Salmonella é um dos principais agentes de enfermidades transmitidas por alimentos em diversos países, sendo a carne de frango um dos principais veículos envolvidos em surtos. O Brasil vem se destacando como um dos maiores exportadores mundiais deste alimento. O ambiente de criação das aves é apontado como um importante foco de infecção das aves e o ambiente industrial de abate e processamento é importante na disseminação deste ·microrganismo. Na busca pela produção de alimentos seguros do ponto de vista microbiológico, uma das ferramentas utilizadas é a subtipagem de microrganismos isolados ao longo da cadeia de produção, que permite determinar rotas de contaminação do produto final. Os objetivos deste trabalho são: o estudo da disseminação dos subtipos de Salmonella Enteritidis nas várias etapas de uma cadeia de produção industrial de carne de frango, empregando-se diversos métodos de subtipagem e a determinação da resistência a antimicrobianos destas cepas. 108 isolados de Salmonella Enteritidis dos fagotipos PT1, PT4 e PT7a foram obtidos nos anos de 2002 e 2003, a partir de amostras ambientais e de frango relativas a sete sub-regiões de uma cadeia produtiva industrial avícola. Os perfis de resistência destes isolados foram determinados frente a antimicrobianos de uso humano e veterinário e eles foram submetidos a subtipagem por PFGE, RAPO, ribotipagem e PCR-ribotipagem. Foram detectados 21 perfis de resistência diferentes, com 6,5% das cepas sensíveis a todas as drogas, 33,3% resistentes a um ou dois antimicrobianos e 83,3% apresentando resistência intermediária a até quatro deles. Os níveis relativamente elevados de resistência são preocupantes e a diminuição da pressão seletiva deve ser um objetivo para os produtores de aves. De modo geral, a subtipagem permitiu separar as cepas em 13 genótipos, com elevada similaridade entre si. Porém, a maior parte das cepas (69,4%) pertenceu a apenas três deles, que foram encontrados ao longo de toda a cadeia produtiva. A ribotipagem foi o método que apresentou o melhor poder discriminatório (D = 0,701), porém nem todas as cepas foram tipáveis por este método. Não foram encontradas correlações entre os perfis de resistência a antimicrobianos e fagotipos, nem entre genótipos e fagotipos. Porém, dois genótipos proximamente correlacionados e predominantemente encontrados em uma sub-região reuniram apenas cepas com resistência intermediária ou resistentes exclusivamente à furazolidona. A similaridade elevada entre os genótipos evidencia a origem clonal das cepas. / Salmonella is one of the most important foodborne disease agents all over the world, and chicken is recognized as an important vehicle of the infection. Chicken production in Brazil has increased in the last couple of years and the country is now ranked 2nd as producer/exporter of this commodity. For this reason there is an increased concern over the safety of these goods. This study deals with the dissemination, antimicrobial resistance, and genetic characterization of S. Enteritidis strains isolated from an industrial chicken production chain. 108 isolates, phagetypes PT1, PT4 and PT7a, were obtained at different steps of the commercial production from farm to frozen cuts, and the broilers were from different producers supplying the same processing plant. Tests for susceptibility to 12 human and veterinary antimicrobial agents were performed. The strains were also typed by PFGE, RAPO, ribotyping, and PCR-ribotyping. 6.5% of the strains were susceptible to the 12 drugs tested and 33.3% were resistant to 1 or 2 of them. Intermediate resistance to up to 4 agents was observed in 83.3% of the isolates. Combining all the typing methods allowed the division of the strains in 13 genotypes with elevated degree of similarity. However, 69.4% of the strains belonged to 3 main phagetypes spread along the production chain. There was no correlation between phagetypes and genotypes, or phagetypes and resistance profiles. However, most strains from one sub-region were from 2 genotypes and showed intermediate resistance to, or were resistant to furazolidone. The high degree of similarity amongst the genotypes indicates the clonal origin of the strains. The relatively high resistance to antimicrobial agents is a cause of concern and trying to diminish the selective pressure has to be a goal for broiler producers.

