Human health hazards from antimicrobial-resistant Escherichia coli of animal origin. Clin. Infect. Diseases

The use of antimicrobial agents in the modern farm industry has created a reservoir of resistant bacteria in food animals. Foods of animal origin are often contaminated with enterococci that are likely to contribute resistance genes, virulence factors, or other properties to enterococci IN humans. The potential hazard to human health from antimicrobial-resistant enterococci in animals is questioned by some scientists because of evidence of host specificity of enterococci. Similarly, the occurrences of specific nosocomial clones of enterococci in hospitals have lead to the misconception that antimicrobial-resistant animal enterococci should be disregarded as a human health hazard. On the basis of review of the literature, we find that neither the results provided by molecular typing that classify enterococci as host-specific organisms nor the occurrence of specific nosocomial clones of enterococci provide reasons to change the current view that antimicrobial-resistantenterococci from animals pose a threat to human health. On the contrary, antimicrobial resistance genes appear to spread freely between enterococci from different reservoirs, irrespective of their apparent host association. Enterococci cause many serious and life-threatening infections, including bloodstream infections. Enterococcal infections are often treated with a combination of an aminoglycoside (e.g., gentamicin) and a cell wall–active agent, such as penicillin (e.g., ampicillin) or a glycopeptide (vancomycin or teicoplanin). En