Extended-Spectrum Beta-Lactamase-Producing Escherichia coli and Other Antimicrobial-Resistant Gram-Negative Pathogens Isolated from Bovine Mastitis: A One Health Perspective.

Antimicrobial resistance (AMR) poses an imminent threat to global public health, driven in part by the widespread use of antimicrobials in both humans and animals. Within the dairy cattle industry, Gram-negative coliforms such as Escherichia coli and Klebsiella pneumoniae stand out as major causative agents of clinical mastitis. These same bacterial species are frequently associated with severe infections in humans, including bloodstream and urinary tract infections, and contribute significantly to the alarming surge in antimicrobial-resistant bacterial infections worldwide. Additionally, mastitis-causing coliforms often carry AMR genes akin to those found in hospital-acquired strains, notably the extended-spectrum beta-lactamase genes. This raises concerns regarding the potential transmission of resistant bacteria and AMR from mastitis cases in dairy cattle to humans. In this narrative review, we explore the distinctive characteristics of antimicrobial-resistant E. coli and Klebsiella spp. strains implicated in clinical mastitis and human infections. We focus on the molecular mechanisms underlying AMR in these bacterial populations and critically evaluate the potential for interspecies transmission. Despite some degree of similarity observed in sequence types and mobile genetic elements between strains found in humans and cows, the existing literature does not provide conclusive evidence to assert that coliforms responsible for mastitis in cows pose a direct threat to human health. Finally, we also scrutinize the existing literature, identifying gaps and limitations, and propose avenues for future research to address these pressing challenges comprehensively.

Accuracy of an AI-based automated plate reading mobile application for the identification of clinical mastitis-causing pathogens in chromogenic culture media.

Using on-farm microbiological culture (OFC), based on chromogenic culture media, enables the identification of mastitis causing pathogens in about 24 h, allows rapid decision making on selective treatment and control management measures of cows with clinical mastitis (CM). However, accurate interpretation of OFC results requires trained and experienced operators, which could be a limitation for the use of OFC in dairy farms. Our hypothesis was that AI-based automated plate reading mobile application can analyze images of microorganisms' colonies in chromogenic culture media with similar diagnostic performance as a trained specialist evaluator. Therefore, the aim of the present study was to evaluate the diagnostic accuracy of an AI-based application (Rumi; OnFarm, Piracicaba, São Paulo, Brazil) for interpreting images of mastitis causing microorganism colonies grown in chromogenic culture media. For this study two trials were organized to compare the results obtained using an AI-based application Rumi with the interpretation of: (1) a trained specialist, using MALDI-TOF MS as the gold standard; (2) farm personnel users (FPU). In trial 1, a total of 476 CM milk samples, from 11 farms located in São Paulo (n = 7) and Minas Gerais (n = 4), southeast Brazil, were inoculated in chromogenic culture media plates (Smartcolor 2, OnFarm, Piracicaba, São Paulo, Brazil) by specialists under lab conditions, and digital images were recorded 24 h after incubation at 37 °C. After that, all the 476 digital images were analyzed by the Rumi and by another specialist (who only had access to the digital images) and the diagnostic accuracy indicators sensitivity (Se) and specificity (Sp) were calculated using MALDI-TOF MS microbiological identification of the isolates as the reference. In Trial 2, a total of 208 CM milk samples, from 150 farms from Brazil, were inoculated in chromogenic culture media plates by FPU, and the results of microbiological growth were visually interpreted by FPU under on-farm conditions. After visual interpretation, results were recorded using an OnFarmApp application (herd manage application for mastitis by OnFarm, Piracicaba, São Paulo, Brazil), and the images of the chromogenic culture plates were captured by the OnFarmApp to be evaluated by Rumi and Bayesian Latent Class Models were performed to compare Rumi and the FPU. In Trial 1, Rumi presented high and intermediate accuracy results, with the only exception of the low Enterococcus spp.'s Se. In comparison with the specialist, Rumi performed similarly in Se and Sp for most groups of pathogens, with the only exception of non-aureus staphylococci where Se results were lower. Both Rumi and the specialist achieved Sp results > 0.96. In Trial 2, Rumi had similar results as the FPU in the Bayesian Latent Class Model analysis. In conclusion, the use of the AI-based automated plate reading mobile application can be an alternative for visual interpretation of OFC results, simplifying the procedures for selective treatment decisions for CM based on OFC.

