1
|
An L, Wu Y, Zhang B, Xu Q, Liao L, Wu S, Xu X, He Q, Pei X, Chen J. Transmission chains and molecular characterizations of extended-spectrum β-lactamase producing Enterobacteriaceae at a veterinary hospital in Chengdu, China. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2024; 124:105658. [PMID: 39168275 DOI: 10.1016/j.meegid.2024.105658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 08/15/2024] [Accepted: 08/17/2024] [Indexed: 08/23/2024]
Abstract
The rapid emergence of Extended-spectrum β-lactamase producing Enterobacteriaceae (ESBL-E) is a major global public health concern. Previous studies have identified that intensive medical care of dogs and cats in veterinary hospitals have accelerated the infections and spread of ESBL-E. To investigate the spread of ESBL-E in a veterinary hospital, a total of 202 samples including hospitalized animals, veterinary healthcare workers and environment were collected from a veterinary hospital in Chengdu, China. ESBL-E were identified by antimicrobial susceptibility testing and 16 s rRNA sequencing and were further conducted on ESBL gene detection and multilocus sequence typing (MLST). At last, strains with transmission potential were analyzed by whole genome sequencing (WGS). Our results showed that the overall prevalence of ESBL-positive isolates was 34.7% (70/202), with 55.3% (26/47) in animals, 29.3% (12/41) in healthcare workers and 28.1% (32/114) in environment swabs. Twenty diverse MLST types were detected, with ST744, ST231 as the most prevalent ones. Transmission chains of two ESBL-E.coli (ST744 blaCTX-M-18, blaTEM-1) from cat_21 to cat_14, and two ESBL-Kp (ST231 blaCTX-M-27, blaTEM-1, blaSHV-1) from cat_20 to cat_37 were further confirmed by WGS. Furthermore, interdisciplinary investigation and cooperation of AMR are needed to better limit the transmissions of high-risk strains and to implement effective public health interventions.
Collapse
Affiliation(s)
- Longyi An
- West China School of Public Health and West China Fourth Hospital, Sichuan University, 16#, Section 3, Renmin Road South, Chengdu 610041, Sichuan, China
| | - Yating Wu
- Beijing Tongzhou District Center for Disease Control and Prevention, Luhe Middle School, 1 North Street, Tongzhou District, Beijing, China
| | - Baochao Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, 16#, Section 3, Renmin Road South, Chengdu 610041, Sichuan, China
| | - Qiuhong Xu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, 16#, Section 3, Renmin Road South, Chengdu 610041, Sichuan, China
| | - Linxuan Liao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, 16#, Section 3, Renmin Road South, Chengdu 610041, Sichuan, China
| | - Shanshan Wu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, 16#, Section 3, Renmin Road South, Chengdu 610041, Sichuan, China
| | - Xin Xu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, 16#, Section 3, Renmin Road South, Chengdu 610041, Sichuan, China
| | - Qiurong He
- West China School of Public Health and West China Fourth Hospital, Sichuan University, 16#, Section 3, Renmin Road South, Chengdu 610041, Sichuan, China
| | - Xiaofang Pei
- West China School of Public Health and West China Fourth Hospital, Sichuan University, 16#, Section 3, Renmin Road South, Chengdu 610041, Sichuan, China; Non-Communicable Diseases Research Center, West China-PUMC C. C. Chen Institute of Health, Sichuan University, Chengdu 610041, China
| | - Jiayi Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, 16#, Section 3, Renmin Road South, Chengdu 610041, Sichuan, China.
| |
Collapse
|
2
|
Yudhanto S, Reinhart JM, de Souza CP, Gochenauer A, Sander WE, Hung CC, Maddox CW, Varga C. Assessing Illinois companion animal veterinarians' antimicrobial prescription practices and the factors that influence their decisions when treating bacterial infections in dogs and cats. Zoonoses Public Health 2024. [PMID: 39044541 DOI: 10.1111/zph.13172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 05/16/2024] [Accepted: 07/11/2024] [Indexed: 07/25/2024]
Abstract
AIMS Judicious antimicrobial use in companion animal practice is critical for maintaining the effectiveness of antimicrobial agents against bacterial infections and reducing the selection of antimicrobial-resistant bacteria. This study aimed to provide insights into companion animal veterinarians' antimicrobial treatment recommendations for common bacterial infections in dogs and cats and describe the factors influencing their prescription choices. METHODS AND RESULTS An online survey using QualtricsXM® software was administered between September and November 2022 to companion animal veterinarians who were Illinois State Veterinary Medical Association members. Descriptive and text analyses were conducted to assess the participants' responses. A total of 78 surveys were included in the analysis. Skin infections were ranked as the most common bacterial infections for which veterinarians prescribed antimicrobial agents, followed by ear, urinary tract, respiratory, and enteric infections. The severity of clinical symptoms and the results of bacterial culture and susceptibility tests were the most influential factors for veterinarians when making antimicrobial prescription choices. Veterinarians were aware of the current antimicrobial prescription guideline recommendations when prescribing antimicrobials empirically to nine hypothetical scenarios of bacterial infections. According to the results of the text analysis that assessed veterinarians' responses to an open-ended question, regarding their challenges when prescribing antimicrobial agents, the pairwise correlation of word frequencies within each response showed the highest correlations between the words 'owner' and 'compliance', 'administration' and 'route', 'cost' and 'culture', and 'patients' and 'acceptance'. CONCLUSIONS The study results can support animal health stakeholders in the development of antimicrobial stewardship programmes to promote appropriate antimicrobial use and limit the emergence of antimicrobial resistance.
Collapse
Affiliation(s)
- Setyo Yudhanto
- Department of Pathobiology, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Jennifer M Reinhart
- Veterinary Teaching Hospital, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Clarissa Pimentel de Souza
- Veterinary Teaching Hospital, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Alexandria Gochenauer
- Veterinary Teaching Hospital, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - William E Sander
- Veterinary Teaching Hospital, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Chien-Che Hung
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Veterinary Diagnostic Laboratory, Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Carol W Maddox
- Department of Pathobiology, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Veterinary Diagnostic Laboratory, Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Csaba Varga
- Department of Pathobiology, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Carl R. Woese Institute for Genomic Biology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| |
Collapse
|
3
|
Dias MC, Alpizar-Jara R, Lavrador C, Marques C, Broens EM, Duarte EL. Companion Animal Owners' Knowledge, Attitudes and Perceptions Regarding Antibiotic Use in Portugal. Antibiotics (Basel) 2024; 13:533. [PMID: 38927199 PMCID: PMC11201214 DOI: 10.3390/antibiotics13060533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/03/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024] Open
Abstract
While multiple studies have focused on the motivations surrounding antibiotic prescription among veterinarians, little is known about companion animal owners' knowledge, attitude and perception (KAP) regarding the topic. A nationwide survey directed toward Portuguese dog and cat owners was conducted online and at veterinary practices to characterize their KAP regarding antibiotics. After database curation, a total of 423 valid submissions were considered. Although 97.9% of respondents stated that they knew what an antibiotic was, 23.5% and 19.2% answered that they were used to treat viral and fungal infections, respectively. Antimicrobial effectiveness was favored over cost when 87.7% of owners agreed they would prefer to spend more money to identify the appropriate antibiotic. Around 87% of respondents recognized antibiotic resistance as a significant health problem and 74.6% strongly agreed/somewhat agreed that antibiotic use in pets may contribute to resistance development. However, only 25.3% recognized that this could promote resistance dissemination, showing little awareness of the interconnection between human and animal health. Moreover, 55.6% of respondents were neutral when asked whether antibiotics used in veterinary medicine were also important for humans. These findings suggest that communication between veterinarians and pet owners can still be improved to further clarify the impact that antibiotic use has in pets from a One-Health perspective, also enabling antimicrobial stewardship interventions.
Collapse
Affiliation(s)
- Margarida Correia Dias
- Department of Veterinary Medicine, School of Science and Technology, Universidade de Évora, 7004-516 Évora, Portugal; (C.L.)
- MED–Mediterranean Institute for Agriculture, Environment and Development & CHANGE–Global Change and Sustainability Institute, Universidade de Évora, 7004-516 Évora, Portugal
| | - Russell Alpizar-Jara
- Department of Mathematics, School of Science and Technology & CIMA Research Centre in Mathematics and Applications, Universidade de Évora, 7004-516 Évora, Portugal
| | - Catarina Lavrador
- Department of Veterinary Medicine, School of Science and Technology, Universidade de Évora, 7004-516 Évora, Portugal; (C.L.)
- MED–Mediterranean Institute for Agriculture, Environment and Development & CHANGE–Global Change and Sustainability Institute, Universidade de Évora, 7004-516 Évora, Portugal
| | - Cátia Marques
- Faculty of Veterinary Medicine, Lusófona University, 376 Campo Grande, 1749-024 Lisbon, Portugal;
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), CECAV—Animal and Veterinary Research Centre, University of Trás-os-Montes and Alto Douro, Quinta de Prados, 5000-801 Vila Real, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Centre for Interdisciplinary Research in Animal Health (CIISA), Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal
- Genevet, Diagnostic Laboratory and ECVM Satellite Training Center, 1495-191 Carnaxide, Portugal
| | - Els M. Broens
- Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584 CS Utrecht, The Netherlands
| | - Elsa L. Duarte
- Department of Veterinary Medicine, School of Science and Technology, Universidade de Évora, 7004-516 Évora, Portugal; (C.L.)
- MED–Mediterranean Institute for Agriculture, Environment and Development & CHANGE–Global Change and Sustainability Institute, Universidade de Évora, 7004-516 Évora, Portugal
| |
Collapse
|
4
|
Rocholl C, Zablotski Y, Schulz B. Online-Assisted Survey on Antibiotic Use by Pet Owners in Dogs and Cats. Antibiotics (Basel) 2024; 13:382. [PMID: 38786111 PMCID: PMC11117295 DOI: 10.3390/antibiotics13050382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 04/19/2024] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
The aim of the study was two-fold: first, to collect data on the use of antibiotics in Germany for dogs and cats and, second, their owners' experiences and opinions. Using an anonymous online survey, dog and cat owners were asked about the last antibiotic administration in their pet. The inclusion criterion was any antibiotic administration within the last year. A total of 708 questionnaires from 463 dogs and 245 cats could be evaluated. Diarrhea was reported as the most common reason for antibiotic administration in dogs (18.4%). Wound infection/abscess/bite injury was the second most common reason in dogs (16.0%). In cats wound infection/abscess/bite injury was the most common reason (23.3%), followed by dental treatment (21.2%) and upper respiratory tract infections (16.7%). The most common antibiotics used systemically in both species were amoxicillin/clavulanic acid (32.5%), amoxicillin (14.8%), metronidazole (6.9%), and doxycycline (6.8%). While efficacy (99.9%) and tolerability (94.8%) were rated as most important for the choice of antibiotics, costs (51.6%) were cited as predominantly unimportant. First-line antibiotics were used significantly more often than critically important antibiotics. The majority of animal owners show awareness for avoidance of antibiotic resistance and the use of critically important antibiotics.
Collapse
Affiliation(s)
- Clara Rocholl
- Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, Ludwig Maximilian University of Munich, 80539 Munich, Germany
| | | | | |
Collapse
|
5
|
De Marchi L, Vernaccini M, Meucci V, Briganti A, Lippi I, Marchetti V, Intorre L. Six-Year Prescription Pattern of Antimicrobial Use in Cats at the Veterinary Teaching Hospital of the University of Pisa. Animals (Basel) 2024; 14:521. [PMID: 38338164 PMCID: PMC10854698 DOI: 10.3390/ani14030521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/19/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024] Open
Abstract
The use of antimicrobials has greatly contributed to improving animal health. However, their inappropriate use reduces their effectiveness in treating bacterial infections and contributes to the selection of resistance. This study aimed to retrospectively evaluate the six-year pattern (2017-2022) of antimicrobial use in cats visiting the Veterinary Teaching Hospital (VTH) of the University of Pisa (Italy). The total number of prescribed antimicrobials, the number of animals for which an antimicrobial was prescribed, and the total number of antimicrobial prescriptions showed a significant time trend decrease during the study period, except for the fixed-dose combinations. The most frequently prescribed antimicrobials were amoxicillin-clavulanic acid (Synulox) (39.1%) followed by enrofloxacin (29.8%). These antimicrobials were mostly prescribed to treat infections affecting the genitourinary tract (~30%), followed by the gastrointestinal tract, skin, and respiratory system affections. Antimicrobials in empirical associations represented 13.0% of the total antimicrobial prescriptions, and the combination of amoxicillin-clavulanic acid (Synulox) with enrofloxacin accounted for the majority. The oral route represented the main route of administration of prescribed antimicrobials, followed by parenteral and topical ones. Amoxicillin-clavulanic acid (Synulox) (37.2%), ceftriaxone (2.7%), and tobramycin (2.8%) were the most prescribed antimicrobials for the oral, parenteral, and topical routes, respectively. Antimicrobial prescriptions complied with prudent use recommendations in terms of availability of diagnosis, respect to the dose range, duration of treatment, and the use of medicinal products approved for the species. On the contrary, antimicrobial susceptibility tests were used infrequently (5.2%), lacking compliance with the existing guidelines observed in companion animal practice. Overall, additional interventions are required not only to improve the responsible use of antimicrobials in our feline practice but also to implement antimicrobial stewardship programs, enhancing diagnostics such as culture and sensitivity testing in the future.
Collapse
Affiliation(s)
| | | | - Valentina Meucci
- Veterinary Teaching Hospital, Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy; (L.D.M.); (M.V.); (A.B.); (I.L.); (V.M.); (L.I.)
| | | | | | | | | |
Collapse
|
6
|
Adebowale OO, Jimoh AB, Adebayo OO, Alamu AA, Adeleye AI, Fasanmi OG, Olasoju M, Olagunju PO, Fasina FO. Evaluation of antimicrobial usage in companion animals at a Veterinary Teaching Hospital in Nigeria. Sci Rep 2023; 13:18195. [PMID: 37875528 PMCID: PMC10598005 DOI: 10.1038/s41598-023-44485-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 10/09/2023] [Indexed: 10/26/2023] Open
Abstract
This study investigated various qualitative and quantitative indices of antimicrobial use (AMU) in companion animals (CAs) at a Veterinary Teaching Hospital (VTH-A) and its annex (VTH- B) from 2019 to 2021. For 694 documented animals, antimicrobial administrations (AADs) were 5, 278 times, of which 98.8% (5217) and 1.2% (61) were in dogs and cats respectively. At the VTH- A, oxytetracycline (1185 times, 22.5%) was mostly administered in dogs and metronidazole (26 times, 0.5%) in cats. Similarly, at VTH- B, oxytetracycline was administered 895 times (17.0%) in dogs while amoxicillin was given 7 times (0.1%) in cats. The prescription diversity (PD) was estimated at 0.73 and 0.82 in VTH-A and VTH-B respectively. The quantity of antimicrobials (AMs) used was 10.1 kg (A, 6.2 kg and B, 3.9 kg). Oxytetracycline administrations and quantity of metronidazole (P < 0.0001) were higher than other Active Ingredients (AIs). Furthermore, 16.5% of AIs were classified as Critically Important Antibiotics (CIA) with the highest priority, while enrofloxacin, ciprofloxacin, and azithromycin fell under the World Health Organisation (WHO) Watch group. The In-Depth Interview (IDI) indicated that the high frequency of oxytetracycline administrations was linked with being the first choice for blood parasite treatment by the clinicians at the hospital. The quantity of metronidazole used was perceived to be higher due to the clinicians' preference for the treatment of acute gastroenteritis, its wider dose range, and the frequency of administration (bi-daily). The study provides baseline data on AMU indices in CAs, for the development of antimicrobial stewardship (AMS) and communication training, and policy modifications to enhance antimicrobial therapy optimization in tertiary veterinary hospital care in Nigeria.
