Institut für Lebensmittelsicherheit und -hygiene Pflanzliche Lebensmittel als Vektoren für ESBL- und Carbapenemase bildende Enterobacteriaceae Katrin Zurfluh Institut für Lebensmittelsicherheit und -hygiene Vetsuisse-Fakultät Universität Zürich, Schweiz www.ils.uzh.ch Institut für Lebensmittelsicherheit und -hygiene Institut für Lebensmittelsicherheit und -hygiene Pigeons: 0.3% Cormorants: 6.6% Freshwater fish: 18% Cattle: 13.7% Bodies of water: 36% Pig: 15.3 % Healthy human: 5.8% Broiler (herd-level): 63.4% Institut für Lebensmittelsicherheit und -hygiene Institut für Lebensmittelsicherheit und -hygiene Importgemüse (Dominican Republic, India, Thailand and Vietnam) 169 Proben (25.4% positiv) Zurfluh et al. 2015 Institut für Lebensmittelsicherheit und -hygiene Importgemüse (Dominican Republic, India, Thailand and Vietnam) Dominican Republic India Thailand Vietnam ESBL DR06 ESBL DR24 ESBL DR45 ESBL DR13 ESBL DR26 ESBL DR47T ESBL DR47B ESBL DR23 ESBL DR27 ESBL DR31 ESBL DR09 ESBL DR28 52SK1 ESBL H238 V ESBL H238 T E37SK2 E37SK2.1 19SK1 46SK1 46SK2 E48t C48SK3gb E3SK2 E49SK1b E49SK2b E49t C49b 28SK1 37SK1 54SK1 54SK2 49SK1 49SK2 45SK1 ESBL H226 T ESBL H226 B ESBL H226 L 23SK1 23SK2 ESBL H241 B ESBL H241 T ESBL H239 V ESBL H239T 33SK1 33SK2 25SK1 18SK1 E5 21SK1 ESBL H242 ESBL H227 2SK1 6SK1 E26SK1 13SK1 40SK1 40SK2 15SK1 E25 41SK1 Bitter Bitter Chilli Curry Curry cucumber cucumber leaves leaves Curry leaves Egg plant Egg plant Egg plant Green Chilli Small Chilli Cucumber Curry leaves Curry leaves Curry leaves Curry Leaves Green Chilli Okra (marrow) Okra Okra Okra Okra Parwal beans Peppermint Cha-om (acacia) Coriander Curry leaves Garlic chives Green Chilli Lemongrass Sweet basil Yard long beans Yard long beans Water mimosa Water spinach Basil leaves Ceylon spinach Curry leaves Egg plant Holy Basil Lemongrass Soy sprouts Yard long beans ST131 ST661 ST405/CC405 ST307 ST38/CC38 ST1742 ST1656 ST45 ST147 ST307 ST167 /CC10 ST410/CC 23 ST1739 ST155/CC155 ST4681 ST1741 ST152 ST1881 ST1740 ST37 ST38/CC38 ST155/CC155 ST443/CC205 ST997 D B1 A A C3 0 Te1 0 TMP5 SM Z S1 0 K3 0 GM 1 0 CI P 5 N A3 0 CT X 3 0 CF 3 0 A M C3 0 AM 1 0 SH V-1 2 SH V-2 a SH V-2 CT X - M - 6 3 CT X - M - 6 5 CT X - M - 2 7 CT X - M - 1 4 CT X - M - 5 5 169 Gemüse Proben 50 Dominikanische Republik 39 Indien 60 Thailand 20 Vietnam B1 B1 B1 D B1 B1 ST4682 B1 B1 ST36 ST58/CC155 ST45 ST208 Antibiotic re sist ance profile B2 D ST4684 ST244 ST641/CC86 ST15 nd ST167/CC10 ST393/CC 31 ST58/CC155 ST48/CC10 ST4680 ST17 ST4679 ST1743 ST226/CC226 ST458 ST1530 ST76 ST3696 ST37 ST16 ST4683 ST37 ST10/CC10 CT X - M - 1 5 C. s a k a z a k ii E. a e r o g e n e s E . c lo a c a e ESBL( s) E.coli Ph ylogroup CT X - M - 3 MLST/ CC Species CT X - M - 1 V ege ta ble K . p n e u m o n ia e Sam ple I D E. co li Origin A A D B1 A B1 B1 A A B1 A B1 43 (25.4%) ESBL-positive Proben 11 (22%) Dominikanische Republik 13 (33%) Indien 11 (18%) Thailand 8 (40%) Vietnam • 60 individuelle ESBL-produzierende Isolate • 47 multiresistent Isolate (> 3 Antibiotika-Klassen) Zurfluh et al. 2015 Institut für Lebensmittelsicherheit und -hygiene Importgemüse (Dominican Republic, India, Thailand and Vietnam) Dominican Republic India Thailand Vietnam ESBL DR06 ESBL DR24 ESBL DR45 ESBL DR13 ESBL DR26 ESBL DR47T ESBL DR47B ESBL DR23 ESBL