The fast-increasing issue of antibiotic unavailability or relatively their shortages in the healthcare system has been the point of concern for many countries. With these shortages come unnecessary costs and the need to utilize less optimal treatment thus increasing the risk of antimicrobial resistance and jeopardizing a patient’s health. This thesis is a collaboration with PLATINEA (Platform for Innovation of Existing Antibiotics), aiming to optimize the usage of antibiotics and to increase the availability of important antibiotics in Sweden. To understand the causes that affect antibiotic unavailability, a good view into the antibiotic and pharmaceutical supply chain is important, especially the purchasing systems of it. The complexities in the purchasing system can lead to interruptions in the antibiotics supply chain thus increasing the risk of antibiotic shortages. These shortages in turn increases the risk of antimicrobial resistance, therefore, the purchasing system requires the need to be analysed extensively. This study aims to explore different purchasing systems and conduct cost-benefit analysis of centralized purchasing system in efforts to help reduce shortages of antibiotics in Sweden. This study is based on the existing literature on centralized and decentralized purchasing and also the pharmaceutical supply chain. Qualitative interviews (semi-structured), multiple reports and articles steered the authors in exploring the purchasing systems and mapping the costs and benefits of centralized purchasing. Throughout the research, emphasis was kept on reducing antibiotic shortages. The findings of this study outline the various costs and benefits of a centralized purchasing system and resulted in the implementation recommendation of it over an existing decentralized purchasing system in Sweden.

No description available.

La résistance aux antibiotiques a pris une ampleur considérable du fait de l’utilisation des antibiotiques dans de nombreux domaines. Pour respecter l’approche « OneHealth », il est essentiel d’avoir une image spécifique de chaque situation, afin d’orienter les recommandations et de limiter la dissémination des gènes, des plasmides et des clones. Nos objectifs étaient adaptés à nos populations d’étude (chevaux et porcs) afin d’ajuster les résultats aux besoins des filières. Dans la filière équine, nous avons quantifié les résistances phénotypiques et identifié les gènes de β-lactamases à spectre étendu (BLSE/AmpC) présents dans le microbiome des chevaux sains, et nous avons identifié les facteurs de risque associés à leur portage en France et au Québec. En France, nous avons également caractérisé les mécanismes de dissémination des gènes de BLSE/AmpC. Nous avons mis en évidence qu’en France et au Québec, les E. coli commensaux provenant de fèces de chevaux sains étaient majoritairement non susceptibles à l’ampicilline, l’amoxicilline/acide clavulanique et la streptomycine et que des E. coli multirésistants et porteurs de gènes codant pour des BLSE/AmpC étaient détectés dans respectivement environ 45% et 8% des chevaux. Le blaCTX-M-1 était majoritairement détecté bien qu’en France d’autres BLSE aient été identifiés (blaCTX-M-2 et blaCTX-M-14) ainsi que le gène AmpC blaCMY-2. L’administration d’un traitement médical, le nombre de personnes s’occupant des chevaux, le type d’activité et le fait de participer à un évènement équestre dans les trois derniers mois ont été identifiés comme des facteurs de risque du portage des E. coli multirésistants ou producteurs de gènes BLSE/AmpC, soit en France soit au Québec. En France, le plasmide IncHI1-ST9 était majoritairement associé aux gènes blaCTX-M-1/2 et à l’opéron fos. Pour la filière porcine, nos objectifs étaient de colliger les données de la base de données du laboratoire EcL entre 2008 et 2016, d’évaluer la présence d’un agrégat spatio-temporel pour les isolats ETEC:F4 non susceptibles à l’enrofloxacine et de caractériser ces isolats et les éléments génétiques mobiles qu’ils transportent. En effet, l’enrofloxacine est un antibiotique de haute importance en santé humaine, et doit donc faire l’objet d’une surveillance accrue. Nous avons trouvé que plus de 90% des isolats d’E. coli entérotoxinogènes détectés chez des cas de porcs malades soumis au