Collapse
Affiliation(s)
- O O Adebowale
- Department of Veterinary Public Health and Preventive Medicine, College of Veterinary Medicine, Federal University of Agriculture Abeokuta, Abeokuta, Ogun State, Nigeria.
| | - A B Jimoh
- Department of Veterinary Public Health and Preventive Medicine, College of Veterinary Medicine, Federal University of Agriculture Abeokuta, Abeokuta, Ogun State, Nigeria
| | - O O Adebayo
- Veterinary Teaching Hospital, College of Veterinary Medicine, Federal University of Agriculture Abeokuta, Abeokuta, Ogun State, Nigeria
| | - A A Alamu
- Department of Veterinary Medicine, College of Veterinary Medicine, Federal University of Agriculture Abeokuta, Abeokuta, Ogun State, Nigeria
| | - A I Adeleye
- Veterinary Teaching Hospital, College of Veterinary Medicine, Federal University of Agriculture Abeokuta, Abeokuta, Ogun State, Nigeria
| | - O G Fasanmi
- Department of Veterinary Laboratory Technology, Federal College of Animal Health and Production Technology, Ibadan, Oyo State, Nigeria
| | - M Olasoju
- Department of Veterinary Public Health and Preventive Medicine, College of Veterinary Medicine, Federal University of Agriculture Abeokuta, Abeokuta, Ogun State, Nigeria
| | - P O Olagunju
- Department of Veterinary Public Health and Preventive Medicine, College of Veterinary Medicine, Federal University of Agriculture Abeokuta, Abeokuta, Ogun State, Nigeria
| | - F O Fasina
- ECTAD, Food and Agriculture Organization of the United Nations (FAO), Rome, Italy
- Department of Veterinary Tropical Diseases, University of Pretoria, Pretoria, South Africa
| |
Collapse
|
7
|
Foglia Manzillo V, Peruzy MF, Gizzarelli M, Izzo B, Sarnelli P, Carrella A, Vinciguerra G, Chirollo C, Ben Fayala NEH, Balestrino I, Oliva G. Examining the Veterinary Electronic Antimicrobial Prescriptions for Dogs and Cats in the Campania Region, Italy: Corrective Strategies Are Imperative. Animals (Basel) 2023; 13:2869. [PMID: 37760269 PMCID: PMC10525136 DOI: 10.3390/ani13182869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 08/03/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- Valentina Foglia Manzillo
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, 80137 Naples, Italy; (V.F.M.); (M.F.P.); (M.G.); (N.E.H.B.F.); (G.O.)
| | - Maria Francesca Peruzy
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, 80137 Naples, Italy; (V.F.M.); (M.F.P.); (M.G.); (N.E.H.B.F.); (G.O.)
| | - Manuela Gizzarelli
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, 80137 Naples, Italy; (V.F.M.); (M.F.P.); (M.G.); (N.E.H.B.F.); (G.O.)
| | - Berardino Izzo
- Veterinary Pharmacovigilance Center of Campania Region, 80137 Naples, Italy; (B.I.); (P.S.); (A.C.); (G.V.); (C.C.)
| | - Paolo Sarnelli
- Veterinary Pharmacovigilance Center of Campania Region, 80137 Naples, Italy; (B.I.); (P.S.); (A.C.); (G.V.); (C.C.)
| | - Antonio Carrella
- Veterinary Pharmacovigilance Center of Campania Region, 80137 Naples, Italy; (B.I.); (P.S.); (A.C.); (G.V.); (C.C.)
| | - Giuseppina Vinciguerra
- Veterinary Pharmacovigilance Center of Campania Region, 80137 Naples, Italy; (B.I.); (P.S.); (A.C.); (G.V.); (C.C.)
| | - Claudia Chirollo
- Veterinary Pharmacovigilance Center of Campania Region, 80137 Naples, Italy; (B.I.); (P.S.); (A.C.); (G.V.); (C.C.)
| | - Nour El Houda Ben Fayala
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, 80137 Naples, Italy; (V.F.M.); (M.F.P.); (M.G.); (N.E.H.B.F.); (G.O.)
| | - Ines Balestrino
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, 80137 Naples, Italy; (V.F.M.); (M.F.P.); (M.G.); (N.E.H.B.F.); (G.O.)
| | - Gaetano Oliva
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, 80137 Naples, Italy; (V.F.M.); (M.F.P.); (M.G.); (N.E.H.B.F.); (G.O.)
| |
Collapse
|
8
|
Allen SE, Verheyen KLP, O'Neill DG, Brodbelt DC. Use of antimicrobials licensed for systemic administration in UK equine practice. Equine Vet J 2023; 55:808-819. [PMID: 36199158 DOI: 10.1111/evj.13878] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 09/23/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Judicious antimicrobial use (AMU) is important for preserving therapeutic effectiveness. Large-scale studies of antimicrobial prescribing can provide clinical benchmarks and help identify opportunities for improved stewardship. OBJECTIVES To describe systemic AMU in UK equine practice and identify factors associated with systemic and Category B (third and fourth generation cephalosporins, quinolones and polymixins) AMU. STUDY DESIGN Retrospective cohort. METHODS Anonymised electronic patient records (EPRs) for all equids attended by 39 UK veterinary practices between 1 January and 31 December 2018 were collected via the VetCompass programme. Systemic antimicrobial prescriptions were identified using electronic keyword searches. Indications for AMU were determined through manual review of a randomly selected subset of EPRs. The types and frequency of systemic antimicrobials prescribed and indications were summarised using descriptive statistics. Mixed-effects logistic regression was used to evaluate practice- and horse-related risk factors. RESULTS Systemic antimicrobials were prescribed to 12 538 (19.5%, 95% confidence interval [CI]: 19.2%-19.8%) of 64 322 equids attended in 2018. Category B antimicrobials were prescribed to 1.9% (95% CI: 1.8%-2.0%) of attended equids and in 8.9% (95% CI: 8.5%-9.4%) of antimicrobial courses. Bacteriological culture was performed in 19.1% (95% CI: 17.1%-21.3%) of Category B antimicrobial courses. The most commonly prescribed antimicrobial classes were potentiated sulphonamides (50.2% of equids receiving antimicrobials) and tetracyclines (33.5% of equids receiving antimicrobials). Integumentary disorders were the most common reason for systemic AMU (40.5% of courses). Urogenital disorders were the most common reason for Category B AMU (31.1% of courses). Increased odds of systemic and Category B AMU were observed in equids <1 year compared with those aged 5-14 years. Breed was associated with AMU, with odds of systemic and Category B AMU highest in Thoroughbreds and Thoroughbred crosses. MAIN LIMITATIONS Convenience sample of practices may limit generalisability. CONCLUSIONS Empirical use of Category B antimicrobials remains commonplace.
Collapse
Affiliation(s)
- Sarah E Allen
- Department of Pathobiology and Population Sciences, Royal Veterinary College, Hertfordshire, UK
| | - Kristien L P Verheyen
- Department of Pathobiology and Population Sciences, Royal Veterinary College, Hertfordshire, UK
| | - Dan G O'Neill
- Department of Pathobiology and Population Sciences, Royal Veterinary College, Hertfordshire, UK
| | - Dave C Brodbelt
- Department of Pathobiology and Population Sciences, Royal Veterinary College, Hertfordshire, UK
| |
Collapse
|
9
|
Jolley A, Love W, Frey E, Lanzas C. Impacts of the COVID-19 pandemic on antimicrobial use in companion animals in an academic veterinary hospital in North Carolina. Zoonoses Public Health 2023; 70:393-402. [PMID: 37029504 PMCID: PMC10330401 DOI: 10.1111/zph.13040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 02/18/2023] [Accepted: 02/23/2023] [Indexed: 04/09/2023]
Abstract
Antimicrobial resistance (AMR) in bacterial pathogens reduces the effectiveness of these drugs in both human and veterinary medicine, making judicious antimicrobial use (AMU) an important strategy for its control. The COVID-19 pandemic modified operations in both human and veterinary healthcare delivery, potentially impacting AMU. The goal of this research is to quantify how antimicrobial drug prescribing practices for companion animals in an academic veterinary hospital changed during the pandemic. A retrospective study was performed using prescribing data for dogs and cats collected from the NC State College of Veterinary Medicine (NCSU-CVM) pharmacy, which included prescriptions from both the specialty referral hospital and primary care services. Records (n = 31,769) for 34 antimicrobial drugs from 2019-2020-before and during the pandemic-related measures at the NCSU-CVM-were compared. The prescribed antimicrobials' importance was categorized using the FDA's Guidance for Industry (GFI #152), classifying drugs according to medical importance in humans. A proportional odds model was used to estimate the probability of more important antimicrobials being administered in patients seen during the pandemic versus before (i.e., critically important vs. highly important vs. important). Rates of AMU per week and per patient visit were also compared. During the pandemic, cumulative antimicrobials prescribed per week were significantly decreased in most services for dogs. Weekly rates for Highly Important antimicrobials were also significantly lower in dogs. For important and critically important antimicrobials, rates per week were significantly decreased in various services overall. Rates of antimicrobial administration per patient visit were significantly increased for Highly Important drugs. Patients in the internal medicine, dermatology, and surgery services received significantly more important antimicrobials during the pandemic than before, while cardiology patients received significantly less. These results suggest that the pandemic significantly impacted prescribing practices of antimicrobials for companion animals in this study.
Collapse
Affiliation(s)
- Ashlan Jolley
- Department of Population Health and Pathobiology, NC State University College of Veterinary Medicine, Raleigh, North Carolina, USA
| | - William Love
- Department of Population Health and Pathobiology, NC State University College of Veterinary Medicine, Raleigh, North Carolina, USA
| | - Erin Frey
- Department of Clinical Sciences, NC State University College of Veterinary Medicine, Raleigh, North Carolina, USA
| | - Cristina Lanzas
- Department of Population Health and Pathobiology, NC State University College of Veterinary Medicine, Raleigh, North Carolina, USA
| |
Collapse
|
10
|
Sobierajski T, Wanke-Rytt M, Chajecka-Wierzchowska W, Śmiałek M, Hryniewicz W. One Health in the consciousness of veterinary students from the perspective of knowledge of antibiotic therapy and antimicrobial resistance: a multi-centre study. Front Public Health 2023; 11:1165035. [PMID: 37293608 PMCID: PMC10244627 DOI: 10.3389/fpubh.2023.1165035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 04/28/2023] [Indexed: 06/10/2023] Open
Abstract
One Health (OH) is one of the most essential global programs to rebalance the animal, human, and plant environments that depend on and affect each other. One element of the OH program is to draw attention to the phenomenon of antimicrobial resistance (AMR), which poses a very high risk to human and animal health. OH is not only a health-promoting project but also has an educational dimension. Therefore, a survey was conducted among 467 veterinary students studying at top academic centers in Poland to find out whether they had heard of OH and whether knowledge of OH influences their knowledge and attitudes related to AMR. The study indicated statistically significant relationships between familiarity with the OH program and the year of study. The higher the year of study, the more students heard about OH. It was also shown that students who had heard of OH were significantly more likely-compared to students who had not heard of OH-to agree that increasing AMR is influenced by the overuse of antibiotics in veterinary medicine (70.7 vs. 55%; p = 0.014) and the use of too low doses of antibiotics in animals (49.8 vs. 28.6%; p = 0.016). The higher the year of study, the higher the percentage of students who say that carbapenems as antibiotics of last resort should be reserved only for humans (70% of final-year students vs. 30.8% of first-year students; p < 0.001). The study's results indicate the effectiveness of education in fostering positive attitudes toward AMR and the impact of knowledge of the OH program on knowledge of antibiotic therapy in the spirit of OH.
Collapse
Affiliation(s)
- Tomasz Sobierajski
- Faculty of Applied Social Sciences and Resocialization, The Center of Sociomedical Research, Warsaw University, Warsaw, Poland
| | - Monika Wanke-Rytt
- Department of Pediatrics With Clinical Assessment Unit, Medical University of Warsaw, Warsaw, Poland
| | - Wioleta Chajecka-Wierzchowska
- Department of Industrial and Food Microbiology, Faculty of Food Science, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Marcin Śmiałek
- Department of Poultry Diseases, Faculty of Veterinary Medicine, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Waleria Hryniewicz
- Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland
| |
Collapse
|
11
|
Heeley AM, Brodbelt DC, O'Neill DG, Church DB, Davison LJ. Assessment of glucocorticoid and antibiotic exposure as risk factors for diabetes mellitus in selected dog breeds attending UK primary-care clinics. Vet Rec 2023; 192:e2785. [PMID: 37004211 PMCID: PMC10952602 DOI: 10.1002/vetr.2785] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/06/2023] [Accepted: 02/22/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Diabetes mellitus (DM) is an important endocrine disorder in dogs. This study explored prior exposure to glucocorticoids or antibiotic treatment as risk factors for developing DM in dogs attending primary-care VetCompass clinics in the UK. METHODS A breed frequency matched case-control study nested in a cohort of dogs (n = 480,469) aged 3 years or over was used to explore associations between glucocorticoid and antibiotic exposure and the odds of developing DM. RESULTS A total of 565 cases and 2179 controls were included. Dogs with DM had over four times the odds of exposure to glucocorticoids within 6 weeks prior to diagnosis (odds ratio [OR] 4.07, 95% confidence interval [CI] 2.41-6.89, p < 0.001) compared to controls within 6 weeks prior to a randomly selected quasi-date of diagnosis. Dogs that had only one unique documented antibiotic course had a decreased odds of developing DM (OR 0.65, 95% CI 0.46-0.91, p = 0.012) compared to dogs that had no documented courses of antibiotics. LIMITATIONS This study only included selected breeds, so the results may not be generalisable to all dog breeds. CONCLUSIONS Exposure to glucocorticoids is associated with a substantial increase in the risk of developing DM for the dog breeds included in this analysis.
Collapse
Affiliation(s)
- Angela M. Heeley
- Department of Pathobiology and Population SciencesRoyal Veterinary CollegeHatfieldUK
| | - Dave C. Brodbelt
- Department of Pathobiology and Population SciencesRoyal Veterinary CollegeHatfieldUK
| | - Dan G. O'Neill
- Department of Pathobiology and Population SciencesRoyal Veterinary CollegeHatfieldUK
| | - David B. Church
- Department of Clinical Science and ServicesRoyal Veterinary CollegeHatfieldUK
| | - Lucy J. Davison
- Department of Clinical Science and ServicesRoyal Veterinary CollegeHatfieldUK
| |
Collapse
|
12
|
Williams A. 'Telemedicine has a valid place in a modern veterinary profession'. Vet Rec 2023; 192:87. [PMID: 36661163 DOI: 10.1002/vetr.2673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Adele Williams and colleagues argue that assumptions made by some regarding remote prescribing from telemedicine providers are incorrect, and that such services can help to improve animal health and welfare and reduce the burden on physical veterinary practices.
Collapse
Affiliation(s)
- Adele Williams
- Adele Williams is a vet and director of R&D at Vet-AI. She writes this along with colleagues at Vet-AI and Joii app
| |
Collapse
|
13
|
Vojtkovská V, Kaluža M, Voslářová E, Večerek V, Tomečková L. The morbidity and the spectrum of applied drugs in shelter cats in the Czech Republic. Front Vet Sci 2022; 9:1025197. [PMID: 36544553 PMCID: PMC9760937 DOI: 10.3389/fvets.2022.1025197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022] Open
Abstract
Maintaining appropriate living conditions and good health of the animals should be one of the main priorities of cat shelters. The aim of this study was to assess the morbidity of shelter cats on the basis of analysis of the shelter health records in terms of the nature and quantity of medicaments and other supportive products administered in two no-kill shelters in the Czech Republic. The subject of the study were the health records of 1,884 cats, which were admitted to the selected shelters from 1.1.2013 to 31.12.2021 and their stay in the shelter was terminated in the monitored period. More than half of all cats whose records were analyzed had at least one health record made during their stay in the shelter. The overall length of stay of cats in the shelter (regardless of the outcome) in which one or more health records were found was significantly longer compared to the length of stay of cats without any health records. The highest number of health records was found in kittens <6 months old. Antibiotics, antiparasitics, and complementary/protective substances were the most used among all administered drugs. Broad-spectrum antibiotics have been administered to cats most often. In terms of classification of antibiotics according to the active substance, the most used antibiotics were penicillins, tetracyclines, and fluoroquinolones. Antibiotics were mostly used to treat diseases related to the upper and lower respiratory tract and their symptoms and gastrointestinal problems. The findings of the study contribute to understanding health problems and approaches to treating the shelter cats.
