Control points to reduce spread of antibiotic resistance: a One-Health approach

Endimiani, Andrea (30 August 2022). Control points to reduce spread of antibiotic resistance: a One-Health approach (Unpublished). In: Annual Congress Swiss Society for Microbiology (SSM). 30.08.22-01.09.22.

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The increasing number of infections due to multidrug-resistant (MDR) Enterobacterales (Ent) has raised questions about the origin and mode of spread of these pathogens. One of the main aims of the NRP72 program (Module 1) was to study standard and new control points for a tru One-Health approach to contain the spread of MDR-Ent. To do so, numerous human and non-human settings were investigated by the recipients of the NRP72 grants. In this presentation, the results obtained by the Endimiani's group for the human settings will be summarized (those focusing on the veterinary settings will be presented by Prof. V. Perreten in session 11). Hybrid whole-genome-sequencing (WGS) with both Illumina and Nanopore technologies was obtained for all strains.
International travelers have shown to be an important source of ESBL producers (especially Escherichia coli, but also Shigella sonnei) and/or hyperepidemic resistance plasmids that can be imported in Switzerland. Moreover, patients – including those affected by COVID-19 - transferred to Switzerland from certain foreign countries may import unusual MDR-Ent species (e.g., Klebsiella michiganensis or K. grimontii) carrying novel/emerging antimicrobial resistance genes (e.g., VIM-, OXA-48-like types carbapenemases and mcr genes). For the first time, it was also shown that employees of veterinary clinics can get colonized at intestinal level with the same carbapenemase-producing E. coli clones (ST410-OXA-181 and ST167-NDM-5) responsible for infection/colonization of pets hospitalized in the same institutions. Finally, a large analysis of K. pneumoniae strains circulating in Switzerland in human and non-human settings revealed that the emerging high-risk ST11 and ST307 lineages were often isolated from non-human settings.
Overall, these results emphasize the importance of expanding WGS-based MDR-Ent One-Health surveillances as well as the need for metadata to track dissemination routes between the different settings.

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