DR27 ESBL DR31 ESBL DR09 ESBL DR28 52SK1 ESBL H238 V ESBL H238 T E37SK2 E37SK2.1 19SK1 46SK1 46SK2 E48t C48SK3gb E3SK2 E49SK1b E49SK2b E49t C49b 28SK1 37SK1 54SK1 54SK2 49SK1 49SK2 45SK1 ESBL H226 T ESBL H226 B ESBL H226 L 23SK1 23SK2 ESBL H241 B ESBL H241 T ESBL H239 V ESBL H239T 33SK1 33SK2 25SK1 18SK1 E5 21SK1 ESBL H242 ESBL H227 2SK1 6SK1 E26SK1 13SK1 40SK1 40SK2 15SK1 E25 41SK1 Bitter Bitter Chilli Curry Curry cucumber cucumber leaves leaves Curry leaves Egg plant Egg plant Egg plant Green Chilli Small Chilli Cucumber Curry leaves Curry leaves Curry leaves Curry Leaves Green Chilli Okra (marrow) Okra Okra Okra Okra Parwal beans Peppermint Cha-om (acacia) Coriander Curry leaves Garlic chives Green Chilli Lemongrass Sweet basil Yard long beans Yard long beans Water mimosa Water spinach Basil leaves Ceylon spinach Curry leaves Egg plant Holy Basil Lemongrass Soy sprouts Yard long beans ST131 ST661 ST405/CC405 ST307 ST38/CC38 ST1742 ST1656 ST45 ST147 ST307 ST167 /CC10 ST410/CC 23 ST1739 ST155/CC155 ST4681 ST1741 ST152 ST1881 ST1740 ST37 ST38/CC38 ST155/CC155 ST443/CC205 ST997 B2 D D B1 A A B1 B1 D B1 B1 ST4682 B1 B1 ST36 ST58/CC155 ST45 ST208 C3 0 Te1 0 TMP5 SM Z S1 0 K3 0 GM 1 0 CI P 5 N A3 0 CT X 3 0 CF 3 0 A M C3 0 AM 1 0 SH V-1 2 SH V-2 a SH V-2 CT X - M - 6 3 CT X - M - 6 5 CT X - M - 2 7 CT X - M - 1 4 CT X - M - 5 5 Antibiotic re sist ance profile Gesamtzahl der Isolate: Escherichia coli Klebsiella pneumoniae Enterobacter cloacae 60 26 26 6 Enterobacter aerogenes Cronobacter sakazakii 1 1 B1 ST4684 ST244 ST641/CC86 ST15 nd ST167/CC10 ST393/CC 31 ST58/CC155 ST48/CC10 ST4680 ST17 ST4679 ST1743 ST226/CC226 ST458 ST1530 ST76 ST3696 ST37 ST16 ST4683 ST37 ST10/CC10 CT X - M - 1 5 C. s a k a z a k ii E. a e r o g e n e s E . c lo a c a e ESBL( s) E.coli Ph ylogroup CT X - M - 3 MLST/ CC Species CT X - M - 1 V ege ta ble K . p n e u m o n ia e Sam ple I D E. co li Origin A A D B1 A B1 Vorherrschende ESBL-Typen: CTX-M-15 CTX-M-14 CTX-M-55 (v.a. Thailand) B1 A A B1 A B1 • Plasmid-assoziiert • Menschen-assoziiert • Kontaminiertes Wasser Good agcriculture practice Institut für Lebensmittelsicherheit und -hygiene Plasmids-Typen – Konjugations-Experimente Donor strain: ESBL-producing Isolates Strain I D ESBL DR06 ESBL DR28 ESBL DR09 ESBL DR47T E37SK2 46SK1 C49b 33SK1 ESBL H226L ESBL H241B 23SK2 ESBL H227 25SK1 33SK2 ESBL H239T ESBL H226T E26SK1 E25 13SK1 Replicon type(s)1 F F, FIB FIA N I1 R HI1B F F, R X2 HI2 N R Acceptor strain: E. coli HK225 (StrepR, RifR) ESBL CTX-M-15 CTX-M-65 CTX-M-15 CTX-M-15 CTX-M-1 CTX-M-15 CTX-M-15 CTX-M-14 CTX-M-55 CTX-M-55 CTX-M-55 CTX-M-15 CTX-M-14 CTX-M-27 CTX-M-63 SHV-12 CTX-M-55 CTX-M-14 CTX-M-15 Species E. coli E. coli K. pneumoniae K. pneumoniae E. coli K. pneumoniae E. aerogenes E. coli E. coli E. coli E. coli K. pneumoniae K. pneumoniae K. pneumoniae K. pneumoniae K. pneumoniae E. coli K. pneumoniae E. cloacae Country of origin Dominican Republic Dominican Republic Dominican Republic Dominican Republic India India India Thailand Thailand Thailand Thailand Thailand Thailand Thailand Thailand Thailand Vietnam Vietnam Vietnam -: not assignable to any of the tested replicon types Institut für Lebensmittelsicherheit und -hygiene Importgemüse (Dominican Republic, India, Thailand and Vietnam) Dominican Republic EAEC India