Department of Microbiology, University of Applied Sciences and Arts, 30453 Hannover, Germany.
Centre de Recerca en Sanitat Animal (CReSA, IRTA), Universitat Autònoma de Barcelona, Bellaterra, 08193 Barcelona, Spain; Veterinary Sciences Division, Al Ain Men's College, Higher Colleges of Technology, 17155- Al Ain, Abu Dhabi, United Arab Emirates; Infectious Diseases Division, Department of Animal Medicine, Faculty of Veterinary Medicine, Zagazig University, 44511-Sharkia, Egypt.
J Dairy Sci. 2020 Apr;103(4):3554-3564. doi: 10.3168/jds.2019-17765. Epub 2020 Feb 20.
Staphylococcus aureus is one of the most common pathogens associated with bovine mastitis in Germany and Denmark. Successful therapy is strongly linked to the susceptibility of the pathogen to the administered antimicrobial. An increase in resistant pathogens in human and veterinary medicine has become a concern worldwide and hampers therapy due to reduced susceptibility. In the present study, susceptibility testing was performed for 85 and 93 S. aureus isolates originating from mastitis cases on 12 German and 8 Danish dairy farms, respectively. Phenotypic examination was performed by detection of minimal inhibitory concentration (MIC) values using the broth microdilution method, followed by genotypic investigations of the blaZ and mecA resistance genes via PCR. The tested antimicrobials were the most frequently used β-lactams in German and Danish dairy farms, including cefquinome, cefoperazone, cephapirin, penicillin, oxacillin, cloxacillin, amoxicillin-clavulanic acid, and cephalexin-kanamycin. Special attention was paid to varying therapy concepts because, in Germany, third- and fourth-generation cephalosporins have been predominantly used in mastitis therapy, whereas in Denmark, restrictive use of penicillin is followed by a general avoidance of cephalosporins. Differences in MIC values were mainly based on determined MIC values (MIC at which 90% of isolates are inhibited). In general, Danish S. aureus isolates were inhibited at comparatively lower MIC values than S. aureus isolated from German dairy farms for most β-lactams. No differences were observed regarding cefquinome, because both German and Danish isolates exhibited MIC and MIC values of 0.5 and 1 µg/mL, respectively. In contrast, the MIC for penicillin against German and Danish S. aureus were 0.5 and ≤0.06 µg/mL, respectively. Resistance genes (blaZ, mecA) were only detected in German S. aureus isolates on 3 dairy farms in Germany. A total of 5 isolates tested positive for both blaZ and mecA, whereas 1 isolate carried the blaZ resistance gene only. A direct correlation between frequently used antimicrobials and reduced susceptibility could not be determined based on results of the present study. In addition to further research to determine factors associated with resistance development, we emphasize the urgent need for internationally standardized clinical breakpoints to assess resistance situations more accurately.
金黄色葡萄球菌是德国和丹麦奶牛乳腺炎最常见的病原体之一。成功的治疗与病原体对所使用的抗菌药物的敏感性密切相关。在人类和兽医医学中,耐药病原体的增加已成为全世界关注的问题,并由于敏感性降低而阻碍了治疗。在本研究中,对分别来自德国 12 个和丹麦 8 个奶牛场乳腺炎病例的 85 株和 93 株金黄色葡萄球菌分离株进行了药敏试验。通过肉汤微量稀释法检测最小抑菌浓度(MIC)值进行表型检测,然后通过 PCR 检测 blaZ 和 mecA 耐药基因。所测试的抗菌药物是德国和丹麦奶牛场最常用的β-内酰胺类药物,包括头孢喹肟、头孢哌酮、头孢噻呋、青霉素、苯唑西林、氯唑西林、阿莫西林-克拉维酸和头孢氨苄-卡那霉素。特别关注不同的治疗概念,因为在德国,第三代和第四代头孢菌素主要用于乳腺炎治疗,而在丹麦,青霉素的使用受到限制,随后普遍避免使用头孢菌素。MIC 值的差异主要基于确定的 MIC 值(抑制 90%分离株的 MIC 值)。一般来说,与来自德国奶牛场的金黄色葡萄球菌分离株相比,丹麦金黄色葡萄球菌分离株对大多数β-内酰胺类药物的抑制作用较低。对于头孢喹肟,没有观察到差异,因为德国和丹麦的分离株的 MIC 和 MIC 值分别为 0.5 和 1 µg/mL。相比之下,青霉素对德国和丹麦金黄色葡萄球菌的 MIC 分别为 0.5 和≤0.06 µg/mL。blaZ 和 mecA 耐药基因仅在德国的 3 个奶牛场的德国金黄色葡萄球菌分离株中检测到。共有 5 株分离株同时携带 blaZ 和 mecA 耐药基因,而 1 株分离株仅携带 blaZ 耐药基因。根据本研究的结果,无法确定常用抗菌药物与敏感性降低之间的直接相关性。除了进一步研究确定与耐药性发展相关的因素外,我们还强调迫切需要国际标准化的临床折点,以更准确地评估耐药情况。