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Gehlen H, Klein KS, Merle R, Lübke-Becker A, Stoeckle SD. Does colonization with MRSA, ESBL - producing Enterobacteriaceae, and/or Acinetobacter baumannii - increase the risk for postoperative surgical site infection? Vet Med Sci 2023; 9:729-737. [PMID: 36646070 PMCID: PMC10029890 DOI: 10.1002/vms3.1073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE Evaluation of the role of indicator pathogens in equine surgical site infection (SSI) and other infection-promoting factors. STUDY DESIGN Cross-sectional study. ANIMALS Horses presenting with an open injury or surgical colic during 1.5 years. METHODS A nasal swab and a faecal sample were collected from every patient upon admission. Furthermore, a wound swab was collected from wounds of injured horses. Details on the wounds and procedures were documented. Laparotomy incisions and injuries were monitored for signs suggesting infection. RESULTS In total, 156 horses presented because of a surgical colic (n = 48) or open injuries (n = 108). Thirteen surgical colic patients and three injured horses did not survive beyond 24 h, and four injured horses were discharged from the clinic at the day of admission. SSIs occurred in 31 (30.7%) injured horses and 11 (31.4%) horses after laparotomy. Regarding injuries, general anaesthesia increased the risk of developing a WI compared to sedation. Indicator pathogens were cultured from 29/42 SSI. In total, 10/11 infected laparotomy incisions and 19/31 injuries with SSI tested positive for multidrug-resistant pathogens (MDRPs) . Indicator pathogens were not detected at admission in any of the horses that developed incisional SSIs after laparotomy but were detected in two of the injured horses that developed SSIs. CONCLUSION MDRPs were identified in almost 70% of the SSI. Less than 5% of the affected animals were colonized with the same pathogen before admission, indicating that colonization with MDR pathogens is only one of the crucial factors for the development of SSI. CLINICAL SIGNIFICANCE Colonization with MDRP seems not to predispose horses to MDR SSIs.
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Affiliation(s)
- Heidrun Gehlen
- Equine Clinic: Surgery and Radiology, Freie Universität Berlin, Berlin, Germany
| | - Katja-Sophia Klein
- Equine Clinic: Surgery and Radiology, Freie Universität Berlin, Berlin, Germany
| | - Roswitha Merle
- Institute for Veterinary Epidemiology and Biostatistics, Freie Universität Berlin, Berlin, Germany
| | - Antina Lübke-Becker
- Institute of Microbiology and Epizootics, Freie Universität Berlin, Berlin, Germany
- Veterinary Centre for Resistance Research (TZR), Freie Universität Berlin, Berlin, Germany
| | - Sabita D Stoeckle
- Equine Clinic: Surgery and Radiology, Freie Universität Berlin, Berlin, Germany
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2
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Genomic Evidence for Direct Transmission of mecC-MRSA between a Horse and Its Veterinarian. Antibiotics (Basel) 2023; 12:antibiotics12020408. [PMID: 36830318 PMCID: PMC9952710 DOI: 10.3390/antibiotics12020408] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
Methicillin-resistant Staphylococcus aureus bearing the mecC gene (mecC-MRSA) has been reported from animals and humans in recent years. This study describes the first mecC-MRSA isolates of human and equine origin in Hungary (two isolates from horses and one from a veterinarian, who treated one of the infected horses, but was asymptomatic). MRSA isolates were identified by cultivation and PCR detection of the species-specific spa gene and mecA/mecC methicillin resistance genes. The isolates were characterized by antibiotic susceptibility testing, MLST, spa, SCCmec typing, PFGE and whole genome sequencing (WGS). All three isolates belonged to the ST130-t843-SCCmec XI genotype, and carried the mecC and blaZ genes. Apart from beta-lactam drugs, they were sensitive to all tested antibiotics. The isolates of the infected horse and its veterinarian had the same PFGE pulsotype and showed only slight differences with WGS. Hence, this is the first description of direct transmission of a mecC-carrying MRSA between a horse and its veterinarian. The emergence of mecC in the country highlights the importance of the appropriate diagnostics in MRSA identification.
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3
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Knych HK, Magdesian KG. Equine antimicrobial therapy: Current and past issues facing practitioners. J Vet Pharmacol Ther 2021; 44:270-279. [PMID: 33650183 DOI: 10.1111/jvp.12964] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 02/06/2023]
Abstract
Equine antimicrobial therapy has advanced over time with the availability of increasing pharmacokinetic and pharmacodynamic studies in horses, allowing for greater evidence-based clinical decision-making. However, many challenges to optimal antimicrobial therapy remain and further research is needed to address these areas. There are a limited number of approved antimicrobials for use in horses, which creates a need for compounded preparations for clinicians. Extra-label drug use is commonplace in equine practice, which warrants continual education of veterinarians about policies and updates. Performance and competitive horses have their own unique concerns when it comes to antimicrobial use and drug testing. In keeping with the use of a broader range of antimicrobials over time, antimicrobial resistance is emerging as an important issue facing veterinary medicine, including equine practice. Another challenge is that of drug interactions and adverse drug events for which there are little scientific data available for horses, especially for critically important diseases such as Rhodococcus equi infection. Finally, much progress has been made in the availability of equine-specific antimicrobial susceptibility break points. These aid clinicians in interpreting culture and susceptibility results and antimicrobial selection. Even with these advances, continuing education and further research are needed in this area.