laboratoire EcL de 2008 à 2016 au Québec, étaient multirésistants. Le virotype LT:STb:F4 prédominait jusqu’en 2014, puis a été dépassé par le virotype LT:STb:STa:F4. Un agrégat spatio-temporel d’isolats LT:STb:STa:F4 non susceptibles à l’enrofloxacine a été détecté entre 04/2015 et 09/2016 au centre de la Montérégie. Nous avons démontré la présence d’un clone ETEC:F4 non susceptible à l’enrofloxacine, à haut risque, qui se dissémine en Amérique du Nord depuis 2013. Les isolats appartenant à ce clone sont ST100, O149:H10. Ils sont multirésistants, et associés à une pathogénicité et une virulence augmentée par rapport aux isolats détectés avant 2000. Ils portent le réplicon IncFII. Les résistances et leur mécanisme de dissémination sont différents selon l’espèce animale. Ces divergences sont fonction de l’usage des antibiotiques, et des échanges possibles avec les différents protagonistes en contact avec les animaux. / Antimicrobial resistance has become an essential issue in the last decades because of the extensive use of antimicrobials in numerous sectors. In order to follow the OneHealth approach, it is critical to have a precise picture of each situation, to adjust recommendations and prevent resistance gene dissemination as well as plasmid and clone spread. Our objectives were adapted to the animal populations under study. Therefore, our results were compatible with each sector. In the equine sector, we quantified phenotypic resistance and identified β-lactamase (ESBL/AmpC) genes present in the intestinal microbiome of healthy horses and we identified risk factors associated with their carriage both in France and in Quebec. Then, in France we characterized ESBL/AmpC gene spread mechanisms. We demonstrated that commensal E. coli originating from the feces of healthy horses were mostly non-susceptible to ampicillin, amoxicillin/clavulanic acid and streptomycin. The presence of multidrug resistant E. coli and of E. coli carrying ESBL/AmpC genes was found in around 45% and 8% of horses respectively. The most frequently detected gene was blaCTX-M-1, although blaCTX-M-2 and blaCTX-M-14 were also identified in France. The AmpC gene blaCMY-2 was identified in both localities. Medical treatment, staff number, activity, and participation in an equestrian event within the last three months were identified as risk factors for MDR or ESBL/AmpC E. coli. In France, commensal E. coli from healthy horses most commonly possessed the IncHI1-ST9 plasmid. This plasmid carries blaCTX-M-1/2 genes and the fos operon. For the swine sector in Quebec, our objectives were to gather data provided by the Animal pathogenic and zoonotic E. coli (APZEC) database between 2008 and 2017, to assess the presence of a spatio-temporal cluster for enrofloxacin non-susceptible ETEC:F4 and to characterize these isolates and the mobile genetic elements they carry. Enrofloxacin is an antibiotic classified as highly important in human medicine and as such needs to come under higher scrutiny. For this sector, we demonstrated that more than 90% of enterotoxigenic E. coli (ETEC) isolates from diseased swine submitted to the EcL between 2008 and 2016, were multidrug resistant. The main virotype in 2014 was LT:STb:F4. It was subsequently replaced by the LT:STb:STa:F4 virotype. A spatio-temporal cluster of LT:STb:STa:F4 isolates non-susceptible to enrofloxacin was detected between 04/2015 and 09/2016 in the centre of the Monteregie region. These isolates constituted an ETEC:F4 high risk enrofloxacin non-susceptible clone, which has been spreading in North America since 2013. Isolates belonging to this clone are ST100, O149H10, phylogroup A, and fimH gene negative. These isolates are multidrug resistant and associated with a higher pathogenicity and virulence than isolates detected before 2000. They all carry the incFII replicon. Resistance and mechanisms of dissemination are different according to the animal species being studied. This is likely due to different patterns of antimicrobial use in each industry and possible interactions with different protagonists in contact with the animals. It is essential to understand the situation for each animal species in order to adapt recommendations for efficiently limiting the spread of resistance genes, plasmids and clones.

