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Atterby, C., Osbjer, K., Tepper, V., Rajala, E., Hernandez, J., Seng, S., . . . Jarhult, J. D. (2019). Carriage of carbapenemase- and extended-spectrum cephalosporinase-producing Escherichia coli and Klebsiella pneumoniae in humans and livestock in rural Cambodia; gender and age differences and detection of bla(OXA-48 )in humans. Zoonoses and Public Health, 66(6), 603-617
Open this publication in new window or tab >>Carriage of carbapenemase- and extended-spectrum cephalosporinase-producing Escherichia coli and Klebsiella pneumoniae in humans and livestock in rural Cambodia; gender and age differences and detection of bla(OXA-48 )in humans
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2019 (English)In: Zoonoses and Public Health, ISSN 1863-1959, E-ISSN 1863-2378, Vol. 66, no 6, p. 603-617Article in journal (Refereed) Published
Abstract [en]

Objectives This study investigates the frequency and characteristics of carbapenemase-producing Escherichia coli/Klebsiella pneumoniae (CPE/K) and extended-spectrum cephalosporinase-producing E. coli/K. pneumoniae (ESCE/K) in healthy humans and livestock in rural Cambodia. Additionally, household practices as risk factors for faecal carriage of ESCE/K are identified. Methods Faecal samples were obtained from 307 humans and 285 livestock including large ruminants, pigs and poultry living in 100 households in rural Cambodia in 2011. Each household was interviewed, and multilevel logistic model determined associations between household practices/meat consumption and faecal carriage of ESCE/K. CPE and ESCE/K were detected and further screened for colistin resistance genes. Results CPE/K isolates harbouring bla(OXA-48 )were identified in two humans. The community carriage of ESCE/K was 20% in humans and 23% in livestock. The same ESBL genes: bla(CTX-M-15), bla(CTX-M-14), bla(CTX-M-27), bla(CTX-M-55), bla(SHV-2), bla(SHV-12), bla(SHV-28); AmpC genes: bla(CMY-2), bla(CMY-42,) bla(DHA-1); and colistin resistance genes: mcr-1-like and mcr-3-like were detected in humans and livestock. ESCE/K was frequently detected in women, young children, pigs and poultry, which are groups in close contact. The practice of burning or burying meat waste and not collecting animal manure indoors and outdoors daily were identified as risk factors for faecal carriage of ESCE/K. Conclusions Faecal carriage of E. coli and K. pneumoniae harbouring extended-spectrum cephalosporinase genes are common in the Cambodian community, especially in women and young children. Exposure to animal manure and slaughter products are risk factors for intestinal colonization of ESCE/K in humans.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
AmpC, Cambodia, carbapenemase, colistin, ESBL, risk factors, rural population, zoonoses
National Category
Microbiology
Research subject
Ecology, Zoonotic Ecology
Identifiers
urn:nbn:se:lnu:diva-86955 (URN)10.1111/zph.12612 (DOI)000473968900001 ()31264805 (PubMedID)2-s2.0-85070192709 (Scopus ID)
Available from: 2019-07-24 Created: 2019-07-24 Last updated: 2019-10-11Bibliographically approved
Ramey, A. M., Hernandez, J., Tyrlöv, V., Uher-Koch, B. D., Schmutz, J. A., Atterby, C., . . . Bonnedahl, J. (2018). Antibiotic-Resistant Escherichia coli in Migratory Birds Inhabiting Remote Alaska. EcoHealth, 15(1), 72-81
Open this publication in new window or tab >>Antibiotic-Resistant Escherichia coli in Migratory Birds Inhabiting Remote Alaska
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2018 (English)In: EcoHealth, ISSN 1612-9202, E-ISSN 1612-9210, Vol. 15, no 1, p. 72-81Article in journal (Refereed) Published
Abstract [en]