Collapse
Affiliation(s)
- Veronika Vojtkovská
- Department of Animal Protection and Welfare and Veterinary Public Health, University of Veterinary Sciences Brno, Brno, Czechia,*Correspondence: Veronika Vojtkovská
| | - Michal Kaluža
- Department of Animal Protection and Welfare and Veterinary Public Health, University of Veterinary Sciences Brno, Brno, Czechia
| | - Eva Voslářová
- Department of Animal Protection and Welfare and Veterinary Public Health, University of Veterinary Sciences Brno, Brno, Czechia
| | - Vladimír Večerek
- Department of Animal Protection and Welfare and Veterinary Public Health, University of Veterinary Sciences Brno, Brno, Czechia
| | - Lenka Tomečková
- Department of Public Veterinary Medicine and Animal Welfare, The University of Veterinary Medicine and Pharmacy in Košice, Košice, Slovakia
| |
Collapse
|
14
|
Taylor S, Caney S, Bessant C, Gunn-Moore D. Online survey of owners' experiences of medicating their cats at home. J Feline Med Surg 2022; 24:1283-1293. [PMID: 35343808 PMCID: PMC10812359 DOI: 10.1177/1098612x221083752] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVES The aim of this study was to use an online survey to obtain information from cat owners about their experiences of medicating their cats. METHODS An online survey containing 35 questions on experiences of medicating cats was circulated to cat owners globally. RESULTS In total, 2507 surveys from 57 countries were analysed; 1724 from 'cat owners' and 783 from 'cat owners+' (respondents with significant cat experience, including veterinary professionals). Around half (50.7%) of cat owners were 'sometimes' or 'never' provided with information or advice on how to administer medication; however, 91.8% of those given information found it 'somewhat' or 'very' useful. Around half (53.6%) of owners sought information from the internet about how to administer medication. Total cat owners (cat owners and cat owners+) administered liquids (61.3%), pastes (45.3%) or tablets (39.5%) directly into their cat's mouth; fewer (22.6-24.1%) hid these medications in food. Total cat owners rated tablets significantly harder to administer than liquids; 53.0% chose liquids as their first-choice formulation while 29.3% chose tablets. Insulin injections and 'spot-ons' were significantly easier to administer than any oral medications. Over half (51.6%) of owners reported that medicating their cat(s) had changed their relationship with them; 77.0% reported that their cat(s) had tried to bite or scratch them when medicating. Other challenges included the cat(s) spitting out tablets (78.7%), refusing medication in food (71.7%) and running away (52.7%). Of the owners who failed to complete a course of medication (35.4%), 27.8% stopped near the end of the course, while 19.3% stopped after a few doses, in both cases as medicating was too difficult. CONCLUSIONS AND RELEVANCE Owners appreciate being provided with information about the administration of medication. Frequent challenges when medicating cats include potential human injury and damage to the owner-cat relationship. Pharmaceutical companies should provide a range of formulations to ease compliance. Veterinary clinics should provide information/demonstrations and internet links when prescribing medications.
Collapse
Affiliation(s)
| | - Sarah Caney
- Vet Professionals, Pentlandfield, Roslin, UK
| | | | - Danièlle Gunn-Moore
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Roslin, UK
| |
Collapse
|
15
|
Aurich S, Prenger-Berninghoff E, Ewers C. Prevalence and Antimicrobial Resistance of Bacterial Uropathogens Isolated from Dogs and Cats. Antibiotics (Basel) 2022; 11:antibiotics11121730. [PMID: 36551391 PMCID: PMC9774110 DOI: 10.3390/antibiotics11121730] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/22/2022] [Accepted: 11/25/2022] [Indexed: 12/05/2022] Open
Abstract
Bacterial urinary tract infection (UTI) is a common diagnosis in companion animal practice and is one of the leading reasons for antimicrobial prescriptions. We analysed 1862 samples from the urinary tract of dogs and cats, submitted to a veterinary microbiological diagnostic laboratory in 2019 and 2020 in Germany. Susceptibility of 962 uropathogenic isolates to 15 antimicrobials, suggested as first- and second-line treatment options for UTI, was determined according to CLSI recommendations. Bacterial growth of uropathogens was detected in 43.9% of dog and in 38.5% of cat samples. Escherichia (E.) coli was the most frequently isolated pathogen (48.4%), followed by Enterococcus spp. (11.9%) and coagulase-positive staphylococci (CoPS; 11.5%). Females were more likely to exhibit a positive microbiological culture. Regarding first-line antibiotics, 93.4% of the most commonly isolated uropathogenic species were susceptible to the first-line antibiotics amoxicillin/clavulanic acid (AMC) and 87.6% to trimethoprim-sulfamethoxazole (SXT), while 76.1% showed decreased susceptibility to ampicillin (AMP). Multidrug resistance (MDR) was detected in 11.9% of E. coli, 50.4% of enterococci, and 42.7% of CoPS; 90.6% of these isolates were susceptible to nitrofurantoin (NIT). Our data indicate that empiric treatment of UTI with AMC or SXT could be recommended and is preferable to treatment with AMX. NIT should be considered for the treatment of MDR uropathogens.
Collapse
|
16
|
Osman M, Albarracin B, Altier C, Gröhn YT, Cazer C. Antimicrobial resistance trends among canine Escherichia coli isolated at a New York veterinary diagnostic laboratory between 2007 and 2020. Prev Vet Med 2022; 208:105767. [PMID: 36181749 PMCID: PMC9703301 DOI: 10.1016/j.prevetmed.2022.105767] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 08/21/2022] [Accepted: 09/21/2022] [Indexed: 11/30/2022]
Abstract
Dogs are a potential source of drug-resistant Escherichia coli, but very few large-scale antimicrobial resistance surveillance studies have been conducted in the canine population. Here, we assess the antimicrobial susceptibility patterns, identify temporal resistance and minimum inhibitory concentration (MIC) trends, and describe associations between resistance phenotypes among canine clinical E. coli isolates in the northeastern United States. Through a retrospective study design, we collected MICs from 7709 E. coli isolates from canine infections at the Cornell University Animal Health Diagnostic Center between 2007 and 2020. The available clinical data were limited to body site. Isolates were classified as resistant or susceptible to six (urinary) and 22 (non-urinary) antimicrobials based on Clinical and Laboratory Standards Institute breakpoints. We used the Mann-Kendall test (MKT) and Sen's slope to identify the presence of a significant trend in the percent of resistant isolates over the study period. Multivariable logistic regression (MLR) models were built with ceftiofur, enrofloxacin, or trimethoprim-sulfamethoxazole resistance as the outcome and either body site and isolation date, or resistance to other antimicrobials as predictors. MIC trends were characterized with survival analysis models, controlling for body site and year of isolation. Overall, 16.4% of isolates were resistant to enrofloxacin, 14.3% to ceftiofur, and 14% to trimethoprim-sulfamethoxazole. The MKT and Sen's slope revealed a significant decreasing temporal trend for gentamicin and trimethoprim-sulfamethoxazole resistance among non-urinary isolates. No significant temporal resistance trends were detected by MKT for other antimicrobials. However, controlling for body-site in MLR models identified a decrease in resistance rates to enrofloxacin and trimethoprim-sulfamethoxazole after 2010. Similarly, survival analysis data confirmed these findings and showed a decrease in MIC values after 2010 for gentamicin and trimethoprim-sulfamethoxazole, but an increase in cephalosporin MICs. MLR showed that non-urinary isolates were significantly more likely than urinary isolates to demonstrate in vitro resistance to ceftiofur, enrofloxacin, and trimethoprim-sulfamethoxazole after controlling for year of isolation. We identified a higher level of ceftiofur resistance among enrofloxacin resistant isolates from urinary and non-urinary origins. Our findings confirmed that dogs are still a non-negligeable reservoir of drug-resistant E. coli in the northeastern United States. The increase in extended-spectrum cephalosporin MIC values in 2018-2020 compared to 2007-2010 constitutes a particularly worrying issue; the relationship between ceftiofur and enrofloxacin resistance suggests that the use of fluoroquinolones could contribute to this trend. Trimethoprim-sulfamethoxazole may be a good first-line choice for empiric treatment of E. coli infections; it is already recommended for canine urinary tract infections.
Collapse
Affiliation(s)
- Marwan Osman
- Cornell Atkinson Center for Sustainability, Cornell University, Ithaca, NY 14853, USA; Department of Public and Ecosystem Health, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.
| | - Belen Albarracin
- Department of Public and Ecosystem Health, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Craig Altier
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Yrjö T Gröhn
- Department of Public and Ecosystem Health, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA; Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Casey Cazer
- Department of Public and Ecosystem Health, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA; Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| |
Collapse
|
17
|
Canine Saliva as a Possible Source of Antimicrobial Resistance Genes. Antibiotics (Basel) 2022; 11:antibiotics11111490. [DOI: 10.3390/antibiotics11111490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/23/2022] [Accepted: 10/24/2022] [Indexed: 11/16/2022] Open
Abstract
While the One Health issues of intensive animal farming are commonly discussed, keeping companion animals is less associated with the interspecies headway of antimicrobial resistance. With the constant advance in veterinary standards, antibiotics are regularly applied in companion animal medicine. Due to the close coexistence of dogs and humans, dog bites and other casual encounters with dog saliva (e.g., licking the owner) are common. According to our metagenome study, based on 26 new generation sequencing canine saliva datasets from 2020 and 2021 reposited in NCBI SRA by The 10,000 Dog Genome Consortium and the Broad Institute within Darwin’s Ark project, canine saliva is rich in bacteria with predictably transferable antimicrobial resistance genes (ARGs). In the genome of potentially pathogenic Bacteroides, Capnocytophaga, Corynebacterium, Fusobacterium, Pasteurella, Porphyromonas, Staphylococcus and Streptococcus species, which are some of the most relevant bacteria in dog bite infections, ARGs against aminoglycosides, carbapenems, cephalosporins, glycylcyclines, lincosamides, macrolides, oxazolidinone, penams, phenicols, pleuromutilins, streptogramins, sulfonamides and tetracyclines could be identified. Several ARGs, including ones against amoxicillin–clavulanate, the most commonly applied antimicrobial agent for dog bites, were predicted to be potentially transferable based on their association with mobile genetic elements (e.g., plasmids, prophages and integrated mobile genetic elements). According to our findings, canine saliva may be a source of transfer for ARG-rich bacteria that can either colonize the human body or transport ARGs to the host bacteriota, and thus can be considered as a risk in the spread of antimicrobial resistance.
Collapse
|
18
|
Glavind AS, Kruse AB, Nielsen LR, Stege H. Monitoring antimicrobial usage in companion animals: exploring the use of the Danish VetStat database. Acta Vet Scand 2022; 64:27. [PMID: 36253805 PMCID: PMC9575193 DOI: 10.1186/s13028-022-00647-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the Danish Veterinary Statistics Program, VetStat, sales data on medicinal products prescribed for veterinary consumption is collected. The Danish Food and Veterinary Administration (DVFA) manages the database and each purchase contains detailed product-specific information linked with a species-specific ID. National surveillance systems are also implemented or being developed in the other European Union Member States. By 2029, all Member States are required to report data on antimicrobial usage for companion animals to the European Medicines Agency. This study aimed to assess the challenges encountered when using the VetStat database to quantify antimicrobial use in Danish companion animals. Raw VetStat data were propagated by the DVFA and originated from veterinary practitioners and Danish pharmacies. RESULTS Comprehensive estimates of antimicrobial use in Danish companion animals were not readily available due to database construct. Antimicrobials sold for use in companion animals (linked to a companion animal ID) comprised a large number of products licensed solely for horses or livestock, while data assigned a replacement code encompassed both topical and peroral antimicrobials licensed for companion animals. Additionally, antimicrobials sold from pharmacies to veterinary practitioners presented the biggest challenge in data retrieval and validation. Treatment data are only transferred to VetStat through the billing systems when Danish veterinarians are treating livestock, but not companion animals. Information on products sold for in-house use in companion animals is only available from pharmacy records without a species-specific ID. As a result, parenteral antimicrobials with multi-species authorization utilized by small animal veterinary practitioners are not accounted for in the overall estimate for companion animals. CONCLUSIONS Owing to the database structure and requirements for data entry, antimicrobial use in companion animals is an approximation. The actual consumption may be significantly higher than what is currently calculated from the database, as the majority of parenteral products are not included. Consumption data can be measured more accurately provided treatment data from veterinary practitioners in small or mixed practices are transferred to the database through the billing system. This would equal the legal requirements for Danish veterinary practitioners treating livestock.
Collapse
Affiliation(s)
- Anne-Sofie Glavind
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Groennegaardsvej 3, 1870, Frederiksberg C, Denmark.
| | - Amanda Brinch Kruse
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Groennegaardsvej 3, 1870, Frederiksberg C, Denmark
| | - Liza Rosenbaum Nielsen
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Groennegaardsvej 3, 1870, Frederiksberg C, Denmark
| | - Helle Stege
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Groennegaardsvej 3, 1870, Frederiksberg C, Denmark
| |
Collapse
|
19
|
More SJ, Collins DM, Meunier NV, Messam LLM, Doyle R, Maguire A, Murray S, Reilly P, Lawler C. Understanding the dog population in the Republic of Ireland: insight from existing data sources? Ir Vet J 2022; 75:16. [PMID: 35836251 PMCID: PMC9281166 DOI: 10.1186/s13620-022-00223-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 06/27/2022] [Indexed: 11/30/2022] Open
Abstract
Background Reliable information about national pet dog populations is an important contributor to informed decision-making, both by governments and national dog welfare organisations. In some countries, there is an improved understanding of aspects of the national pet dog population, but as yet limited published information is available in Ireland. The current study reviews the utility of existing data to inform our understanding of recent changes to the pet dog population in Ireland, including both biological and organisational processes. Results Based on national data on dog licencing and microchipping registration, pet dog numbers have remained relatively stable in recent years (ie prior to the COVID-19 pandemic). Since 2015, there has been a substantial decrease in the number of dogs managed through dog control centres. Although the completeness of the data are likely variable, there appears to be substantial, and increasing, number of dogs moving from Ireland to other countries, including UK, Sweden, Italy, Germany and Singapore. We also note an increase (albeit much smaller) in the number of dogs being moved into Ireland. Conclusions This study highlights the challenges faced when using existing national data to gain insights into the dog population of Ireland. The linking of existing national databases (individual dog identification, dog licencing, dog control statistics) has the potential to improve both the representativeness and accuracy of information about the Irish pet dog population. In the next phases of our work, we will focus on the work of dog welfare organisations, given both the increased role played by these organisations and the substantial public funding that has been committed in this sector. Supplementary Information The online version contains supplementary material available at 10.1186/s13620-022-00223-8.
