Department Biological Safety, Unit Epidemiology, Zoonoses and Antimicrobial Resistance, German Federal Institute for Risk Assessment, Berlin, Germany.
Department Infectious Disease Epidemiology, Unit Healthcare-Associated Infections, Surveillance for Antibiotic Resistance and Consumption, Robert Koch Institute, Berlin, Germany.
Front Public Health. 2022 Jun 9;10:823613. doi: 10.3389/fpubh.2022.823613. eCollection 2022.
A joint comparative regional analysis of different resistance combinations across human and veterinary medicine has not been previously conducted in Germany. This study analyses 16 resistance combinations from four antibiotics in from different human and food-producing animal populations in three German regions: East, North West and South West. The data were collected from the three national surveillance and monitoring systems for antimicrobial resistance (AMR) bacteria in humans (ARS), food-safety (Zoonosis Monitoring) and animal pathogens (GE-Vet) from January 2014 to December 2017. Analyses were performed using cluster analysis (hierarchical clustering, average linkage) in R. We included data from 537,215 isolates from human clinical isolates, from clinical as well as non-clinical isolates from food-producing animals and from food. The majority of the data originated from the North West region. There were two main clusters built on 54 different human and animal populations. We observed close similarities of resistance combinations in human isolates from the different regions within the same human populations from outpatient cares, general wards and ICUs. These resistance combinations clustered separately from non-clinical isolates from broilers, turkeys, cattle and pigs; except for some of clinical isolates from these populations which clustered closely to isolates from human populations. Frequently, the resistance combinations in isolates from farms clustered closely to the resistance combinations in isolates from slaughterhouses from broilers and turkeys over all regions. However, the resistance combinations in isolates from retail meat populations tended to cluster separately within their respective populations in between all regions.
在德国，尚未对人类医学和兽医医学中的不同耐药组合进行联合比较区域性分析。本研究分析了来自三个德国地区（东部、西北部和西南部）的四个抗生素中的 16 种耐药组合：来自不同人类和食用动物种群的 数据来自 2014 年 1 月至 2017 年 12 月间进行的三个国家抗菌药物耐药性（AMR）细菌监测和监测系统：针对人类的（ARS）、食品安全（动物传染病监测）和动物病原体（GE-Vet）。分析使用 R 中的聚类分析（层次聚类、平均链接）进行。我们纳入了来自 537,215 个人类临床分离株、来自食品生产动物的临床和非临床分离株以及食品的数据。这些数据主要来源于西北部地区。在 54 个不同的人类和动物群体中建立了两个主要聚类。我们观察到，不同地区的人类分离株中的耐药组合具有相似性，这些分离株来自门诊护理、普通病房和 ICU 的不同人群。这些耐药组合与来自肉鸡、火鸡、牛和猪的非临床分离株聚类分开；除了这些人群的一些临床分离株与来自人类人群的分离株聚类紧密。经常，来自农场的 分离株中的耐药组合与来自不同地区肉鸡和火鸡屠宰场的分离株中的耐药组合聚类紧密。然而，来自零售肉种群的 分离株中的耐药组合在所有地区之间的各自种群中倾向于单独聚类。
