Multidrug-resistant bacteria in animals and humans

The increasing burden of antimicrobial-resistant bacteria causes morbidity and mortality, especially among patients affected by healthcare-associated infections. Limited treatment options challenge clinicians in both human and veterinary medicine. To summarize current evidence for the occurrence of antimicrobial-resistant bacteria and their zoonotic transmission between humans and animals with a focus on data from Germany. Review of scientific literature and publications from German national public health institutions. Methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum β‑lactamase (ESBL) producing Enterobacteriaceae are frequently transmitted between animals and humans. The rates of asymptomatic carriage are increased among persons with livestock contact compared with the general population. The occurrence of carbapenemase-producing Enterobacteriaceae has been documented on German pig and chicken farms, but investigations into their prevalence and zoonotic importance are pending. Colistin is frequently used in veterinary medicine to treat diarrhoea and causes selection pressure for colistin-resistant Gram-negative bacteria harbouring mcr genes. Vancomycin-resistant enterococci (VRE), oxazolidinone-resistant Gram-positive bacteria and multiresistant staphylococci are further antimicrobial-resistant microorganisms, which might have a zoonotic potential. Besides human healthcare and livestock, the problem of antimicrobial-resistant bacteria also affects companion animals (e. g. dogs, cats and horses), wildlife and the environment, which underlines the need to prevent antimicrobial resistance in a One Health approach.