We explored the abundance of antibiotic-resistant Escherichia coli among migratory birds at remote sites in Alaska and used a comparative approach to speculate on plausible explanations for differences in detection among species. At a remote island site, we detected antibiotic-resistant E. coli phenotypes in samples collected from glaucous-winged gulls (Larus glaucescens), a species often associated with foraging at landfills, but not in samples collected from black-legged kittiwakes (Rissa tridactyla), a more pelagic gull that typically inhabits remote areas year-round. We did not find evidence for antibiotic-resistant E. coli among 347 samples collected primarily from waterfowl at a second remote site in western Alaska. Our results provide evidence that glaucous-winged gulls may be more likely to be infected with antibiotic-resistant E. coli at remote breeding sites as compared to sympatric black-legged kittiwakes. This could be a function of the tendency of glaucous-winged gulls to forage at landfills where antibiotic-resistant bacterial infections may be acquired and subsequently dispersed. The low overall detection of antibiotic-resistant E. coli in migratory birds sampled at remote sites in Alaska is consistent with the premise that anthropogenic inputs into the local environment or the relative lack thereof influences the prevalence of antibiotic-resistant bacteria among birds inhabiting the area.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
Antibiotic resistance, Bacteria, E. coli, Gull, Migratory bird, Waterfowl
National Category
Microbiology
Research subject
Ecology, Zoonotic Ecology
Identifiers
urn:nbn:se:lnu:diva-74121 (URN)10.1007/s10393-017-1302-5 (DOI)000435527600008 ()29230612 (PubMedID)2-s2.0-85037681192 (Scopus ID)
Available from: 2018-05-09 Created: 2018-05-09 Last updated: 2019-08-29Bibliographically approved
Johansson, H., Ellström, P., Artursson, K., Berg, C., Bonnedahl, J., Hansson, I., . . . Gonzalez-Acuna, D. (2018). Characterization of Campylobacter spp. isolated from wild birds in the Antarctic and Sub-Antarctic. PLoS ONE, 13(11), Article ID e0206502.
Open this publication in new window or tab >>Characterization of Campylobacter spp. isolated from wild birds in the Antarctic and Sub-Antarctic
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2018 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 11, article id e0206502Article in journal (Refereed) Published
Abstract [en]

A lack of knowledge of naturally occurring pathogens is limiting our ability to use the Antarctic to study the impact human-mediated introduction of infectious microorganisms have on this relatively uncontaminated environment. As no large-scale coordinated effort to remedy this lack of knowledge has taken place, we rely on smaller targeted efforts to both study present microorganisms and monitor the environment for introductions. In one such effort, we isolated Campylobacter species from fecal samples collected from wild birds in the Antarctic Peninsula and the sub-Antarctic island of South Georgia. Indeed, in South Georgia, we found Campylobacter lari and the closely related Campylobacter peloridis, but also distantly related human-associated multilocus sequence types of Campylobacter jejuni. In contrast, in the Antarctic Peninsula, we found C. tart and two closely related species, Campylobacter subantarcticus and Campylobacter volucris, but no signs of human introduction. In fact, our finding of human-associated sequence types of C. jejuni in South Georgia, but not in the Antarctic Peninsula, suggests that efforts to limit the spread of infectious microorganisms to the Antarctic have so far been successful in preventing the introduction of C. jejuni. However, we do not know how it came to South Georgia and whether the same mode of introduction could spread it from there to the Antarctic Peninsula.

Place, publisher, year, edition, pages
Public Library of Science, 2018
National Category
Infectious Medicine Ecology
Research subject
Ecology, Zoonotic Ecology
Identifiers
urn:nbn:se:lnu:diva-79096 (URN)10.1371/journal.pone.0206502 (DOI)000449772600017 ()30412585 (PubMedID)2-s2.0-85056405179 (Scopus ID)
Available from: 2018-12-07 Created: 2018-12-07 Last updated: 2019-08-29Bibliographically approved
Sandegren, L., Stedt, J., Lustig, U., Bonnedahl, J., Andersson, D. I. & Jaerhult, J. D. (2018). Long-term carriage and rapid transmission of extended spectrum beta-lactamase-producing E-coli within a flock of Mallards in the absence of antibiotic selection. Environmental Microbiology Reports, 10(5), 576-582
Open this publication in new window or tab >>Long-term carriage and rapid transmission of extended spectrum beta-lactamase-producing E-coli within a flock of Mallards in the absence of antibiotic selection
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2018 (English)In: Environmental Microbiology Reports, ISSN 1758-2229, E-ISSN 1758-2229, Vol. 10, no 5, p. 576-582Article in journal (Refereed) Published
Abstract [en]