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Affiliation(s)
- Heather K Knych
- Kenneth L. Maddy Equine Analytical Pharmacology Laboratory and Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, California, USA
| | - K Gary Magdesian
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA
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4
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Prescott JF. Outpacing the resistance
tsunami
: Antimicrobial stewardship in equine medicine, an overview. EQUINE VET EDUC 2020. [DOI: 10.1111/eve.13318] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- J. F. Prescott
- Department of Pathobiology University of Guelph Guelph Ontario Canada
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5
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Dziubinski N, Mählmann K, Lübke-Becker A, Lischer C. Retrospective Identification of Bacterial Isolates From Emergency Laparotomy Surgical Site Infections in Horses. J Equine Vet Sci 2020; 87:102927. [PMID: 32172917 DOI: 10.1016/j.jevs.2020.102927] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/25/2019] [Accepted: 01/06/2020] [Indexed: 11/16/2022]
Abstract
Surgical site infection (SSI) with multiresistant bacteria is an important cause of postoperative morbidity after laparotomy in horses. The objective of this study was to identify bacteria isolates and their antibiotic resistance patterns associated with the development of wound infection in horses after laparotomy. This is a retrospective case series. Medical records of horses that underwent ventral midline exploratory laparotomy in a four-year period at one equine hospital were reviewed. Results of microbiologic culture and susceptibility testing are described. The study group consisted of 183 (100%) horses that recovered from anesthesia after laparotomy. The prevalence of infection was 19% (24/124) after first surgery and 83% (19/23) after relaparotomy. The most common microbial isolates were bacteria of the family Enterobacteriaceae followed by Staphylococcus ssp., Enterococcus ssp., Streptococcus ssp., and Bacteroides ssp. Bacteria from the family Enterobacteriaceae showed the lowest resistance to amphenicols, cephalosporins, and quinolones groups of antibiotics. Coagulase-positive Staphylococci were sensitive to amphenicols and only 33% were resistant to trimethoprim/sulfamethoxazole. The most commonly used perioperative and postoperative antibiotics were gentamicin and amoxicillin. Limitations include poor control over exposure factors, covariates, and potential confounders during the surgery, recovery time, or period of hospitalization; relying on others for accurate outcome assessment and recordkeeping; lack of follow-up information once animals were discharged from the hospital. Despite 5 days of antibiotic prophylaxis, the rate of incisional infection is still high. The most common isolates from SSI belong to the family Enterobacteriaceae and the genus Staphylococcus, which showed high resistance to the antibiotics used before the gastrointestinal surgery.
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Affiliation(s)
- Natalia Dziubinski
- Freie Universität Berlin, Klinik für Pferde, Allgemeine Chirurgie und Radiologie, Berlin, Germany.
| | - Kathrin Mählmann
- Freie Universität Berlin, Klinik für Pferde, Allgemeine Chirurgie und Radiologie, Berlin, Germany
| | - Antina Lübke-Becker
- Freie Universität Berlin, Klinik für Pferde, Allgemeine Chirurgie und Radiologie, Berlin, Germany
| | - Christoph Lischer
- Freie Universität Berlin, Klinik für Pferde, Allgemeine Chirurgie und Radiologie, Berlin, Germany
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6
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Soimala T, Lübke-Becker A, Schwarz S, Feßler AT, Huber C, Semmler T, Merle R, Gehlen H, Eule JC, Walther B. Occurrence and molecular composition of methicillin-resistant Staphylococcus aureus isolated from ocular surfaces of horses presented with ophthalmologic disease. Vet Microbiol 2018; 222:1-6. [PMID: 30080662 DOI: 10.1016/j.vetmic.2018.06.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 06/11/2018] [Indexed: 10/28/2022]
Abstract
Severe infections due to methicillin-resistant Staphylococcus aureus (MRSA) have been increasingly recognized in virtually all fields of veterinary medicine. Our objective was to study the occurrence, phylogenetic relationships and antimicrobial resistance properties of MRSA isolated from ocular surfaces of horses prior to invasive procedures. Within a 49-week sampling period, ocular swabs obtained from 46 eyes of 44 horses, including eyes with clinical signs of conjunctivitis/blepharitis, keratitis or uveitis were screened for the presence of S. aureus. As a result, seven samples were positive for S. aureus (15.2%), with six of them being classified as MRSA (13%). In addition, all isolates were resistant or showed reduced susceptibility to tetracyclines, the aminoglycosides gentamicin and kanamycin, fluoroquinolones, and the combination sulfamethoxazole/trimethoprim. Since a very close relationship between the MRSA isolates was assumed after pulsed-field gel electrophoresis employing the restriction endonuclease ApaI, whole genome sequencing (WGS) was used to shed more light on the phylogenetic relationships and the molecular composition of all MRSA isolates. Analysis of WGS data revealed closely related MRSA belonging to sequence type 398, spa type t011 and dru type dt10q, harboring an SCCmec IV element and the Staphylococcus aureus pathogenicity island SaPIbov5. Moreover, all MRSA were positive for a beta-hemolysin converting phage carrying genes of the immune evasion cluster (IEC). Since cases of eye infections due to MRSA were often associated with fatal outcomes, more research is needed with respect to the origin of MRSA isolated from ocular surfaces to implement sufficient barrier and infection control measures.
