Coinfections and Phenotypic Antimicrobial Resistance in Strains Isolated From Diseased Swine in North Western Germany-Temporal Patterns in Samples From Routine Laboratory Practice From 2006 to 2020.

() is one major bacterial porcine respiratory tract pathogen causing disease outbreaks worldwide, although effective commercial vaccines are available. Due to frequent failure of this preventive measure, treatment with antimicrobials is indispensable to prevent animal losses within an outbreak situation. To preserve the effectivity of antimicrobial substances to fight should therefore be the primary aim of any interventions. In this study, the temporal development of antimicrobial resistance in was analyzed retrospectively in the time period 2006-2020 from a routine diagnostic database. In parallel, frequent coinfections were evaluated to identify most important biotic cofactors as important triggers for disease outbreaks in endemically infected herds. The proportion of serotype 2 decreased over time but was isolated most often from diseased swine (57% in 2020). In ~1% of the cases, was isolated from body sites outside the respiratory tract as brain and joints. The lowest frequencies of resistant isolates were found for cephalothin and ceftiofur (0.18%), florfenicol (0.24%), tilmicosin (2.4%), tiamulin (2.4%), enrofloxacin (2.7%), and spectinomycin (3.6%), while the highest frequencies of resistant isolates were found for gentamicin (30.9%), penicillin (51.5%), and tetracycline (78.2%). For enrofloxacin, tiamulin, tilmicosin, and tetracycline, significantly lower frequencies of resistant isolates were found in the time period 2015-2020 compared to 2006-2014, while gentamicin-resistant isolates increased. In summary, there is only a low risk of treatment failure due to resistant isolates. In maximum, up to six coinfecting pathogens were identified in pigs positive for . Most often pigs were coinfected with Porcine Circovirus 2 (56%), (24.8%), or the Porcine Reproductive and Respiratory Syndrome Virus (23.3%). Potential synergistic effects between these pathogens published from experimental findings can be hypothesized by these field data as well. To prevent disease outbreaks in endemically infected herds more efficiently in the future, next to environmental trigger factors, preventive measures must also address the coinfecting agents.