Multidrug-resistant bacteria in Germany: The impact of sources outside healthcare facilities

Idelevich E., Lanckohr C., Horn D., Wieler L., Becker K., Köck R.

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.