RESUMEN
Antimicrobial resistances (AMR) in bacteria, such as ESBL/AmpC-producing E. coli, are a burden to human and animal health. This burden is mainly driven by the consumption and release of antimicrobial substances into the environment. The pollution and contamination of habitats by AMR in bacteria and antimicrobial substances can lead to the transmission of bacterial AMR to wildlife. Therefore, it is necessary to understand the transmission cycle of antibiotics and resistant bacteria between humans, and animals as well as their occurrences in the environment. Environmental factors associated with the occurrence of bacterial AMR in wildlife can lead to a better understanding of the distribution of bacterial AMR in humans and animals using One Health approaches. Here, we analyzed data gathered in the framework of the German zoonoses monitoring program in 2016 and 2020 using spatiotemporal statistics to identify relevant environmental factors (e.g., livestock density, climatic variables, and human density) in association with the spatial distribution of ESBL/AmpC-producing E. coli. For this purpose, we developed a generic data integration and analysis pipeline to link spatially explicit environmental factors to the monitoring data. Finally, we built a binomial generalized linear mixed model (GLMM) to determine the factors associated with the spatial distribution of ESBL/AmpC-producing E. coli. In 2016 and 2020, 807 fecal samples from hunted wild boar (Sus scrofa L.) were randomly taken in 13 federal states and selectively analyzed for ESBL/AmpC-producing E. coli. Forty-eight isolates were identified in 12 German federal states, with an overall prevalence of 6%. We observed an almost three times higher probability of ESBL/AmpC-producing E. coli isolates in wild boar in counties with high cattle densities (OR = 2.57, p ≤ 0.01). Furthermore, we identified a seasonal effect in areas with high precipitation during the off-hunting seasons (OR = 2.78, p = 0.025) and low precipitation throughout the years (OR = 0.42, p = 0.025). However, due to the low amount of identified isolates, confidence intervals were wide, indicating a high level of uncertainty. This suggests that further studies on smaller scales need to be conducted with multiannual data and improved metadata, e.g., on the location, the hunting procedure, and species characteristics to be collected during field sampling.
RESUMEN
Computational traceback methodologies are important tools for investigations of widespread foodborne disease outbreaks as they assist investigators to determine the causative outbreak location and food item. In modeling the entire food supply chain from farm to fork, however, these methodologies have paid little attention to consumer behavior and mobility, instead making the simplifying assumption that consumers shop in the area adjacent to their home location. This paper aims to fill this gap by introducing a gravity-based approach to model food-flows from supermarkets to consumers and demonstrating how models of consumer shopping behavior can be used to improve computational methodologies to infer the source of an outbreak of foodborne disease. To demonstrate our approach, we develop and calibrate a gravity model of German retail shopping behavior at the postal-code level. Modeling results show that on average about 70 percent of all groceries are sourced from non-home zip codes. The value of considering shopping behavior in computational approaches for inferring the source of an outbreak is illustrated through an application example to identify a retail brand source of an outbreak. We demonstrate a significant increase in the accuracy of a network-theoretic source estimator for the outbreak source when the gravity model is included in the food supply network compared with the baseline case when contaminated individuals are assumed to shop only in their home location. Our approach illustrates how gravity models can enrich computational inference models for identifying the source (retail brand, food item, location) of an outbreak of foodborne disease. More broadly, results show how gravity models can contribute to computational approaches to model consumer shopping interactions relating to retail food environments, nutrition, and public health.