Molecular characterization of antimicrobial resistance in Klebsiella pneumoniae isolated from Brazilian dairy herds.

In this observational study, phenotypic and genotypic patterns of antimicrobial resistance (AMR) in Klebsiella pneumoniae isolated from intramammary infections, clinical mastitis, fresh feces, rectal swabs, animal hindlimbs, and bulk tank milk samples from Brazilian dairy herds were investigated. In addition, we identified specific genetic variants present among extended-spectrum ß-lactamase (ESBL) producers. We obtained 169 isolates of K. pneumoniae from 2009 to 2011 on 24 Brazilian dairy farms located in 4 Brazilian states. The AMR profile of all isolates was determined using disk-diffusion assays. The antimicrobial panel included drugs commonly used as mastitis treatment in Brazilian dairy herds (gentamicin, cephalosporins, sulfamethoxazole-trimethoprim, tetracycline) as well as antimicrobials of critical importance for human health (meropenem, ceftazidime, fluoroquinolones). The K. pneumoniae isolates resistant to tetracycline, fluoroquinolones, sulfamethoxazole-trimethoprim, or chloramphenicol were screened for presence of drug-specific AMR genes [tet, qnr, aac(6')-Ib, floR, catA2, cm1A, dfr, sul] using PCR. In addition, we identified ESBL genes present among ESBL-producers by using whole genome sequencing. Genomes were assembled and annotated, and patterns of AMR genes were investigated. Resistance was commonly detected against tetracycline (22.5% of all isolates), streptomycin (20.7%), and sulfamethoxazole-trimethoprim (9.5%). Antimicrobial resistance rates were higher in K. pneumoniae isolated from intramammary infections in comparison with isolates from feces (19.2 and 0% of multidrug resistance in intramammary and fecal isolates, respectively). In contrast, no difference in AMR rates was observed when contrasting hind limbs and isolates from intramammary infections. The genes tetA, sul2, and floR were the most frequently observed AMR genes in K. pneumoniae resistant to tetracycline, sulfamethoxazole-trimethoprim, and chloramphenicol, respectively. The tetA gene was present exclusively in isolates from milk. The genes blaCTX-M8 and blaSHV-108 were present in 3 ESBL-producing K. pneumoniae, including an isolate from bulk tank milk. The 3 isolates were of sequence type 281 and had similar mobile genetic elements and virulence genes. Our study reinforced the epidemiological importance and dissemination of blaCTX-M-8 pST114 plasmid in food-producing animals in Brazil.

Leptospira reservoirs among wildlife in Brazil: Beyond rodents.

Leptospirosis is a disease of great importance in tropical regions. Infection occurs mainly through contact with water contaminated with the urine of infected animals, especially that of rodents. Despite the diversity and abundance of wild fauna in Brazil, little is known about the role of other wild species in the epidemiology of leptospirosis. This study aimed to investigate new reservoirs of Leptospira among wildlife in Brazil, using serological and molecular diagnoses in a large-sized sample. Biological samples were collected from 309 free-ranging mammals, belonging to 16 species. The majority of the animals included were opossums (Didelphis albiventris) and coatis (Nasua nasua). Blood and urine samples were subjected to the microscopic agglutination test (MAT) and real-time PCR, respectively. Genetic characterization of genomospecies was performed using PCR amplicons. Statistical analysis was applied to test associations between positive diagnoses and age, sex, season and type of environment. The prevalence of infection found via MAT and PCR was 11% and 5.5%, respectively. If these tests are taken to be complementary, the overall prevalence was 16%. The most common serogroups were Djasiman and Australis, while L. santarosai was the prevalent genomospecies. Significant differences in prevalence between animal species were observed. Greater risk of infection was detected among adult opossums than among young ones. The influence of each serogroup and genomospecies was tested for the same variables, and this revealed higher risk of infection by L. santarosai among male opossums than among females. The present study highlights the exposure and carrier status of several wild species in Brazil and it indicates that coatis and other carnivores are priorities for further investigations.

Integration host factor is important for biofilm formation by Salmonella enterica Enteritidis.

