Acquired antibiotic resistance of Pseudomonas spp., Escherichia coli and Acinetobacter spp. in the Western Balkans and Hungary with a One Health outlook.

Abstract

An increasing rate of antibiotic resistance (AR) has been observed in the Gram-negative bacteria A. baumannii, P. aeruginosa, and E. coli in the human, environmental, and food animal domains worldwide, thus posing a serious global health challenge. Acquired AR genes of these species were overviewed from selected Western Balkans countries together with those from the European Union member states Croatia and Hungary. The AR determinants published from Albania, Bosnia-Herzegovina, Serbia, and Croatia included diverse acquired β-lactamase genes, with several of them possessing carbapenemase activity, such as bla _VIM, bla _NDM, bla _KPC, bla _OXA-23, bla _OXA-66, and bla _OXA-72. Furthermore, acquired aminoglycoside, chloramphenicol, fosfomycin, tetracycline, sulfonamide, quinolone, and/or colistin resistance determinants were detected in the three domains of the One Health approach. The in vitro AR profile of representative isolates have also been overviewed. Multidrug-resistant P. aeruginosa isolates of the ST235 high-risk clone were mainly reported within clinical settings. The distribution of the E. coli ST131 and A. baumannii ST2 high-risk clones in both clinical and environmental settings highlight their adaptability and effective dissemination. Systematic infection control practices are advised to combat the spread of antibiotic resistance, and further research from a One Health perspective is encouraged into its emergence and dissemination.