Heike Kaspar

Non-targeted methods (NTMs) using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) show promise in bacterial resistance detection, yet temporal variations in spectral features pose significant challenges. These proteomic patterns, which characterize bacterial phenotypes and pathological functions, may vary over time due to bacterial adaptation, virulence, or resistance mechanisms, resulting in large prediction uncertainties and potentially degrading NTM performance. We present a comprehensive screening method to detect temporal changes in MALDI-TOF spectral patterns, demonstrated using methicillin-resistant and -susceptible Staphylococcus aureus (MRSA/MSSA) isolates collected over several years. Our approach combines convolutional neural networks (CNNs) with statistical methods, including significance testing, kernel density estimation, and receiver operating characteristics for dataset shift detection. We employ Gradient-weighted Class Activation Mapping (Grad-CAM) for post hoc feature description, enabling biochemical characterization of temporal changes. This analysis reveals crucial insights into the dynamic relationship between spectral data patterns over time, addressing key challenges in developing robust NTMs for routine applications.

Non-targeted methods (NTMs) require robust methods for comparing spectral data for reliable classification and identification. Traditional approaches using match factors reduce complex spectral relationships to single values, limiting their utility in quality assurance. This study presents an evaluation of spectral comparison methodologies, contrasting classical Mahalanobis distance (MD) with neural network approaches, namely, neural classification distance (NCD). Using matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry data from bacterial isolates, we systematically assessed these methods across varying levels of spectral variability. The MD approach exhibited consistent performance under controlled conditions but showed limitations with increasing spectral complexity. In contrast, the NCD demonstrated adaptability across all scenarios, revealing its capability in handling complex spectral relationships. Through this exemplary example, we present the mathematical framework for quantifying spectral variations and establish criteria for method selection in different analytical scenarios. This work provides a foundation for proposing data quality metrics in NTMs and offers practical implementations for routine quality assurance. The methodology developed here extends beyond mass spectrometry applications and contributes to the broader field of analytical quality control in complex spectral analysis.

Colistin (polymyxin E) is increasingly used as a last-resort antibiotic for the treatment of severe infections with multidrug-resistant Gram-negative bacteria. In contrast to human medicine, colistin is also used in veterinary medicine for metaphylaxis. Our objective was to decipher common colistin resistance mechanisms in Klebsiella pneumoniae isolates from animals. In total, 276 veterinary K. pneumoniae isolates, derived from companion animals or livestock, and 12 isolates from human patients were included for comparison. Six out of 276 veterinary isolates were colistin resistant (2.2%). Human isolates belonging to high-risk clonal lineages (e.g., ST15, ST101, ST258), displayed multidrug-resistant phenotypes and harboured many resistance genes compared to the veterinary isolates. However, the common colistin resistance mechanism in both human and animal K. pneumoniae isolates were diverse alterations of MgrB, a critical regulator of lipid A modification. Additionally, deleterious variations of lipopolysaccharide (LPS)-associated proteins (e.g., PmrB P95L, PmrE P89L, LpxB A152T) were identified. Phylogenetic analysis and mutation patterns in genes encoding LPS-associated proteins indicated that colistin resistance mechanisms developed independently in human and animal isolates. Since only very few antibiotics remain to treat infections with MDR bacteria, it is important to further analyse resistance mechanisms and the dissemination within different isolates and sources.