Salmonella enterica Enteritidis forms biofilms and survives in agricultural environments, infecting poultry and eggs. Bacteria in biofilms are difficult to eradicate compared to planktonic cells, causing serious problems in industry and public health. In this study, we evaluated the role of ihfA and ihfB in biofilm formation by S. enterica Enteritidis by employing different microbiology techniques. Our data indicate that ihf mutant strains are impaired in biofilm formation, showing a reduction in matrix formation and a decrease in viability and metabolic activity. Phenotypic analysis also showed that deletion of ihf causes a deficiency in curli fimbriae expression, cellulose production and pellicle formation. These results show that integration host factor has an important regulatory role in biofilm formation by S. enterica Enteritidis.

Estudos da fauna flebotomínica (Diptera: Psychodidae: Phlebotominae) e infecção natural por Leishmania infantum em municípios da região noroeste do estado de São Paulo, Brasil / Studies on the phlebotomine sandflies fauna (Diptera: Psychodidae: Phlebotominae) and on the natural infection by Leishmania infantum in municipalities of northwest region of the State of São Paulo

A expansão geográfica e o crescente aumento dos casos de leishmaniose visceral na região noroeste do estado de São Paulo despertaram o interesse em desenvolver estudo para identificar a fauna flebotomínica e avaliar sua infecção natural por Leishmania infantum nos municípios de Fernandópolis, Santa Fé do Sul e Votuporanga. Foram realizados inquéritos entomológicos com a utilização de armadilhas luminosas do tipo CDC, instaladas em diferentes ecótopos peridomiciliares, durante o período de agosto de 2013 a novembro de 2014. A detecção de DNA de L. infantum em flebotomíneos foi realizada por meio da Reação em Cadeia da Polimerase (PCR). Foram coletados 507 flebotomíneos, sendo 116 fêmeas (22,9 %) e 391 machos (77,1 %), representados por sete espécies, com predomínio de Lutzomyia longipalpis, com 461 exemplares (90,9 %). As análises moleculares revelaram DNA de L. infantum em um exemplar de L. longipalpis capturado em Fernandópolis. Estes resultados confirmam a presença desta espécie nos municípios pesquisados. E o encontro de pelo menos um exemplar, naturalmente infectado, em Fernandópolis evidencia a necessidade de realizar ações de controle direcionadas aos vetores neste município, com o intuito de conter sua dispersão e prevenir a ocorrência de casos humanos de leishmaniose visceral.

The geographical expansion and the increase of visceral leishmaniasis cases in northwest region ofthe São Paulo state aroused the interest of conducting a study to identify the phlebotomine sandfliesfauna, and to evaluate the rate of natural infection by Leishmania infantum in Fernandópolis, SantaFé do Sul and Votuporanga. Entomological surveys were conducted using the CDC miniature lighttraps, installed in different types of peridomestic ecotopes, during the period from August 2013 toNovember 2014. The L. infantum DNA detection in phlebotomine sandflies was performed by meansof conventional Polymerase Chain Reaction (PCR). Five hundred seven phlebotomine sandfliesspecimens were collected, being 116 females (22.9 %) and 391 males (77.1 %), which were representedby seven species, prevailing Lutzomyia longipalpis, with 461 specimens (90.9 %). Molecular analysisrevealed DNA of L. infantum in one specimen of L. longipalpis from Fernandópolis. These findingsconfirm the occurrence of this species in all of the surveyed municipalities. And the existence ofat least one specimen, naturally infected in Fernandópolis, highlights the need for performing thefurther control measures directed to the vectors in this municipality, for restraining their spread andto prevent the occurrence of human cases of visceral leishmaniasis.

Integration host factor is important for biofilm formation by Salmonella enterica Enteritidis

Salmonella enterica Enteritidis forms biofilms and survives in agricultural environments, infecting poultry and eggs. Bacteria in biofilms are difficult to eradicate compared to planktonic cells, causing serious problems in industry and public health. In this study, we evaluated the role of ihfA and ihfB in biofilm formation by S. enterica Enteritidis by employing different microbiology techniques. Our data indicate that ihf mutant strains are impaired in biofilm formation, showing a reduction in matrix formation and a decrease in viability and metabolic activity. Phenotypic analysis also showed that deletion of ihf causes a deficiency in curli fimbriae expression, cellulose production and pellicle formation. These results show that integration host factor has an important regulatory role in biofilm formation by S. enterica Enteritidis.

