbon (δ13C) composition. A significant difference in δ13C and δ15N values in Varsinais-Suomi and Ostrobothnia compared to Lappi was apparent and is likely to indicate variable local dietary habits. Nonetheless, the concurrent variation in δ15N and δ13C values is indicative of changes in prey composition rather than regional changes in baseline isotope signatures. We noted significantly higher Hg concentrations in Lapland population compared to the other regions. Since there was a high correlation between Hg and stable isotope values, dietary habits seem to have a strong effect on Hg exposure in WTE nestlings in Finland. In addition Hg was positively associated with alanine aminotransferase and total bilirubin. The statistical relationship between Hg and total bilirubin could indicate negative impact on liver function

Genomic characterization of ESBL/AmpC-producing and high-risk clonal lineages of Escherichia coli and Klebsiella pneumoniae in imported dogs with shelter and stray background

Objectives: Extended spectrum ,B-lactamase (ESBL)-and ampicillinase C (AmpC)-carrying Enterobacteriaceae have been widely reported among companion animals. According to previous studies, dogs with a shelter or stray background might be at risk of carrying such bacteria. The aim of this study was to ex-plore, with whole-genome sequencing (WGS), the genomic characteristics of ESBL-producing Escherichia coli and Klebsiella pneumoniae isolated from imported dogs with a stray or shelter background. Methods: E. coli (n = 58) and K. pneumoniae (n = 2) isolates from imported dogs originating from seven countries were included. Phenotypic resistance was investigated by selective isolation and antibiotic sus-ceptibility testing. Whole-genome sequencing was used to study the genomic characteristics and the pres-ence of antimicrobial resistance genes (ARGs) and virulence determinants of the ESBL/AmpC-producing E. coli and K. pneumoniae isolates. Results: A high diversity of different ARGs (n = 56) and sequence types (STs) (n = 32), including high -risk clonal lineages ST410 (n = 3) and ST307 (n = 1), was identified in E. coli and K. pneumoniae isolates, respectively. Genes encoding resistance to ,beta-lactams accounted for the majority, with the most frequent being blaCTX-M-15. Moreover, 17 (29%) E. coli isolates qualified as presumptive extraintestinal pathogenic and/or uropathogenic E. coli. Conclusions: Our results highlight the multiplicity of genetic backgrounds disseminating ESBL/AmpC-genes in the studied dogs, calling for further investigation of possible drivers responsible for the dissem-ination of ARGs in animal shelters and amongst stray dogs. From a public health perspective, enhanced genomic surveillance of ESBL/AmpC-producing Enterobacteriaceae in dogs is needed in Finland. (C) 2022 The Authors. Published by Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy.Peer reviewe

Clonal dissemination of successful emerging clone mecA-MRSA t304/ST6 among humans and hedgehogs in the Helsinki metropolitan area in Finland

