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Antibiotika-resistente Erreger in Deutschland

Die Rolle von nicht nosokomialen Ansteckungsquellen

Multidrug-resistant bacteria in Germany

The impact of sources outside healthcare facilities

  • Originalien und Übersichten
  • Published:
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Zusammenfassung

Hintergrund

Die Frage, ob die zunehmende Verbreitung von Erregern mit Antibiotika-Multiresistenzen (MRE) beim Menschen durch Übertragungen von Tieren erklärbar ist, wird öffentlich diskutiert.

Ziel der Arbeit

Diese Übersichtsarbeit trägt Daten zum Vorkommen von Methicillin-resistenten Staphylococcus aureus (MRSA) und Extended-Spectrum Beta-Lactamase (ESBL) bildenden Enterobakterien bei Mensch und Tier zusammen und beschreibt die Erkenntnisse zur zoonotischen Transmission.

Material und Methoden

Es wurde eine Literaturrecherche durchgeführt. Relevante Literatur wurde durch Screening von Überschriften und Abstracts identifiziert und ergänzt durch Publikationen von Infektionsschutzbehörden bzw. die dort zitierten Originalarbeiten.

Ergebnisse

Es zeigte sich eine Vielzahl nosokomialer Verbreitungswege von MRE sowie eine zunehmende Relevanz von außerhalb des Gesundheitswesens gelegenen Infektionsquellen.

Diskussion

Für eine effektive Prävention von MRE ist ein interdisziplinärer Ansatz notwendig, der sowohl die Grenzen medizinischer und pharmazeutischer Fachgebiete als auch die Grenzen zwischen Human- und Veterinärmedizin überschreitet.

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.

Objectives

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.

Material and 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.

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Authors and Affiliations

  1. Institut für Medizinische Mikrobiologie, Universitätsklinikum Münster, 48149, Münster, Deutschland

    Evgeny A. Idelevich, Karsten Becker &  Robin Köck

  2. Klinik für Anästhesiologie, operative Intensivmedizin und Schmerztherapie, Universitätsklinikum Münster, Münster, Deutschland

    Christian Lanckohr

  3. Apotheke, Universitätsklinikum Münster, Münster, Deutschland

    Dagmar Horn

  4. Robert Koch-Institut, Berlin, Deutschland

    Lothar H. Wieler

  5. Institut für Mikrobiologie und Tierseuchen, Freie Universität Berlin, Berlin, Deutschland

    Lothar H. Wieler

  6. Fachgruppe Zoonosen, Deutschen Gesellschaft für Hygiene und Mikrobiologie (DGHM), Münster, Deutschland

    Lothar H. Wieler &  Robin Köck

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  1. Evgeny A. Idelevich
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  2. Christian Lanckohr
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  4. Lothar H. Wieler
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  6. Robin Köck
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Correspondence to Robin Köck.

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Interessenkonflikte

Prof. Dr. Wieler, Prof. Dr. Becker und Priv.-Doz. Dr. Köck erhielten/erhalten Förderungen im Rahmen der Zoonose-Forschungsverbünde „FBI-Zoo“ bzw. „MedVet-Staph“ durch das Bundesministerium für Bildung und Forschung. Dr. Idelevich erhielt Förderungen im Rahmen des Programms „Innovative Medizinische Forschung“ (IMF) der Medizinischen Fakultät der Universität Münster für die Untersuchungen zur Prävention und Therapie mit Bakteriophagenendolysinen.

Priv.-Doz. Dr. Köck erhielt Zuwendungen von Becton Dickinson, Pfizer, Paul Hartmann, B. Braun Melsungen, MSD Sharpe & Dohme und Astellas Pharma. Prof. Dr. Becker erhielt Zuwendungen von Cepheid, Cubist, Novartis, Oxoid, Pfizer und Siemens. Dr. Lanckohr erhielt Zuwendungen von Astellas Pharma, Pfizer, Novartis und Sanofi. Dr. Idelevich erhielt Zuwendungen von Pfizer, Astellas Pharma und Novartis.

Dieser Beitrag enthält keine Studien an Menschen oder Tieren.

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Idelevich, E., Lanckohr, C., Horn, D. et al. Antibiotika-resistente Erreger in Deutschland. Bundesgesundheitsbl. 59, 113–123 (2016). https://doi.org/10.1007/s00103-015-2261-z

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