An overview of extended-spectrum beta-lactamases in veterinary medicine and their public health consequences.

Serious human and animal infections caused by bacteria are usually treated with beta-lactams. Extended-spectrum beta-lactamases (ESBLs) constitute the most clinically and economically important enzymes that are able to hydrolyze and inactivate beta-lactam antibiotics in veterinary medicine. The spread of ESBLs represents a serious threat to healthcare systems, drastically undermining therapeutic options. The relationship between drug usage and the emergence of resistance has been extensively reported. Nevertheless, the use of antimicrobials in veterinary medicine and the emergence of ESBLs in animals remains a matter of debate. Moreover, there is still controversy about whether antibiotic usage in farm animals poses a potential public health risk. This review will (i) deal with aspects related to the presence of ESBLs in veterinary medicine, (ii) its link with human medicine, and (iii) discuss strategies to be implemented to preserve antimicrobial effectiveness. New insights relative to old questions concerning antimicrobial use in domestic animals are also presented.

Enterotoxin genes in coagulase-negative and coagulase-positive staphylococci isolated from bovine milk.

The objective of this study was to isolate and identify the main staphylococcal species causing bovine mastitis in 10 Brazilian dairy herds and study their capability to produce enterotoxins. Herds were selected based on size and use of milking technology, and farms were visited once during the study. All mammary glands of all lactating cows were screened using the California Mastitis Test (CMT) and a strip cup. A single aseptic milk sample (20 mL) was collected from all CMT-positive quarters. Identification of Staphylococcus spp. was performed using conventional microbiology, and PCR was used to determine the presence of enterotoxin-encoding genes (sea, seb, sec, and sed). Of the 1,318 CMT-positive milk samples, Staphylococcus spp. were isolated from 263 (19.9%). Of these isolates, 135 (51%) were coagulase-positive staphylococci (CPS) and 128 (49%) were coagulase-negative staphylococci (CNS). Eighteen different species of CNS were isolated, among which S. warneri, S. epidermidis and S. hyicus were the most frequent. The distribution of Staphylococcus species was different among herds: S. epidermidis was found in 8 herds, S. warneri was found in 7 herds, and S. hyicus in 6 herds. Some of the CNS species (S. saprophyticus ssp. saprophyticus, S. auricularis, S. capitis, and S. chromogenes) were isolated in only one of the farms. Genes related to production of enterotoxins were found in 66% (n=85) of all CNS and in 35% of the CPS isolates. For both CNS and CPS isolates, the most frequently identified enterotoxin genes were sea, seb, and sec; the prevalence of sea differed between CPS (9.5%) and CNS (35.1%) isolates. Staphylococcus warneri isolates showed a greater percentage of sea than seb, sec, or sed, whereas S. hyicus isolates showed a greater percentage of sea than sec. Over 60% of CNS belonged to 3 major species, which carried 62.2 to 81.3% of the enterotoxin genes. The high prevalence highlights the potential for food poisoning caused by these species. For possible high-risk situations for food poisoning, such as milk produced with total bacterial counts greater than regulatory levels and stored under inappropriate temperatures, monitoring contamination with CNS could be important to protect human health. Because the prevalence of CNS intramammary infections in dairy herds is usually high, and these species can be found in great numbers in bulk milk, identification of risk factors for production of staphylococcal enterotoxins should be considered in future studies.

Relationship between teat-end condition, udder cleanliness and bovine subclinical mastitis.

The aims of the present study were to relate intramammary infection (IMI) occurrence and somatic cell count (SCC) with teat-end condition (TEC) and udder cleanliness (UC). Milk samples from 1931 teats were evaluated according to the presence of IMI and SCC. Scores were applied to teats according to the TEC and to UC. Teats ends with a very rough ring had the largest number of IMI when compared to the other three categories, as well as animals with dirtier udders. The change in a TEC score increased by around 30% the chance of IMI. Also, the chance of the animal developing IMI increased by approximately 47% when the UC score increased. No significant association between both scores and quarter SCC was found. It can be concluded that animals with very rough teat end rings and very dirty udders have a greater predisposition to IMI.