No description available.

Introducción: La resistencia antimicrobiana es un problema alarmante en la salud pública mundial. A mediados del 2017, la Organización Mundial de la Salud (OMS) reportó una lista de las bacterias para la búsqueda de nuevos antibióticos, incluyendo sobre todo enterobacterias. En el Perú, hubo reporte de casos de Klebsiella pneumoniae resistente a antibióticos en diferentes regiones del país. Por lo tanto, existe una necesidad de encontrar nuevos sitios diana de acción farmacológica para enfrentar esta problemática sanitaria. Objetivo: Identificar las moléculas orgánicas con capacidad de inhibición de la enzima Glucosa 1-fosfato Timidilil Transferasa (RmlA) de K. pneumoniae resistente a antibióticos utilizando la técnica de acoplamiento molecular. Materiales y métodos: Se realizó un estudio in-silico, mediante programas para acoplamiento molecular por ordenador local. La semejanza de fármacos con el sustrato natural de la enzima fue dada con programas de similaridad de ligandos, se obtuvieron datos teóricos de las interacciones entre los fármacos seleccionados con el sitio activo de la enzima. Finalmente se analizó cada ligando en función de sus energías libres. Resultados: Se analizó computacionalmente 14100 unidades farmacológicas con posible interacción con la enzima RmlA de K. pneumoniae resistente a antibióticos, según las energías libres de interacción los valores enteros están entre 96 a 103 (kcal/mol), frente al valor de acoplamiento del sustrato-enzima de -222.357 (kcal/mol). Conclusiones: Se encontraron posibles fármacos inhibidores de la enzima RmlA de K. pneumonia, es necesario continuar con la valoración y estudio de estos fármacos en estudios laboratoriales para mejorar la propuesta de inhibición enzimática basada en este trabajo de investigación computacional. / Introduction: Antimicrobial resistance is an alarming problem in global public health. In mid-2017, the World Health Organization (WHO) reported a list of bacteria for the search for new antibiotics, including especially Enterobacteriaceae. In Peru, there were reports of cases of antibiotic-resistant Klebsiella pneumoniae in different regions of the country. Therefore, there is a need to find new target sites for pharmacological action to address this health problem. Objective: Identify organic molecules with the capacity to inhibit the enzyme Glucose 1-phosphate Thymidylyl Transferase (RmlA) of antibioticresistant K. pneumoniae using the molecular docking technique. Materials and methods: An in-silico study was carried out, using programa for molecular docking by local computer. The similarity of drugs with the natural substrate of the enzyme was given with ligand similarity programs, theoretical data were obtained on the interactions between the selected drugs with the active site of the enzyme. Finally, each ligand was analyzed based on its free energies. Results: 14100 pharmacological units with possible interaction with the RmlA enzyme of antibiotic-resistant K. pneumoniae were computationally analyzed. According to the interaction free energies, the integer values are between 96 to 103 (kcal/mol), compared to the coupling value of the substrate. enzyme of -222,357 (kcal/mol). Conclusions: Possible drugs that inhibit the RmlA enzyme of K. pneumonia were found; it is necessary to continue with the evaluation and study of these drugs in laboratory studies to improve the proposal for enzyme inhibition based on this computational research work.

No description available.

No description available.

Over the course of the last decades, the continuous exposure of bacteria to antibiotics—at least in parts due to misprescription, misuse, and misdosing—has led to the widespread development of antimicrobial resistances. This development poses a threat to the available medication in losing their effectiveness in treating bacterial infections. On the drug development side, only minor advances have been made to bring forward novel therapeutics. In addition to increasing the efforts and approaches of tapping the natural sources of new antibiotics, synthetic approaches to developing novel antimicrobials are being pursued. In this study, BDTL049 was rationally designed using knowledge based on the properties of natural antibiotics. BDTL049 is a carbosilane dendritic system with bow-tie type topology, which has antimicrobial activity at concentrations comparable to clinically established natural antibiotics. In this report, we describe its mechanism of action on the Gram-positive model organism Bacillus subtilis. Exposure to BDTL049 resulted in a complex transcriptional response, which pointed toward disturbance of the cell envelope homeostasis accompanied by disruption of other central cellular processes of bacterial metabolism as the primary targets of BDTL049 treatment. By applying a combination of whole-cell biosensors, molecular staining, and voltage sensitive dyes, we demonstrate that the mode of action of BDTL049 comprises membrane depolarization concomitant with pore formation. As a result, this new molecule kills Gram-positive bacteria within minutes. Since BDTL049 attacks bacterial cells at different targets simultaneously, this might decrease the chances for the development of bacterial resistances, thereby making it a promising candidate for a future antimicrobial agent.