Methicillin-resistant Staphylococcus aureus (MRSA) carrying mecC gene (mecC-MRSA) is frequently reported among European hedgehogs (Europeaus erineaus) due to co-evolutionary adaptation to dermatophyte infection in European hedgehogs. The occurrence of MRSA in European hedgehogs in Finland is unknown. Consequently, we investigated the occurrence of MRSA in wild hedgehogs from urban Helsinki metropolitan area in 2020–2021 and applied whole genome sequencing (WGS) to further characterize the studied isolates and compared them with human clinical MRSA isolates. Altogether 115 dead hedgehogs were screened for MRSA using selective cultivation methods. Presumptive MRSA isolates were tested for antimicrobial susceptibility and confirmed MRSA isolates were further characterized by spa-typing and WGS. Hedgehog derived MRSA isolates were compared with clinical human MRSA isolates using core genome multilocus sequence typing (cgMLST). In total MRSA was recovered from 11 out of 115 (10%) hedgehogs. Among these four different spa types (t304; n = 4, t8835; n = 4, t5133; n = 2 and t622; n = 1) and three different sequence types (STs) (ST6; n = 6, ST7663; n = 4 and ST2840; n = 1) were identified. From the studied MRSA isolates seven harboured the mecA gene (mecA-MRSA) and four were identified as mecC-MRSA. All mecA-MRSA isolates carried immune evasion cluster genes, and one isolate was positive for Panton-Valentine leukocidin. cgMLST comparison revealed close genetic relatedness among three hedgehog and two human mecA-MRSA isolates all belonging to t304/ST6. Our results suggest a clonal dissemination of a successful MRSA clone among humans and hedgehogs. Further studies are warranted to investigate the sources and dissemination of such clone in urban environments. We observed a relatively low occurrence of mecC-MRSA in Finnish hedgehogs.Methicillin-resistant Staphylococcus aureus (MRSA) carrying mecC gene (mecC-MRSA) is frequently reported among European hedgehogs (Europeaus erineaus) due to co-evolutionary adaptation to dermatophyte infection in European hedgehogs. The occurrence of MRSA in European hedgehogs in Finland is unknown. Consequently, we investigated the occurrence of MRSA in wild hedgehogs from urban Helsinki metropolitan area in 2020–2021 and applied whole genome sequencing (WGS) to further characterize the studied isolates and compared them with human clinical MRSA isolates. Altogether 115 dead hedgehogs were screened for MRSA using selective cultivation methods. Presumptive MRSA isolates were tested for antimicrobial susceptibility and confirmed MRSA isolates were further characterized by spa-typing and WGS. Hedgehog derived MRSA isolates were compared with clinical human MRSA isolates using core genome multilocus sequence typing (cgMLST). In total MRSA was recovered from 11 out of 115 (10%) hedgehogs. Among these four different spa types (t304; n = 4, t8835; n = 4, t5133; n = 2 and t622; n = 1) and three different sequence types (STs) (ST6; n = 6, ST7663; n = 4 and ST2840; n = 1) were identified. From the studied MRSA isolates seven harboured the mecA gene (mecA-MRSA) and four were identified as mecC-MRSA. All mecA-MRSA isolates carried immune evasion cluster genes, and one isolate was positive for Panton-Valentine leukocidin. cgMLST comparison revealed close genetic relatedness among three hedgehog and two human mecA-MRSA isolates all belonging to t304/ST6. Our results suggest a clonal dissemination of a successful MRSA clone among humans and hedgehogs. Further studies are warranted to investigate the sources and dissemination of such clone in urban environments. We observed a relatively low occurrence of mecC-MRSA in Finnish hedgehogs.Peer reviewe

Nordic Vets against AMR—An Initiative to Share and Promote Good Practices in the Nordic–Baltic Region

In the Nordic countries, antimicrobial use in animals and the prevalence of antimicrobial resistance are among the lowest in Europe. The network “Nordic Vets Against AMR” organized a meeting in 2021, with key actors including representatives from universities, veterinary authorities and veterinary organizations in Finland, Norway and Sweden. This paper reflects the most important discussions on education, research, policy and future perspectives, including the experiences of these countries. It concludes that Nordic veterinarians are well placed to lead the way in the fight against antimicrobial resistance and that the sharing of experiences can support colleagues in other countries. Veterinary education must go hand in hand with research activities and continuously updated guidelines and legislation. There is also a need for postgraduate training on antimicrobial resistance and prudent antimicrobial use. The veterinary profession must, by any means necessary, protect the efficiency of antimicrobials for the sake of animal health, animal welfare and productivity, as well as public health. While restrictive use of antimicrobials is crucial, the ability of veterinarians to use this medical tool is also important for the sake of animal welfare and global food security

Wastewater surveillance of antibiotic-resistant bacterial pathogens : A systematic review

