Prevalence of faecal carriage of extended‐spectrum β‐lactamase (ESBL)‐producing Escherichia coli in veterinary hospital staff and students

Abstract

Extended-spectrum β-lactamase (ESBL)-producing bacteria causing clinical infections are often also multidrug-resistant (MDR; resistance to ≥3 antimicrobial drug classes), therefore treatment options may be limited. High carriage rates of these potentially zoonotic bacteria have been found in livestock and companion animals. Therefore, people working in veterinary hospitals may be a high-risk population for carriage. This is the first study to determine the prevalence and longitudinal carriage of antimicrobial-resistant (AMR) and ESBL-producing faecal Escherichia coli in veterinary hospital staff and students. Prevalence of faecal AMR and ESBL-producing E coli was determined in 84 staff members and students in three UK veterinary hospitals. Twenty-seven participants were followed for six weeks to investigate longitudinal carriage. Antimicrobial susceptibility and phenotypic ESBL production were determined and selected isolates were whole genome sequenced. ESBL-producing E coli were isolated from five participants (5.95 per cent; 95 per cent CI 0.89 to 11.0 per cent); two participants carried ESBL-producing E coli resistant to all antimicrobials tested. Carriage of MDR E coli was common (32.1 per cent; 95per cent CI 22.2 to 42.1 per cent) and there was a high prevalence of ciprofloxacin resistance (11.9 per cent; 95 per cent CI 4.98 to 18.8 per cent). ESBL-producing E coli were isolated from seven longitudinal participants (25.9 per cent; 95 per cent CI 9.40 to 42.5 per cent); two participants carried ESBL-producing E coli for the entire study period. Twenty-six participants (96.3 per cent; 95 per cent CI 89.2 to 100) carried ≥1 MDR E coli isolate during the six-week period, with seven participants (25.9 per cent) carrying ≥1 MDR isolate for at least five out of six weeks. The prevalence of faecal ESBL-producing E coli in cross-sectional participants is similar to asymptomatic general populations. However, much higher levels of carriage were observed longitudinally in participants. It is vital that veterinary hospitals implement gold-standard biosecurity to prevent transmission of MDR and ESBL-producing bacteria between patients and staff. Healthcare providers should be made aware that people working in veterinary hospitals are a high-risk population for carriage of MDR and ESBL-producing bacteria, and that this poses a risk to the carrier and for transmission of resistance throughout the wider community.

Whole Genome Sequencing and Characterization of Multidrug-Resistant (MDR) Bacterial Strains Isolated From a Norwegian University Campus Pond

“…Strain NMBU_W13E19 displayed the gene combination eilA, Air and lpfA (encoding for long polar fimbriae) that was recently reported from a bla CTX−M -producing E. coli strain isolated from a wastewater treatment plant in China (Jiang et al, 2019) and in eight food-producing animal isolates (seven turkey and one laying hen) in Poland (Zajac et al, 2019). This particular gene combination was also seen in the first clinical isolate of an E. coli harboring the mcr-1 gene in Mexico, isolated in 2017 (Merida-Vieyra et al, 2019), as well as in six ESBL-producing E. coli strains isolated from veterinary hospital staff and students in three United Kingdom veterinary hospitals (Royden et al, 2019). The NMBU_W12E19 strain has an unusual array of virulence genes when compared to typical and atypical EAEC strains.…”

Extended-Spectrum β-lactamase-Producing Enterobacteriaceae Shedding in Farm Horses Versus Hospitalized Horses: Prevalence and Risk Factors

“…This also applies to veterinary hospital staff. In a longitudinal study involving veterinary hospital staff and students, a higher level of ESBL-producing E. coli carriage was observed longitudinally [41], which underlines the necessity to implement gold standards biosecurity programs in veterinary hospitals.…”

Third Generation Cephalosporin Resistant Enterobacterales Infections in Hospitalized Horses and Donkeys: A Case–Case–Control Analysis

“…For example, E. coli ST38 is an emerging clone in Germany [48], E. cloacae ST66 was isolated from human hospitals in Japan, France, Spain and Israel [43], and K. pneumoniae ST35 was isolated from China and Yemen [49,50]. This ST dissemination has major implications for human medicine and the "one health" approach, due to the close human-horse proximities and interactions [51].…”