ArticlePloS one2022
Comparison of approaches for source attribution of ESBL-producing Escherichia coli in Germany.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Animal sources of antimicrobial-resistant bacterial infections in humans: a systematic review.Epidemiology and infection · 2023Pooled it
- Seasonal prevalence of extended-spectrum β-lactamase-producing bacteria in food-chain animals, humans, and the surrounding environment in Fayoum governorate: a one health approach.Frontiers in microbiology · 2026Article
- Article
- Ecological and public health dimensions of ESBL-producingVeterinary world · 2025Review
- Integration sites ofFrontiers in microbiology · 2025Article
- Antimicrobial Resistance and Extended-Spectrum Beta-Lactamase Genes inPathogens (Basel, Switzerland) · 2023Article
- Prevalence and Types of Extended-Spectrum β-Lactamase-Producing Bacteria in Retail Seafood.Foods (Basel, Switzerland) · 2023Review
- [Therapy-relevant antibiotic resistances in a One Health context].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2023Review
- Comparison of Source Attribution Methodologies for Human Campylobacteriosis.Pathogens (Basel, Switzerland) · 2023Article
- Building an International One Health Strain Level Database to Characterise the Epidemiology of AMR Threats: ESBL-AmpC ProducingAntibiotics (Basel, Switzerland) · 2023Article
- ESBL-Positive Enterobacteriaceae from Dogs of Santiago and Boa Vista Islands, Cape Verde: A Public Health Concern.Antibiotics (Basel, Switzerland) · 2023Article
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Extended-spectrum beta-lactamase (ESBL)-producing Escherichia (E.) coli have been widely described as the cause of treatment failures in humans around the world. The origin of human infections with these microorganisms is discussed controversially and in most cases hard to identify. Since they pose a relevant risk to human health, it becomes crucial to understand their sources and the transmission pathways. In this study, we analyzed data from different studies in Germany and grouped ESBL-producing E. coli from different sources and human cases into subtypes based on their phenotypic and genotypic characteristics (ESBL-genotype, E. coli phylogenetic group and phenotypic antimicrobial resistance pattern). Then, a source attribution model was developed in order to attribute the human cases to the considered sources. The sources were from different animal species (cattle, pig, chicken, dog and horse) and also from patients with nosocomial infections. The human isolates were gathered from community cases which showed to be colonized with ESBL-producing E. coli. We used the attribution model first with only the animal sources (Approach A) and then additionally with the nosocomial infections (Approach B). We observed that all sources contributed to the human cases, nevertheless, isolates from nosocomial infections were more related to those from human cases than any of the other sources. We identified subtypes that were only detected in the considered animal species and others that were observed only in the human population. Some subtypes from the human cases could not be allocated to any of the sources from this study and were attributed to an unknown source. Our study emphasizes the importance of human-to-human transmission of ESBL-producing E. coli and the different role that pets, livestock and healthcare facilities may play in the transmission of these resistant bacteria. The developed source attribution model can be further used to monitor future trends. A One Health approach is necessary to develop source attribution models further to integrate also wildlife, environmental as well as food sources in addition to human and animal data.
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