Collapse
Affiliation(s)
- Simon J More
- UCD Centre for Veterinary Epidemiology and Risk Analysis, School of Veterinary Medicine, University College Dublin, Belfield, Dublin, D04 W6F6, Ireland. .,School of Veterinary Medicine, University College Dublin, Belfield, Dublin, D04 W6F6, Ireland.
| | - Daniel M Collins
- UCD Centre for Veterinary Epidemiology and Risk Analysis, School of Veterinary Medicine, University College Dublin, Belfield, Dublin, D04 W6F6, Ireland
| | - Natascha V Meunier
- Animal Health Ireland, 4-5 The Archways, Carrick on Shannon, Co. Leitrim, N41 WN27, Ireland
| | - Locksley L McV Messam
- School of Veterinary Medicine, University College Dublin, Belfield, Dublin, D04 W6F6, Ireland
| | - Rob Doyle
- Department of Agriculture, Food and the Marine, Kildare St, Dublin, D02 WK12, Ireland
| | - Aiden Maguire
- Department of Agriculture, Food and the Marine, Kildare St, Dublin, D02 WK12, Ireland
| | - Sean Murray
- Department of Agriculture, Food and the Marine, Kildare St, Dublin, D02 WK12, Ireland
| | - Patricia Reilly
- Department of Agriculture, Food and the Marine, Kildare St, Dublin, D02 WK12, Ireland
| | - Catherine Lawler
- Department of Agriculture, Food and the Marine, Kildare St, Dublin, D02 WK12, Ireland
| |
Collapse
|
20
|
Kovačević Z, Vidović J, Erdeljan M, Cincović M, Ružić Z, Galić I, Kukurić T, Stojanac N, Horvat O. Veterinary Practitioners' Standpoints and Comprehension towards Antimicrobial Use-Are There Opportunities for Antimicrobial Stewardship Improvement? Antibiotics (Basel) 2022; 11:antibiotics11070867. [PMID: 35884121 PMCID: PMC9311883 DOI: 10.3390/antibiotics11070867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/04/2022] [Accepted: 06/16/2022] [Indexed: 12/10/2022] Open
Abstract
The main subject of the research is the assessment of the knowledge, attitudes and behaviors of veterinarians regarding the use of antibiotics (AMU) and antimicrobial resistance (AMR) through a questionnaire conducted among veterinarians in the northern region of Serbia. A total of 62 respondents completed the questionnaire, which represents a response rate of 44.3%. Male veterinarians are less likely to be in the group of veterinarians with insufficient knowledge (p < 0.05). Veterinarians engaged in mixed practice (small and large animals) (p < 0.001) and veterinarians who have over 100 patients per month (p < 0.005) are also less likely to be in the group with insufficient knowledge of antimicrobial resistance. The proportion of those with insufficient knowledge is growing among veterinarians whose source is the Internet (p < 0.01), while the proportion of those with insufficient knowledge about antimicrobial resistance is declining among veterinarians whose source of information is continuous education (p < 0.05). The majority of the respondents (n = 59, 95.2%) completely agreed that AMR is a very big issue in the global health sector right now. Unfortunately, there are crucial gaps in the knowledge and attitudes of the surveyed participants. They do not appear to be aware of the importance of AMU in veterinary medicine and its influence on overall AMR, or the crucial part that non-prescribed antibiotics have in all of it. Positively, many veterinarians use good practice AMU guidelines in their everyday practice and in line with the global trend of AMU reduction, respondents have also decreased their AMU compared to the previous year.
Collapse
Affiliation(s)
- Zorana Kovačević
- Department for Veterinary Medicine, Faculty of Agriculture, University of Novi Sad, 21000 Novi Sad, Serbia; (Z.K.); (J.V.); (M.E.); (M.C.); (I.G.); (T.K.); (N.S.)
| | - Jovana Vidović
- Department for Veterinary Medicine, Faculty of Agriculture, University of Novi Sad, 21000 Novi Sad, Serbia; (Z.K.); (J.V.); (M.E.); (M.C.); (I.G.); (T.K.); (N.S.)
| | - Mihajlo Erdeljan
- Department for Veterinary Medicine, Faculty of Agriculture, University of Novi Sad, 21000 Novi Sad, Serbia; (Z.K.); (J.V.); (M.E.); (M.C.); (I.G.); (T.K.); (N.S.)
| | - Marko Cincović
- Department for Veterinary Medicine, Faculty of Agriculture, University of Novi Sad, 21000 Novi Sad, Serbia; (Z.K.); (J.V.); (M.E.); (M.C.); (I.G.); (T.K.); (N.S.)
| | - Zoran Ružić
- Department for Veterinary Medicine, Faculty of Agriculture, University of Novi Sad, 21000 Novi Sad, Serbia; (Z.K.); (J.V.); (M.E.); (M.C.); (I.G.); (T.K.); (N.S.)
- Correspondence:
| | - Ivan Galić
- Department for Veterinary Medicine, Faculty of Agriculture, University of Novi Sad, 21000 Novi Sad, Serbia; (Z.K.); (J.V.); (M.E.); (M.C.); (I.G.); (T.K.); (N.S.)
| | - Tijana Kukurić
- Department for Veterinary Medicine, Faculty of Agriculture, University of Novi Sad, 21000 Novi Sad, Serbia; (Z.K.); (J.V.); (M.E.); (M.C.); (I.G.); (T.K.); (N.S.)
| | - Nenad Stojanac
- Department for Veterinary Medicine, Faculty of Agriculture, University of Novi Sad, 21000 Novi Sad, Serbia; (Z.K.); (J.V.); (M.E.); (M.C.); (I.G.); (T.K.); (N.S.)
| | - Olga Horvat
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia;
| |
Collapse
|
21
|
Hamame A, Davoust B, Cherak Z, Rolain JM, Diene SM. Mobile Colistin Resistance ( mcr) Genes in Cats and Dogs and Their Zoonotic Transmission Risks. Pathogens 2022; 11:698. [PMID: 35745552 PMCID: PMC9230929 DOI: 10.3390/pathogens11060698] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Pets, especially cats and dogs, represent a great potential for zoonotic transmission, leading to major health problems. The purpose of this systematic review was to present the latest developments concerning colistin resistance through mcr genes in pets. The current study also highlights the health risks of the transmission of colistin resistance between pets and humans. Methods: We conducted a systematic review on mcr-positive bacteria in pets and studies reporting their zoonotic transmission to humans. Bibliographic research queries were performed on the following databases: Google Scholar, PubMed, Scopus, Microsoft Academic, and Web of Science. Articles of interest were selected using the PRISMA guideline principles. Results: The analyzed articles from the investigated databases described the presence of mcr gene variants in pets including mcr-1, mcr-2, mcr-3, mcr-4, mcr-5, mcr-8, mcr-9, and mcr-10. Among these articles, four studies reported potential zoonotic transmission of mcr genes between pets and humans. The epidemiological analysis revealed that dogs and cats can be colonized by mcr genes that are beginning to spread in different countries worldwide. Overall, reported articles on this subject highlight the high risk of zoonotic transmission of colistin resistance genes between pets and their owners. Conclusions: This review demonstrated the spread of mcr genes in pets and their transmission to humans, indicating the need for further measures to control this significant threat to public health. Therefore, we suggest here some strategies against this threat such as avoiding zoonotic transmission.
Collapse
Affiliation(s)
- Afaf Hamame
- Faculté de Pharmacie, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Aix Marseille University, 19-21 Boulevard Jean Moulin, CEDEX 05, 13385 Marseille, France;
- IHU-Méditerranée Infection, 19-21 Boulevard Jean Moulin, CEDEX 05, 13385 Marseille, France;
| | - Bernard Davoust
- IHU-Méditerranée Infection, 19-21 Boulevard Jean Moulin, CEDEX 05, 13385 Marseille, France;
| | - Zineb Cherak
- Faculté des Sciences de la Nature et de la Vie, Université Batna-2, Route de Constantine, Fésdis, Batna 05078, Algeria;
| | - Jean-Marc Rolain
- Faculté de Pharmacie, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Aix Marseille University, 19-21 Boulevard Jean Moulin, CEDEX 05, 13385 Marseille, France;
- IHU-Méditerranée Infection, 19-21 Boulevard Jean Moulin, CEDEX 05, 13385 Marseille, France;
| | - Seydina M. Diene
- Faculté de Pharmacie, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Aix Marseille University, 19-21 Boulevard Jean Moulin, CEDEX 05, 13385 Marseille, France;
- IHU-Méditerranée Infection, 19-21 Boulevard Jean Moulin, CEDEX 05, 13385 Marseille, France;
| |
Collapse
|
22
|
Prior CD, Moodley A, Karama M, Malahlela MN, Leisewitz A. Prevalence of methicillin resistance in
Staphylococcus pseudintermedius
isolates from dogs with skin and ear infections in South Africa. J S Afr Vet Assoc 2022. [DOI: 10.36303/jsava.2022.93.1.505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Affiliation(s)
- CD Prior
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria,
South Africa
| | - A Moodley
- International Livestock Research Institute,
Kenya
| | - M Karama
- Veterinary Public Health Section, Faculty of Veterinary Science, University of Pretoria,
South Africa
| | - MN Malahlela
- Veterinary Public Health Section, Department of Paraclinical Sciences, Faculty of Veterinary Science, University of Pretoria,
South Africa
| | - A Leisewitz
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria,
South Africa
| |
Collapse
|
23
|
Stein MR, Weese JS, Stull JW, McClure JT, Evason M. Knowledge, attitudes and influencers of cat owners in North America around antimicrobials and antimicrobial stewardship. J Feline Med Surg 2022; 24:e90-e97. [PMID: 35471142 PMCID: PMC9161435 DOI: 10.1177/1098612x221090456] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Objectives The primary aims of this study were to determine preferences of North American cat owners when they are prescribed an antimicrobial for their cat with regard to cost, method of administration and the importance of antibiotics for treating infections in people, and to establish baseline knowledge, attitudes and influencers of cat owners on antimicrobial resistance and stewardship. Methods An online questionnaire was used for data collection from two cat-owner groups: US cat owners and Canadian cat owners. Participants were queried on antimicrobial resistance and stewardship, and their preferences for their own cat when prescribed an antimicrobial, with respect to cost, method of drug administration and the importance of a drug for treating infections in people. Responses were evaluated through conjoint analysis and Likert-type questions. Data were analyzed using descriptive and analytic statistics. Results A total of 630 complete responses were included in the final analysis. Cost (37%) and method of administration (38%) were of similar participant preference when assessed using conjoint analysis. The importance of a drug for treating infections in people was lower priority (21%). The majority of cat owners preferred an antimicrobial that was ‘very important’ in treating human infections. A low proportion (21%) of participants responded that antimicrobial use in pets posed a risk to humans. Participants with a university education were more likely to respond that antimicrobial use in pets was a concern for people (31%; P <0.001). Conclusions and relevance Cat owners prioritize antimicrobial cost and method of administration equally. Few cat owners recognized the human antimicrobial resistance risks associated with antimicrobial use in pets.
Collapse
Affiliation(s)
- Madeleine R Stein
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Prince Edward Island, Canada.,Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, MA, USA
| | - J Scott Weese
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Prince Edward Island, Canada.,Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Jason W Stull
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Prince Edward Island, Canada
| | - J Trenton McClure
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Prince Edward Island, Canada
| | - Michelle Evason
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Prince Edward Island, Canada.,Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.,IDEXX Laboratories, Portland, ME, USA
| |
Collapse
|
24
|
Moerer M, Merle R, Bäumer W. A Cross-Sectional Study of Veterinarians in Germany on the Impact of the TÄHAV Amendment 2018 on Antimicrobial Use and Development of Antimicrobial Resistance in Dogs and Cats. Antibiotics (Basel) 2022; 11:484. [PMID: 35453235 PMCID: PMC9028039 DOI: 10.3390/antibiotics11040484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 12/10/2022] Open
Abstract
To minimize the use of third- and fourth-generation cephalosporins and fluoroquinolones, the 2018 amendment to the regulations of veterinary pharmacies (TÄHAV) introduced legal restrictions in Germany. In an online survey among German veterinarians, we investigated the influence of these requirements on the use of antibiotics in the treatment of dogs and cats and the development of resistance rates. It was found that, on average, between 21% and 30% of daily treated dogs and cats received antimicrobial therapy. The TÄHAV amendment led to a less frequent use of highest priority critically important antimicrobials (HPCIA) in 79% (240/303) of respondents and less antimicrobial use in general in 36% (108/303). As a result of these legal changes, 63% (190/303) of participants requested antimicrobial susceptibility testing (AST) more frequently. Participants consulted ASTs particularly frequently for treatment of otitis externa with 63% (190/303), cystitis with 55% (168/303), wounds with 44% (132/303), and pyoderma with 29% (88/303). Veterinarians also noted an increased loss of antimicrobial efficacy, especially when treating these diseases. The results of our survey confirm that the TÄHAV amendment is having a positive impact on prudent antibiotic use, with participants performing more ASTs, using HPCIA less frequently, and choosing alternative antimicrobials for therapy.
Collapse
Affiliation(s)
- Marianne Moerer
- Institute of Pharmacology and Toxicology, Department of Veterinary Medicine, Freie Universität Berlin, Koserstraße 20, 14195 Berlin, Germany;
| | - Roswitha Merle
- Institute for Veterinary Epidemiology and Biostatistics, Department of Veterinary Medicine, Freie Universität Berlin, Königsweg 67, 14163 Berlin, Germany;
| | - Wolfgang Bäumer
- Institute of Pharmacology and Toxicology, Department of Veterinary Medicine, Freie Universität Berlin, Koserstraße 20, 14195 Berlin, Germany;
| |
Collapse
|
25
|
Hur B, Hardefeldt LY, Verspoor KM, Baldwin T, Gilkerson JR. Evaluating the dose, indication and agreement with guidelines of antimicrobial use in companion animal practice with natural language processing. JAC Antimicrob Resist 2022; 4:dlab194. [PMID: 35156027 PMCID: PMC8827557 DOI: 10.1093/jacamr/dlab194] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/24/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND As antimicrobial prescribers, veterinarians contribute to the emergence of MDR pathogens. Antimicrobial stewardship programmes are an effective means of reducing the rate of development of antimicrobial resistance. A key component of antimicrobial stewardship programmes is selecting an appropriate antimicrobial agent for the presenting complaint and using an appropriate dose rate for an appropriate duration. OBJECTIVES To describe antimicrobial usage, including dose, for common indications for antimicrobial use in companion animal practice. METHODS Natural language processing (NLP) techniques were applied to extract and analyse clinical records. RESULTS A total of 343 668 records for dogs and 109 719 records for cats administered systemic antimicrobials from 1 January 2013 to 31 December 2017 were extracted from the database. The NLP algorithms extracted dose, duration of therapy and diagnosis completely for 133 046 (39%) of the records for dogs and 40 841 records for cats (37%). The remaining records were missing one or more of these elements in the clinical data. The most common reason for antimicrobial administration was skin disorders (n = 66 198, 25%) and traumatic injuries (n = 15 932, 19%) in dogs and cats, respectively. Dose was consistent with guideline recommendations in 73% of cases where complete clinical data were available. CONCLUSIONS Automated extraction using NLP methods is a powerful tool to evaluate large datasets and to enable veterinarians to describe the reasons that antimicrobials are administered. However, this can only be determined when the data presented in the clinical record are complete, which was not the case in most instances in this dataset. Most importantly, the dose administered varied and was often not consistent with guideline recommendations.
