Abstract
Enterococci are intrinsically resistant to various antimicrobial classes and able to acquire resistance to clinically relevant drugs via horizontal transfer. Consequently, limited therapeutic options are available for treatment of enterococcal infections. Zoonotic transfer of antimicrobial resistance in enterococci has been studied for two decades. The first studies hypothesizing possible animal-to-human transmission of resistant strains and mobile genetic elements are dated 1993. Since then a considerable amount of papers has been published on this subject, providing the groundwork for important decisions limiting antimicrobial use in animal husbandry. In this chapter, the relative contribution by animal enterococci to antimicrobial resistance in human infections was reviewed taking into consideration the potential impact associated with different enterococcal species, animal hosts, epidemiological routes and mechanisms of transfer. The authors conclude that potential zoonotic risks mainly concern horizontal transfer of resistance genes and clonal transmission of multidrug-resistant Enterococcus faecalis sequence type ST16. The impact of clonal transmission from food animals to people appears to be negligible for other multidrug-resistant E. faecalis and E. faecium lineages responsible for hospital infections. Although it has been demonstrated experimentally that antimicrobial resistant enterococci of animal origin can transiently colonise the human digestive tract and transfer their resistance genes to the indigenous microflora, the actual risks associated with foodborne transmission are controversial, mainly limited to poultry meat products and possibly differ between geographical areas. Research is warranted to explore the ecology of enterococcal mobile genetic elements carrying resistance genes of clinical relevance and to develop suitable technologies to perform this type of studies.
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