Implications of Veterinary Medicine in the comprehension and stewardship of antimicrobial resistance phenomenon. From the origin till nowadays

Evidence for the transmission of antimicrobial resistant bacteria between humans and companion animals: A scoping review

Objective

Transmission of antimicrobial resistant bacteria between people and household pets, such as dogs and cats, is an emerging global public health problem. This scoping review synthesized existing evidence of human-pet bacteria transmission to understand the magnitude and breadth of this issue.

Methods

The search included specific and generic terms for bacteria, resistance, transmission, pets, and humans. Searches were conducted through PubMed, Scopus, Web of Science, CABI Global Health, Networked Digital Library of Theses and Dissertations, Google Scholar. All studies published in English and Mandarin that isolated bacteria from pets (cats and dogs) and humans who had contact with the pets, and reported phenotypic or genotypic antimicrobial sensitivity test results, were included in this review. In cases of bacterial species that are commonly associated with pets, such as Staphylococcus pseudintermedius and Pasteurella multocida, we also included studies that only isolated bacteria from humans.

Results

After removing duplication, the search captured 9355 studies. A total of 1098 papers were screened in the full-text review, and 562 studies were identified as eligible according to our inclusion criteria. The primary reason for exclusion was the lack of sensitivity testing. The included studies were published between 1973 and 2021. The most common study location was the United States (n = 176, 31.3%), followed by the United Kingdom (n = 53, 9.4%), Japan (n = 29, 5.2%), and Canada (n = 25, 4.4%). Most of the included studies were case reports (n = 367, 63.4%), cross-sectional/prevalence studies (n = 130, 22.4%), and case series (n = 51, 8.8%). Only few longitudinal studies (n = 14, 2.4%), case-control studies (n = 12, 2.1%), and cohort studies (n = 5, 0.9%) were included in our review. Most studies focused on Pasteurella multocida (n = 221, 39.3%), Staphylococcus aureus (n = 81, 14.4%), and Staphylococcus pseudintermedius (n = 52, 8.9%). For the 295 studies that used strain typing methods to compare bacteria from humans and pets, most used DNA banding pattern-based methods (n = 133, 45.1%) and DNA sequencing-based methods (n = 118, 40.0%).

Conclusion

Transmission of bacteria could occur in both directions: pets to humans (e.g., S. pseudintermedius and P. multocida) and humans to pets (e.g., S. aureus). The majority of studies provided a low level of evidence of transmission (e.g., case reports), suggesting that more rigorous longitudinal, cohort, or case-control studies are needed to fully understand the risk of human-pet resistant bacterial transmission.

Antimicrobial efficacy of Mentha piperata-derived biogenic zinc oxide nanoparticles against UTI-resistant pathogens

Misuse of antibiotics leads to the worldwide spread of antibiotic resistance, which motivates scientists to create new antibiotics. The recurring UTI due to antibiotics-resistant microorganism's challenges scientists globally. The biogenic nanoparticles have the potential to meet the escalating requirements of novel antimicrobial agents. The green synthesis of nanoparticles (NPs) gained more attention due to their reliable applications against resistant microbes. The current study evaluates the biogenic ZnO NPs of Mentha piperata extract against resistant pathogens of urinary tract infections by agar well diffusion assay. The biogenic ZnO NPs revealed comparatively maximum inhibition in comparison to synthetic antibiotics against two bacterial strains (Proteus mirabilis, Pseudomonas aeruginosa) and a fungal strain (Candida albicans).The synthesized biogenic ZnO NPs alone revealed maximum activities than the combination of plant extract (PE) and ZnO NPs, and PE alone. The physiochemical features of ZnO NPs characterized through UV-Vis spectroscopy, FTIR, XRD, SEM, and EDX. The UV-Vis spectroscopy revealed 281.85 nm wavelengths; the XRD pattern revealed the crystalline structure of ZnO NPs. The FTIR analysis revealed the presence of carboxylic and nitro groups, which could be attributed to plant extract. SEM analysis revealed spherical hollow symmetry due to electrostatic forces. The analysis via EDX confirmed the presence of Zn and oxygen in the sample. The physiochemical features of synthesized ZnO NPs provide pivotal information such as quality and effectiveness. The current study revealed excellent dose-dependent antimicrobial activity against the pathogenic isolates from UTI-resistant patients. The higher concentration of ZnONPs interacts with the cell membrane which triggers oxidative burst. They may bind with the enzymes and proteins and brings epigenetic alteration which leads to membrane disruption or cell death.