Collapse
Affiliation(s)
- Brian Hur
- Asia-Pacific Centre for Animal Health, Melbourne Veterinary School, University of Melbourne, Parkville, Victoria, Australia
- School of Computing and Information Systems, University of Melbourne, Parkville, Victoria, Australia
| | - Laura Y. Hardefeldt
- Asia-Pacific Centre for Animal Health, Melbourne Veterinary School, University of Melbourne, Parkville, Victoria, Australia
| | - Karin M. Verspoor
- School of Computing and Information Systems, University of Melbourne, Parkville, Victoria, Australia
- School of Computing Technologies, RMIT University, Melbourne, Victoria, Australia
| | - Timothy Baldwin
- School of Computing and Information Systems, University of Melbourne, Parkville, Victoria, Australia
| | - James R. Gilkerson
- Asia-Pacific Centre for Animal Health, Melbourne Veterinary School, University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|
26
|
Walker B, Sánchez-Vizcaíno F, Barker EN. Effect of an antimicrobial stewardship intervention on the prescribing behaviours of companion animal veterinarians: A pre-post study. Vet Rec 2022; 190:e1485. [PMID: 35202485 DOI: 10.1002/vetr.1485] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 01/06/2022] [Accepted: 02/02/2022] [Indexed: 12/22/2022]
Abstract
BACKGROUND Antimicrobial stewardship is a cornerstone of efforts to combat antimicrobial resistance. We evaluated the impact of a formal discussion of antimicrobial stewardship for dogs and cats on systemic antimicrobial prescribing behaviours among companion animal veterinarians. METHODS Electronic health records including information about the prescription of antimicrobials were collected from a multisite UK veterinary practice between 2017 and 2020. We undertook interrupted time series analysis using a quasi-Poisson model to compare the pre- and postintervention change in level and slope for multiple outcomes. RESULTS After the intervention, there were sustained reductions in the prescription rate of cefovecin to cats and metronidazole to dogs and increases in amoxicillin-clavulanic acid prescribing. There was no evidence for an immediate change in overall prescribing rates in either species, although rates increased over the 12 months after the intervention. There was a transient increase in the proportion of dogs who had their weight recorded at the time of prescription. Results suggest decreases in the prescription of off-licence antimicrobials in both species and the likelihood of underdosing in dogs. CONCLUSIONS Discussion of antimicrobial stewardship is more likely to influence the antimicrobial choice than whether to prescribe or not. Interventions may benefit by focusing on appropriate antimicrobial selection rather than overall prescription frequency.
Collapse
Affiliation(s)
- Ben Walker
- Population Health Sciences, University of Bristol, Canynge Hall, Bristol, UK
| | | | - Emi N Barker
- Bristol Veterinary School, University of Bristol, Langford, Bristol, UK.,Langford Vets, University of Bristol, Langford, Bristol, UK
| |
Collapse
|
27
|
Taylor DD, Martin JN, Scallan Walter EJ. Survey of companion animal veterinarians' antimicrobial drug prescription practices and awareness of antimicrobial drug use guidelines in the United States. Zoonoses Public Health 2022; 69:277-285. [DOI: 10.1111/zph.12915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 10/13/2021] [Accepted: 11/17/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Daniel D. Taylor
- Colorado School of Public Health Colorado Integrated Food Safety Center of Excellence Aurora Colorado USA
| | - Jennifer N. Martin
- College of Agricultural Sciences Department of Animal Sciences Colorado State University Fort Collins Colorado USA
| | - Elaine J. Scallan Walter
- Colorado School of Public Health Colorado Integrated Food Safety Center of Excellence Aurora Colorado USA
| |
Collapse
|
28
|
Kalnins NJ, Croton C, Haworth M, Gibson J, Purcell SL, Stewart AJ. A VetCompass Australia Study of Antimicrobial Use in Dog-to-Dog Bite Wounds (1998-2018). Antibiotics (Basel) 2022; 11:55. [PMID: 35052931 PMCID: PMC8773322 DOI: 10.3390/antibiotics11010055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/20/2021] [Accepted: 12/23/2021] [Indexed: 12/10/2022] Open
Abstract
Although dog-to-dog bite wounds (DBW) are a common presentation to veterinary clinics, antimicrobial prescribing habits of Australian clinics have not been reported. This study determined the frequency and results of DBW cultures; antimicrobial selection; and importance class of antimicrobials prescribed relative to wound severity, geographic location, or year. A systematic sample of 72,507 patient records was retrieved from the VetCompass Australia database. Records for 1713 dog bite events involving 1655 dogs were reviewed for presenting signs, results of culture and susceptibility testing (C&S), antimicrobial treatment, geographical location, and outcome. A crossed random effects multivariable logistic regression model was used to determine if antimicrobial importance was associated with wound severity, year, and location, and to assess the differences in antimicrobial prescription between geographical locations, clinics, and veterinarians. Antimicrobials were prescribed in 86.1% of DBW. Amoxicillin-clavulanic acid was prescribed in 70% (1202/1713) with underdosing in 15.8% (191/1202). High-importance antimicrobial use was associated with wound severity (p < 0.001), year category (p = 0.007), and surgery (p = 0.03). C&S testing was recorded as having been performed in only one case. Differences in individual veterinarian prescribing habits were stronger than the clinic culture, suggesting that education utilizing clinic-wide antimicrobial guidelines may aid in improving antimicrobial stewardship.
Collapse
Affiliation(s)
- Nicole Jacqueline Kalnins
- School of Veterinary Science, The University of Queensland, Gatton, QLD 4343, Australia; (N.J.K.); (M.H.); (J.G.); (S.L.P.)
| | - Catriona Croton
- Faculty of Health, Engineering and Sciences, School of Sciences, University of Southern Queensland, Toowoomba, QLD 4350, Australia;
| | - Mark Haworth
- School of Veterinary Science, The University of Queensland, Gatton, QLD 4343, Australia; (N.J.K.); (M.H.); (J.G.); (S.L.P.)
| | - Justine Gibson
- School of Veterinary Science, The University of Queensland, Gatton, QLD 4343, Australia; (N.J.K.); (M.H.); (J.G.); (S.L.P.)
| | - Sarah Leonie Purcell
- School of Veterinary Science, The University of Queensland, Gatton, QLD 4343, Australia; (N.J.K.); (M.H.); (J.G.); (S.L.P.)
| | - Allison Jean Stewart
- School of Veterinary Science, The University of Queensland, Gatton, QLD 4343, Australia; (N.J.K.); (M.H.); (J.G.); (S.L.P.)
| |
Collapse
|
29
|
Analysis of canine cardiovascular therapeutic agent prescriptions using electronic health records in primary care veterinary practices in the United Kingdom. J Vet Cardiol 2021; 39:35-45. [PMID: 34968989 DOI: 10.1016/j.jvc.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 11/10/2021] [Accepted: 11/15/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION/OBJECTIVES Canine cardiovascular (CV) diseases are often managed in primary care settings. The objectives were to describe CV therapeutic agent (CVTA) prescribing patterns in primary care practices in the United Kingdom (UK) and to evaluate recorded clinical signs, diagnostic tests and justifications for use of torasemide, a recently marketed and authorised loop-diuretic in the UK. ANIMALS, MATERIALS AND METHODS Electronic health records (EHRs) describing 3,579,420 consultations (1,043,042 unique dogs) were collated (1 April 2014 and 31 December 2018) by the Small Animal Veterinary Surveillance Network from 270 veterinary practices. Consultations prescribing at least one CVTA were identified. Annual variation in individual CVTA prescriptions was analysed using mixed-effects binomial regression models. Free-text clinical narratives were manually read to determine the first-prescribing event for torasemide. RESULTS Twenty-nine thousand and seven consultations (0.81% of all consultations, 95% confidence interval [CI], 0.76-0.86) prescribed CVTA in 14,148 (1.36%) dogs. Furosemide (52.8% of CV-prescribing consultations, 95% CI 50.7-54.9) and pimobendan (51.9%, 95% CI 50.1-53.7) were most prescribed. Longitudinal analysis (2014-2018) showed a significant negative temporal trend for angiotensin-converting enzyme inhibitors (p < 0.001), and furosemide (p = 0.003) and a positive temporal trend for pimobendan (p = 0.020) and torasemide (p < 0.001). First prescriptions of torasemide were identified in 16.5% of torasemide-prescribing consultations. Where justification for prescription of torasemide was identified (32.5%), furosemide resistance was the most common (92.0%). CONCLUSIONS EHRs can be used to temporally monitor prescribing habits, including responses to market authorisations. Despite authorisation in the UK for torasemide use as a first-line diuretic, it was most commonly prescribed after furosemide resistance.
Collapse
|
30
|
Bennani H, Cornelsen L, Stärk KDC, Häsler B. Evaluating Integrated Surveillance for Antimicrobial Use and Resistance in England: A Qualitative Study. Front Vet Sci 2021; 8:743857. [PMID: 34805336 PMCID: PMC8596565 DOI: 10.3389/fvets.2021.743857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 10/04/2021] [Indexed: 11/18/2022] Open
Abstract
Integrated surveillance systems for antimicrobial use (AMU) and antimicrobial resistance (AMR) require regular evaluation to ensure the effectiveness and efficiency of the system. An important step in the evaluation is to choose an appropriate tool for the purpose of the evaluation. The “Integrated Surveillance System Evaluation” (ISSE) framework is a conceptual framework that was developed to evaluate One Health (OH) integration in surveillance system for AMU/AMR. This study aimed to evaluate the performance and value of integrated surveillance system for AMU/AMR in England by applying the ISSE framework, which was used to develop data collection protocols and define the study design. A qualitative study using semi-structured interviews was conducted to collect the data and analyse it thematically. Eighteen stakeholders from human, animal, food and environment sectors that are involved in AMU/AMR surveillance were interviewed. Four main themes emerged from the analysis: (1) Cross-sectoral integration in the surveillance system for AMU/AMR; (2) Production of OH outputs and outcomes; (3) Drivers and barriers to cross-sectoral collaboration; and 4) Need for more cross-sectoral collaboration. The findings showed that there were links between integrated surveillance information, decision making and interventions. However, there were only few OH examples, such as the UK AMR contingency plan, where the potential of cross-sectoral collaboration was fully exploited. A lot of the benefits described were related to the generation of information and increase in knowledge and understanding without links to how the information generated was used. While these intangible benefits have a value on their own, being able to link surveillance information and mitigation measures would help to enhance the value of integrated surveillance. In terms of improvement, the main areas identified were the development of more harmonised methods for data collection and analysis, provision of resources dedicated to cross-sectoral collaboration, improved coordination, and collection of surveillance data from the environment and from companion animals. By identifying links between OH surveillance information produced and various outputs and outcomes; this study helped to understand the wider benefits of integrated surveillance for AMU/AMR in England and provided insights on how the system could be improved and efficiency increased.
Collapse
Affiliation(s)
- Houda Bennani
- Veterinary Epidemiology, Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
| | - Laura Cornelsen
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Katharina D C Stärk
- Veterinary Epidemiology, Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom.,Department of Animal Health, Federal Food Safety and Veterinary Office, Bern, Switzerland
| | - Barbara Häsler
- Veterinary Epidemiology, Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
| |
Collapse
|
31
|
Hand Hygiene Evaluation Using Two Different Evaluation Tools and Hand Contamination of Veterinary Healthcare Workers in a Swiss Companion Animal Clinic. Vet Sci 2021; 8:vetsci8110260. [PMID: 34822633 PMCID: PMC8623950 DOI: 10.3390/vetsci8110260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/05/2021] [Accepted: 10/29/2021] [Indexed: 12/17/2022] Open
Abstract
Hand hygiene (HH) is the most important measure to prevent nosocomial infections. HH compliance in companion animal clinics has been reported to be poor. The present study compared an online application with the WHO evaluation form to assess the WHO five moments of HH in a Swiss companion animal clinic. In 202 hand swabs from 87 staff members, total viable count (TVC) before and after patient contact was evaluated and the swabs were tested for selected antimicrobial resistant microorganisms of public health importance. HH compliance (95% confidence interval) was 36.6% (33.8–39.5%) and was similar when assessed with the two evaluation tools. HH differed between hospital areas (p = 0.0035) and HH indications (p < 0.0001). Gloves were worn in 22.0% (18.0–26.6%) of HH observations and were indicated in 37.2% (27.3–48.3%) of these observations. Mean TVC before patient contact was lower (0.52 log CFU/cm2) than after patient contact (1.02 log CFU/cm2) but was similar before patient contact on gloved and ungloved hands. Three hand swabs (1.5% (0.4–4.3%)) were positive for methicillin-resistant Staphylococcus aureus. Gloving should not be regarded as a substitute for HH. Overall, HH in companion animal medicine should urgently be fostered.
Collapse
|
32
|
Scarborough R, Hardefeldt L, Browning G, Bailey K. Pet Owners and Antibiotics: Knowledge, Opinions, Expectations, and Communication Preferences. Antibiotics (Basel) 2021; 10:antibiotics10111326. [PMID: 34827264 PMCID: PMC8615269 DOI: 10.3390/antibiotics10111326] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 12/23/2022] Open
Abstract
Despite the important role of antimicrobial use in companion animals in the global challenge presented by antimicrobial resistance (AMR), very few studies have quantified pet owner factors that can contribute to suboptimal veterinary antimicrobial use. We conducted an online survey of pet owners, asking about their experiences with veterinarians, their opinions on antibiotic use and knowledge of antibiotics, and their communication preferences regarding judicious prescribing. Just over half (54%) of the 558 pet owners had received antibiotics for their pet at their last non-routine veterinary consultation and most owners were happy (83%) with the antibiotic prescribing decision of their veterinarian. A quarter (25%) indicated that they had been surprised, disappointed or frustrated when a veterinarian had not given their pet antibiotics; 15% had explicitly requested them. Owners placed a higher priority on their pet receiving the most effective treatment than on treatment being cheap or convenient. Most respondents recognized the limitations of antibiotic therapy and the risks associated with antibiotic use, but 50% believed the risks were confined to the treated animal; only a minority was aware of inter-species transfer of bacteria. Pet owners indicated that they would find judicious prescribing messages focused on the direct risks of antibiotics to their pet more compelling than those about public health. Our findings suggest that veterinary communications about responsible antibiotic use should focus on pet owners’ priorities and address or bypass their gaps in understanding regarding antibiotic resistance.
Collapse
Affiliation(s)
- Ri Scarborough
- Asia-Pacific Centre for Animal Health, Department of Veterinary Biosciences, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, VIC 3010, Australia; (L.H.); (G.B.); (K.B.)
- National Centre for Antimicrobial Stewardship, Peter Doherty Institute, Parkville, VIC 3052, Australia
- Correspondence:
| | - Laura Hardefeldt
- Asia-Pacific Centre for Animal Health, Department of Veterinary Biosciences, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, VIC 3010, Australia; (L.H.); (G.B.); (K.B.)
- National Centre for Antimicrobial Stewardship, Peter Doherty Institute, Parkville, VIC 3052, Australia
| | - Glenn Browning
- Asia-Pacific Centre for Animal Health, Department of Veterinary Biosciences, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, VIC 3010, Australia; (L.H.); (G.B.); (K.B.)
- National Centre for Antimicrobial Stewardship, Peter Doherty Institute, Parkville, VIC 3052, Australia
| | - Kirsten Bailey
- Asia-Pacific Centre for Animal Health, Department of Veterinary Biosciences, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, VIC 3010, Australia; (L.H.); (G.B.); (K.B.)