La résistance aux antimicrobiens (RAM) est un problème de santé publique mondial avec des répercussions importantes en médecine vétérinaire et humaine. Elle est classiquement associée à une surutilisation des antimicrobiens. Les bactéries commensales des animaux et des humains, tel Escherichia coli, sont souvent utilisées comme bactéries indicatrices pour surveiller la RAM. Parmi les mécanismes de résistance de E. coli, la production de β-lactamases à spectre étendue (BLSE) ou de type AmpC est particulièrement inquiétante. Ces enzymes peuvent inactiver une classe d’antimicrobien de très haute importance en santé humaine également utilisée en médecine vétérinaire : les céphalosporines de 3e génération. La prévalence générale de la RAM ainsi que la présence de E. coli producteur de BLSE/AmpC dans les troupeaux laitiers québécois sont inconnues. De plus, la transmission de ces bactéries résistantes et les facteurs de risque associés à leurs excrétions par les bovins laitiers sont actuellement peu documentés. L’objectif général de cette thèse était d’explorer la RAM par une étude transversale observationnelle sur des fermes québécoises de bovins laitiers sélectionnées aléatoirement (n = 101). La première étape du projet constituait à décrire la prévalence de cette RAM pour la bactérie E. coli isolée des matières fécales des animaux (vaches en lactation, veaux pré-sevrage) et de l’environnement (fosse à fumier). La prévalence de RAM observée pour les E. coli indicateurs était faible (<5%) pour les antimicrobiens de très haute importance en médecine humaine (céphalosporines de 3e génération et fluoroquinolones). Cependant, il y avait une prévalence élevée (85%) de fermes avec la présence d’au moins un E. coli producteur de BLSE/AmpC. La RAM était particulièrement importante pour les E. coli isolés chez les veaux pré-sevrage. Pour la deuxième étape, cette RAM était analysée au niveau génétique par le séquençage du génome entier des E. coli les plus résistants. La grande majorité de la RAM (>95%) était expliquée par des mutations ou des gènes de résistance. Certains de ceux-ci étaient à proximité l’un de l’autre et leur configuration laissait supposer qu’une partie de ces gènes étaient présents sur des éléments génétiques mobiles. De plus, il y avait une dissémination clonale de E. coli résistant entre les fermes. La dernière étape constituait à déterminer des facteurs de risque (utilisation des antimicrobiens ou pratiques à la ferme) de la RAM. Grâce à des analyses multivariées utilisant l’intelligence artificielle, il a été possible d’observer des facteurs de risque significatifs associés à la taille de la ferme et à la santé des animaux. Bref, un portrait de la situation de la RAM est maintenant établi dans les troupeaux de bovins laitiers du Québec pour 2017. Il s’agit d’un phénomène complexe qui ne se limite pas simplement à un lien direct avec l’utilisation des antimicrobiens. Ces travaux serviront de bases pour suivre l’évolution temporelle de la RAM. De plus, des études prospectives pourraient être réalisées afin de confirmer les impacts des observations notées dans cette thèse. L’ensemble de ces informations seront déterminantes en vue d’établir des mesures concrètes pour tenter de limiter cette importante problématique. / Antimicrobial resistance (AMR) is a global public health problem with major repercussions in both veterinary and human medicine. It is classically associated with the overuse of antimicrobials. Animal and human commensal bacteria, such as Escherichia coli, are often used as indicator bacteria to monitor AMR. Among the resistance mechanisms of E. coli, the production of an extended-spectrum β-lactamase (ESBL) or AmpC-type is of particular concern. These enzymes can inactivate a class of antimicrobials of great importance in human health also used in veterinary medicine: third-generation cephalosporins. The overall prevalence of AMR and the presence of ESBL/AmpC-producing E. coli are unknown in Québec dairy herds. Furthermore, the transmission of these resistant bacteria and the risk factors associated with their excretion by dairy cattle are currently poorly documented. The overall objective of this thesis was to explore AMR through an observational cross-sectional study on randomly selected Québec dairy farms (n = 101). The first step of the project was to describe the prevalence of AMR for E. coli isolated from animal feces (lactating cows, pre-weaned calves) and the environment (manure pit). The prevalence of AMR observed for indicator E. coli was low (<5%) for antimicrobials of very high importance in human medicine (third-generation cephalosporins and fluoroquinolones). However, there was a high prevalence (85%) of farms with at least one ESBL/AmpC-producing E. coli. AMR was particularly high for E. coli isolated from pre-weaned calves. In the second step, AMR was analyzed at the genetic level by whole genome sequencing of the most resistant E. coli isolates. The vast majority of AMR (>95%) was explained by mutations or resistance genes. Some of these were in close proximity to each other, and their configuration suggested that some of these genes were present on mobile genetic elements. In addition, there was clonal dissemination of resistant E. coli between farms. The final step was to identify risk factors (antimicrobial use or farm practices) for AMR. Using artificial intelligence methods for multivariate analyses, it was possible to identify significant risk factors associated with farm size and the health of animals. In summary, our results provide a portrait of the AMR situation in Québec dairy herds. This complex phenomenon is not simply limited to a direct link with antimicrobial use. This work will serve as a baseline for monitoring the temporal evolution of AMR. In addition, prospective studies could be carried out to confirm the impacts of the observations noted in this thesis. All this information will be decisive in establishing concrete measures to try and limit this major problem.