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Tierärztliche Hochschule Hannover Untersuchungen Zum Auftreten

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Tierärztliche Hochschule Hannover Untersuchungen Zum Auftreten Tierärztliche Hochschule Hannover Untersuchungen zum Auftreten verschiedener bakterieller Zoonoseerreger und zu den Risikofaktoren in norddeutschen Schweinemastbeständen INAUGURAL – DISSERTATION zur Erlangung des Grades einer Doktorin oder eines Doktors der Veterinärmedizin - Doctor medicinae veterinariae - ( Dr. med. vet. ) vorgelegt von Susanne Döhne Marburg/Lahn Hannover 2010 Wissenschaftliche Betreuung: Prof. Dr. L. Kreienbrock, Institut für Biometrie, Epidemiologie und Informationsverarbeitung Prof. Dr. K.-H. Waldmann, Klinik für kleine Klauentiere und forensische Medizin und Ambulatorische Klinik 1. Gutachter: Prof. Dr. L. Kreienbrock, Prof. Dr. K.-H. Waldmann 2. Gutachter: Prof. Dr. T. Blaha Tag der mündlichen Prüfung: 03.11.2010 Diese Dissertation wurde gefördert durch das Bundesministerium für Bildung und Forschung im Rahmen des Projektes FBI-Zoo Veröffentlichungen Erste Ergebnisse dieser Arbeit wurden bereits veröffentlicht: DÖHNE, S., A. VON ALTROCK, R. MERLE, K.-H. WALDMANN u. L. KREIENBROCK (2009): Incidence and antimicrobial susceptibility of Salmonella in fattening pig herds in Northern Germany. In: 14 th ISAH Congress Vechta, 19.-23. Juli 2009, Proceedings Vol.2 DÖHNE, S., A. VON ALTROCK, R. MERLE, K.-H. WALDMANN u. L. KREIENBROCK (2009): Resistenzen von Salmonella spp. in norddeutschen Schweinemastbetrieben. In: DVG-Fachgruppentagung Epidemiologie und Dokumentation: „Krankheitsdynamik in Populationen – Bedeutung von Surveillance und Impfprogrammen“, Gießen, 2.-4. September 2009 Inhaltsverzeichnis 1 Einleitung 13 2 Literaturübersicht 15 2.1 Lebensmittelbedingte Zoonosen 15 2.2 Salmonella enterica ssp. enterica 16 2.2.1 Erregereigenschaften ..................................................................................................16 2.2.2 Nachweis von Salmonella spp. ..............................................................................18 2.2.3 Epidemiologie ..............................................................................................................24 2.3 Campylobacter spp. 33 2.3.1 Erregereigenschaften ..................................................................................................33 2.3.2 Nachweis von Campylobacter spp. ......................................................................35 2.3.3 Epidemiologie ..............................................................................................................38 2.4 Y. enterocolitica 44 2.4.1 Erregereigenschaften ..................................................................................................44 2.4.2 Nachweis von Y. enterocolitica ...............................................................................46 2.4.3 Epidemiologie ..............................................................................................................49 2.5 Antibiotikaresistenzen 54 2.5.1 Allgemeines ..................................................................................................................54 2.5.2 Resistenzen bei Salmonella spp. ...........................................................................58 2.5.3 Resistenzen bei Campylobacter spp. ..................................................................59 2.5.4 Mikrodilutionstest und MHK-Wert ........................................................................62 3 Material und Methoden 65 3.1 Aufbau und Ziel der Studie 65 3.2 Art und Herkunft der untersuchten Proben 66 3.3 Kulturelle Untersuchung 67 3.3.1 Salmonella spp.............................................................................................................67 3.3.2 Campylobacter spp. ....................................................................................................68 3.3.3 Y. enterocolitica...........................................................................................................69 3.4 Serologische Untersuchung 70 3.4.1 Salmonella spp.............................................................................................................70 3.4.2 Campylobacter spp. ....................................................................................................71 3.4.3 Y. enterocolitica...........................................................................................................71 3.5 Antimikrobielle Empfindlichkeitsprüfung 72 3.5.1 Empfindlichkeitstestung der Salmonella spp.-Isolate........................................72 3.5.2 Empfindlichkeitstestung der Campylobacter spp.