Francis C Onwugamba1, J Ross Fitzgerald2, Kateryn Rochon3, Luca Guardabassi4, Abraham Alabi5, Stefan Kühne6, Martin P Grobusch7, Frieder Schaumburg8. 1. Institute of Medical Microbiology, University Hospital Münster, Münster, Germany. 2. The Roslin Institute, University of Edinburgh, Edinburgh, UK. 3. Department of Entomology, University of Manitoba, Winnipeg, Canada. 4. Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark. 5. Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon; Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Deutsches Zentrum für Infektionsforschung, Tübingen, Deutschland, Germany. 6. Julius Kühn Institute, Federal Research Centre for Cultivated Plants, Kleinmachnow, Germany. 7. Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon; Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Deutsches Zentrum für Infektionsforschung, Tübingen, Deutschland, Germany; Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. 8. Institute of Medical Microbiology, University Hospital Münster, Münster, Germany. Electronic address: frieder.schaumburg@ukmuenster.de.
Abstract
BACKGROUND: 'Filth flies' feed and develop in excrement and decaying matter and can transmit enteric pathogens to humans and animals, leading to colonization and infection. Considering these characteristics, 'filth flies' are potential vectors for the spread of antimicrobial resistance (AMR). This review defines the role of flies in the spread of AMR and identifies knowledge gaps. METHODS: The literature search (original articles, reviews indexed for PubMed) was restricted to the English language. References of identified studies were screened for additional sources. RESULTS: 'Filth flies' are colonized with antimicrobial-resistant bacteria of clinical relevance. This includes extended spectrum beta-lactamase-, carbapenemase-producing and colistin-resistant (mcr-1 positive) bacteria. Resistant bacteria in flies often share the same genotypes with bacteria from humans and animals when their habitat overlap. The risk of transmission is most likely highest for enteric bacteria as they are shed in high concentration in excrements and are easily picked up by flies. 'Filth flies' can 'bio-enhance' the transmission of AMR as bacteria multiply in the digestive tract, mouthparts and regurgitation spots. CONCLUSION: To better understand the medical importance of AMR in flies, quantitative risk assessment models should be refined and fed with additional data (e.g. vectorial capacity, colonization dose). This requires targeted ecological, epidemiological and in vivo experimental studies.
BACKGROUND: 'Filth flies' feed and develop in excrement and decaying matter and can transmit enteric pathogens to humans and animals, leading to colonization and infection. Considering these characteristics, 'filth flies' are potential vectors for the spread of antimicrobial resistance (AMR). This review defines the role of flies in the spread of AMR and identifies knowledge gaps. METHODS: The literature search (original articles, reviews indexed for PubMed) was restricted to the English language. References of identified studies were screened for additional sources. RESULTS: 'Filth flies' are colonized with antimicrobial-resistant bacteria of clinical relevance. This includes extended spectrum beta-lactamase-, carbapenemase-producing and colistin-resistant (mcr-1 positive) bacteria. Resistant bacteria in flies often share the same genotypes with bacteria from humans and animals when their habitat overlap. The risk of transmission is most likely highest for enteric bacteria as they are shed in high concentration in excrements and are easily picked up by flies. 'Filth flies' can 'bio-enhance' the transmission of AMR as bacteria multiply in the digestive tract, mouthparts and regurgitation spots. CONCLUSION: To better understand the medical importance of AMR in flies, quantitative risk assessment models should be refined and fed with additional data (e.g. vectorial capacity, colonization dose). This requires targeted ecological, epidemiological and in vivo experimental studies.
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