Wild birds have been suggested as transmitters and reservoirs for antibiotic resistant bacteria. We performed an experimental study investigating carriage time and interindividual transmission of extended spectrum beta-lactamase- (ESBL-)producing Escherichia coli in Mallards (Anas platyrhynchos) to assess if the birds carry the bacteria long enough to transfer them geographically during migration. Mallards were inoculated intraoesophageally with four different strains of ESBL-producing E. coli and kept together in a flock. The ESBL-strains belonged to sequence types previously shown to spread between birds and humans. Culturing from faecal samples showed presence of ESBL-producing E. coli the entire 29 day experimental period. An extensive and rapid transmission of the different ESBL-strains between individuals (including non-inoculated controls) was observed. In necropsy samples, we detected ESBL-strains in the cecum even in faeces-negative birds, indicating that this part of the intestine could function as a reservoir of resistant bacteria. We demonstrate that birds can carry ESBL-producing E. coli for long enough times to travel far during migration and the extensive interindividual transmission suggests spread between individuals in a dense bird population as a mechanism that allow persistence of resistant bacteria.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2018
National Category
Ecology Infectious Medicine
Research subject
Ecology, Zoonotic Ecology
Identifiers
urn:nbn:se:lnu:diva-78616 (URN)10.1111/1758-2229.12681 (DOI)000446986500008 ()30043488 (PubMedID)2-s2.0-85053510845 (Scopus ID)
Available from: 2018-11-01 Created: 2018-11-01 Last updated: 2019-08-29Bibliographically approved
Tjernberg, A. R., Bonnedahl, J., Inghammar, M., Egesten, A., Kahlmeter, G., Naucler, P., . . . Ludvigsson, J. F. (2017). Coeliac disease and invasive pneumococcal disease: a population-based cohort study. Epidemiology and Infection, 145(6), 1203-1209
Open this publication in new window or tab >>Coeliac disease and invasive pneumococcal disease: a population-based cohort study
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2017 (English)In: Epidemiology and Infection, ISSN 0950-2688, E-ISSN 1469-4409, Vol. 145, no 6, p. 1203-1209Article in journal (Refereed) Published
Abstract [en]

Severe infections are recognized complications of coeliac disease (CD). In the present study we aimed to examine whether individuals with CD are at increased risk of invasive pneumococcal disease (IPD). To do so, we performed a population-based cohort study including 29 012 individuals with biopsy-proven CD identified through biopsy reports from all pathology departments in Sweden. Each individual with CD was matched with up to five controls (n = 144 257). IPD events were identified through regional and national microbiological databases, including the National Surveillance System for Infectious Diseases. We used Cox regression analyses to estimate hazard ratios (HRs) for diagnosed IPD. A total of 207 individuals had a record of IPD whereas 45/29 012 had CD (0.15%) and 162/144 257 were controls (0.11%). This corresponded to a 46% increased risk for IPD [HR 1.46, 95% confidence interval (CI) 1.05-2.03]. The risk estimate was similar after adjustment for socioeconomic status, educational level and comorbidities, but then failed to attain statistical significance (adjusted HR 1.40, 95% CI 0.99-1.97). Nonetheless, our study shows a trend towards an increased risk for IPD in CD patients. The findings support results seen in earlier research and taking that into consideration individuals with CD may be considered for pneumococcal vaccination.

Place, publisher, year, edition, pages
Cambridge University Press, 2017
National Category
Infectious Medicine
Research subject
Ecology, Zoonotic Ecology
Identifiers
urn:nbn:se:lnu:diva-64304 (URN)10.1017/S0950268816003204 (DOI)000398972000012 ()2-s2.0-85010858898 (Scopus ID)
Available from: 2017-05-24 Created: 2017-05-24 Last updated: 2019-09-06Bibliographically approved
Atterby, C., Börjesson, S., Ny, S., Järhult, J. D., Byfors, S. & Bonnedahl, J. (2017). ESBL-producing Escherichia coli in Swedish gulls: A case of environmental pollution from humans?. PLoS ONE, 12(12), Article ID e0190380.
Open this publication in new window or tab >>ESBL-producing Escherichia coli in Swedish gulls: A case of environmental pollution from humans?
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2017 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 12, article id e0190380Article in journal (Refereed) Published
Abstract [en]

