Animal & Veterinary
Enterococcus From Retail Meats by Johnnie David, FDA
DR. DAVIS: -- ground beef followed by faecium. For pork chops, it is where we got the predominantly most of our faecalis from. We can see that there was a steady increase over the years for the percentage of faecalis that we isolated from our pork chops.
Also, there is a slight decrease in the number of faecium that we are getting out of our pork chops, dropping from 25 percent down to right around 10 percent. Our hirae decreased, but it was relatively consistent and fairly low throughout all six years.
Doing antimicrobial resistance over the six years, we found for our aminoglycosides, we saw roughly about ten, anywhere between 10 and 20 percent faecalis over the years, consistently were resistant to aminoglycosides. We saw a spike here for Kanamycin here for Enterococcus faecium, but it still kind of fit the trend and faecalis roughly around 10 to 20 percent over the years for our aminoglycosides.
We had a little less than 10 percent for most of our resistance for hirae. For penicillin for our beta-lactam resistance, we mostly found those with our faecium isolates. For tetracycline, it was relatively high for all three species, hirae, faecalis, and faecium.
For our macrolides, we saw that we had fairly similar resistance among all species for all six years. For nitrofurans, we mostly saw resistance mainly with our faecium isolates, very little with our hirae, and hardly anything for our faecalis isolates. There was no resistance to Linezolid.
For our Streptogramin resistance, we saw most of it with our faecium. We had a couple of spikes for the first two years, but for our hirae we had a definite decrease in resistance to our Streptogramins.
Flavomycin, we mainly saw a high level resistance between our faecium isolates, in our hirae isolates. We hardly saw any -- well we hardly got any -- we got very little resistance displayed by our faecalis isolates. It was pretty high for Linezolid, it was pretty high among all three species. Here you can see where our bacitracin stops after 2004, but it was relatively high for faecalis and faecium, somewhat low for hirae.
Ciprofloxacin was mainly only displayed by our faecium isolates and we hardly saw any resistance for chloramphenicol.
Here, which is very important for us, we saw no resistance to Vancomycin for all six years from our retail meat isolates. So that is relatively good news.
Resistance by species. Although these tables are available publically on line, I just wanted to go through and describe the resistance by species and source because the data I just presented was among all sources lumped together, but when you look at it by source, for Enterococcus faecalis, most of our resistance was found in our chicken breast isolates and our ground turkey isolates. This is a little bit -- well it may not be that unusual, but however, most of our faecalis isolates came from pork chops. However, most of our resistance is found from a source where we got almost the least amount of faecalis from.
So just because a sample or a commodity did not produce the most amount of isolates, we will produce the most amount of isolates, we will find the most amount of resistance in another commodity.
Most of that resistance we found in chicken breasts and ground turkey mainly were aminoglycosides, the macrolides, and we found low levels of resistance to nitrofurans, penicillin, chloramphenicol, Flavomycin, and ciprofloxacin.
The same thing with faecium. Most of our resistance was predominantly found in ground turkey and to a lesser extent to chicken breasts. Recall for faecium most of our isolates came from chicken breast. Ground turkey was somewhat -- we got much less isolates from ground turkey than we did from chicken breast, but most of our resistance was found in ground turkey.
Those classes were aminoglycosides, macrolides, nitrofurantoins, nitrofurans, where between the two commodities we had similar patterns of resistance, resistant to penicillin. Flavomycin was very high among ground turkey. From all sources with the highest being from ground turkey, we found resistance to ciprofloxacin and streptogramin. We found no resistance from all the commodities from chloramphenicol.
For hirae, most of our resistance came from chicken breast once again. However, most of our hirae isolates came from ground beef. Our resistance from the chicken breast was mainly to aminoglycosides. It was low among ground beef, even though we got most of our hirae isolates from ground beef.
Our macrolides we saw similar resistance among all sources. Our nitrofuran, we saw resistance to nitrofurans, penicillin, Flavomycin was very high. Ciprofloxacin and Streptogramins, and once again, no resistance to chloramphenicol.
Among all species and all sources, we saw no resistance to Vancomycin, no resistance to Linezolid, very high resistance to lincomycin and we saw relatively high resistance to tetracycline among all of our isolates and among all sources.
For multiple drug resistance, this data was basically arranged in such a way that it showed -- we are talking about resistance to each individual drug. We have not broken this down into classes yet. When we go in and analyze this further, we will go in and look at classes but today, this data is representing to two or more individual multidrug resistance would be defined as two or more individual agents. Like I said, we have not broken this down into class yet.
Looking at that, we see that we roughly have among our isolates that were resistant to two or more drugs, we have had a consistent trend of about 45 percent of our faecium isolates from chicken breast were resistant to two or more drugs.
We see a pretty steady percentage of resistance to two or more drugs for our faecalis isolates as well from chicken breast.
I see a similar trend with our faecalis isolates where it is roughly around 30 percent of our faecalis isolates over the years was consistently resistant to two or more antimicrobials and the same thing here.
We started out at 17 percent and in 2007 we are back to around 17 percent for faecium isolates.
Here we start seeing a slight decrease for ground beef isolates for faecalis. We started out at about 20 percent in 2002 and now we are down to about 8 percent in 2007.
We are pretty much consistent with our faecium isolates from 18 percent to 12 percent. It is not that big of a drop, not that significant of a decrease, and resistance to two or more antimicrobials in ground beef.
For our pork chops, we see a consistent trend among our faecalis isolates where they basically stayed about 27 percent of our isolates were resistant to two or more antimicrobials for faecalis.
While we see a steady decrease for our faecium isolates, where we started out at 18 percent in 2002 and are down to 7 percent in 2007.
Currently we are screening these isolates. We are looking at beta-lactam resistance and we are basically looking at the different classes of beta-lactamases. We are screening for those genes currently and we are also picking back up, looking at the high level aminoglycoside resistance.
We are looking for these six genes where preliminary work by two of our people, Sonya Bodeis and Shawn McDermott have already done some initial screening and we found that this bi-functional gene here is the most predominant one among our aminoglycoside resistant isolates, followed by aph(3’)-IIIa and aph(2’’)-Id.
We have yet to find any of these last three in any of our isolates so far, but we are continuing to screen those to screen all of our isolates. I think we have gotten up to 2005, so we still need to do 2006 and 2007.
I would like to acknowledge the NARMS team and our division for their hard work in getting these isolates analyzed and all the data organized. Also the people in DAFM for their assistance with getting this data analyzed and getting these isolates done.
DR. LIMBAGO: I guess we will hold questions until the end. Our next speaker is Felicita Medalla from CDC.