title: Antimicrobial-resistant enterococci in animals and meat: a human health hazard?
abstract: Enterococcus faecium and Enterococcus faecalis belong to the gastrointestinal flora of humans and animals. Although normally regarded harmless commensals, enterococci may cause a range of different infections in humans, including urinary tract infections, sepsis, and endocarditis. The use of avoparcin, gentamicin, and virginiamycin for growth promotion and therapy in food animals has lead to the emergence of vancomycin- and gentamicin-resistant enterococci and quinupristin/dalfopristin-resistant E. faecium in animals and meat. This implies a potential risk for transfer of resistance genes or resistant bacteria from food animals to humans. The genes encoding resistance to vancomycin, gentamicin, and quinupristin/dalfopristin have been found in E. faecium of human and animal origin; meanwhile, certain clones of E. faecium are found more frequently in samples from human patients, while other clones predominate in certain animal species. This may suggest that antimicrobial-resistant E. faecium from animals could be regarded less hazardous to humans; however, due to their excellent ability to acquire and transfer resistance genes, E. faecium of animal origin may act as donors of antimicrobial resistance genes for other more virulent enterococci. For E. faecalis, the situation appears different, as similar clones of, for example, vancomycin- and gentamicin-resistant E. faecalis have been obtained from animals and from human patients. Continuous surveillance of antimicrobial resistance in enterococci from humans and animals is essential to follow trends and detect emerging resistance.
authors.affiliation: Antimicrobial Resistance Reference Laboratory and Surveillance Unit, Department of Microbiological Surveillance and Research, Statens Serum Institut, Artillerivej 5, Copenhagen, Denmark. ama@ssi.dk
authors.forename: Anette M
authors.initials: AM
authors.lastname: Hammerum
authors.forename: Camilla H
authors.initials: CH
authors.lastname: Lester
authors.forename: Ole E
authors.initials: OE
authors.lastname: Heuer
mesh_terms: D000818:Animals; D000890:Anti-Infective Agents / Q000008:administration & dosage; D004251:DNA Transposable Elements / Q000235:genetics; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D013293:Enterococcus faecalis / Q000187:drug effects / Q000235:genetics* / Q000254:growth & development; D016984:Enterococcus faecium / Q000187:drug effects / Q000235:genetics* / Q000254:growth & development; D022761:Gene Transfer, Horizontal / Q000235:genetics; D005839:Gentamicins / Q000008:administration & dosage; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy; D006801:Humans; D007422:Intestines / Q000382:microbiology; D008460:Meat / Q000382:microbiology*; D023421:Models, Animal; D020713:Vancomycin Resistance / Q000235:genetics; D019155:Veterinary Drugs / Q000008:administration & dosage
chemical_list: D000890:Anti-Infective Agents; D004251:DNA Transposable Elements; D005839:Gentamicins; D019155:Veterinary Drugs