title: Multidrug resistant Enterobacteriaceae in New Zealand: a current perspective.
abstract: In this article we review mechanisms and potential transmission pathways of multidrug resistance in Enterobacteriaceae, with an emphasis on extended-spectrum β-lactamase (ESBL)-production. This provides background to better understand challenges presented by this important group of antimicrobial resistant bacteria, and inform measures aimed at prevention and control of antimicrobial resistance in general. Humans and animals interact at various levels; household pets cohabit with humans, and other animals interact with people through direct contact, as well as through the food chain and the environment. These interactions offer opportunity for bacteria such as ESBL-producers to be shared and transmitted between species and, in turn, increase the risk of zoonotic and reverse-zoonotic disease transmission. A key step in curtailing antimicrobial resistance is improved stewardship of antimicrobials, including surveillance of their use, better infection-control and prevention, and a better understanding of prescribing practice in both veterinary and medical professions in New Zealand. This will also require prospective observational studies to examine risk factors for antimicrobial resistance. Due to the interconnectedness of humans, animals and the environment actions to effect the changes required should be undertaken using a One Health approach.
authors.affiliation: a mEpiLab, Institute of Veterinary, Animal and Biomedical Sciences , Massey University , Private Bag 11-222, Palmerston North , New Zealand.
authors.forename: L J
authors.initials: LJ
authors.lastname: Toombs-Ruane
authors.affiliation: a mEpiLab, Institute of Veterinary, Animal and Biomedical Sciences , Massey University , Private Bag 11-222, Palmerston North , New Zealand.
authors.forename: J
authors.initials: J
authors.lastname: Benschop
authors.affiliation: a mEpiLab, Institute of Veterinary, Animal and Biomedical Sciences , Massey University , Private Bag 11-222, Palmerston North , New Zealand.
authors.forename: S
authors.initials: S
authors.lastname: Burgess
authors.affiliation: b Department of Preventive and Social Medicine , University of Otago , Dunedin , New Zealand.
authors.forename: P
authors.initials: P
authors.lastname: Priest
authors.affiliation: c Department of Pathology , University of Otago , Christchurch , New Zealand.
authors.forename: D R
authors.initials: DR
authors.lastname: Murdoch
authors.affiliation: a mEpiLab, Institute of Veterinary, Animal and Biomedical Sciences , Massey University , Private Bag 11-222, Palmerston North , New Zealand.
authors.forename: N P
authors.initials: NP
authors.lastname: French
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002353:Carrier State; D024901:Drug Resistance, Multiple, Bacterial; D004755:Enterobacteriaceae / Q000187:drug effects* / Q000235:genetics / Q000378:metabolism; D006801:Humans; D009520:New Zealand
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antimicrobial resistance; E. coli; ESBL; Klebsiella pneumoniae; One Health; antimicrobial stewardship