背景:在荷兰,作为欧洲监测计划的一部分,在屠宰时健康肉鸡的共生指示大肠杆菌中监测抗菌素耐药性(AMR)。在一个单独的家禽健康计划中,在来自患病肉鸡的兽用病原体中监测AMR。到目前为止,目前尚不清楚这两种AMR监测方法在同一动物群体中的结果如何相关.
目的:本研究旨在调查非野生型易感性监测结果之间的关联(使用流行病学临界值,ECOFF,根据欧盟法规的规定)从健康肉鸡中分离出的共生大肠杆菌(即主动监测),监测临床耐药性的结果(使用临床断点,以确定从患病肉鸡中分离出的大肠杆菌(即被动监测)在兽医实践中对抗生素治疗的敏感性。
方法:分析了通过肉汤微量稀释获得的来自荷兰的共生指示大肠杆菌和临床大肠杆菌的数据。2014-2019年。使用广义线性多变量模型(泊松回归)来确定时间趋势并确定平均抗性比例的差异。
结果:对于氨苄西林的大多数时间点,观察到的共生大肠杆菌和临床大肠杆菌的耐药比例相似,置信区间重叠,庆大霉素,头孢噻肟,四环素,粘菌素和甲氧苄啶/磺胺。统计分析表明,只有头孢噻肟和四环素,平均耐药比例不同。在共生大肠杆菌中,随着时间的推移,观察到抗性比例下降,除了庆大霉素.在临床大肠杆菌中,在抗性比例中没有检测到时间趋势,除了头孢噻肟和粘菌素.
结论:一般来说,在共生和临床大肠杆菌中监测的耐药比例相似。然而,发现了一些相关的差异,这可以用监测方法的类型来解释,即主动或被动监视。从健康动物中分离出的共生大肠杆菌的随机样本(主动监测),更适合监测AMR时间趋势。来自患病动物的临床分离株样本(被动监测),导致检测低流行耐药性的机会更高:即头孢噻肟和粘菌素。临床大肠杆菌数据显示随着时间的推移波动更大,并且需要更长一段时间的数据来确定关联。这项研究显示了主动和被动监视组件对AMR监视的价值。
BACKGROUND: In the Netherlands, antimicrobial resistance (AMR) is monitored in commensal indicator Escherichia coli from healthy broilers at slaughter as part of a European monitoring programme. In a separate programme for poultry health, AMR is monitored in veterinary pathogens from diseased broilers. So far, it is unknown how the outcomes of these two AMR monitoring approaches in the same animal population are associated.
OBJECTIVE: This study aims to investigate the association between the outcomes of monitoring non-wildtype susceptibility (using epidemiological cut-off values,
ECOFF, as prescribed by EU legislation) in commensal E. coli isolated from healthy broilers (i.e. active surveillance) with the outcomes of monitoring clinical resistance (using clinical breakpoints, to determine susceptibility for antibiotic treatment in veterinary practice) in E. coli isolated from diseased broilers (i.e. passive surveillance).
METHODS: Data acquired by broth microdilution was analysed for commensal indicator E. coli and clinical E. coli from the Netherlands, 2014-2019. A generalized linear multivariable model (Poisson regression) was used to determine time trends and identify differences in mean resistant proportions.
RESULTS: Observed resistant proportions of the monitored commensal E. coli and clinical E. coli were similar with overlapping confidence intervals for most time points for ampicillin, gentamicin, cefotaxime, tetracycline, colistin and trimethoprim/sulfonamide. The statistical analysis showed that only for cefotaxime and tetracycline, mean resistant proportions were different. In commensal E. coli, a decrease of resistant proportions over time was observed, except for gentamicin. In clinical E. coli, no time trend was detected in resistant proportions, except for cefotaxime and colistin.
CONCLUSIONS: Generally, the resistant proportions monitored in commensal and clinical E. coli were similar. However, some relevant differences were found, which can be explained by the type of monitoring approach, i.e. active or passive surveillance. The random sample of commensal E. coli isolated from healthy animals (active surveillance), was more suitable to monitor AMR time trends. The sample of clinical isolates from diseased animals (passive surveillance), resulted in a higher chance to detect low-prevalent resistance: i.e. cefotaxime and colistin. The clinical E. coli data showed more fluctuation over time, and data from a longer period of time would be needed to determine the association. This study shows the value of both an active and a passive surveillance component for AMR monitoring.