Examining the Veterinary Electronic Antimicrobial Prescriptions for Dogs and Cats in the Campania Region, Italy: Corrective Strategies Are Imperative

Companion animals are increasingly being recognised as important contributors to the spread of antimicrobial-resistant bacteria. The present work aimed to measure the antimicrobial drug prescribing in dogs and cats in the Campania Region, Italy by analysing the Veterinary Electronic Prescriptions (VEPs) between 2019 and 2020. The medical records associated with antimicrobial drug prescriptions were collected according to the drug administration (systemic or topical) and the rationale for the treatment chosen. In the period under investigation, 166,879 drugs were prescribed of which 129,116 (73.4%) were antimicrobial. A total of 83,965 (65%) antibiotics were prescribed to dogs, 40,477 (31.4%) to cats, and 4674 (3.6%) to other companion animals. In dogs, 90.5% of VEPs prescribed for systemic treatment included an antimicrobial Critically Important or Highly Important or Important for human medicine (WHO, 2018). The most widely prescribed class was fluoroquinolones. The antimicrobials prescribed were mainly metronidazole-spiramycin (29.7%), amoxicillin-clavulanic (19.6%), enrofloxacin and cephalexin in dogs (16.5%) and enrofloxacin (22.6%) and amoxicillin-clavulanic acid (21.4%) in cats. Based on the results, the widespread use of broad-spectrum antimicrobials and the use of molecules for which limitations should be observed according to the EMA guidelines has emerged.

Prototype for rapid test devices to detect residues of sulfonamides in chicken carcasses from traditional breeders in Surabaya, Indonesia

Background and Aim

Sulfadiazine, one of the sulfonamide group's active compounds, is widely used for therapeutic production against several diseases. Veterinary drug residues can have a significant impact on human health conditions. This study aimed to develop a prototype of rapid test devices (RTDs) for detecting sulfadiazine residues on chicken carcasses based on the color indication.

Materials and Methods

Seven samples of carcasses collected from traditional breeders in Surabaya-Indonesia were prepared and tested using RTDs. This sample represents the population considering that in the last report, the use of antibiotics was more than 40%, while the ability to monitor RTDs was estimated at 100. The standard color of purple by Hex code standard color or decimal code color was used to compare the positive samples. A light-emitting diode (LED) lamp was used to observe purple color. Analysis of sulfonamides resulting from RTDs was compared using a ultraviolet-visible spectrophotometer.

Results

Sulfonamides contamination levels of 50% and 100% were detected at concentrations of 0.472 μg/mL and 0.642 μg/mL, respectively. Sulfonamides contamination that was <0.395 μg/mL did not appear purple.

Conclusion

The study's findings showed that RTDs can be used to detect sulfonamides residues at a limit of detection 0.5 mg/mL after a 45 min exposure to an LED operating at a wavelength of 980 nm (p < 0.05). The limitation of RTDs was not being able to monitor the presence of residues bound in fat samples. Rapid test devices can be developed for commonly monitoring devices due to the limited technology available in the market.

Does Nitrofurantoin Improve the Portfolio of Vets against Resistant Bacteria in Companion Animals?

