Limited contribution of non-intensive chicken farming to ESBL-producing Escherichia coli colonization in humans in Vietnam: an epidemiological and genomic analysis.

OBJECTIVES: To investigate the risk of colonization with ESBL-producing Escherichia coli (ESBL-Ec) in humans in Vietnam associated with non-intensive chicken farming. METHODS: Faecal samples from 204 randomly selected farmers and their chickens, and from 306 age- and sex-matched community-based individuals who did not raise poultry were collected. Antimicrobial usage in chickens and humans was assessed by medicine cabinet surveys. WGS was employed to obtain a high-resolution genomic comparison between ESBL-Ec isolated from humans and chickens. RESULTS: The adjusted prevalence of ESBL-Ec colonization was 20.0% (95% CI 10.8%-29.1%) and 35.2% (95% CI 30.4%-40.1%) in chicken farms and humans in Vietnam, respectively. Colonization with ESBL-Ec in humans was associated with antimicrobial usage (OR = 2.52, 95% CI = 1.08-5.87) but not with involvement in chicken farming. blaCTX-M-55 was the most common ESBL-encoding gene in strains isolated from chickens (74.4%) compared with blaCTX-M-27 in human strains (47.0%). In 3 of 204 (1.5%) of the farms, identical ESBL genes were detected in ESBL-Ec isolated from farmers and their chickens. Genomic similarity indicating recent sharing of ESBL-Ec between chickens and farmers was found in only one of these farms. CONCLUSIONS: The integration of epidemiological and genomic data in this study has demonstrated a limited contribution of non-intensive chicken farming to ESBL-Ec colonization in humans in Vietnam and further emphasizes the importance of reducing antimicrobial usage in both human and animal host reservoirs

Something old, someting new : Update of the 2009 and 2013 ABCD guidelines on prevention and management of feline infectious diseases

OVERVIEW: The ABCD has published 34 guidelines in two Special Issues of the Journal of Feline Medicine and Surgery (JFMS): the first in July 2009 (Volume 11, Issue 7, pages 527-620) and the second in July 2013 (Volume 15, Issue 7, pages 528-652). The present article contains updates and new information on 18 of these (17 disease guidelines and one special article 'Prevention of infectious diseases in cat shelters'). For detailed information, readers are referred to the guidelines published in the above-mentioned JFMS Special Issues

Haemoplasmosis in cats:European guidelines from the ABCD on prevention and management

OVERVIEW: Haemoplasmas are haemotropic bacteria that can induce anaemia in a wide range of mammalian species. Infection in cats: Mycoplasma haemofelis is the most pathogenic of the three main feline haemoplasma species known to infect cats. ' Candidatus Mycoplasma haemominutum' and ' Candidatus Mycoplasma turicensis' are less pathogenic but can result in disease in immunocompromised cats. Male, non-pedigree cats with outdoor access are more likely to be haemoplasma infected, and ' Candidatus M haemominutum' is more common in older cats. All three haemoplasma species can be carried asymptomatically. Transmission: The natural mode of transmission of haemoplasma infection is not known, but aggressive interactions and vectors are possibilities. Transmission by blood transfusion can occur and all blood donors should be screened for haemoplasma infection. DIAGNOSIS AND TREATMENT: PCR assays are the preferred diagnostic method for haemoplasma infections. Treatment with doxycycline for 2-4 weeks is usually effective for M haemofelis-associated clinical disease (but this may not clear infection). Little information is currently available on the antibiotic responsiveness of ' Candidatus M haemominutum' and ' Candidatus M turicensis'

European multicenter study on antimicrobial resistance in bacteria isolated from companion animal urinary tract infections

BACKGROUND: There is a growing concern regarding the increase of antimicrobial resistant bacteria in companion animals. Yet, there are no studies comparing the resistance levels of these organisms in European countries. The aim of this study was to investigate geographical and temporal trends of antimicrobial resistant bacteria causing urinary tract infection (UTI) in companion animals in Europe. The antimicrobial susceptibility of 22 256 bacteria isolated from dogs and cats with UTI was determined. Samples were collected between 2008 and 2013 from 16 laboratories of 14 European countries. The prevalence of antimicrobial resistance of the most common bacteria was determined for each country individually in the years 2012-2013 and temporal trends of bacteria resistance were established by logistic regression. RESULTS: The aetiology of uropathogenic bacteria differed between dogs and cats. For all bacterial species, Southern countries generally presented higher levels of antimicrobial resistance compared to Northern countries. Multidrug-resistant Escherichia coli were found to be more prevalent in Southern countries. During the study period, the level of fluoroquinolone-resistant E. coli isolated in Belgium, Denmark, France and the Netherlands decreased significantly. A temporal increase in resistance to amoxicillin-clavulanate and gentamicin was observed among E. coli isolates from the Netherlands and Switzerland, respectively. Other country-specific temporal increases were observed for fluoroquinolone-resistant Proteus spp. isolated from companion animals from Belgium. CONCLUSIONS: This work brings new insights into the current status of antimicrobial resistance in bacteria isolated from companion animals with UTI in Europe and reinforces the need for strategies aiming to reduce resistance