Thailand Vietnam ESBL DR06 ESBL DR24 ESBL DR45 ESBL DR13 ESBL DR26 ESBL DR47T ESBL DR47B ESBL DR23 ESBL DR27 ESBL DR31 ESBL DR09 ESBL DR28 52SK1 ESBL H238 V ESBL H238 T E37SK2 E37SK2.1 19SK1 46SK1 46SK2 E48t C48SK3gb E3SK2 E49SK1b E49SK2b E49t C49b 28SK1 37SK1 54SK1 54SK2 49SK1 49SK2 45SK1 ESBL H226 T ESBL H226 B ESBL H226 L 23SK1 23SK2 ESBL H241 B ESBL H241 T ESBL H239 V ESBL H239T 33SK1 33SK2 25SK1 18SK1 E5 21SK1 ESBL H242 ESBL H227 2SK1 6SK1 E26SK1 13SK1 40SK1 40SK2 15SK1 E25 41SK1 Bitter Bitter Chilli Curry Curry cucumber cucumber leaves leaves Curry leaves Egg plant Egg plant Egg plant Green Chilli Small Chilli Cucumber Curry leaves Curry leaves Curry leaves Curry Leaves Green Chilli Okra (marrow) Okra Okra Okra Okra Parwal beans Peppermint Cha-om (acacia) Coriander Curry leaves Garlic chives Green Chilli Lemongrass Sweet basil Yard long beans Yard long beans Water mimosa Water spinach Basil leaves Ceylon spinach Curry leaves Egg plant Holy Basil Lemongrass Soy sprouts Yard long beans ST131 ST661 ST405/CC405 ST307 ST38/CC38 ST1742 ST1656 ST45 ST147 ST307 ST167 /CC10 ST410/CC 23 ST1739 ST155/CC155 ST4681 ST1741 ST152 ST1881 ST1740 ST37 ST38/CC38 ST155/CC155 ST443/CC205 ST997 B2 C3 0 Te1 0 TMP5 SM Z S1 0 K3 0 GM 1 0 CI P 5 N A3 0 CT X 3 0 CF 3 0 A M C3 0 AM 1 0 SH V-1 2 SH V-2 a SH V-2 CT X - M - 6 3 CT X - M - 6 5 CT X - M - 2 7 CT X - M - 1 4 CT X - M - 5 5 Escherichia coli Klebsiella pneumoniae D B1 A A B1 B1 B1 D B1 B1 ST4682 B1 B1 ST36 ST58/CC155 ST45 ST208 Ant ibiot ic resist an ce profile D ST4684 ST244 ST641/CC86 ST15 nd ST167/CC10 ST393/CC 31 ST58/CC155 ST48/CC10 ST4680 ST17 ST4679 ST1743 ST226/CC226 ST458 ST1530 ST76 ST3696 ST37 ST16 ST4683 ST37 ST10/CC10 CT X - M - 1 5 C. s a k a z a k ii E. a e r o g e n e s E . c lo a c a e ESBL( s) E.coli Phylogroup CT X - M - 3 MLST/ CC Species CT X - M - 1 Ve ge ta ble K . p n e u m o n ia e Sam ple I D E. co li Origin A Epidemic colones: E. coli B2:ST131 E. coli D:ST405 E. coli D:ST38 K. pneumoniae ST15 K. pneumoniae ST147 A D B1 A B1 B1 A A EAEC E. coli D:ST38 B1 A B1 Zurfluh et al. 2015 Institut für Lebensmittelsicherheit und -hygiene Situation Produktion in der Schweiz (RTE Salate) 238 Proben (5 % positiv) S. fonticola K. ascorbata blaESBL chromosomal codiert Normalflora Pflanze Nüesch et al. 2015 Institut für Lebensmittelsicherheit und -hygiene Importgemüse (Thailand and Vietnam) Zurfluh, Poirel, Nordmann, Stephan, 2015 Institut für Lebensmittelsicherheit und -hygiene Fakten zu pKS22::blaOXA-181 blaOXA-181 51, 000kb IncX3-type pKS22::blaOXA-181, IncX3 pKP3-A, ColE2, KP, JN205800 Adapted from Liu et al. 2015 Zurfluh, Poirel, Nordmann, Stephan, 2015 Institut für Lebensmittelsicherheit und -hygiene Take home messages − Nicht nur als Vektor für „foodborne pathogens“, sondern auch zunehmend als Vektor für antibiotikaresistente Bakterien (internationaler Handel, good agriculture practice!) − Import: mehrheitlich E. coli und Klebsiella pneumoniae CH: Serratia fonticola und Kluyvera ascorbata − ESBL und Carbapenemase Gene sind oft auf Plasmiden, oder anderen mobilen Element lokalisiert − Nicht nur kommensalen sondern auch multiresistente Pathogene (Bsp EAEC) Institut für Lebensmittelsicherheit und -hygiene Herzlichen Dank für Ihre Aufmerksamkeit!
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