ESBL-producing bacteria are present in wildlife and the environment might serve as a resistance reservoir. Wild gulls have been described as frequent carriers of ESBL-producing E. coli strains with genotypic characteristics similar to strains found in humans. Therefore, potential dissemination of antibiotic resistance genes and bacteria between the human population and wildlife need to be further investigated. Occurrence and characterization of ESBL-producing E. coli in Swedish wild gulls were assessed and compared to isolates from humans, livestock and surface water collected in the same country and similar time-period. Occurrence of ESBL-producing E. coli in Swedish gulls is about three times higher in gulls compared to Swedish community carriers (17% versus 5%) and the genetic characteristics of the ESBL-producing E. coli population in Swedish wild gulls and Swedish human are similar. ESBL-plasmids IncF-and IncI1-type carrying ESBL-genes blaCTX-M-15 or blaCTX-M-14 were most common in isolates from both gulls and humans, but there was limited evidence of clonal transmission. Isolates from Swedish surface water harbored similar genetic characteristics, which highlights surface waters as potential dissemination routes between wildlife and the human population. Even in a low-prevalence country such as Sweden, the occurrence of ESBL producing E. coli in wild gulls and the human population appears to be connected and the occurrence of ESBL-producing E. coli in Swedish gulls is likely a case of environmental pollution.

Place, publisher, year, edition, pages
PLOS, 2017
National Category
Microbiology in the medical area
Research subject
Ecology, Microbiology
Identifiers
urn:nbn:se:lnu:diva-69794 (URN)10.1371/journal.pone.0190380 (DOI)000419033400056 ()2-s2.0-85039802074 (Scopus ID)
Available from: 2018-01-12 Created: 2018-01-12 Last updated: 2019-09-06Bibliographically approved
Woksepp, H., Hallgren, A., Borgström, S., Kullberg, F., Wimmerstedt, A., Oscarsson, A., . . . Schon, T. (2017). High target attainment for beta-lactam antibiotics in intensive care unit patients when actual minimum inhibitory concentrations are applied. European Journal of Clinical Microbiology and Infectious Diseases, 36(3), 553-563
Open this publication in new window or tab >>High target attainment for beta-lactam antibiotics in intensive care unit patients when actual minimum inhibitory concentrations are applied
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2017 (English)In: European Journal of Clinical Microbiology and Infectious Diseases, ISSN 0934-9723, E-ISSN 1435-4373, Vol. 36, no 3, p. 553-563Article in journal (Refereed) Published
Abstract [en]

Patients in the intensive care unit (ICU) are at risk for suboptimal levels of beta-lactam antibiotics, possibly leading to poor efficacy. Our aim was to investigate whether the actual minimum inhibitory concentration (MIC) compared to the more commonly used arbitrary epidemiological cut-off values (ECOFFs) would affect target attainment in ICU patients on empirical treatment with broad-spectrum beta-lactam antibiotics and to identify risk factors for not reaching target. In a prospective, multicenter study, ICU patients ae<yen>18 years old and treated with piperacillin/tazobactam, meropenem, or cefotaxime were included. Clinical and laboratory data were recorded. Serum trough antibiotic levels from three consecutive days were analyzed by liquid chromatography-mass spectrometry (LC-MS). The target was defined as the free trough concentration above the MIC (100% fT(> MIC)). MICECOFF was used as the target and, when available, the actual MIC (MICACTUAL) was applied. The median age of the patients was 70 years old, 52% (58/111) were males, and the median estimated glomerular filtration rate (eGFR) was 48.0 mL/min/1.73 m(2). The rate of patients reaching 100% fT > MICACTUAL was higher (89%, 31/35) compared to the same patients using MICECOFF (60%, p = 0.002). In total, 55% (61/111) reached 100% fT > MICECOFF. Increased renal clearance was independently associated to not reaching 100% fT > MICECOFF. On repeated sampling, > 77% of patients had stable serum drug levels around the MICECOFF. Serum concentrations of beta-lactam antibiotics vary extensively between ICU patients. The rate of patients not reaching target was markedly lower for the actual MIC than when the arbitrary MIC based on the ECOFF was used, which is important to consider in future studies.