- National Centre for Antimicrobial Stewardship, Peter Doherty Institute, Parkville, VIC 3052, Australia
| |
Collapse
|
33
|
Weese JS, Stull JW, Evason M, Webb J, Ballance D, McKee T, Bergman PJ. A multicenter study of antimicrobial prescriptions for cats diagnosed with bacterial urinary tract disease. J Feline Med Surg 2021; 24:806-814. [PMID: 34709080 PMCID: PMC9315180 DOI: 10.1177/1098612x211054815] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Objectives The aim of this study was to evaluate initial antimicrobial therapy in cats
diagnosed with upper or lower bacterial urinary tract infections at
veterinary practices in the USA and Canada. Methods Electronic medical records from a veterinary practice corporation with
clinics in the USA and Canada were queried between 2 January 2016 and 3
December 2018. Feline patient visits with a diagnosis field entry of urinary
tract infection, cystitis and pyelonephritis, as well as variation of those
names and more colloquial diagnoses such as kidney and bladder infection,
and where an antimicrobial was prescribed, were retrieved. Results Prescription data for 5724 visits were identified. Sporadic cystitis was the
most common diagnosis (n = 5051 [88%]), with 491 (8.6%) cats diagnosed with
pyelonephritis and 182 (3.2%) with chronic or recurrent cystitis. Cefovecin
was the most commonly prescribed antimicrobial for all conditions, followed
by amoxicillin–clavulanic acid. Significant differences in antimicrobial
drug class prescribing were noted between practice types and countries, and
over the 3-year study period. For sporadic cystitis, prescription of
amoxicillin–clavulanic acid increased significantly and cefovecin decreased
between 2016 and 2018, and 2017 and 2018, while fluoroquinolone use
increased between 2017 and 2018. Conclusions and relevance The results indicate targets for intervention and some encouraging trends.
Understanding how antimicrobials are used is a key component of
antimicrobial stewardship and is required to establish benchmarks, identify
areas for improvement, aid in the development of interventions and evaluate
the impact of interventions or other changes.
Collapse
Affiliation(s)
- J Scott Weese
- Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Jason W Stull
- Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Michelle Evason
- Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Jinelle Webb
- Mississauga-Oakville Veterinary Emergency and Specialty Hospital, Oakville, ON, Canada
| | | | | | | |
Collapse
|
34
|
Tompson AC, Mateus ALP, Brodbelt DC, Chandler CIR. Understanding Antibiotic Use in Companion Animals: A Literature Review Identifying Avenues for Future Efforts. Front Vet Sci 2021; 8:719547. [PMID: 34692805 PMCID: PMC8531418 DOI: 10.3389/fvets.2021.719547] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 09/02/2021] [Indexed: 12/25/2022] Open
Abstract
Addressing antibiotic use is essential to tackle antimicrobial resistance, a major human and animal health challenge. This review seeks to inform stewardship efforts in companion animals by collating research insights regarding antibiotic use in this group and identifying overlooked avenues for future research and stewardship efforts. The development of population-based methods has established that antibiotics are frequently used in companion animal care. Research insights are also contributing toward an in-depth comprehension of the contexts to antibiotic use. Qualitative approaches, for example, have enabled a nuanced understanding in four key areas: interactions with owners, clinical and financial risk management, time pressures, and clinic dynamics. This review identifies that much of the existing research frames antibiotic use as the result of choices made by the individuals at the interface of their use. Future research and policy endeavours could look beyond the moment of prescribing to consider the societal structures and networks in which companion animal antibiotic use is entangled. A diversification in research approaches and frameworks through which antibiotic use is understood will facilitate the identification of additional targets for stewardship initiatives beyond providing information and awareness campaigns.
Collapse
Affiliation(s)
- Alice C Tompson
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Ana L P Mateus
- VEEPH Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
| | - Dave C Brodbelt
- VEEPH Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
| | | |
Collapse
|
35
|
Makita K, Sugahara N, Nakamura K, Matsuoka T, Sakai M, Tamura Y. Current Status of Antimicrobial Drug Use in Japanese Companion Animal Clinics and the Factors Associated With Their Use. Front Vet Sci 2021; 8:705648. [PMID: 34631848 PMCID: PMC8500396 DOI: 10.3389/fvets.2021.705648] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 09/01/2021] [Indexed: 11/28/2022] Open
Abstract
The Japanese National Action Plan on Antimicrobial Resistance (AMR) was adopted to strengthen AMR surveillance and monitoring in companion animals. The Japanese Veterinary Antimicrobial Resistance Monitoring (JVARM) system monitors the sale of veterinary antimicrobial drugs by pharmaceutical companies, and the sale of human drugs by principal wholesale companies to companion animal (dogs and cats) clinics. However, the data do not include sales by local drug suppliers and personal importation to companion animal clinics in Japan. The purposes of this study were to estimate total antimicrobial drug use by companion animal clinics in Japan and to identify the factors associated with their use. In 2018, questionnaires gathering data on attributes of the clinic and volumes of antimicrobial drugs used were sent to 212 clinics across Japan by the Japan Veterinary Medical Association. Out of the clinics, 170 valid questionnaires were returned (80.2% response rate). Antimicrobial drugs were categorized first as human, veterinary, or imported drugs and then further categorized as important drugs (critically important drugs for humans and second-choice veterinary drugs) or others. Total antimicrobial drug use was estimated based on the number of clinics reported in 2016. The relationships between antimicrobial drug use and various questionnaire items were analyzed using non-parametric regression analysis. Total antimicrobial drug use was estimated at 29.9t, which was 2.1 times higher than reported by the JVARM survey on the sales of antimicrobial drugs. In terms of total use, important drugs and human drugs accounted for 12.6 and 61.8%, respectively. Clinic income per veterinarian was associated with total antimicrobial use per veterinarian. The proportion of important drugs among all antimicrobial drugs used in a clinic was high in recently established clinics with middle-aged and older directors.
Collapse
Affiliation(s)
- Kohei Makita
- Veterinary Epidemiology Unit, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Japan
| | - Nami Sugahara
- Veterinary Epidemiology Unit, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Japan
| | | | | | - Masato Sakai
- Japan Veterinary Medical Association, Tokyo, Japan
| | - Yutaka Tamura
- Center for Veterinary Drug Development, Rakuno Gakuen University, Ebetsu, Japan
| |
Collapse
|
36
|
Lhermie G, La Ragione RM, Weese JS, Olsen JE, Christensen JP, Guardabassi L. Indications for the use of highest priority critically important antimicrobials in the veterinary sector. J Antimicrob Chemother 2021; 75:1671-1680. [PMID: 32240295 DOI: 10.1093/jac/dkaa104] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Among the measures taken to preserve the clinical efficacy of highest priority critically important antimicrobials (HP-CIAs), the WHO has recommended avoiding their use in food-producing animals. Little is known regarding the indications for which different antimicrobial classes are used in animals, even in countries where data on antimicrobial use are available. OBJECTIVES To outline, in a narrative review, the diseases for which HP-CIAs are used in veterinary medicine, highlighting incongruences with international guidelines and disease conditions where effective alternatives to HP-CIAs are missing. METHODS Scientific literature, national reports and expert opinion were used to describe the indications for the use of HP-CIAs in the main food-producing (pigs, cattle and poultry) and companion (horses, dogs and cats) animal species. RESULTS The most common indications for use of HP-CIAs are enteric and respiratory infections in pigs, cattle and poultry, urogenital infections in dogs and cats and respiratory infections in horses. In some instances, no valid and convenient alternatives to colistin and macrolides are available against certain porcine enteric and bovine respiratory pathogens. Effective, legal and convenient alternatives to HP-CIAs are also lacking for managing common infections in cats, for which oral administration is difficult, Rhodococcus equi infections in horses, some enteric and respiratory infections in poultry and MDR infections in all companion animal species. CONCLUSIONS Future research and stewardship programmes should focus on the disease conditions identified by this review to reduce the use of HP-CIAs in the veterinary sector.
Collapse
Affiliation(s)
- Guillaume Lhermie
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA.,IHAP, Université de Toulouse, INRA, ENVT, Toulouse, France
| | - Roberto Marcello La Ragione
- Department of Pathology and Infectious Diseases, School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7AL, UK
| | - J Scott Weese
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - John Elmerdahl Olsen
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 1870 Frederiksberg C, Denmark
| | - Jens Peter Christensen
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 1870 Frederiksberg C, Denmark
| | - Luca Guardabassi
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 1870 Frederiksberg C, Denmark.,Department of Pathobiology & Population Sciences, Royal Veterinary College, Hawkhead Lane, North Mymms, Hatfield, Herts AL9 7TA, UK
| |
Collapse
|
37
|
Schnepf A, Kramer S, Wagels R, Volk HA, Kreienbrock L. Evaluation of Antimicrobial Usage in Dogs and Cats at a Veterinary Teaching Hospital in Germany in 2017 and 2018. Front Vet Sci 2021; 8:689018. [PMID: 34250070 PMCID: PMC8260837 DOI: 10.3389/fvets.2021.689018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/12/2021] [Indexed: 11/13/2022] Open
Abstract
In contrast to food-producing animals, where the documentation of the usage of antimicrobials is regulated by law, antimicrobial usage (AMU) in dogs and cats is only sparsely monitored. We collected data generated by an electronic practice management software (EPMS) between January 1, 2017 and December 31, 2018 to investigate AMU. All information was obtained from clinical routine data from the Department of Small Animal Medicine and Surgery (DSAM), University of Veterinary Medicine Hannover (TiHo). In 2017, 78,076 drug administrations were documented for 5,471 dogs and cats, of which 14,020 (17.96%) were antimicrobial drugs (AMs) specifically documented in 2,910 (51.31%) dogs and cats. In 2018, 104,481 drug administrations were documented for 5,939 dogs and cats. Of these drug administrations, 18,170 (17.39%) AM administrations were documented for 3,176 (53.48%) dogs and cats. Despite the increasing documentation of AM administrations, differences between 2017 and 2018 were not statistically significant [odds ratio (OR), 1.01; 95% confidence interval (CI), 0.98–1.03]. Prescription diversity (PD) in 2017 for dogs was 0.92 and for cats 0.89. In 2018, PD for dogs was 0.93 and for cats 0.88. As well as the documented number of AM administrations, the documented amount of active ingredients administered in 2018 (total: 17.06 kg; dogs: 16.11 kg, cats: 0.96 kg) increased compared with 2017 (total: 15.60 kg; dogs: 14.80 kg, cats: 0.80 kg). In 2017 and 2018, the most commonly administered antimicrobial groups were penicillins, nitroimidazoles, and quinolones for dogs and cats, respectively. While the in-house point-of-care administration accounts for the largest share of the documented amount of AMs administered, the highest number of documented AM administrations was assigned to inpatient care in 2017 and 2018, respectively. However, AM administration in outpatient care remained the lowest in both years. Since no statistically significant difference in AM administrations was observed between 2017 and 2018 and the most commonly used AMs at the DSAM were ranked, data can be used as a baseline to evaluate how changes in in-house guidelines and future legal requirements affect the prescribing culture. Data generated within the DSAM should be evaluated annually.
Collapse
Affiliation(s)
- Anne Schnepf
- Department of Biometry, Epidemiology and Information Processing, WHO Collaborating Centre for Research and Training for Health in the Human-Animal-Environment Interface, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Sabine Kramer
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Rolf Wagels
- Information and Data Service (TiHo-IDS), University of Veterinary Medicine Hannover, Hannover, Germany
| | - Holger A Volk
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Lothar Kreienbrock
- Department of Biometry, Epidemiology and Information Processing, WHO Collaborating Centre for Research and Training for Health in the Human-Animal-Environment Interface, University of Veterinary Medicine Hannover, Hannover, Germany
| |
Collapse
|
38
|
Rule EK, Boyle AG, Redding LE. Antimicrobial prescribing patterns in equine ambulatory practice. Prev Vet Med 2021; 193:105411. [PMID: 34147960 DOI: 10.1016/j.prevetmed.2021.105411] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 05/23/2021] [Accepted: 06/07/2021] [Indexed: 12/29/2022]
Abstract
Antimicrobial resistance is one of the most important public health risks facing our world today. Antimicrobials are commonly prescribed in equine veterinary medicine, but limited information exists documenting their use in practice. The goal of this study was to investigate antimicrobial prescription patterns in regards to prescription frequency, duration, drug class, clinician and affected body system in an equine ambulatory setting via retrospective analysis of billing and electronic medical records. Risk factors associated with antimicrobial prescription including the nature of the visit, submission of a culture, body system affected and clinician were assessed using multivariable regression. We found that antimicrobials were prescribed in 8.5 % of visits with a median number of 3.5 (IQR 0.8-12.2) animal-defined daily doses (ADD), defined as the number of daily doses of all antimicrobials prescribed to a patient at a single visit. Aminoglycosides were the most common class of antimicrobials prescribed and trimethoprim sulfamethoxazole was the most common drug prescribed overall. Amikacin was primarily used for patients presenting with musculoskeletal signs, and the median number of ADDs for visits where amikacin was prescribed was 1 (IQR 0.9-1.9), while the median number of antimicrobial ADDs for all other visits was 4.4 (IQR 0-14.1). Statistically significant differences in antimicrobial use patterns existed across clinicians, months, years and affected body systems. Horses presenting with ocular (OR 1199; 95 % CI 204-7,037; p < 0.001) and integumentary (OR 365; 95 % CI 87.2-1532; p < 0.001) signs were most likely to be prescribed an antimicrobial. Emergency visits (OR 5.61; 95 % CI 3.19-9.89; p < 0.001) and submission of a bacterial culture (OR 3.58; 95 % CI 2.11-6.09; p < 0.001) were associated with an increased likelihood of an antimicrobial prescription. This observational study was the first to quantitatively characterize antimicrobial use patterns in equine ambulatory practice in the United States, which is an important step needed to determine appropriateness of use and develop and evaluate antimicrobial stewardship guidelines.
Collapse
Affiliation(s)
- Emily K Rule
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, School of Veterinary Medicine, 382 West Street Road, Kennett Square, PA, 19348, USA.
| | - Ashley G Boyle
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, School of Veterinary Medicine, 382 West Street Road, Kennett Square, PA, 19348, USA
| | - Laurel E Redding
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, School of Veterinary Medicine, 382 West Street Road, Kennett Square, PA, 19348, USA
| |
Collapse
|
39
|
Hopman NEM, Wagenaar JA, van Geijlswijk IM, Broens EM. Development and Pilot of an Interactive Online Course on Antimicrobial Stewardship in Companion Animals. Antibiotics (Basel) 2021; 10:antibiotics10050610. [PMID: 34065607 PMCID: PMC8161360 DOI: 10.3390/antibiotics10050610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/06/2021] [Accepted: 05/17/2021] [Indexed: 11/28/2022] Open
Abstract
A holistic approach to antimicrobial use (AMU) and prescribing is needed to combat the problem of antimicrobial resistance (AMR). Previously, an antimicrobial stewardship programme (ASP) was developed, introduced, and evaluated in 44 Dutch companion animal clinics, which resulted in an optimization of AMU. As a follow-up to this, an online course was developed to promote awareness of AMU, AMR, and responsible antimicrobial prescribing. The aim of this paper is to describe the development and pilot, including evaluation, of this course, which will be disseminated more widely among Dutch companion animal veterinarians. The interactive programme consists of a major e-learning component and two online, face-to-face meetings. The course comprises five different parts corresponding with five consecutive weeks. Theory on several topics is offered, for example on AMU and AMR in general, Dutch regulations and guidelines on veterinary AMU, behavioural change, and possible methods to quantify AMU. Additionally, several assignments are offered, for example to reflect upon one’s own current antimicrobial prescribing behaviour. Interactive discussion and peer-to-peer learning are promoted. Since September 2020, the course has been offered in a pilot phase, and the feedback is promising. Evaluation of the pilot phase will result in recommendations for further optimization and dissemination.
Collapse
Affiliation(s)
- Nonke E. M. Hopman
- Department Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Yalelaan 1, 3584 CL Utrecht, The Netherlands; (J.A.W.); (E.M.B.)
- Correspondence:
| | - Jaap A. Wagenaar
- Department Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Yalelaan 1, 3584 CL Utrecht, The Netherlands; (J.A.W.); (E.M.B.)
