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过去10年(2011 - 2021年)意大利AMR监测:微生物学和全基因组测序数据风险评估

Monitoring AMR in from Italy in the last 10 years (2011-2021): Microbiological and WGS data risk assessment.

作者信息

Conesa A, Garofolo G, Di Pasquale A, Cammà C

机构信息

Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise Giuseppe Caporale - IZSAM Teramo Italy.

出版信息

EFSA J. 2022 May 25;20(Suppl 1):e200406. doi: 10.2903/j.efsa.2022.e200406. eCollection 2022 May.

Abstract

is considered as the main pathogen in human food-borne outbreaks worldwide. Over the past years, several studies have reported antimicrobial resistance (AMR) in strains. In Europe, the official monitoring of AMR comprises the testing of spp. from food-producing animals because this microorganism is responsible for human infections and usually predominant in poultry. Food-producing animals are considered to be a major source of campylobacteriosis through contamination of food products. Concerns are growing due to the current classification of by the WHO as a 'high priority pathogen' due to the emergence of resistance to multiple drugs such as those belonging to the fluoroquinolones, macrolides and other classes, which limits the treatment alternatives. Knowledge about the contributions of different food sources to gastrointestinal disease is fundamental to prioritise food safety interventions and to establish proper control strategies. Assessing the genetic diversity among species is essential to the understanding of their epidemiology and population structure. Using a population genetic approach and grouping the isolates into sequence types within different clonal complexes, it is possible to investigate the source of the human cases. The work programme was aimed for the fellow to assess the AMR of isolated from humans, poultry and birds from wild and urban Italian habitats. Given the public health concern represented by resistant pathogens in food-producing animals and the paucity of data about this topic in Italy, the aim was to identify correlations between phenotypic and genotypic AMR and comparing the origin of the isolates. The work programme allowed the fellow to acquire knowledge, skills and competencies on the web-based tools used by IZSAM to process the NGS data and perform bioinformatics analyses for the identification of epidemiological clusters, the study of AMR patterns in . isolates, and the assessment of the human exposure to such AMR pathogens. Furthermore, the fellow became able to transfer the acquired knowledge through innovative web-based didactical tools applied to WGS and clustering of specific food-borne pathogens, with particular reference to . . To achieve this objective, 2,734 strains isolated from domestic and wild animals and humans, during the period 2011-2021 were analysed. The resistance phenotypes of the isolates were determined using the microdilution method with EUCAST breakpoints, for the following antibiotics: nalidixic acid, ciprofloxacin, chloramphenicol, erythromycin, gentamicin, streptomycin, tetracycline. The data were complemented by WGS data for each strain, uploaded in the Italian information system for the collection and analysis of complete genome sequence of pathogens isolated from animal, food and environment (GENPAT) developed and maintained at IZSAM; information like clonal complex and sequence type to understand the phylogenetical distance between strains according to their origins were also considered. This work underlines that a better knowledge of the resistance levels of is necessary, and mandatory monitoring of species in the different animal productions is strongly suggested.

摘要

被认为是全球人类食源性疾病暴发的主要病原体。在过去几年中,多项研究报告了该菌株的抗菌药物耐药性(AMR)。在欧洲,AMR的官方监测包括检测来自食品生产动物的该菌,因为这种微生物会导致人类感染且通常在家禽中占主导地位。食品生产动物被认为是通过食品污染导致弯曲杆菌病的主要来源。由于世界卫生组织目前将其列为“高度优先病原体”,因为出现了对多种药物(如氟喹诺酮类、大环内酯类和其他类别药物)的耐药性,这限制了治疗选择,人们的担忧日益增加。了解不同食物来源对胃肠道疾病的影响对于确定食品安全干预措施的优先级和制定适当的控制策略至关重要。评估该菌种之间的遗传多样性对于理解其流行病学和种群结构至关重要。使用群体遗传学方法并将分离株分组为不同克隆复合体中的序列类型,就有可能调查人类病例的来源。该工作计划旨在让研究员评估从意大利野生和城市栖息地的人类、家禽和鸟类中分离出的该菌的AMR。鉴于食品生产动物中耐药病原体对公共卫生的影响以及意大利关于这一主题的数据匮乏,目的是确定表型和基因型AMR之间的相关性,并比较分离株的来源。该工作计划使研究员能够获得关于IZSAM用于处理二代测序(NGS)数据并进行生物信息学分析以识别流行病学集群、研究该菌分离株中的AMR模式以及评估人类接触此类AMR病原体的网络工具的知识、技能和能力。此外,研究员能够通过应用于全基因组测序(WGS)和特定食源性病原体聚类的创新网络教学工具,特别是针对该菌,传播所获得的知识。为实现这一目标,分析了2011年至2021年期间从家畜、野生动物和人类中分离出的2734株该菌。使用带有欧洲抗菌药物敏感性试验委员会(EUCAST)断点的微量稀释法测定分离株对以下抗生素的耐药表型:萘啶酸、环丙沙星、氯霉素、红霉素、庆大霉素、链霉素、四环素。这些数据由每个菌株的WGS数据补充,这些数据上传至意大利病原体全基因组序列收集与分析信息系统(GENPAT),该系统由IZSAM开发和维护;还考虑了克隆复合体和序列类型等信息,以根据菌株来源了解它们之间的系统发育距离。这项工作强调,有必要更好地了解该菌的耐药水平,并强烈建议对不同动物生产中的该菌种进行强制性监测。

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