Place, publisher, year, edition, pages
Springer, 2017
National Category
Pharmacology and Toxicology Microbiology in the medical area
Research subject
Biomedical Sciences, Pharmacology
Identifiers
urn:nbn:se:lnu:diva-62056 (URN)10.1007/s10096-016-2832-4 (DOI)000394353500019 ()27815778 (PubMedID)2-s2.0-84994226380 (Scopus ID)
Available from: 2017-04-03 Created: 2017-04-03 Last updated: 2019-08-29Bibliographically approved
Tjernberg, A. R., Bonnedahl, J. & Ludvigsson, J. F. (2016). Does Celiac Disease Influence Survival in Sepsis?: A Nationwide Longitudinal Study. PLoS ONE, 11(4), Article ID e0154663.
Open this publication in new window or tab >>Does Celiac Disease Influence Survival in Sepsis?: A Nationwide Longitudinal Study
2016 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 4, article id e0154663Article in journal (Refereed) Published
Abstract [en]

Background Individuals with celiac disease (CD) are at increased risk of sepsis. The aim of this study was to examine whether CD influences survival in sepsis of bacterial origin. Methods Nationwide longitudinal registry-based study. Through data on small intestinal biopsies from Sweden's 28 pathology departments, we identified 29,096 individuals with CD (villous atrophy, Marsh stage III). Each individual with CD was matched with five population-based controls. Among these, 5,470 had a record of sepsis according to the Swedish Patient Register (1,432 celiac individuals and 4,038 controls). Finally we retrieved data on mortality in sepsis patients through the Swedish Cause of Death Registry. Results CD was associated with a 19% increase in overall mortality after sepsis (95% confidence interval (CI) = 1.09-1.29), with the highest relative risk occurring in children (adjusted hazard ratio (aHR) = 1.62; 95% CI = 0.67-3.91). However, aHR for death from sepsis was lower (aHR = 1.10) and failed to reach statistical significance (95% CI = 0.72-1.69). CD did not influence survival within 28 days after sepsis (aHR = 0.98; 95% CI = 0.80-1.19). Conclusions Although individuals with CD seem to be at an increased risk of overall death after sepsis, that excess risk does not differ from the general excess mortality previously seen in celiac patients in Sweden. CD as such does not seem to influence short-term or sepsis-specific survival in individuals with sepsis and therefore is not an independent risk factor for poor prognosis in sepsis.

National Category
Microbiology in the medical area
Research subject
Ecology, Zoonotic Ecology
Identifiers
urn:nbn:se:lnu:diva-53273 (URN)10.1371/journal.pone.0154663 (DOI)000375211700121 ()2-s2.0-84964859397 (Scopus ID)
Available from: 2016-06-10 Created: 2016-06-10 Last updated: 2019-05-20Bibliographically approved
Atterby, C., Ramey, A. M., Hall, G. G., Järhult, J., Börjesson, S. & Bonnedahl, J. (2016). Increased prevalence of antibiotic-resistant E. coli in gulls sampled in Southcentral Alaska is associated with urban environments. Infection Ecology & Epidemiology, 6(1), 1-7, Article ID 32334.
Open this publication in new window or tab >>Increased prevalence of antibiotic-resistant E. coli in gulls sampled in Southcentral Alaska is associated with urban environments
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2016 (English)In: Infection Ecology & Epidemiology, ISSN 2000-8686, E-ISSN 2000-8686, Vol. 6, no 1, p. 1-7, article id 32334Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Antibiotic-resistant bacteria pose challenges to healthcare delivery systems globally; however, limited information is available regarding the prevalence and spread of such bacteria in the environment. The aim of this study was to compare the prevalence of antibiotic-resistant bacteria in large-bodied gulls (Larus spp.) at urban and remote locations in Southcentral Alaska to gain inference into the association between antibiotic resistance in wildlife and anthropogenically influenced habitats.

METHODS: Escherichia coli was cultured (n=115 isolates) from fecal samples of gulls (n=160) collected from a remote location, Middleton Island, and a more urban setting on the Kenai Peninsula.

RESULTS: Screening of E. coli from fecal samples collected from glaucous-winged gulls (Larus glaucescens) at Middleton Island revealed 8% of isolates were resistant to one or more antibiotics and 2% of the isolates were resistant to three or more antibiotics. In contrast, 55% of E. coli isolates derived from fecal samples collected from large-bodied gulls (i.e. glaucous, herring [Larus argentatus], and potentially hybrid gulls) on the Kenai Peninsula were resistant to one or more antibiotics and 22% were resistant to three or more antibiotics. In addition, total of 16% of the gull samples from locations on the Kenai Peninsula harbored extended-spectrum cephalosporin-resistant E. coli isolates (extended-spectrum beta-lactamases [ESBL] and plasmid-encoded AmpC [pAmpC]), in contrast to Middleton Island where no ESBL- or pAmpC-producing isolates were detected.

