Kauter Anne, Epping Lennard, Ghazisaeedi Fereshteh, Lübke-Becker Antina, Wolf Silver A, Kannapin Dania, Stoeckle Sabita D, Semmler Torsten, Günther Sebastian, Gehlen Heidrun, Walther Birgit
Advanced Light and Electron Microscopy (ZBS-4), Robert Koch Institute, Berlin, Germany.
Genome Sequencing and Genomic Epidemiology (MF2), Robert Koch Institute, Berlin, Germany.
Front Microbiol. 2021 Apr 16;12:671676. doi: 10.3389/fmicb.2021.671676. eCollection 2021.
Previous research identified veterinary clinics as hotspots with respect to accumulation and spread of multidrug resistant extended-spectrum β-lactamase (ESBL)-producing (EC). Therefore, promoting the prudent use of antibiotics to decrease selective pressure in that particular clinical environment is preferable to enhance biosecurity for animal patients and hospital staff. Accordingly, this study comparatively investigated the impact of two distinct perioperative antibiotic prophylaxis (PAP) regimens (short-term versus prolonged) on ESBL-EC carriage of horses subjected to colic surgery. While all horses received a combination of penicillin/gentamicin (P/G) as PAP, they were assigned to either the "single-shot group" (SSG) or the conventional "5-day group" (5DG). Fecal samples collected on arrival (t), on the 3rd (t) and on the 10th day after surgery (t) were screened for ESBL-EC. All isolates were further investigated using whole genome sequences. In total, 81 of 98 horses met the inclusion criteria for this study. ESBL-EC identified in samples available at t, t and t were 4.8% (SSG) and 9.7% (5DG), 37% (SSG) and 47.2% (5DG) as well as 55.6% (SSG) and 56.8% (5DG), respectively. Regardless of the P/G PAP regimen, horses were 9.12 times (95% CI 2.79-29.7) more likely to carry ESBL-EC at t compared to t ( < 0.001) and 15.64 times (95% CI 4.57-53.55) more likely to carry ESBL-EC at t compared to t ( < 0.001). ESBL-EC belonging to sequence type (ST) 10, ST86, ST641, and ST410 were the most prevalent lineages, with (60%) being the dominant ESBL gene. A close spatio-temporal relationship between isolates sharing a particular ST was revealed by genome analysis, strongly indicating local spread. Consequently, hospitalization itself has a strong impact on ESBL-EC isolation rates in horses, possibly masking differences between distinct PAP regimens. The results of this study reveal accumulation and spread of multi-drug resistant ESBL-EC among horses subjected to colic surgery with different P/G PAP regimens, challenging the local hygiene management system and work-place safety of veterinary staff. Moreover, the predominance of particular ESBL-EC lineages in clinics providing health care for horses needs further investigation.
先前的研究表明，兽医诊所是产超广谱β-内酰胺酶（ESBL）的多重耐药肠杆菌科细菌（EC）聚集和传播的热点。因此，在该特定临床环境中促进抗生素的谨慎使用以降低选择压力，对于加强动物患者和医院工作人员的生物安全更为可取。据此，本研究比较调查了两种不同的围手术期抗生素预防（PAP）方案（短期与长期）对接受结肠手术马匹的ESBL-EC携带情况的影响。虽然所有马匹均接受青霉素/庆大霉素（P/G）联合用药作为PAP，但它们被分配到“单次给药组”（SSG）或传统的“5天组”（5DG）。在入院时（t0）、术后第3天（t1）和第10天（t2）采集粪便样本，筛查ESBL-EC。所有分离株均使用全基因组序列进行进一步研究。总共98匹马中有81匹符合本研究的纳入标准。在t0、t1和t2时可用样本中鉴定出的ESBL-EC分别为4.8%（SSG）和9.7%（5DG）、37%（SSG）和47.2%（5DG）以及55.6%（SSG）和56.8%（5DG）。无论采用P/G PAP方案如何，与t0相比，马匹在t1时携带ESBL-EC的可能性高9.12倍（95%CI 2.79 - 29.7）（P<0.001），与t1相比，在t2时携带ESBL-EC的可能性高15.64倍（95%CI 4.57 - 53.55）（P<0.001）。属于序列类型（ST）10、ST86、ST641和ST410的ESBL-EC是最常见的谱系，CTX-M（60%）是主要的ESBL基因。基因组分析揭示了共享特定ST的分离株之间存在密切的时空关系，强烈表明存在局部传播。因此，住院本身对马匹的ESBL-EC分离率有很大影响，可能掩盖了不同PAP方案之间的差异。本研究结果揭示了在接受不同P/G PAP方案的结肠手术马匹中，多重耐药ESBL-EC的聚集和传播，对当地卫生管理系统和兽医工作人员的工作场所安全构成挑战。此外，在为马匹提供医疗保健的诊所中，特定ESBL-EC谱系的优势需要进一步研究。
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