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Extended-Spectrum Cephalosporin- and/or Colistin-Resistant Enterobacteriaceae in Swiss Travellers to Tanzania and Thailand, in the local population, in broiler chicken and in chicken meat

English title Extended-Spectrum Cephalosporin- and/or Colistin-Resistant Enterobacteriaceae in Swiss Travellers to Tanzania and Thailand, in the local population, in broiler chicken and in chicken meat
Applicant Hatz Christoph
Number 170063
Funding scheme Project funding (Div. I-III)
Research institution Institut für Epidemiologie, Biostatistik und Prävention Universität Zürich
Institution of higher education University of Zurich - ZH
Main discipline Tropical Medicine
Start/End 01.09.2017 - 28.02.2021
Approved amount 568'003.00
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All Disciplines (4)

Discipline
Tropical Medicine
Veterinary Medicine
Infectious Diseases
Medical Microbiology

Keywords (9)

travellers; drug resistance; local population; extended-spectrum beta-lactamase; Enterobacteriaceae; colonization; food chain; environment; animals

Lay Summary (German)

Lead
Antibiotika-Resistenzen sind ein weltweit zunehmendes Problem. Tierzucht und internationale Reisetätigkeit werden als wesentliche Faktoren bei der Entstehung und Verbreitung von resistenten Bakterien betrachtet. Dieses Projekt untersucht die Verbreitungsmechanismen an den Tier-Mensch und der Mensch-Mensch Schnittstellen (‚One Health‘-Ansatz).
Lay summary

Ziele des Forschungsprojektes

Antibiotika-Resistenz, ihre Entstehung und Verbreitung sowie die daraus resultierenden Folgen sind in den letzten Jahren zunehmend in den Fokus der Wissenschaft und der Öffentlichkeit gerückt. Studien haben gezeigt, dass ein Zusammenhang zwischen Antibiotika-Gebrauch im Allgemeinen, aber auch speziell in der Masttierzucht, und der Entstehung von Resistenzen besteht.  Zudem ist bekannt, dass internationale Reisen wesentlich zur Verbreitung von Antibiotika-resistenten Bakterien beitragen.

Dieses Projekt beschäftigt sich mit der Frage, wie sich Antibiotika-resistenten Bakterien zwischen Mensch und Tier und zwischen Menschen verbreiten. Insbesondere geht es der Frage nach, ob die bei Tieren vorkommenden resistenten Bakterien denen bei Menschen entsprechen und ob die bei Reisenden nachgewiesenen Bakterien denen der Lokalbevölkerung entsprechen. Diese Informationen können wesentlich dazu beitragen, Übertragungsmechanismen zu verstehen und damit gegebenenfalls zu reduzieren.

Wissenschaftlicher und gesellschaftlicher Kontext des Forschungsprojektes

Auf individueller Ebene sind Infektionen mit Antibiotika-resistenten Bakterien mit erhöhter Morbidität und Mortalität assoziiert. Auf gesellschaftlicher Ebene führen sie zu Mehrkosten, nicht zuletzt im Gesundheitssystem. Detailliertere Kenntnisse zur Übertragungsepidemiologie werden dazu beitragen, präventive Massnahmen zu entwickeln.