CONCLUSION: Our findings indicate that increased prevalence of antibiotic resistance is associated with urban environments in Southcentral Alaska and presumably influenced by anthropogenic impacts. Further investigation is warranted to assess how migratory birds may maintain and spread antimicrobial-resistant bacteria of relevance to human and animal health.

Place, publisher, year, edition, pages
Taylor & Francis, 2016
Keywords
ESBL, anthropogenic, antimicrobial resistance, gull, pAmpC
National Category
Infectious Medicine
Research subject
Ecology, Zoonotic Ecology
Identifiers
urn:nbn:se:lnu:diva-62225 (URN)10.3402/iee.v6.32334 (DOI)27649798 (PubMedID)2-s2.0-85032725706 (Scopus ID)
Available from: 2017-04-12 Created: 2017-04-12 Last updated: 2019-08-29Bibliographically approved
Stedt, J., Bonnedahl, J., Hernandez, J., Waldenström, J., McMahon, B. J., Tolf, C., . . . Drobni, M. (2015). Carriage of CTX-M type extended spectrum beta-lactamases (ESBLs) in gulls across Europe. Acta Veterinaria Scandinavica, 57, Article ID 74.
Open this publication in new window or tab >>Carriage of CTX-M type extended spectrum beta-lactamases (ESBLs) in gulls across Europe
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2015 (English)In: Acta Veterinaria Scandinavica, ISSN 0044-605X, Vol. 57, article id 74Article in journal (Refereed) Published
Abstract [en]

Background: Extended spectrum beta-lactamases (ESBLs), a group of enzymes conferring resistance to third generation cephalosporins have rapidly increased in Enterobacteriacae and pose a major challenge to human health care. Resistant isolates are common in domestic animals and clinical settings, but prevalence and genotype distribution varies on a geographical scale. Although ESBL genes are frequently detected in bacteria isolated from wildlife samples, ESBL dissemination of resistant bacteria to the environment is largely unknown. To address this, we used three closely related gull species as a model system and collected more than 3000 faecal samples during breeding times in nine European countries. Samples were screened for ESBL-producing bacteria, which were characterized to the level of ESBL genotype groups (SHV, TEM), or specific genotypes (CTX-M). Results: ESBL-producing bacteria were frequently detected in gulls (906 of 3158 samples, 28.7 %), with significant variation in prevalence rates between countries. Highest levels were found in Spain (74.8 %), The Netherlands (37.8 %) and England (27.1 %). Denmark and Poland represented the other extreme with no, or very few positive samples. Genotyping of CTX-M isolates identified 13 different variants, with bla(CTX-M-1) and bla(CTX-M-14) as the most frequently detected. In samples from England, Spain and Portugal, blaCTX-M-14 dominated, while in the rest of the sampled countries blaCTX-M-1 (except Sweden where bla(CTX-M-15) was dominant) was the most frequently detected genotype, a pattern similar to what is known from studies of human materials. Conclusions: CTX-M type ESBLs are common in the faecal microbiota from gulls across Europe. The gull ESBL genotype distribution was in large similar to published datasets from human and food-production animals in Europe. The data suggests that the environmental dissemination of ESBL is high from anthropogenic sources, and widespread occurrence of resistant bacteria in common migratory bird species utilizing urban and agricultural areas suggests that antibiotic resistance genes may also be spread through birds.

Keywords
ESBL, CTX-M, Wildlife, Birds, Gulls, Antibiotic resistance, E. coli, Europe
National Category
Microbiology Veterinary Science
Research subject
Ecology, Zoonotic Ecology
Identifiers
urn:nbn:se:lnu:diva-47378 (URN)10.1186/s13028-015-0166-3 (DOI)000363921100001 ()26526188 (PubMedID)2-s2.0-84945962826 (Scopus ID)
Available from: 2015-11-24 Created: 2015-11-24 Last updated: 2020-01-28Bibliographically approved
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-3182-389X

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