-Isolate ................................73 3.6 Fragebogen 75 3.7 Statistische Auswertung 75 4 Ergebnisse 81 4.1 Serologische und kulturelle Untersuchung auf Einzeltierebene 81 4.2 Serologische und kulturelle Untersuchung auf Betriebsebene 85 4.3 Vergleich der serologischen und kulturellen Ergebnisse 87 4.4 Auftreten mehrerer Erreger 89 4.4.1 Erregerkombinationen auf Einzeltierebene ..........................................................89 4.4.2 Erregerkombinationen auf Bestandsebene............................................................89 4.5 Risikofaktoren für das Auftreten der Erreger 93 4.5.1 Dichotome Risikovariablen ......................................................................................93 4.5.2 Stetige Risikovariablen ..............................................................................................95 4.5.3 Risikofaktoren für das Auftreten von einem oder mehreren Erregern...........96 4.6 Auswertung der Resistenzen 100 4.6.1 Resistenzen bei Salmonella spp. ...........................................................................100 4.6.2 Resistenzen bei Campylobacter spp. ..................................................................102 4.6.3 Vergleich der Resistenzen bei Salmonella spp. und Campylobacter spp. 106 4.6.4 Risikofaktorenanalyse für das Auftreten von Antibiotikaresistenzen..........107 5 Diskussion 111 5.1 Serologische und kulturelle Prävalenzen 112 5.2 Auftreten von Erregerkombinationen 122 5.3 Erregerbekämpfung 124 5.4 Analyse der Risikofaktoren 126 5.5 Einflussfaktoren für das Auftreten mehrerer Erreger 132 5.6 Empfindlichkeitstestung von Salmonella spp. und Campylobacter spp. 134 6 Zusammenfassung 141 7 Summary 145 8 Literaturverzeichnis 147 Abkürzungsverzeichnis In dieser Arbeit wurden neben den allgemein üblichen Abkürzungen folgende spezielle Kurzformen verwendet: ACSSuT Ampicillin, Chloramphenicol, Streptomycin, Sulfonamid, Tetrazyklin ACSSuT+Nx ACSSuT + Nalidixinsäure Ak Antikörper AMP Ampicillin ATCC American Type Culture Collection BfR Bundesinstitut für Risikobewertung BLE Bundesanstalt für Landwirtschaft und Ernährung BMBF Bundesministerium für Bildung und Forschung BPLS Brillantgrün-Phenolrot-Lactose-Saccharose BPW Buffered-Pepton-Water C. Campylobacter CFU Colony forming unit CHL Chloramphenicol CIN Cefsulidin-Irgascin-Novobiocin CIP Ciprofloxacin CLSI Clinical and Laboratory Standards Institute, früher NCCLS COL Colistin DANMAP Danish Integrated Antimicrobial Resistance Monitoring and Research Programme DNA Desoxysribonukleinsäure DSM Deutsche Sammlung von Mikroorganismen dt. Phagentyp definitiver Phagentyp ECOFF epidemiologischer Cutoff ELISA Enzyme-linked Immunosorbent Assay ERY Erythromycin EUCAST European Committee on Antimicrobial Susceptibility Testing FARM French Antimicrobial Resistance Monitoring in Bacteria of animal origin FBI-Zoo “Food-borne zoonotic infections of humans” FFN Florfenicol FOT Cefotaxim GEN Gentamicin GERMAP Bericht über Antibiotikaverbrauch und Verbreitung von Antibiotikaresistenzen in Deutschland ITC Irgasan-Ticarcilin- Kaliumchlorat IfsG Infektionsschutzgesetz ITAVARM Italian Veterinary Antimicrobial Resistance Monitoring Қ-Wert Kappa-Wert KAN Kanamycin KBE Koloniebildende Einheiten Kbp Kilobasenpaar Ln. Lymphknoten MARAN Monitoring of antimicrobial resistance and antibiotic usage in Animals in the Netherlands MHK-Wert minimale Hemmstoffkonzentration MHB Müller-Hinton-Bouillon MKTTn Müller-Kaufmann-Tetrathionat-Novobiocin NAL Nalidixinsäure NORM-VET Usage of Antimicrobial Agents an Occurrence of Antimicrobial Resistance in Norway p.i. post infectionem RVS Rappaport-Vassiliadis -Medium RDNC reagiert mit Phagen, aber passt zu keinem bekannten Phagentyp (reacts, but does not not conform) S. Salmonella SAM Ampicillin / Sulbactam SMX Sulfamethoxazol SPF spezifisch pathogenfrei spp. mehrere, nicht im Einzelnen zu nennende Spezies eines Genus ssp. Subspezies STR Streptomycin SVARM Swedish Veterinary Antimicrobial Resistance Monitoring SULF Sulfonamid SXT Sulfamethoxazol / Trimethoprim TAZ Ceftazidim TET Tetrazyklin TMP Trimethoprim VAV Veterinary Monitoring of Antimicrobial resistance in Spain WHO World Health Organisation XLD Xylose-Lysin-Desoxycholat Y. Yersinia Yop Yersinia outer protein ZIPP „Zoonoses in Pork Production / Kontrolle von aus der Produktionskette Schweinefleisch hervorgehenden Zoonosen“ Einleitung 13 1 Einleitung Verbraucher stellen in der gegenwärtigen Zeit besonders hohe Ansprüche an gesundheitlich unbedenkliche Lebensmittel. Der Lebensmittelsicherheit von Schweinefleisch kommt in diesem Zusammenhang eine herausragende Bedeutung zu, da es in Europa das am häufigsten verzehrte Fleisch ist. Schweine können die bakteriellen Zoonoseerreger Salmonella spp., Campylobacter spp. und Y. enterocolitica asymptomatisch im Magen-Darm-Trakt beherbergen. Diese Krankheitserreger kontaminieren unter bestimmten Umständen das Schweinefleisch während der Schlachtung. Durch den Verzehr des erregerbelasteten Schweinefleisches ist eine orale Infektion des Menschen möglich. Die durch Salmonella spp., Campylobacter
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