title: [Multidrug-resistant bacteria in Germany. The impact of sources outside healthcare facilities].
abstract: BACKGROUND
  Currently, there is an ongoing discussion about the question whether the emergence of multidrug-resistant microorganisms (MDRO) among humans is due to transfer of these bacteria from animals.
  
  
  OBJECTIVE
  This review summarizes data on the occurrence of methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum beta-lactamase (ESBL) producing enterobacteria in animals and humans, and describes knowledge about transmission pathways.
  
  
  METHODS
  After a scientific literature analysis, relevant articles were identified by screening of titles and abstracts, amended by publications of infection control authorities and the respective reference lists.
  
  
  RESULTS
  MDRO are both transmitted in the nosocomial setting and are increasingly detected as sources of infection outside healthcare facilities.
  
  
  CONCLUSIONS
  Due to new transmission pathways of MDRO an inter-disciplinary approach towards prevention is necessary, involving medical, pharmaceutical and veterinary expertise.
authors.affiliation: Institut für Medizinische Mikrobiologie, Universitätsklinikum Münster, 48149, Münster, Deutschland.
authors.forename: Evgeny A
authors.initials: EA
authors.lastname: Idelevich
authors.affiliation: Klinik für Anästhesiologie, operative Intensivmedizin und Schmerztherapie, Universitätsklinikum Münster, Münster, Deutschland.
authors.forename: Christian
authors.initials: C
authors.lastname: Lanckohr
authors.affiliation: Apotheke, Universitätsklinikum Münster, Münster, Deutschland.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Horn
authors.affiliation: Robert Koch-Institut, Berlin, Deutschland.|Institut für Mikrobiologie und Tierseuchen, Freie Universität Berlin, Berlin, Deutschland.|Fachgruppe Zoonosen, Deutschen Gesellschaft für Hygiene und Mikrobiologie (DGHM), Münster, Deutschland.
authors.forename: Lothar H
authors.initials: LH
authors.lastname: Wieler
authors.affiliation: Institut für Medizinische Mikrobiologie, Universitätsklinikum Münster, 48149, Münster, Deutschland.
authors.forename: Karsten
authors.initials: K
authors.lastname: Becker
authors.affiliation: Institut für Medizinische Mikrobiologie, Universitätsklinikum Münster, 48149, Münster, Deutschland. robin.koeck@ukmuenster.de.|Fachgruppe Zoonosen, Deutschen Gesellschaft für Hygiene und Mikrobiologie (DGHM), Münster, Deutschland. robin.koeck@ukmuenster.de.
authors.forename: Robin
authors.initials: R
authors.lastname: Köck
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D003428:Cross Infection / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects*; D019317:Evidence-Based Medicine; D005858:Germany / Q000453:epidemiology; D006268:Health Facilities / Q000706:statistics & numerical data; D006801:Humans; D015995:Prevalence; D012307:Risk Factors; D015047:Zoonoses / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotics; Germany; Livestock; Pets; Zoonosis