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Gram-positive ESKAPE pathogens in Germany: A comprehensive analysis of occurrence and resistance development in
Marwa Bassiouny1,2, Heinrich Neubauer1, Lisa D Sprague1
1Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut (FLI), Naumburger Str. 96a, 07743 Jena, Germany.
Abstract:
Antimicrobial resistance (AMR) is a global problem affecting both humans and animals. Multidrug resistance (MDR) infections are predominantly caused by a group of bacteria known as ESKAPE pathogens, namely Enterococcus (E.) faecium, Staphylococcus (S.) aureus, Klebsiella (K.) pneumoniae, Acinetobacter (A.) baumannii, Pseudomonas (P.) aeruginosa, and Enterobacter species. They are among the top threats to public health worldwide as their acquisition of AMR genes has significantly diminished available treatment alternatives for severe infections, increased disease burden, and elevated mortality rates due to treatment failures. The current review aimed to investigate the occurrence and resistance development of the Gram-positive ESKAPE pathogens, E. faecium and S. aureus, in animals, food, and environmental sources in Germany. S. aureus has been extensively investigated in human medicine, and there is a decent knowledge regarding their presence in animals, food, and the environmental health sectors. However, limited published work exists on E. faecium in non-human samples. MDR isolates of both bacteria, harbouring resistance genes conferring resistance to several antimicrobial classes, have been detected in various companion animals and livestock species, as well as food and environmental samples across different regions of Germany. Notably, isolates with identical genotypes have been found in both animals and farm employees, underscoring the potential for cross-infection between animals and humans. This review highlights the impact of E. faecium and S. aureus in non-human sources in Germany and emphasizes the importance of addressing MDR from a One-Health perspective.
Insights
Multidrug-resistant Enterococcus faecium and Staphylococcus aureus are present in German animals, food, and environments. Findings highlight potential animal-to-human transmission, emphasizing a One Health approach to combat antimicrobial resistance.
Area of Science:
- Veterinary Microbiology
- Public Health
- One Health
Background:
- Antimicrobial resistance (AMR) is a critical global health threat, with multidrug-resistant (MDR) infections often caused by ESKAPE pathogens.
- ESKAPE pathogens, including Enterococcus faecium and Staphylococcus aureus, are major contributors to treatment failures and increased mortality.
- While S. aureus is well-studied in human and animal health, E. faecium in non-human sources remains less explored.
Purpose of the Study:
- To review the occurrence and resistance patterns of E. faecium and S. aureus in animal, food, and environmental samples within Germany.
- To assess the extent of AMR development in these Gram-positive ESKAPE pathogens in non-human settings.
- To evaluate the potential for cross-transmission between animals and humans.
Main Methods:
- Literature review of published studies on E. faecium and S. aureus in Germany.
- Analysis of data concerning antimicrobial resistance genes and genotypic similarities.
- Examination of findings across animal, food, and environmental sources.
Main Results:
- MDR E. faecium and S. aureus isolates were detected in diverse animal species, food products, and environmental samples across Germany.
- Identical bacterial genotypes were identified in both animals and farm workers, indicating potential transmission routes.
- Resistance to multiple antimicrobial classes was a common feature of the isolated MDR strains.
Conclusions:
- E. faecium and S. aureus pose a significant AMR challenge in non-human sources in Germany.
- The potential for zoonotic transmission necessitates integrated surveillance and control strategies.
- A One Health perspective is crucial for effectively managing antimicrobial resistance in these critical pathogens.