In clinical practice in dogs and cats, antimicrobials are frequently used, sometimes overused or misused, increasing antimicrobial resistance (AMR). In order to limit the phenomenon, laws have been enacted and guidelines for prudent and rational use of antibiotics have been developed. Interestingly, old molecules such as nitrofurantoin could be used to achieve therapeutic success and overcome AMR. To better understand the suitability of this molecule in veterinary medicine, the authors performed a revision of the literature, searching on PubMed and entering the following keywords: nitrofurantoin, veterinary medicine, dog, and cat connected by the Boolean operator "and", without restrictions on the date of publication. Thirty papers were finally selected. It is possible to appreciate that papers dealing with nitrofurantoin have been written from the early 1960s to the middle of the 1970s, and then a long period passed without publications. Only at the beginning of the new century, nitrofurantoin was included or was sometimes the focus of papers dealing with its efficacy in veterinary medicine, mainly in the treatment of urinary tract infections. One recent paper dealt with pharmacokinetic features, and none was dedicated to pharmacokinetic/pharmacodynamic integration or modeling. Nitrofurantoin appears to be still effective against several pathogens that rarely develop resistance to this molecule.

Domestic Pets in the United Arab Emirates as Reservoirs for Antibiotic-Resistant Bacteria: A Comprehensive Analysis of Extended-Spectrum Beta-Lactamase Producing Escherichia coli Prevalence and Risk Factors

Extended-spectrum β-lactamases resistant (ESBL-R) Escherichia coli (E. coli) has been reported from healthy and sick pets. However, data from Middle Eastern countries, including the United Arab Emirates (UAE), are minimal. This study provides the first evidence of ESBL-R E. coli carriage among pets in the UAE. A total of 148 rectal swabs were collected from domestic cats (n = 122) and dogs (n = 26) attending five animal clinics in the UAE. Samples were cultured directly onto selective agar, and suspected colonies were confirmed as ESBL-producing using phenotypic and molecular methods. Confirmed isolates were screened for their phenotypic resistance to twelve antimicrobial agents using the Kirby Bauer method. The owners of the pets completed a questionnaire at the time of sampling, and the data were used to identify risk factors. ESBL-R E. coli was detected in rectal swabs of 35 out of 148 animals (23.65%) (95% confidence interval [CI]: 17.06-31.32). Multivariable logistic regression analysis identified cats and dogs with access to water in ditches and puddles as 3.71 (p-value = 0.020) times more likely to be positive to ESBL-R E. coli than those without access to open water sources. Ciprofloxacin resistance was evident in 57.14% (44/77) of the ESBL-R E. coli isolates. The percentage of resistance to azithromycin and cefepime was 12.99% (10/77) and 48.05% (37/77), respectively. The bla_CTX-M gene was detected in 82% of the PCR-screened isolates (n = 50). Multidrug resistance (MDR) phenotypes were evident in 91% (70/77) of the isolates. In conclusion, ESBL-R E. coli was detected at a noticeable rate among healthy pet cats and dogs in the UAE, and the majority are MDR to clinically important antimicrobials such as fluoroquinolones and 3rd and 4th generation cephalosporins. Our results call for strengthening antimicrobial stewardship among companion animal veterinarians in the UAE to reduce the potential transmission of ESBL-R E. coli between pets, humans, and urban environments.

Sepsis Management in Southeast Asia: A Review and Clinical Experience

Sepsis is a life-threatening condition that causes a global health burden associated with high mortality and morbidity. Often life-threatening, sepsis can be caused by bacteria, viruses, parasites or fungi. Sepsis management primarily focuses on source control and early broad-spectrum antibiotics, plus organ function support. Comprehensive changes in the way we manage sepsis patients include early identification, infective focus identification and immediate treatment with antimicrobial therapy, appropriate supportive care and hemodynamic optimization. Despite all efforts of clinical and experimental research over thirty years, the capacity to positively influence the outcome of the disease remains limited. This can be due to limited studies available on sepsis in developing countries, especially in Southeast Asia. This review summarizes the progress made in the diagnosis and time associated with sepsis, colistin resistance and chloramphenicol boon, antibiotic abuse, resource constraints and association of sepsis with COVID-19 in Southeast Asia. A personalized approach and innovative therapeutic alternatives such as CytoSorb® are highlighted as potential options for the treatment of patients with sepsis in Southeast Asia.