Antimicrobial resistance (AMR) data from humans are mostly collected from clinical isolates, whereas from livestock data also exist from colonizing pathogens. In Germany, livestock data are collected from clinical and nonclinical isolates. We compared resistance levels of clinical and nonclinical isolates of Escherichia coli from weaning and fattening pigs with clinical outpatient isolates of humans from urban and rural areas. We also studied the association of AMR with available antimicrobial use (AMU) data from humans and pigs. Differences between rural and urban isolates were minor and did not affect the comparison between human and pig isolates. We found higher resistance levels to most antimicrobials in human isolates compared to nonclinical isolates of fattening pigs. Resistance to ampicillin, however, was significantly more frequent in clinical isolates of fattening pigs and in clinical and nonclinical isolates of weaning pigs compared to isolates from humans. The opposite was observed for ciprofloxacin. Co-trimoxazole resistance proportions were higher in clinical isolates of weaning and fattening pigs as compared to isolates from humans. Resistance proportions were higher in clinical isolates than in nonclinical isolates from pigs of the same age group and were also higher in weaner than in fattening pigs. Significant associations of AMU and AMR were found for gentamicin resistance and aminoglycoside use in humans (borderline) and for ampicillin resistance in clinical isolates and penicillin use in fattening pigs. In summary, we found significant differences between isolates from all populations, requiring more detailed analyses supported by molecular data and better harmonized data on AMU and AMR.

Livestock data on antimicrobial resistance (AMR) are commonly collected from bacterial populations of clinical and non-clinical isolates. In contrast to data on non-clinical isolates from livestock, data on clinical isolates are not harmonized in Europe. The Normalized Resistance Interpretation (NRI) method was applied to overcome the lack of harmonization of laboratory methods and interpretation rules between monitoring systems. Statistical analyses were performed to identify associations between the isolate type (clinical vs. non-clinical) and resistance to four antimicrobials (ampicillin, tetracycline, gentamicin, and nalidixic acid) per animal category in Germany and France. Additional statistical analyses comparing clinical and non-clinical isolates were performed with the available data on the same antimicrobial panel and animal categories from the UK and Norway. Higher resistance prevalence was found in clinical isolates compared to non-clinical isolates from calves to all antimicrobials included in Germany and France. It was also found for gentamicin in broilers from France. In contrast, in broilers and turkeys from Germany and France and in broilers from the UK, a higher resistance level to ampicillin and tetracycline in non-clinical isolates was encountered. This was also found in resistance to gentamicin in isolates from turkeys in Germany. Resistance differed within countries and across years, which was partially in line with differences in antimicrobial use patterns. Differences in AMR between clinical and non-clinical isolates of Escherichia coli are associated with animal category (broiler, calf, and turkey) and specific antimicrobials. The NRI method allowed comparing results of non-harmonized AMR systems and might be useful until international harmonization is achieved.

In the European Union, various fluoroquinolones are authorised for the treatment of food producing animals. Each administration poses an increased risk of development and spread of antimicrobial resistance. The aim of this study was to investigate the impact of parenteral administration of enrofloxacin on the prevalence of enrofloxacin and ciprofloxacin susceptibilities in the commensal intestinal E. coli population. E. coli isolates from faeces of twelve healthy pigs were included. Six pigs were administered enrofloxacin on day 1 to 3 and after two weeks for further three days. The other pigs formed the control group. MIC values were determined. Virulence and resistance genes were detected by PCR. Phylogenetic grouping was performed by PCR. Enrofloxacin and ciprofloxacin were analysed in sedimentation samples by HPLC. Susceptibility shifts in commensal E. coli isolates were determined in both groups. Non-wildtype E. coli could be cultivated from two animals of the experimental group for the first time one week after the first administration and from one animal of the control group on day 28. The environmental load with enrofloxacin in sedimentation samples showed the highest amount between days one and five. The repeated parenteral administration of enrofloxacin to pigs resulted in rapidly increased MIC values (day 28: MIC up to 4 mg/L, day 35: MIC ≥ 32mg/L). E. coli populations of the control group in the same stable without direct contact to the experimental group were affected. The parenteral administration of enrofloxacin to piglets considerably reduced the number of the susceptible intestinal E. coli population which was replaced by E. coli strains with increased MIC values against enrofloxacin. Subsequently also pigs of the control were affected suggesting a transferability of strains from the experimental group through the environment to the control group especially as we could isolate the same PFGE strains from both pig groups and the environment.