- Wageningen Bioveterinary Research, Houtribweg 39, 8221 RA Lelystad, The Netherlands
| | - Ingeborg M. van Geijlswijk
- IRAS Veterinary Pharmacology and Therapeutics Group, Department Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 106, 3584 CM Utrecht, The Netherlands;
| | - Els M. Broens
- Department Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Yalelaan 1, 3584 CL Utrecht, The Netherlands; (J.A.W.); (E.M.B.)
| |
Collapse
|
40
|
Mouiche MMM, Mpouam SE, Moffo F, Nkassa CMN, Mbah CK, Mapiefou NP, Awah-Ndukum J. Prescription Pattern of Antimicrobial Use in Small Animal Veterinary Practice in Cameroon. Top Companion Anim Med 2021; 44:100540. [PMID: 33984558 DOI: 10.1016/j.tcam.2021.100540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 03/28/2021] [Accepted: 04/22/2021] [Indexed: 11/25/2022]
Abstract
Retrospective data on antimicrobial use (AMU) within the period ranging from January 2012-December 2015 was collected to assess the antimicrobial prescription patterns in pets (cats and dogs) treated by 16 veterinary private practitioners in the 2 main urban cities of Cameroon (Douala and Yaounde). The vet practitioners were interviewed in order to analyze prescribing behavior and factors influencing antimicrobial prescription. Out of a total of 3928 antimicrobial prescriptions, 3673(93.5%) were recorded in dogs and 255 (6.5%) in cats during the study period in 7 veterinary clinics. The most prescribed antimicrobials were sulfamethoxypyridazine-trimethoprim (dog: 31.2%; cat: 28.6%), benzylpenicillin-streptomycin (dogs:19.0%; cat:21.9%) and marbofloxacin (dogs:18.3%; cats:16.1%). Almost, 64.6% of antimicrobial prescription in dogs was categorized as highly important antimicrobials and 34.9% as critically important antimicrobial agents. In cats, 77.9% of antimicrobial prescription was categorized as highly important antimicrobials and 22.1% as critically important antimicrobial agents. Antimicrobials were mostly used for gastro-intestinal disorders (31.9%) and skin diseases (24. 1%) in dogs while they were mostly applied for surgical problems (29.8%), musculo-skeletal disease (20.4%) and gastro-intestinal tract diseases (19.6%) in cats. Fluoroquinolones were administered as first option instead of third option. Antimicrobials were associated with other veterinary drugs (anti-inflammatory, internal and external parasite therapy) in 75.3% of cases. The prescription of antimicrobials was based on clinical diagnosis (symptom-based), ease of drug administration, owner's purchasing power and antibiogram. This study highlights the necessity to promote antimicrobial stewardship in pet medicine in Cameroon. Confirmatory diagnosis and antibiotic susceptibility testing before antibiotic prescription should be encouraged. The uncontrolled use of critically important antimicrobials for human medicine and especially their indiscriminate use may favor the occurrence of AMR public health issues.
Collapse
Affiliation(s)
- Mohamed Moctar Mouliom Mouiche
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon.
| | - Serge Eugene Mpouam
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Frédéric Moffo
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Claire Murielle Nno Nkassa
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Cleophas Kahtita Mbah
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Nabilah Pemi Mapiefou
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | | |
Collapse
|
41
|
Goggs R, Menard JM, Altier C, Cummings KJ, Jacob ME, Lalonde-Paul DF, Papich MG, Norman KN, Fajt VR, Scott HM, Lawhon SD. Patterns of antimicrobial drug use in veterinary primary care and specialty practice: A 6-year multi-institution study. J Vet Intern Med 2021; 35:1496-1508. [PMID: 33942943 PMCID: PMC8163138 DOI: 10.1111/jvim.16136] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 04/14/2021] [Accepted: 04/16/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Combatting antimicrobial resistance requires a One Health approach to antimicrobial stewardship including antimicrobial drug (AMD) use evaluation. Current veterinary AMD prescribing data are limited. OBJECTIVES To quantify companion animal AMD prescribing in primary care and specialty practice across 3 academic veterinary hospitals with particular focus on third-generation cephalosporins, fluoroquinolones, and carbapenems. ANIMALS Dogs and cats presented to 3 academic veterinary hospitals from 2012 to 2017. METHODS In this retrospective study, AMD prescribing data from 2012 to 2017 were extracted from electronic medical records at each hospital and prescriptions classified by service type: primary care, specialty practice or Emergency/Critical Care (ECC). Hospital-level AMD prescribing data were summarized by species, service type, AMD class, and drug. Multivariable logistic full-factorial regression models were used to estimate hospital, year, species, and service-type effects on AMD prescribing. Estimated marginal means and confidence intervals were plotted over time. RESULTS The probability of systemic AMD prescribing for any indication ranged between 0.15 and 0.28 and was higher for dogs than cats (P < .05) apart from 2017 at hospital 1. Animals presented to primary care were least likely to receive AMDs (dogs 0.03-0.15, cats 0.03-0.18). The most commonly prescribed AMD classes were aminopenicillins/β-lactamase inhibitors (0.02-0.15), first-generation cephalosporins (0.00-0.09), fluoroquinolones (0.00-0.04), nitroimidazoles (0.01-0.06), and tetracyclines (0.00-0.03). Among the highest priority classes, fluoroquinolones (dogs 0.00-0.09, cats 0.00-0.08) and third-generation cephalosporins (dogs 0.00-0.04, cats 0.00-0.05) were most frequently prescribed. CONCLUSIONS AND CLINICAL IMPORTANCE Antimicrobial drug prescribing frequencies were comparable to previous studies. Additional stewardship efforts might focus on fluoroquinolones and third-generation cephalosporins.
Collapse
Affiliation(s)
- Robert Goggs
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Julie M Menard
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Craig Altier
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Kevin J Cummings
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Megan E Jacob
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Denise F Lalonde-Paul
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Mark G Papich
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Keri N Norman
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine, Texas A&M University, College Station, Texas, USA
| | - Virginia R Fajt
- Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine, Texas A&M University, College Station, Texas, USA
| | - H Morgan Scott
- Department of Veterinary Pathobiology, College of Veterinary Medicine, Texas A&M University, College Station, Texas, USA
| | - Sara D Lawhon
- Department of Veterinary Pathobiology, College of Veterinary Medicine, Texas A&M University, College Station, Texas, USA
| |
Collapse
|
42
|
Breaking new ground in antimicrobial stewardship in companion animal veterinary practice. Nat Commun 2021; 12:2445. [PMID: 33907195 PMCID: PMC8079427 DOI: 10.1038/s41467-021-22542-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 03/16/2021] [Indexed: 11/15/2022] Open
Abstract
Singleton and colleagues publish in Nature Communications an intervention study to reduce antimicrobial usage in companion animal practice. They identify significant reductions in antimicrobial usage with their more active intervention group over approximately a 6-month period. The study offers an exciting way forward to explore further the trial interventions and assess alternative methods to improve antimicrobial stewardship in veterinary practice.
Collapse
|
43
|
Golding SE, Ogden J, Higgins HM. Examining the Effect of Context, Beliefs, and Values on UK Farm Veterinarians' Antimicrobial Prescribing: A Randomized Experimental Vignette and Cross-Sectional Survey. Antibiotics (Basel) 2021; 10:445. [PMID: 33921073 PMCID: PMC8071438 DOI: 10.3390/antibiotics10040445] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/07/2021] [Accepted: 04/09/2021] [Indexed: 12/28/2022] Open
Abstract
Antimicrobial resistance (AMR) is a pressing threat to public and animal health. There is evidence that antimicrobial prescribing and stewardship behaviors by veterinarians (vets) are influenced by non-clinical factors, such as psychological, social, and environmental factors. This study explored the role of context, beliefs, and values on vets' antimicrobial prescribing decisions. UK-based practicing farm vets (n = 97) were recruited to an online study. Using an experimental vignette methodology, vets were randomly assigned across four conditions, to examine the effects of different contexts (pressure on farm economics, the farmer, or the vet-farmer relationship, compared to a control condition) on vets' likelihood of prescribing antibiotics. Vets' beliefs about different groups' responsibility for causing and preventing AMR and vets' values were also measured. Key findings were that context alone, values, and beliefs about groups' responsibilities for causing AMR were not predictive of vets' likelihood of prescribing antibiotics. However, vets' beliefs about groups' responsibilities for preventing AMR were predictive of an increased likelihood of prescribing antibiotics, when vets were exposed to the experimental condition of the vignette in which the vet-farmer relationship was under pressure. Farm vets also believed that different groups have different levels of responsibility for causing and preventing AMR. Results should be interpreted cautiously, given the smaller than planned for sample size, and the possibility for both false negatives and false positives. Further research is needed to explore how these findings could inform antimicrobial stewardship interventions in veterinary medicine.
Collapse
Affiliation(s)
- Sarah E. Golding
- School of Psychology, Faculty of Health and Medical Sciences, Stag Hill Campus, University of Surrey, Guildford GU2 7XH, UK;
| | - Jane Ogden
- School of Psychology, Faculty of Health and Medical Sciences, Stag Hill Campus, University of Surrey, Guildford GU2 7XH, UK;
| | - Helen M. Higgins
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, Cheshire CH64 7TE, UK;
| |
Collapse
|
44
|
Allerton F, Prior C, Bagcigil AF, Broens E, Callens B, Damborg P, Dewulf J, Filippitzi ME, Carmo LP, Gómez-Raja J, Harpaz E, Mateus A, Nolff M, Phythian CJ, Timofte D, Zendri F, Jessen LR. Overview and Evaluation of Existing Guidelines for Rational Antimicrobial Use in Small-Animal Veterinary Practice in Europe. Antibiotics (Basel) 2021; 10:antibiotics10040409. [PMID: 33918617 PMCID: PMC8069046 DOI: 10.3390/antibiotics10040409] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 11/16/2022] Open
Abstract
Antimicrobial stewardship guidelines (ASGs) represent an important tool to help veterinarians optimize their antimicrobial use with the objective of decreasing antimicrobial resistance. The aim of this study was to map and qualitatively assess the ASGs for antimicrobial use in cats and dogs in Europe. Country representatives of the European Network for Optimization of Veterinary Antimicrobial Treatment (ENOVAT) were asked to identify ASGs published in their countries. All collated ASGs updated since January 2010 containing recommendations on antimicrobial therapy for at least three conditions affecting different organ systems in cats and dogs underwent detailed review including AGREE II analysis. Out of forty countries investigated, fifteen ASGs from eleven countries met the inclusion criteria. Several critical principles of antimicrobial use were identified, providing a framework that should assist development of stewardship guidance. The AGREE II analysis highlighted several methodological limitations of the currently available ASGs. This study sheds light on the lack of national ASGs for dogs and cats in multiple European countries and should encourage national bodies to prioritize guideline development in small animals. A greater awareness of the need to use a structured approach to guideline development could improve the quality of ASGs in the future.
Collapse
Affiliation(s)
- Fergus Allerton
- Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull B90 4NH, UK
- Correspondence:
| | - Cameron Prior
- Veterinary Specialists Scotland, 1 Deer Park Road Livingston, Scotland EH54 8AG, UK;
| | - Arzu Funda Bagcigil
- Department of Microbiology, Faculty of Veterinary Medicine, Istanbul University-Cerrahpaşa, 34320 Avcılar, Istanbul, Turkey;
| | - Els Broens
- Faculty of Veterinary Medicine, Department of Biomolecular Health Sciences, Utrecht University, Yalelaan 1, 3584 CL Utrecht, The Netherlands;
| | - Bénédicte Callens
- Centre of Knowledge on Antimicrobial Use and Resistance, Galileelaan 5/02, 1210 Brussels, Belgium;
| | - Peter Damborg
- Department of Veterinary and Animal Sciences, University of Copenhagen, Stigbøjlen 4, 1870 Frederiksberg, Denmark;
| | - Jeroen Dewulf
- Veterinary Epidemiology Unit, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium;
| | | | - Luís Pedro Carmo
- Veterinary Public Health Institute, Vetsuisse Faculty, University of Bern, Schwarzenburgstrasse 161, 3097 Liebefeld, Bern, Switzerland;
| | | | - Erez Harpaz
- Faculty of Veterinary Medicine, Institute for Production Animal Clinical Science, Norwegian University of Life Sciences, Small Ruminant Research and Herd Health, Høyland, 4325 Sandnes, Norway; (E.H.); (C.J.P.)
| | - Ana Mateus
- Hawkshead Campus, Royal Veterinary College, University of London, Hawkshead Lane, Hatfield AL9 7TA, Hertfordshire, UK;
| | - Mirja Nolff
- Clinic for Small Animal Surgery Tierspital Zürich, Vetsuisse Faculty, University of Zürich, Winterthurerstrasse 260, 8057 Zürich, Switzerland;
| | - Clare J. Phythian
- Faculty of Veterinary Medicine, Institute for Production Animal Clinical Science, Norwegian University of Life Sciences, Small Ruminant Research and Herd Health, Høyland, 4325 Sandnes, Norway; (E.H.); (C.J.P.)
| | - Dorina Timofte
- Department of Veterinary Anatomy, Leahurst Campus, Institute of Infection, Veterinary and Ecological Sciences, Physiology and Pathology, University of Liverpool, Neston CH64 7TE, UK; (D.T.); (F.Z.)
| | - Flavia Zendri
- Department of Veterinary Anatomy, Leahurst Campus, Institute of Infection, Veterinary and Ecological Sciences, Physiology and Pathology, University of Liverpool, Neston CH64 7TE, UK; (D.T.); (F.Z.)
| | - Lisbeth Rem Jessen
- Department of Veterinary Clinical Sciences, Faculty of Health Sciences, University of Copenhagen, Dyrlægevej 16, 1870 Frederiksberg C, Denmark;
| |
Collapse
|
45
|
Tsvetanova A, Powell RM, Tsvetanov KA, Smith KM, Gould DJ. Melting corneal ulcers (keratomalacia) in dogs: A 5-year clinical and microbiological study (2014-2018). Vet Ophthalmol 2021; 24:265-278. [PMID: 33794048 DOI: 10.1111/vop.12885] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 03/15/2021] [Accepted: 03/15/2021] [Indexed: 01/26/2023]
Abstract
OBJECTIVES To identify bacterial microorganisms associated with canine keratomalacia, review their antimicrobial sensitivity, and evaluate clinical outcomes compared to results of microbial culture. METHODS Retrospective analysis of clinical records of dogs diagnosed with a melting corneal ulcer presented to a referral hospital in Hertfordshire, UK between 2014 and 2018. RESULTS One hundred and ten melting corneal ulcers were sampled in 106 dogs. The most common pure bacterial isolate was Pseudomonas aeruginosa (n = 26) followed by β-hemolytic Streptococcus (n = 12). Melting corneal ulcers that cultured coagulase-positive Staphylococcus, coliform bacteria, Pasteurella multocida, Enterococcus, and Streptococcus viridans presented in smaller numbers and were analyzed together (n = 16). Multiple cultures were identified in nine cases (n = 9). Forty-seven cultures yielded no bacterial growth (n = 47). The susceptibility to fluoroquinolones remained high with the exception of β-hemolytic Streptococci. There was no significant difference in the ulcer severity at presentation in regard to the cultured bacteria. Overall, 63 eyes (57%) received surgical grafting in addition to medical treatment. In 14 cases (13%), the progression of corneal melting despite medical ± surgical treatment resulted in enucleation. Fifty-seven percent (8/14) of the enucleated eyes cultured pure Pseudomonas aeruginosa isolates. In contrast, all β-hemolytic Streptococcus-associated ulcers healed. CONCLUSIONS The most common bacterial species associated with canine keratomalacia were Pseudomonas aeruginosa and β-hemolytic Streptococcus. Because of the variation in antibacterial sensitivity between these two species, bacterial culture and sensitivity testing should be performed in all dogs presenting with keratomalacia. Melting corneal ulcers associated with pure Pseudomonas infection were significantly more likely to result in globe loss than melting corneal ulcers associated with other cultures.