Participant Reactions to Two-Way Immersion (TWI) Programs

The purpose of this study was to elicit participant reactions to two-way immersion (TWI) programs in the United States of America. A large number of recent studies have focused on instructor views and perspectives of two-way immersion programs, so this study aimed to gain insight from students who are, or who have, participated in TWI programs throughout North America. One hundred fifty-one TWI schools throughout the United States were contacted and asked to participate in this study. Two similar surveys were developed, one for current TWI students, and another for former TWI students. Students from these two groups were asked to fill out a confidential online survey that addressed specific linguistic skills, abilities, and preferences, as well as connection to the cultures of the target language. Forty-eight percent of the survey respondents were native speakers of English, and the remaining 52% were non-native speakers of English. The number of respondents to the former student survey was so low that the data were inconclusive, and, therefore, will not be included in this study. Since the survey was conducted online, the data were stored in a comma-delimited format for further evaluation. The data were then tallied and analyzed for common themes

Plasmid mediated quinolone resistance in Enterobacteriaceae

This thesis describes the occurrence of Plasmid Mediated Quinolone Resistance (PMQR) in Salmonella and E. coli from The Netherlands and other European countries. Furthermore, the genetic background of these genes was characterized. Fluoroquinolones are widely used antibiotics in both human and veterinary medicine. Resistance to fluoroquinolones is considered to be a risk for human health and is mainly caused by chromosomal mutations in topoisomerase genes. Since 1998, different types of PMQR emerged encoded by different resistant genes: qnrA, qnrS, qnrB, qnrC, qnrD, aac(6’)-1b-cr, oqxAB and qepA. PMQR in Enterobacteriaceae results in reduced susceptibility to (fluoro)quinolones to levels below clinical breakpoints. However, PMQR is considered clinically relevant because it facilitates the acquisition of full quinolone resistance. In a national study, the earliest identified PMQR-positive Salmonella isolate in The Netherlands was a human qnrS1-positive S. Corvallis isolate obtained in 2003. Furthermore, eight different Salmonella serovars were found harbouring different PMQR genes (qnrS1, qnrB2 and qnrB19). Almost all isolates were of human origin. Further study revealed the presence of PMQR genes on different plasmid families, including IncN plasmids carrying qnrS1, qnrB2 or qnrB19. But also qnrS1 on ColE, IncR or incHI2 plasmids. The majority of these plasmids were self-transferable by conjugation. However, PMQR-genes were also present on smaller non-conjugative plasmids.More recently, a continuous low prevalence of PMQR-suspected Salmonella isolates was observed in The Netherlands with a slight tendency to increase. The earliest identified PMQR-positive E. coli in animals from The Netherlands was a qnrS1-carrying E. coli obtained from a broiler obtained in 2009. To date, the prevalence of PMQR-suspected E. coli in food-producing animals in The Netherlands is low and only observed in broilers and veal calves. A European study demonstrated a low prevalence of PMQR-positive Salmonella isolates, with qnrS1, qnrB19 and qnrB2 as the predominant PMQR-determinants identified. The rare qnrD1 was identified in eight different serovars from three different countries. This study demonstrated a wide spread of PMQR genes in Europe among Salmonella from different sources despite the low prevalence and it suggest poultry to be the main source for PMQR-determinants in Salmonella. Similar to Salmonella, the prevalence of PMQR was low in E. coli with predominant variant qnrS1 in isolates from poultry (Gallus gallus and turkeys). Antibiotic resistant bacteria can spread over great distances via travel of people or transport of animals, but also by the worldwide trade in food and feed. In this thesis two examples of import of multidrug resistant Enterobacteriaceae are discussed: PMQR-positive, multidrug resistant Salmonella obtained in humans originated from or had a travel history to the African continent and PMQR-positive, multidrug resistant Enterobacteriaceae identified on culinary herbs from Southeast Asia. Despite the strong reduction of fluoroquinolone usage in animals in The Netherlands, resistance is still high in commensal E. coli and Campylobacter spp. in some food-producing animal species. Although fluoroquinolone resistance is mainly caused by chromosomal mutations, PMQR complicates the development and spread of fluoroquinolone resistance which makes it important to include this in the surveillance