Direct link to Lay Summary Last update: 30.09.2016

Responsible applicant and co-applicants

Employees

Publications

Publication
Antimicrobial-Resistant Escherichia coli Strains and Their Plasmids in People, Poultry, and Chicken Meat in Laos
Moser Aline I., Kuenzli Esther, Campos-Madueno Edgar I., Büdel Thomas, Rattanavong Sayaphet, Vongsouvath Manivanh, Hatz Christoph, Endimiani Andrea (2021), Antimicrobial-Resistant Escherichia coli Strains and Their Plasmids in People, Poultry, and Chicken Meat in Laos, in Frontiers in Microbiology, 12, 1-15.
Travellers returning from the island of Zanzibar colonized with MDR Escherichia coli strains: assessing the impact of local people and other sources.
Moser Aline I, Kuenzli Esther, Büdel Thomas, Campos-Madueno Edgar I, Bernasconi Odette J, DeCrom-Beer Susan, Jakopp Barbara, Mohammed Ali Haji, Hassan Nadir Khatib, Fehr Jan, Zinsstag Jakob, Hatz Christoph, Endimiani Andrea (2020), Travellers returning from the island of Zanzibar colonized with MDR Escherichia coli strains: assessing the impact of local people and other sources., in The Journal of antimicrobial chemotherapy.
Whole-genome characterization of a Shewanella algae strain co-harboring blaCTX-M-15 and armA genes on a novel IncC plasmid
Endimiani Andrea, Bernasconi Odette J., Büdel Thomas, Campos-Madueno Edgar I., Kuenzli Esther, Hatz Christoph, Carattoli Alessandra (2020), Whole-genome characterization of a Shewanella algae strain co-harboring blaCTX-M-15 and armA genes on a novel IncC plasmid, in Antimicrobial Agents and Chemotherapy.
On the island of Zanzibar people in the community are frequently colonized with the same MDR Enterobacterales found in poultry and retailed chicken meat
Büdel Thomas, Kuenzli Esther, Campos-Madueno Edgar I, Mohammed Ali Haji, Hassan Nadir Khatib, Zinsstag Jakob, Hatz Christoph, Endimiani Andrea (2020), On the island of Zanzibar people in the community are frequently colonized with the same MDR Enterobacterales found in poultry and retailed chicken meat, in Journal of Antimicrobial Chemotherapy.
Polyclonal gut colonization with extended-spectrum cephalosporin- and/or colistin-resistant Enterobacteriaceae: a normal status for hotel employees on the island of Zanzibar, Tanzania
Büdel Thomas, Kuenzli Esther, Clément Mathieu, Bernasconi Odette J, Fehr Jan, Mohammed Ali Haji, Hassan Nadir Khatib, Zinsstag Jakob, Hatz Christoph, Endimiani Andrea (2019), Polyclonal gut colonization with extended-spectrum cephalosporin- and/or colistin-resistant Enterobacteriaceae: a normal status for hotel employees on the island of Zanzibar, Tanzania, in Journal of Antimicrobial Chemotherapy.

Collaboration

Group / person Country
Types of collaboration
Faculty of Tropical Medicine, Mahidol University, Bangkok Thailand (Asia)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
Zanzibar Ministry of Health Tanzania (Africa)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
Zanzibar Food and Drugs Board Tanzania (Africa)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
31st European Congress of Clinical Microbiology and Infectious Diseases (ECCMID), Vienna 9-12 July 2021 [online meeting due to Covid-19] Poster Multidrug-resistant Escherichia coli strains from people, poultry and chicken meat in Laos: comparison with those isolated from the gut of travellers visiting the country 09.07.2021 Vienna (on-line due to Covid-19), Austria Endimiani Andrea; Künzli Esther; Hatz Christoph; Moser Aline Isabelle; Büdel Thomas;
ASM-Microbe 2019 Poster Extended-Spectrum Cephalosporin- and/or Colistin-Resistant E. coli in Tanzania: High Prevalence of Gut Colonization in Healthy People and Chicken Meat Contamination 20.06.2019 San Francisco, United States of America Endimiani Andrea; Künzli Esther; Büdel Thomas; Zinsstag Jakob; Hatz Christoph;
ASM-Microbe 2019 Talk given at a conference Extended-Spectrum Cephalosporin- and/or Colistin-Resistant E. coli in Tanzania: High Prevalence of Gut Colonization in Healthy People and Chicken Meat Contamination 20.06.2019 San Francisco, United States of America Hatz Christoph; Büdel Thomas; Künzli Esther; Endimiani Andrea; Zinsstag Jakob;
Microbe Poster Extended-Spectrum Cephalosporin- and Colistin-Resistant E. coli in Tanzania: High Prevalence of Gut Colonization in Healthy People and Chicken Meat Contamination 19.06.2019 San Francisco, United States of America Endimiani Andrea; Büdel Thomas; Hatz Christoph; Künzli Esther; Zinsstag Jakob;
Microbe Talk given at a conference Extended-Spectrum Cephalosporin- and Colistin-Resistant E. coli in Tanzania: High Prevalence of Gut Colonization in Healthy People and Chicken Meat Contamination 19.06.2019 San Francisco, United States of America Künzli Esther; Hatz Christoph; Büdel Thomas; Zinsstag Jakob; Endimiani Andrea;
29th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) Talk given at a conference High prevalence of gut colonization with extended-spectrum cephalosporin- and colistin-resistant Enterobacteriaceae in healthy people in Zanzibar, Tanzania 13.04.2019 Amsterdam, Netherlands Büdel Thomas; Hatz Christoph; Endimiani Andrea; Künzli Esther; Zinsstag Jakob;
ASM Microbe 2018 Individual talk Carbapenemase Producers: Epidemiology in Travelers and Community-Associated Infections 07.06.2018 Atlanta, United States of America Endimiani Andrea;
How to stay ahead in the race against resistant pathogens Individual talk Emerging clinical needs not covered with the current automation 22.11.2017 Bern, Belvieu Hotel, Switzerland Endimiani Andrea;


