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In addition to acute care hospitals, rehabilitation centres are increasingly confronted with multi-resistant pathogens. Long durations of stay and intensive treatments impose special hygienic challenges.We investigated an extended spectrum beta-lactamase-Klebsiella pneumoniae (ESBL-K. pneumoniae) outbreak in a neurorehabilitation centre. We defined confirmed cases as patients who stayed in the centre during the outbreak period and from whom ESBL-K. pneumoniae was isolated with the outbreak sequence type. Probable cases had an epidemiological link to at least one confirmed case but no isolate for typing. Next generation sequencing (NGS) was performed on 53 isolates from patients. Environmental sampling was performed. Systematic microbiological screening was implemented and ESBL-K. pneumoniae-positive patients were cohorted in a designated ward.We identified 30 confirmed and 6 probable cases. NGS revealed three genetic clusters: Cluster 1 - the outbreak cluster - with isolates of 30 cases (sequence type ST15), Cluster 2 with 7 patients (ST405) and Cluster 3 with 8 patients (ST414). In two patients, the outbreak strain developed further antibiotic resistance, one with colistin resistance and the other carbapenem resistance. The outbreak ceased after strict isolation measures.Epidemiology and NGS results paired with the effectiveness of cohorting suggest that transmission occurred mainly from person to person in this outbreak. There was an apparent association of the probability to acquire ESBL-K. pneumoniae and treatment intensity, whereas infection rate was related to morbidity. The identification of the outbreak clone and additional clusters plus the development of additional antibiotic resistance shows the relevance of NGS and highlights the need for timely and efficient outbreak management.

The idea of "Comparative Medicine" was founded by distinguished scientists in the 1900s, in which context the name of Rudolf Ludwig Carl Virchow always comes into the limelight. This discipline was practiced thoroughly with the study of every infective disease transmitted naturally from vertebrates to man, namely the zoonoses. The following article will highlight the concept of "Comparative Medicine" with the example of tuberculosis research carried out during the second half of the 19th century. After the discipline took an interesting turn toward increasing specialization in the field, particularly after the Second World War, infection research in veterinary and human medicine developed and progressed in different directions. Since the 1990s, this development has contradicted the awareness, that a great number of diseases can be successfully combated through interdisciplinary efforts only, which has now led to the concept of "One health". In view of this, functional molecular epidemiology will play an invaluable role in the future in recognizing associations between host and pathogen-genotypes, particularly in research pertaining to emerging and re-emerging infections, which include the zoonoses. Zoonotic research is the crux of such a concept; hence, this article will portray some of the developments in Germany over the last few years, by virtue of which the "One health" dogma brings zoonotic research to life.