Publisher Copyright: 2022, Tiwari, Kurittu, Al-Mustapha, Heljanko, Johansson, Thakali, Mishra, Lehto, Lipponen, Oikarinen, Pitkänen, WastPan Study Group and Heikinheimo.Infectious diseases caused by antibiotic-resistant bacterial (ARB) pathogens are a serious threat to human and animal health. The active surveillance of ARB using an integrated one-health approach can help to reduce the emergence and spread of ARB, reduce the associated economic impact, and guide antimicrobial stewardship programs. Wastewater surveillance (WWS) of ARB provides composite samples for a total population, with easy access to the mixed community microbiome. This concept is emerging rapidly, but the clinical utility, sensitivity, and uniformity of WWS of ARB remain poorly understood especially in relation to clinical evidence in sewershed communities. Here, we systematically searched the literature to identify studies that have compared findings from WWS of ARB and antibiotic resistance genes (ARG) with clinical evidence in parallel, thereby evaluating how likely WWS of ARB and ARG can relate to the clinical cases in communities. Initially, 2,235 articles were obtained using the primary search keywords, and 1,219 articles remained after de-duplication. Among these, 35 articles fulfilled the search criteria, and an additional 13 relevant articles were included by searching references in the primary literature. Among the 48 included papers, 34 studies used a culture-based method, followed by 11 metagenomics, and three PCR-based methods. A total of 28 out of 48 included studies were conducted at the single sewershed level, eight studies involved several countries, seven studies were conducted at national or regional scales, and five at hospital levels. Our review revealed that the performance of WWS of ARB pathogens has been evaluated more frequently for Escherichia coli, Enterococcus spp., and other members of the family Enterobacteriaceae, but has not been uniformly tested for all ARB pathogens. Many wastewater-based ARB studies comparing the findings with clinical evidence were conducted to evaluate the public health risk but not to relate with clinical evidence and to evaluate the performance of WWS of ARB. Indeed, relating WWS of ARB with clinical evidence in a sewershed is not straightforward, as the source of ARB in wastewater cannot be only from symptomatic human individuals but can also be from asymptomatic carriers as well as from animal sources. Further, the varying fates of each bacterial species and ARG within the sewerage make the aim of connecting WWS of ARB with clinical evidence more complicated. Therefore, future studies evaluating the performance of many AMR pathogens and their genes for WWS one by one can make the process simpler and the interpretation of results easier.Peer reviewe

Nordic Vets against AMR—An Initiative to Share and Promote Good Practices in the Nordic–Baltic Region

Peer reviewe

Wastewater surveillance of antibiotic-resistant bacterial pathogens : A systematic review

Infectious diseases caused by antibiotic-resistant bacterial (ARB) pathogens are a serious threat to human and animal health. The active surveillance of ARB using an integrated one-health approach can help to reduce the emergence and spread of ARB, reduce the associated economic impact, and guide antimicrobial stewardship programs. Wastewater surveillance (WWS) of ARB provides composite samples for a total population, with easy access to the mixed community microbiome. This concept is emerging rapidly, but the clinical utility, sensitivity, and uniformity of WWS of ARB remain poorly understood especially in relation to clinical evidence in sewershed communities. Here, we systematically searched the literature to identify studies that have compared findings from WWS of ARB and antibiotic resistance genes (ARG) with clinical evidence in parallel, thereby evaluating how likely WWS of ARB and ARG can relate to the clinical cases in communities. Initially, 2,235 articles were obtained using the primary search keywords, and 1,219 articles remained after de-duplication. Among these, 35 articles fulfilled the search criteria, and an additional 13 relevant articles were included by searching references in the primary literature. Among the 48 included papers, 34 studies used a culture-based method, followed by 11 metagenomics, and three PCR-based methods. A total of 28 out of 48 included studies were conducted at the single sewershed level, eight studies involved several countries, seven studies were conducted at national or regional scales, and five at hospital levels. Our review revealed that the performance of WWS of ARB pathogens has been evaluated more frequently for Escherichia coli, Enterococcus spp., and other members of the family Enterobacteriaceae, but has not been uniformly tested for all ARB pathogens. Many wastewater-based ARB studies comparing the findings with clinical evidence were conducted to evaluate the public health risk but not to relate with clinical evidence and to evaluate the performance of WWS of ARB. Indeed, relating WWS of ARB with clinical evidence in a sewershed is not straightforward, as the source of ARB in wastewater cannot be only from symptomatic human individuals but can also be from asymptomatic carriers as well as from animal sources. Further, the varying fates of each bacterial species and ARG within the sewerage make the aim of connecting WWS of ARB with clinical evidence more complicated. Therefore, future studies evaluating the performance of many AMR pathogens and their genes for WWS one by one can make the process simpler and the interpretation of results easier.publishedVersionPeer reviewe