Camels are the most valuable livestock species in the Horn of Africa and play a pivotal role in the nutritional sustainability for millions of people. Their health status is therefore of utmost importance for the people living in this region. Streptococcus agalactiae, a Group B Streptococcus (GBS), is an important camel pathogen. Here we present the first epidemiological study based on genetic and phenotypic data from African camel derived GBS. Ninety-two GBS were characterized using multilocus sequence typing (MLST), capsular polysaccharide typing and in vitro antimicrobial susceptibility testing. We analysed the GBS using Bayesian linkage, phylogenetic and minimum spanning tree analyses and compared them with human GBS from East Africa in order to investigate the level of genetic exchange between GBS populations in the region. Camel GBS sequence types (STs) were distinct from other STs reported so far. We mapped specific STs and capsular types to major disease complexes caused by GBS. Widespread resistance (34%) to tetracycline was associated with acquisition of the tetM gene that is carried on a Tn916-like element, and observed primarily among GBS isolated from mastitis. The presence of tetM within different MLST clades suggests acquisition on multiple occasions. Wound infections and mastitis in camels associated with GBS are widespread and should ideally be treated with antimicrobials other than tetracycline in East Africa.

GERMAP ist konzipiert als Bericht und Atlas zum Antibiotikaverbrauch und zur Antibiotikaresistenz in der Human- und Veterinärmedizin. Der Bericht wird gemeinsam vom Bundesamt für Verbraucherschutz und Lebensmittelsicherheit, der Paul-Ehrlich-Gesellschaft für Chemotherapie und dem Infektionszentrum am Universitätsklinikum Freiburg in Zusammenarbeit mit 11 weiteren Gesellschaften, Verbänden, Institutionen herausgegeben. Bisher erschienen GERMAP 2008 und GERMAP 2010. GERMAP ist kostenlos im Internet als pdf-Datei erhältlich. Vorbilder für GERMAP sind die seit vielen Jahren in skandinavischen Ländern verfügbaren ähnlichen Berichte. GERMAP 2010 zeigt die bis 2008 /2009 aktualisierten verfügbaren Daten zum Antibiotikaverbrauch in der Humanmedizin, enthält gegenüber GERMAP 2008 leider keine aktualisierten Daten zum Antibiotikaverbrauch in der Veterinärmedizin, zu denen aufgrund einer neuen Verordnung zur Erfassung der Abgabemengen in GERMAP 2012 vermutlich wieder berichtet werden kann. Zu wichtigen Befunden im Bereich Antibiotikaresistenz in der Humanmedizin gehört die Beobachtung, dass MRSA-Stämme relativ gut empfindlich gegenüber Cotrimoxazol, Doxycyclin, Rifampicin, Linezolid und Gentamicin waren. Clindamycin-Resistenz war bei den klassischen nosokomialem MRSA hoch ( > 50 %), bei den ambulant erworbenen MRSA niedrig ( < 10 %). Die Daten zur Penicillin-Resistenz von Pneumokokken, den häufigsten Erregern ambulant erworbener Pneumonien im Erwachsenenalter, zeigen eine konsistent sehr niedrige Rate für Deutschland. Für die Fluorchinolon-Resistenz von E. coli schwankten die Werte zwischen < 10 % und > 20 %. Relativ hohe Resistenzraten zeigen die Isolate von verschiedenen Tieren und unterschiedlichen Indikationen bei Ampicillin, Tetracyclinen und Cotrimoxazol. Die Fluorchinolon-Resistenzrate bei E.coli vom Tier war sehr unterschiedlich; bei Isolaten von Kälbern betrug sie > 25 %, bei Isolaten von Ferkeln, Masthähnen und Truthühnern < 10 %. GERMAP 2012 ist bereits in Arbeit und wird zu vielen Kapiteln neue Daten präsentieren können. Zunehmend sollen Kommentare, spezielle Berichte und Stellungnahmen integriert werden. Es soll damit eine bessere Basis für die Entwicklung von Leitlinien und Empfehlungen für die adäquate Therapie von Infektionskrankheiten bei Menschen und Tieren wie auch für politische Meinungsbildung und Entscheidungshilfe geschaffen werden.