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Dissemination of NDM-1
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Infectious Diseases.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Infectious Diseases.
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2012 (English)In: Lancet. Infectious diseases (Print), ISSN 1473-3099, E-ISSN 1474-4457, Vol. 12, no 2, 99-100 p.Article in journal, Letter (Refereed) Published
Place, publisher, year, edition, pages
2012. Vol. 12, no 2, 99-100 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-169320DOI: 10.1016/S1473-3099(11)70333-4ISI: 000299656000009OAI: oai:DiVA.org:uu-169320DiVA: diva2:506204
Available from: 2012-02-28 Created: 2012-02-28 Last updated: 2013-05-27Bibliographically approved
In thesis
1. Antimicrobial Resistance and Production of Extended Spectrum Beta-Lactamases in Enterobacteriaceae from Birds in Bangladesh
Open this publication in new window or tab >>Antimicrobial Resistance and Production of Extended Spectrum Beta-Lactamases in Enterobacteriaceae from Birds in Bangladesh
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The dissemination of members of the Enterobacteriaceae family with extended spectrum beta-lactamases (ESBLs) and metallo-beta-lactamases (MBLs) has become a global concern. ESBLs and MBLs have been reported in humans, domestic animals, wildlife and the environment, and their isolation frequencies are increasing rapidly worldwide.  Most studies have been performed in developed countries and quite few in developing countries, where the antibiotic consumption is often poorly controlled. To explore the environmental contamination of antibiotic resistance in Bangladesh, and of ESBLs and MBLs in particular, fecal samples from poultry and wild birds were studied in this thesis.

Samples were collected from both sick birds (poultry having Escherichia coli infections) and healthy birds (free-range poultry, seagulls and crows) residing in different environmental niches. Samples from patients and fresh/sea water were included, to follow the chain of antibiotic resistance in bacteria from humans to the environment. Information regarding the antibiotic usage in poultry production was also collected. The susceptibility of avian E. coli isolates cultured with and without selective pressure was tested against antibiotics commonly used in human and veterinary medicine in Bangladesh. Special attention was paid to ESBL-producing isolates, which were further characterized genetically.

The results of the studies showed that E. coli isolates from commercial poultry, free-range poultry, gulls and crows were resistant to several classes of antibiotics, and that the level and spectrum of antibiotic resistance varied between different bird populations. There was no NDM-producer found among the birds, but ESBL-producing Enterobacteriaceae could be found in up to 59% of the crows, the birds with the highest carriage rate of multiresistant  Enterobacteriaceae of all bird species studied. The most common ESBL-type was CTX-M-15, which also is the most common in the human population in Bangladesh. Birds also shared clinically important sequence types with humans, including E. coli clone O25b-ST131.

In conclusion, ESBL-producing bacteria with multiresistance are easily spread to wild birds. Their opportunistic feeding behavior at poorly managed hospital waste dumps and nearby water bodies makes them into both reservoirs and active spreaders. The high level of antibiotic resistant and ESBL-producing bacteria in the bird population of Bangladesh is worrying, and there is no easy solution in sight. Nationwide programs are necessary to both improve the management of hospital waste and sewage and the control of the antibiotic usage to prevent further environmental contamination. 

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2013. 75 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 911
Antimicrobial Resistance, ESBL, CTX-M, NDM, Poultry, Wild birds, E. coli, Bangladesh, Enterobacteriaceae, Antibiotics
National Category
Microbiology in the medical area
Research subject
Epidemiology; Microbiology; Medical Science
urn:nbn:se:uu:diva-199686 (URN)978-91-554-8691-4 (ISBN)
Public defence
2013-06-12, Hörsalen, Klinisk mikrobiologi, Dag Hammarskjöldsväg 17 ingång D1, Uppsala, 09:00 (English)

Time of defence has been changed to 09:00 am on 2013-05-27

Available from: 2013-05-22 Created: 2013-05-13 Last updated: 2013-08-30

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