Genomic epidemiology of nosocomial carbapenemase-producing Citrobacter freundii in sewerage systems in the Helsinki metropolitan area, Finland

Multi-drug resistance is emerging in Citrobacter freundii, which is the third most common carbapenemase-producing (CP) Enterobacteriaceae in humans in Finland due to recent outbreaks. The objective of this study was to determine if wastewater surveillance (WWS) could detect CP C. freundii strains causing infections in humans. Selective culturing was used to isolate CP C. freundii from the hospital environment, hospital wastewater, and untreated municipal wastewater in Helsinki, Finland, between 2019 and 2022. Species were identified using MALDI-TOF, and presumptive CP C. freundii isolates were subjected to antimicrobial susceptibility testing and further characterized by whole genome sequencing. A genomic comparison was conducted to compare isolates collected from the hospital environment, untreated municipal wastewater, and a selection of isolates from human specimens from two hospitals in the same city. We also examined the persistence of CP C. freundii in the hospital environment and the impact of our attempts to eradicate it. Overall, 27 blaKPC − 2-carrying C. freundii were detected in the hospital environment (ST18; n = 23 and ST8; n = 4), while 13 blaKPC − 2-carrying C. freundii (ST8) and five blaVIM − 1-carrying (ST421) C. freundii were identified in untreated municipal wastewater. CP C. freundii was not identified in hospital wastewater. We found three clusters (cluster distance threshold ≤ 10 allelic difference) after comparing the recovered isolates and a selection of isolates from human specimens. The first cluster consisted of ST18 isolates from the hospital environment (n = 23) and human specimens (n = 4), the second consisted of ST8 isolates from the hospital environment (n = 4), untreated municipal wastewater (n = 6), and human specimens (n = 2), and the third consisted of ST421 isolates from the untreated municipal wastewater (n = 5). Our results support previous studies suggesting that the hospital environment could act as a source of transmission of CP C. freundii in clinical settings. Furthermore, the eradication of CP Enterobacteriaceae from the hospital environment is challenging. Our findings also showed that CP C. freundii is persistent throughout the sewerage system and demonstrate the potential of WWS for detecting CP C. freundii.Peer reviewe

Clonal dissemination of successful emerging clone mecA-MRSA t304/ST6 among humans and hedgehogs in the Helsinki metropolitan area in Finland

Methicillin-resistant Staphylococcus aureus (MRSA) carrying mecC gene (mecC-MRSA) is frequently reported among European hedgehogs (Europeaus erineaus) due to co-evolutionary adaptation to dermatophyte infection in European hedgehogs. The occurrence of MRSA in European hedgehogs in Finland is unknown. Consequently, we investigated the occurrence of MRSA in wild hedgehogs from urban Helsinki metropolitan area in 2020–2021 and applied whole genome sequencing (WGS) to further characterize the studied isolates and compared them with human clinical MRSA isolates. Altogether 115 dead hedgehogs were screened for MRSA using selective cultivation methods. Presumptive MRSA isolates were tested for antimicrobial susceptibility and confirmed MRSA isolates were further characterized by spa-typing and WGS. Hedgehog derived MRSA isolates were compared with clinical human MRSA isolates using core genome multilocus sequence typing (cgMLST). In total MRSA was recovered from 11 out of 115 (10%) hedgehogs. Among these four different spa types (t304; n = 4, t8835; n = 4, t5133; n = 2 and t622; n = 1) and three different sequence types (STs) (ST6; n = 6, ST7663; n = 4 and ST2840; n = 1) were identified. From the studied MRSA isolates seven harboured the mecA gene (mecA-MRSA) and four were identified as mecC-MRSA. All mecA-MRSA isolates carried immune evasion cluster genes, and one isolate was positive for Panton-Valentine leukocidin. cgMLST comparison revealed close genetic relatedness among three hedgehog and two human mecA-MRSA isolates all belonging to t304/ST6. Our results suggest a clonal dissemination of a successful MRSA clone among humans and hedgehogs. Further studies are warranted to investigate the sources and dissemination of such clone in urban environments. We observed a relatively low occurrence of mecC-MRSA in Finnish hedgehogs