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Escherichia coli carrying IncK-blaCMY-2 plasmids mediating resistance to extended-spectrum cephalosporins (ESC) has been frequently described in food-producing animals and in humans. This study aimed to characterize IncK-blaCMY-2-positive ESC-resistant E. coli isolates from poultry production systems in Denmark, Finland, and Germany, as well as from Danish human blood infections, and further compare their plasmids. Whole-genome sequencing (Illumina) of all isolates (n = 46) confirmed the presence of the blaCMY-2 gene. Minimum inhibitory concentration (MIC) testing revealed a resistant phenotype to cefotaxime as well as resistance to ≥3 antibiotic classes. Conjugative transfer of the blaCMY-2 gene confirmed the resistance being on mobile plasmids. Pangenome analysis showed only one-third of the genes being in the core with the remainder being in the large accessory gene pool. Single nucleotide polymorphism (SNP) analysis on sequence type (ST) 429 and 1286 isolates showed between 0–60 and 13–90 SNP differences, respectively, indicating vertical transmission of closely related clones in the poultry production, including among Danish, Finnish, and German ST429 isolates. A comparison of 22 ST429 isolates from this study with 80 ST429 isolates in Enterobase revealed the widespread geographical occurrence of related isolates associated with poultry production. Long-read sequencing of a representative subset of isolates (n = 28) allowed further characterization and comparison of the IncK-blaCMY-2 plasmids with publicly available plasmid sequences. This analysis revealed the presence of highly similar plasmids in ESC-resistant E. coli from Denmark, Finland, and Germany pointing to the existence of common sources. Moreover, the analysis presented evidence of global plasmid transmission and evolution. Lastly, our results indicate that IncK-bla

Small water supplies face similar problems worldwide, regardless of ownership or management type. Non-compliance with water quality regulations is more frequent in small supplies than in large ones, as are waterborne disease outbreaks. The new EU Drinking Water Directive requires risk-based approach (RBA) to secure water safety as is recommended in the WHO's Guidelines for drinking water quality through 'water safety plans'. This is already in regulation in the Nordic countries, although less used in small supplies. In this research, we explore the challenges, barriers and possible solutions to implementing RBA and improving compliance in small supplies. This was achieved by conducting and analysing interviews with 53 stakeholders from all 8 Nordic countries to produce recommendations for action by the different implicated actors. Our findings suggest the centrality of governmental policy, including support for continuous training, provision of simple RBA guidelines and increasing cooperation in the water sector. The Nordic experience reflects global challenges with small water supplies and the trend towards systematic preventive management epitomized in the framework for drinking water safety advocated by the World Health Organization since 2004.

The emergence of extended-spectrum cephalosporin (ESC)-resistant Escherichia coli is a global concern. This study aimed to assess the prevalence and transmission of ESC-resistant E. coli in the Danish broiler production system. Samples from two vertically integrated Production Systems (1 and 2) and two slaughterhouses (A and B) were analyzed (n = 943) for the occurrence of ESC-resistant E. coli from 2015 to 2018. ESC-resistant E. coli isolates were whole-genome sequenced (WGS) for characterization of the multi-locus sequence type (MLST), antibiotic resistance genes, virulence genes, and plasmid replicon types. An ad hoc core genome (cg) MLST based on 2513 alleles was used to examine the genetic relatedness among isolates. The prevalence of ESC-resistant E. coli in the conventional Production System 1 was 2.7%, while in Production System 2 the prevalence was 26.7% and 56.5% for samples from the conventional and organic production, respectively. The overall prevalence of ESC-resistant E. coli in broiler thigh and fecal samples ranged from 19.3% in Slaughterhouse A to 22.4% in Slaughterhouse B. In total, 162 ESC-resistant E. coli were isolated and shown to belong to 16 different sequence types (STs). The most prevalent STs were ST2040 (n = 85) and ST429 (n = 22). Seven ESC resistance genes were detected: blaCMY-2 (n = 119), blaTEM-52B (n = 16), blaCTX-M-1 (n = 5), blaTEM-52C (n = 3), blaCTX-M-14 (n = 1), blaSHV-12 (n = 1), and up-regulation of ampC (n = 16), with an unknown resistance gene in one isolate (n = 1). The carriage of blaCMY-2 in 119 isolates was primarily associated with IncI1 (n = 87), and IncK plasmids (n = 31). Highly similar blaCMY-2 carrying E. coli isolates from ST429 were found in production systems as well as in slaughterhouses. In conclusion, findings

Listeria monocytogenes is an ubiquitously occurring foodborne bacterial pathogen known to contaminate foods during the production processes. To assess the presence and persistence of L. monocytogenes in Danish ready-to-eat (RTE) food production companies in response to a Listeria awareness campaign, the production environment of selected companies were sampled in 2016 and in 2020. Whole genome sequencing (WGS) was performed to characterize the isolates (n = 50, plus 35 isolates obtained from the routine surveillance during 2016–2020), including investigation of the presence of virulence, persistence and resistance genes. The number of companies that tested positive by culture was 17/39 (43.6%) in 2016 and 11/34 (32.4%) in 2020, indicating a limited effect of the campaign. WGS analyses of the 85 isolates showed that the most common sequence types (STs) were ST8 and ST121. The single nucleotide polymorphism (SNP) analysis showed that isolates coming from the same company and belonging to the same ST exhibited <10 SNP differences regardless of the sampling year and whether the samples came from the environment or products, indicating the persistence of the specific STs. Several prevalent STs were found in clinical cases concurrently, including genetically similar isolates. This highlights the issue of persistent L. monocytogenes in the food production environment and the need for improved risk communication and mitigation strategies.