Practical considerations of surveillance of Salmonella serovars other than Enteritidis and Typhimurium

Non-typhoid Salmonella serovars other than Salmonella enterica serovars S. Enteritidis (SE) and S.Typhimurium (ST) are isolated throughout the world with huge variations in prevalence. Besides the more generally occurring serovars, such as S. Infantis and S. Hadar, there are many examples of serovars that are principally reported from the regions and are most probably associated with local reservoirs. In most countries of the world, no formal surveillance systems for human salmonellosis are in place and data are limited to ad hoc studies. Data on animals, food and animal feed are even more scarce. The identification of non-SE/ST serovars may be hampered by a lack of experience in serotyping and the availability of quality-assured antisera. Subtyping Salmonella remains important to identify sources of human infections and to target interventions and control measurements. However, in the future, there will be an increasing use of culture-independent diagnostic assays, with the consequence that epidemiological subtyping and antimicrobial susceptibility data will no longer be generated. The validation of these assays for all serovars, particularly the rare ones, needs attention. Although current subtyping based on the Kauffmann-White scheme is well established, and has been shown to be robust, a new generation of subtyping methods will replace it in the near future

Campylobacter in primary animal production and control strategies to reduce the burden of human campylobacteriosis

Campylobacteriosis is one of the most important bacterial food-borne illnesses in humans. One significant source of infection is the handling and consumption of poultry meat, although other sources also contribute considerably. Controlling Campylobacter in broilers reduces the human burden of illness. Broilers can easily become colonised with Campylobacter and preventive measures in primary production have a limited and unpredictable effect. Vaccination, competitive exclusion, bacteriophage therapy and the use of bacteriocins are not yet commercially available. However, measures in the slaughterhouse can reduce contamination in the final product. At present, the most promising control strategy is to keep colonised and non-colonised flocks separate during slaughter ('scheduled processing'). The virtually Campylobacter-free meat can supply the fresh poultry meat market, while the meat from infected flocks can be treated to reduce the Campylobacter concentration. Meat from infected flocks can be treated by freezing but chemical decontamination appears to be more cost effective. A variant of this scenario is to treat only highly contaminated meat. The authors conclude that, until new techniques become commercially available, scheduled processing is the most cost-effective approach. Finally, the authors describe trends in antimicrobial resistance in Campylobacter

Antimicrobial prescription behavior among veterinary practitioners in the Netherlands: a cultural theory on attitudes and trade-off decisionmaking

Background: To curb the increasing threat of antimicrobial resistance, antimicrobial use in farm animals should be minimized. Veterinary antimicrobial prescription behaviour is influenced by trade-off decision making. Trade-offs are value decisions, which derive from a hierarchy of attitudes. In this study we explore and theorize on changes and differences in professional values and attitudes, affecting trade-off decision making, using a cultural anthropological methodology Materials/methods: The theory has been formed by deduction from findings of recent qualitative and quantitative research concerning antimicrobial prescription behaviour of farm animal veterinarians in the Netherlands and literature review. Results: For the veterinary profession, four fundamental attitudes have been identified as constituting work values, job satisfaction and as underpinning trade-off decision making. These are: 1. ‘intrinsic to the work’ attitude 2. ‘intellectually challenging’ attitude 3. ‘accountable to society’ attitude 4. ‘economic efficiency’ attitude All four can be present, although seldom equally strong, in the individual veterinarian, While making a trade-off decision, one of the four attitudes dominates the other three. In case of an antimicrobial prescription decision, especially the third and fourth attitude can cause a dilemma. This may result in veterinarians deciding differently in comparable prescribing situations, depending on the dominant attitude. Submersion in a context (sector subset) in which economic efficiency values prevail, is likely to induce a bias in trading off towards the economic efficiency attitude. Conclusion: The scope of antimicrobial reduction policy interventions should broaden from farm level to sector and market level, because economic efficiency values may counteract further antimicrobial reduction