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Inter-host Transmission of Carbapenemase-Producing Escherichia coli among Humans and Backyard Animals
China Agr Univ, Peoples R China; Hunan Agr Univ, Peoples R China.
Shandong Acad Clin Med, Peoples R China.
China Agr Univ, Peoples R China.
Shandong Ctr Dis Control and Prevent, Peoples R China.
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2019 (English)In: Journal of Environmental Health Perspectives, ISSN 0091-6765, E-ISSN 1552-9924, Vol. 127, no 10, article id 107009Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The rapidly increasing dissemination of carbapenem-resistant Enterobacteriaceae (CRE) in both humans and animals poses a global threat to public health. However, the transmission of CRE between humans and animals has not yet been well studied. OBJECTIVES: We investigated the prevalence, risk factors, and drivers of CRE transmission between humans and their backyard animals in rural China. METHODS: We conducted a comprehensive sampling strategy in 12 villages in Shandong, China. Using the household [residents and their backyard animals (farm and companion animals)] as a single surveillance unit, we assessed the prevalence of CRE at the household level and examined the factors associated with CRE carriage through a detailed questionnaire. Genetic relationships among human- and animal-derived CRE were assessed using whole-genome sequencing-based molecular methods. RESULTS: A total of 88 New Delhi metallo-beta-lactamases-type carbapenem-resistant Escherichia coli (NDM-EC), including 17 from humans, 44 from pigs, 12 from chickens, 1 from cattle, and 2 from dogs, were isolated from 65 of the 746 households examined. The remaining 12 NDM-EC were from flies in the immediate backyard environment. The NDM-EC colonization in households was significantly associated with a) the number of species of backyard animals raised/kept in the same household, and b) the use of human and/or animal feces as fertilizer. Discriminant analysis of principal components (DAPC) revealed that a large proportion of the core genomes of the NDM-EC belonged to strains from hosts other than their own, and several human isolates shared closely related core single-nucleotide polymorphisms and bla(NDM)( )genetic contexts with isolates from backyard animals. CONCLUSIONS: To our knowledge, we are the first to report evidence of direct transmission of NDM-EC between humans and animals. Given the rise of NDM-EC in community and hospital infections, combating NDM-EC transmission in backyard farm systems is needed.

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US DEPT HEALTH HUMAN SCIENCES PUBLIC HEALTH SCIENCE , 2019. Vol. 127, no 10, article id 107009
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URN: urn:nbn:se:liu:diva-162352DOI: 10.1289/EHP5251ISI: 000492748900009PubMedID: 31642700OAI: oai:DiVA.org:liu-162352DiVA, id: diva2:1374026
Note

Funding Agencies|National Natural Science Foundation of ChinaNational Natural Science Foundation of China [81361138021, 81861138051, 81661138002]; National Key Research and Development Program of China [2018YFD0500300]; Swedish Research CouncilSwedish Research Council [D0879801]; Medical Research CouncilMedical Research Council UK (MRC) [MR/P007295/1]

Available from: 2019-11-28 Created: 2019-11-28 Last updated: 2020-01-15

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