Urban cloudburst management may include the intentional temporary storage of flood water in green recreational areas. In cities with combined sewers, this will expose the population visiting the area to sewage and increase the risk of diarrhoeal disease. We present a unique approach to estimate the risk of diarrhoeal disease after urban flooding. The exposure scenario was: rainwater mixed with sewage flows into a park; sewage with pathogens deposited on the grass; after discharge, a baby plays on the grass and is exposed to the pathogens in the deposited sewage by hand-to-mouth transfer. The work included modelling the transport of sewage into four parks intended to be flooded during future cloudbursts. A flood simulation experiment was conducted to estimate the deposition of pathogens from sewage to grass and transfer from grass to hand. Hand-to-mouth transfer, based on literature values, was used to estimate the ingested dose of pathogens. The probability of illness was estimated by QMRA. The estimated average probability of illness varied between 0.03 and 17%. If the probability of illness is considered unacceptable, the cloudburst plans should be changed, or interventions, such as informing the public about the risk or restricting access to the flooded area, should be implemented.

Listeriosis is a foodborne infection caused by Listeria monocytogenes. The clinical spectrum of listeriosis ranges from mild to invasive disease including bacteraemia or meningitis. Listeria monocytogenes can also be transmitted from mother to fetus in utero or to the neonate during birth. Risk factors for invasive disease include immunosuppression, advanced age, and pregnancy. The incubation is longer than for most foodborne pathogens, usually a few weeks. In Denmark, invasive forms of listerioses in humans are monitored in the Danish surveillance system. The 30-day mortality of registered cases of listeriosis is about 25% [1].

The low proportion of households with piped drinking water in Greenlandic settlements – and elsewhere in the Arctic, leads to improvised methods of household water storage and water saving practices that could present a risk for public health. This interview-based study investigated the perceptions of safety and acceptability of the water supply in rural Greenlandic households. The bacterial quality of the water distributed by the public supply before and after storage in the homes, of alternative water sourced from nature by the users themselves, and of shared handwash basins used in un-piped homes, was analyzed. The treated water distributed by the rural Greenlandic water supply was acceptable to most users, although half of them expressed concerns about its quality, and distrusted the state of the infrastructure delivering piped water. For drinking, most respondents preferred untreated water from nature, but a majority used mainly piped water for practical reasons of access. The microbial quality of the public water supply met legislative requirements in most cases, but was found to deteriorate during both distribution to some taps, and storage in the homes, which constitutes a challenge to the reliable provision of safe water to users. Water from alternative sources showed slightly higher heterotrophic plate counts (HPC) than piped water, but no Escherichia coli. As for washbasins, they were found to have high levels of contamination in all three bacterial parameters investigated (HPC, coliforms and E. coli), indicating a possible transmission route for pathogens. In conclusion, while the quality of treated water was overall good at distribution, the water saving and storage practices developed to compensate for the lack of piping may threaten public health. Alternative water sources are culturally important and trusted by users, although the possible impact of changes in climate and land use on the reliability of their q

AprX is an alkaline metalloprotease produced by Pseudomonas spp. and encoded by its initial gene of the aprX-lipA operon. The intrinsic diversity among Pseudomonas spp. regarding their proteolytic activity is the main challenge for the development of accurate methods for spoilage prediction of ultra-high temperature (UHT) treated milk in the dairy industry. In the present study, 56 Pseudomonas strains were characterized by assessing their proteolytic activity in milk before and after lab-scale UHT treatment. From these, 24 strains were selected based on their proteolytic activity for whole genome sequencing (WGS) to identify common genotypic characteristics that correlated with the observed variations in proteolytic activity. Four groups (A1, A2, B and N) were determined based on operon aprX-lipA sequence similarities. These alignment groups were observed to significantly influence the proteolytic activity of the strains, with an average proteolytic activity of A1 > A2 > B > N. The lab-scale UHT treatment did not significantly influence their proteolytic activity, indicating a high thermal stability of proteases among strains. Amino acid sequence variation of biologically-relevant motifs in the AprX sequence, namely the Zn2+-binding motif at the catalytic domain and the C-terminal type I secretion signaling mechanism, were found to be highly conserved within alignment groups. These motifs could serve as future potential genetic biomarkers for determination of alignment groups and thereby strain spoilage potential.