Associated projects

Number Title Start Funding scheme
153377 Intestinal Carriage of Extended-Spectrum Cephalosporin-Resistant Enterobacteriaceae among People and Pets in Households: Descriptive Epidemiology and Role of Microbiota 01.09.2014 Project funding (Div. I-III)
192514 Multidrug-Resistant Enterobacterales Colonizing Swiss Embassy Employees and Relatives Worldwide: Molecular Features, Metagenomics, and Transmission to the Householders at Return 01.03.2021 Project funding (Div. I-III)

Abstract

Background - Extended-spectrum cephalosporin (ESC-R-Ent) and carbapenem-resistant Enterobacteriaceae (Carb-R-Ent) are an increasing problem worldwide. Moreover, the recent emergence of colistin-resistant Enterobacteriaceae (Col-R-Ent) carrying the plasmid-mediated mechanism mcr-1 represents another life-threatening attack of multidrug-resistant (MDR) bacteria against our antibiotic armamentarium. The importance of MDR Gram-negative bacteria (MDR GNB) was taken up in the Swiss Strategy “Antibiotikaresistenzen” (StAR) of the Swiss Government. While initially considered to be mainly health-care-related, the experience of recent years has shown that a high proportion of infections, especially with extended-spectrum ß-lactamase-producing Enterobacteriaceae (ESBL-Ent), are community-acquired. Among potential factors facilitating the emergence and the spread of these MDR GNB are the extensive use of antibiotics in animal farming and international travel. However, the exact impact of the different factors, as well as the underlying mechanism, is still poorly understood. An integrated “One Health” study on Swiss travellers to Tanzania and Thailand, local people working in the tourism industry, broiler chicken and chicken meat will provide new insights into the spread of ESC-R-, Carb-R-, and/or Col-R-Ent, not only through international travel but also at the human-human and the animal-human interface.Tanzania and Thailand are both major travel destinations for Swiss travellers. Travellers returning from these two countries are frequently colonized with ESBL-Ent. However, data regarding the spread of Col-R-Ent carrying mcr-1 in travellers are needed. Aim - To evaluate the impact of international travel on the spread of ESC-R-, Carb-R- and/or Col-R-Ent at the human-human- and animal-human interface.Objectives - i) Determining incidence and prevalence of colonization with ESC-R-, Carb-R and/or Col-R-Ent as well as associated risk factors in travellers, local people and chicken/chicken meat; ii) Comparing microbiological characteristics of the MDR Enterobacteriaceae found in the host groups and evaluate them with regard to potential transmission dynamics.Setting - Recruiting Travel Clinics: Zurich and Basel. Microbiological analyses: Institute for Infectious Diseases, University of Bern. Local collaborators: Zanzibar Food and Drug Board, Zanzibar Ministry of Health, Tanzania, and Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.Participants - Travellers presenting for pre-travel medical advice at the travel clinics in Zurich and Basel. Healthy people working in the tourism industry in Tanzania and Thailand. Broiler chicken and chicken meat produced and sold locally.Study Design - The study includes a cohort study in travellers and a cross-sectional study of the population, chicken and chicken meat locally, assessing i) the colonization incidence in travellers as well as the colonization prevalence in the local population and associated risk factors; ii) colonization prevalence in broiler chicken and chicken meat. Expected Outcome - Incidence and prevalence of colonization in travellers and the local population and associated animal source risk factors. Knowledge and epidemiological pattern of microbiological characteristics, genetic distances and homologies (sequencing types, resistance genes and plasmids) of the Enterobacteriaceae found in travellers, local people, broiler chicken and chicken meat.
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