Collapse
Affiliation(s)
- Agata Tsvetanova
- Davies Veterinary Specialists, Manor Farm Business Park, Hertfordshire, UK
| | | | - Kamen A Tsvetanov
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Kerry M Smith
- Davies Veterinary Specialists, Manor Farm Business Park, Hertfordshire, UK
| | - David J Gould
- Davies Veterinary Specialists, Manor Farm Business Park, Hertfordshire, UK
| |
Collapse
|
46
|
Elmoslemany A, Elsohaby I, Alorabi M, Alkafafy M, Al-Marri T, Aldoweriej A, Alaql FA, Almubarak A, Fayez M. Diversity and Risk Factors Associated with Multidrug and Methicillin-Resistant Staphylococci Isolated from Cats Admitted to a Veterinary Clinic in Eastern Province, Saudi Arabia. Antibiotics (Basel) 2021; 10:antibiotics10040367. [PMID: 33807318 PMCID: PMC8066541 DOI: 10.3390/antibiotics10040367] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 03/24/2021] [Accepted: 03/29/2021] [Indexed: 11/16/2022] Open
Abstract
Understanding the distribution, antimicrobial resistance (AMR), and risk factors associated with multidrug-resistant (MDR) and methicillin-resistant staphylococci (MRS) isolated from cats admitted to veterinary clinics may decrease the risk of MDR and MRS transmission to humans and other cats. As such, the objectives of this study were to investigate the diversity in Staphylococcus spp. recovered from different anatomical locations in healthy and diseased cats and to determine the occurrence of MDR and MRS spp. as well as possible risk factors associated with colonization in these cats. Five swabs were collected from the anus, skin, ear canal, conjunctival sac, and nares of each cat (209 healthy and 191 diseased) admitted to a veterinary clinic in Eastern Province, Saudi Arabia, between January and December 2018. Prior to sample collection, cat owners completed a questionnaire collecting information on cat demographics, health status, management, and antimicrobial usage. In total, 179 Staphylococcus isolates were recovered from healthy (n = 71) and diseased (n = 108) cats, including 94 (52.5%) coagulase-positive staphylococci (CoPS), and 85 (47.5%) coagulase-negative staphylococci (CoNS). Five Staphylococcus spp. were identified, namely, Staphylococcus aureus, Staphylococcus pseudintermedius, Staphylococcus felis, Staphylococcus capitis, and Staphylococcus saprophyticus. Staphylococcus isolates were most commonly resistant to penicillin (56.4%) and ciprofloxacin (25.7%); however, no isolate was resistant to clindamycin. Thirty (16.8%) Staphylococcus spp. (24 S. aureus and 6 S. pseudintermedius) isolates were MDR, with resistance to up to six different antibiotic classes. Only 17 (9.5%) Staphylococcus spp. (15 methicillin-resistant S. aureus and 2 methicillin-resistant S. pseudintermedius) harbored the mecA gene. Risk factor analysis showed that cats with a history of antibiotic therapy, those raised mainly indoors with a child, and those who visit a veterinary clinic for treatment were at higher risk of MDR and MRS colonization. In conclusion, MDR and MRS were common in healthy and diseased cats in Saudi Arabia. Thus, an effective antimicrobial stewardship program and further studies using a One Health approach are required to investigate the role of cats as vectors for AMR transmission to humans.
Collapse
Affiliation(s)
- Ahmed Elmoslemany
- Hygiene and Preventive Medicine Department, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafr El-Sheikh 33516, Egypt;
| | - Ibrahim Elsohaby
- Department of Animal Medicine, Faculty of Veterinary Medicine, Zagazig University, Zagazig City 44511, Egypt
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE C1A 4P3, Canada
- Correspondence: ; Tel.: +1-902-566-6063
| | - Mohammed Alorabi
- Department of Biotechnology, College of Science, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia; (M.A.); (M.A.)
| | - Mohamed Alkafafy
- Department of Biotechnology, College of Science, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia; (M.A.); (M.A.)
| | - Theeb Al-Marri
- Al-Ahsa Veterinary Diagnostic Lab, Ministry of Environment, Water and Agriculture, Al-Ahsa 31982, Saudi Arabia; (T.A.-M.); (A.A.); (M.F.)
| | - Ali Aldoweriej
- Veterinary Health and Monitoring, Ministry of Environment, Water and Agriculture, Riyadh 11195, Saudi Arabia;
| | - Fanan A. Alaql
- Department of Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Abdullah Almubarak
- Al-Ahsa Veterinary Diagnostic Lab, Ministry of Environment, Water and Agriculture, Al-Ahsa 31982, Saudi Arabia; (T.A.-M.); (A.A.); (M.F.)
| | - Mahmoud Fayez
- Al-Ahsa Veterinary Diagnostic Lab, Ministry of Environment, Water and Agriculture, Al-Ahsa 31982, Saudi Arabia; (T.A.-M.); (A.A.); (M.F.)
- Department of Bacteriology, Veterinary Serum and Vaccine Research Institute, Ministry of Agriculture, Cairo 131, Egypt
| |
Collapse
|
47
|
Singleton DA, Rayner A, Brant B, Smyth S, Noble PJM, Radford AD, Pinchbeck GL. A randomised controlled trial to reduce highest priority critically important antimicrobial prescription in companion animals. Nat Commun 2021; 12:1593. [PMID: 33707426 PMCID: PMC7952375 DOI: 10.1038/s41467-021-21864-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 02/12/2021] [Indexed: 01/31/2023] Open
Abstract
Robust evidence supporting strategies for companion animal antimicrobial stewardship is limited, despite frequent prescription of highest priority critically important antimicrobials (HPCIA). Here we describe a randomised controlled trial where electronic prescription data were utilised (August 2018-January 2019) to identify above average HPCIA-prescribing practices (n = 60), which were randomly assigned into a control group (CG) and two intervention groups. In March 2019, the light intervention group (LIG) and heavy intervention group (HIG) were notified of their above average status, and were provided with educational material (LIG, HIG), in-depth benchmarking (HIG), and follow-up meetings (HIG). Following notification, follow-up monitoring lasted for eight months (April-November 2019; post-intervention period) for all intervention groups, though HIG practices were able to access further support (i.e., follow-up meetings) for the first six of these months if requested. Post-intervention, in the HIG a 23.5% and 39.0% reduction in canine (0.5% of total consultations, 95% confidence interval, 0.4-0.6, P = 0.04) and feline (4.4%, 3.4-5.3, P < 0.001) HPCIA-prescribing consultations was observed, compared to the CG (dogs: 0.6%, 0.5-0.8; cats: 7.4%, 6.0-8.7). The LIG was associated with a 16.7% reduction in feline HPCIA prescription (6.1% of total consultations, 5.3-7.0, P = 0.03). Therefore, in this trial we have demonstrated effective strategies for reducing veterinary HPCIA prescription.
Collapse
Affiliation(s)
- David A Singleton
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston, UK.
| | | | - Bethaney Brant
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston, UK
| | - Steven Smyth
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston, UK
| | - Peter-John M Noble
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston, UK
| | - Alan D Radford
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston, UK
| | - Gina L Pinchbeck
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston, UK
| |
Collapse
|
48
|
Salgado-Caxito M, Benavides JA, Munita JM, Rivas L, García P, Listoni FJP, Moreno-Switt AI, Paes AC. Risk factors associated with faecal carriage of extended-spectrum cephalosporin-resistant Escherichia coli among dogs in Southeast Brazil. Prev Vet Med 2021; 190:105316. [PMID: 33725561 DOI: 10.1016/j.prevetmed.2021.105316] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 02/24/2021] [Accepted: 02/28/2021] [Indexed: 12/11/2022]
Abstract
Faecal carriage of extended-spectrum cephalosporin-resistant Escherichia coli (ESC-R E. coli) in dogs has been reported worldwide and can reduce the effectiveness of treatments against bacterial infections. However, the drivers that influence faecal carriage of ESC-R E. coli in dogs are poorly understood. The aims of this study were to estimate the prevalence of ESC-R E. coli among dogs prior to their admission to a veterinary teaching hospital and to identify risk factors associated with the faecal carriage of ESC-R E. coli. Rectal swabs (n = 130) were collected from dogs and screened for ESC-R E. coli using MacConkey agar supplemented with cefotaxime (2 μg/mL). E. coli species was confirmed by MALDI-TOF and screening of extended-spectrum beta-lactamase (ESBL) genes was conducted by multiplex PCR. Questionnaires were completed by each dog's owner to test several human and dog characteristics associated with ESC-R E. coli. The prevalence of faecal carriage of ESC-R E. coli was 9.2 % and 67 % of ESC-R E. coli isolates harboured ESBL genes including CTX-M alone or in combination with TEM. All ESC-R E. coli isolates were resistant to ceftriaxone, cefpodoxime, and cefotaxime and were susceptible to cefoxitin and carbapenems. The likelihood of carrying ESC-R E. coli was 15 times higher (OR = 14.41 [95 % CI: 1.80-38.02], p < 0.01) if the dog was treated with antibiotics 3-12 months prior to sampling and 8 times higher (OR = 7.96 [95 % CI: 2.96-92.07], p < 0.01) if the dog had direct contact with livestock, but 15 times lower (OR = 0.07 [95 % CI: 0.01-0.32], p < 0.01) if the dog was dewormed during the previous year. Our findings confirm the faecal carriage of ESC-R E. coli in subclinical dogs and call for further investigation regarding the impact of deworming on antibiotic-resistant bacteria in companion animals.
Collapse
Affiliation(s)
- Marília Salgado-Caxito
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animal Science, Sao Paulo State University (UNESP), Botucatu, Brazil; Millennium Initiative for Collaborative Research On Bacterial Resistance (MICROB-R), Santiago, Chile.
| | - Julio A Benavides
- Millennium Initiative for Collaborative Research On Bacterial Resistance (MICROB-R), Santiago, Chile; Departamento de Ecología y Biodiversidad, Facultad de Ciencias de la Vida, Universidad Andres Bello, Santiago, Chile; Centro de Investigación para la Sustentabilidad, Facultad de Ciencias de la Vida, Universidad Andres Bello, Santiago, Chile
| | - Jose M Munita
- Millennium Initiative for Collaborative Research On Bacterial Resistance (MICROB-R), Santiago, Chile; Genomics and Resistant Microbes Group, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Lina Rivas
- Millennium Initiative for Collaborative Research On Bacterial Resistance (MICROB-R), Santiago, Chile; Genomics and Resistant Microbes Group, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Patricia García
- Millennium Initiative for Collaborative Research On Bacterial Resistance (MICROB-R), Santiago, Chile; Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Fernando J P Listoni
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animal Science, Sao Paulo State University (UNESP), Botucatu, Brazil
| | - Andrea I Moreno-Switt
- Millennium Initiative for Collaborative Research On Bacterial Resistance (MICROB-R), Santiago, Chile; Escuela de Medicina Veterinaria, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Antonio C Paes
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animal Science, Sao Paulo State University (UNESP), Botucatu, Brazil
| |
Collapse
|
49
|
Bennani H, Cornelsen L, Stärk KDC, Häsler B. Characterisation and mapping of the surveillance system for antimicrobial resistance and antimicrobial use in the United Kingdom. Vet Rec 2021; 188:e10. [PMID: 33835538 DOI: 10.1002/vetr.10] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/01/2020] [Accepted: 09/22/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Surveillance of antimicrobial resistance (AMR) is an essential component of any strategy to mitigate AMR and needs regular evaluation to ensure its effectiveness. A first step for any evaluation is to describe the system and context. In this study, we aimed to characterise and map the surveillance system for AMR and antimicrobial use (AMU) in the United Kingdom (UK) using a One Health (OH) approach and to identify integration points in the system. METHODS To describe the surveillance system for AMR/AMU, international guidelines for establishing surveillance systems for AMR and AMU were used. A review of the literature was conducted to collect information on the different parameters identified. RESULTS Multiple data collection systems exist for AMU and AMR in humans, animals and food. Each sector is responsible for the planning, implementation, analysis and reporting of its own surveillance for AMR and AMU. Some cross-sectoral collaborative activities exist such as the UK AMR contingency plan and the publication of UK OH reports; there are opportunities for further integration such as the harmonisation of data analyses methods and interpretation across sectors and the publication of joint surveillance reports. CONCLUSION This overview of key stakeholders, data collection streams, reporting, linkages within and across sectors and international monitoring forms an important basis for future evaluation of the UK AMR/AMU surveillance system from a OH perspective.
Collapse
Affiliation(s)
- Houda Bennani
- Veterinary Epidemiology, Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, UK
| | - Laura Cornelsen
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, Bloomsbury, UK
| | - Katharina D C Stärk
- Veterinary Epidemiology, Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, UK.,SAFOSO AG, Bern-Liebefeld, Switzerland
| | - Barbara Häsler
- Veterinary Epidemiology, Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, UK
| |
Collapse
|
50
|
Schmitt K, Kuster SP, Zurfluh K, Jud RS, Sykes JE, Stephan R, Willi B. Transmission Chains of Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae at the Companion Animal Veterinary Clinic-Household Interface. Antibiotics (Basel) 2021; 10:antibiotics10020171. [PMID: 33572066 PMCID: PMC7914568 DOI: 10.3390/antibiotics10020171] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/03/2021] [Accepted: 02/05/2021] [Indexed: 11/16/2022] Open
Abstract
Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) among animals and humans are a public health threat. This study analyzed the occurrence of ESBL-E in a high-risk environment in a companion animal clinic and two animal patients’ households. In an intensive care unit (ICU), rectal swabs from 74 dogs and cats, 74 hand swabs from staff and 298 swabs from surfaces were analyzed for ESBL-E. Seventeen hospitalized patients (23%) and ten (3%) surfaces in the ICU tested ESBL-E positive. Transmission chains for Klebsiella pneumoniae ST307 blaCTX-M-15 and Escherichia coli ST38 blaCTX-M-14, ST88 blaCTX-M-14 and ST224 blaCTX-M-1 were observed over extended periods of time (14 to 30 days) with similar strains isolated from patients and the clinical environment. After discharge, two colonized dogs (dogs 7 and 12) and their household contacts were resampled. Dog 7 tested repeatedly positive for 77 days, dog 12 tested negative; six (24%) surfaces in the household of the persistently colonized dog tested ESBL-E positive. The owner of dog 7 and one of the owners of dog 12 were colonized. Based on whole genome sequencing, isolates from the owners, their dogs and other ICU patients belonged to the same clusters, highlighting the public health importance of ESBL-E in companion animal clinics.
Collapse
Affiliation(s)
- Kira Schmitt
- Institute for Food Safety and Hygiene, University of Zurich, Winterthurerstrasse 272, CH-8057 Zurich, Switzerland; (K.S.); (K.Z.)
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Mittelstrasse 43, CH-3012 Bern, Switzerland
| | - Stefan P. Kuster
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, CH-8091 Zurich, Switzerland;
| | - Katrin Zurfluh
- Institute for Food Safety and Hygiene, University of Zurich, Winterthurerstrasse 272, CH-8057 Zurich, Switzerland; (K.S.); (K.Z.)
| | - Rahel S. Jud
- Division of Critical Care Medicine, Department of Small Animals, University of Zurich, Winterthurerstrasse 260, CH-8057 Zurich, Switzerland;
| | - Jane E. Sykes
- Department of Medicine & Epidemiology, University of California-Davis, 2108 Tupper Hall, Davis, CA 95618, USA;
| | - Roger Stephan
- Institute for Food Safety and Hygiene, University of Zurich, Winterthurerstrasse 272, CH-8057 Zurich, Switzerland; (K.S.); (K.Z.)
- Correspondence:
| | - Barbara Willi
- Clinic for Small Animal Internal Medicine, University of Zurich, Winterthurerstrasse 260, CH-8057 Zurich, Switzerland;
| |
Collapse
|