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Affiliation(s)
- Tanawan Soimala
- Small Animal Clinic, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Antina Lübke-Becker
- Institute of Microbiology and Epizootics, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Stefan Schwarz
- Institute of Microbiology and Epizootics, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Andrea T Feßler
- Institute of Microbiology and Epizootics, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Charlotte Huber
- Microbial Genomics (NG1), Robert Koch Institute, Berlin, Germany
| | - Torsten Semmler
- Microbial Genomics (NG1), Robert Koch Institute, Berlin, Germany
| | - Roswitha Merle
- Institute for Veterinary Epidemiology and Biostatistics, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Heidrun Gehlen
- Equine Clinic, Surgery and Radiology, Department of Veterinary Medicine, Freie Universität Berlin, Germany
| | - Johanna C Eule
- Small Animal Clinic, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Birgit Walther
- Institute of Microbiology and Epizootics, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany; Advanced Light and Electron Microscopy, Robert Koch Institute, Berlin, Germany.
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7
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Spijk JN, Schmitt S, Schoster A. Infections caused by multidrug‐resistant bacteria in an equine hospital (2012–2015). EQUINE VET EDUC 2017. [DOI: 10.1111/eve.12837] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- J. N. Spijk
- Equine Department Vetsuisse Faculty University of ZurichZurich Switzerland
| | - S. Schmitt
- Institute of Veterinary Bacteriology Vetsuisse Faculty University of Zurich Zurich Switzerland
| | - A. Schoster
- Equine Department Vetsuisse Faculty University of ZurichZurich Switzerland
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8
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Boyle AG, Rankin SC, Duffee LA, Morris D. Prevalence of Methicillin-Resistant Staphylococcus aureus from Equine Nasopharyngeal and Guttural Pouch Wash Samples. J Vet Intern Med 2017; 31:1551-1555. [PMID: 28661019 PMCID: PMC5598885 DOI: 10.1111/jvim.14783] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 05/04/2017] [Accepted: 05/23/2017] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) is recognized as a cause of nosocomial infections in both human and veterinary medicine. Studies that examine the nasopharynx and guttural pouches of the horse as carriage sites for MRSA have not been reported. HYPOTHESIS/OBJECTIVE MRSA colonizes the nasopharynx and guttural pouch of horses. To determine the prevalence of MRSA in equine nasopharyngeal wash (NPW) and guttural pouch lavage (GPL) samples in a field population of horses. SAMPLES One hundred seventy-eight samples (123 NPW and 55 GPL) from 108 horses. METHODS Prospective study. Samples were collected from a convenience population of clinically ill horses with suspected Streptococcus equi subsp. equi (S. equi) infection, horses convalescing from a known S. equi infection, and asymptomatic horses undergoing S. equi screening. Samples were submitted for S. aureus aerobic bacterial culture with mannitol salt broth and two selective agars (cefoxitin CHROMagar as the PBP2a inducer and mannitol salt agar with oxacillin). Biochemical identification of Staphylococcus species and pulsed-field gel electrophoresis (PFGE), to determine clonal relationships between isolates, were performed. RESULTS Methicillin-resistant Staphylococcus (MRS) was isolated from the nasopharynx of 7/108 (4%) horses. Three horses had MRSA (2.7%), and 4 had MR-Staphylococcus pseudintermedius (MRSP). MRSA was isolated from horses on the same farm. PFGE revealed the 3 MRSA as USA 500 strains. CONCLUSIONS AND CLINICAL IMPORTANCE Sampling the nasopharynx and guttural pouch of community-based horses revealed a similarly low prevalence rate of MRSA as other studies sampling the nares of community-based horses. More study is required to determine the need for sampling multiple anatomic sites when screening horses for MRSA.
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Affiliation(s)
- A G Boyle
- Department of Clinical Studies New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Pennsylvania, PA
| | - S C Rankin
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Pennsylvania, PA
| | - L A Duffee
- Department of Clinical Studies Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Pennsylvania, PA
| | - D Morris
- Department of Clinical Studies Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Pennsylvania, PA
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9
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Robinson C, Timofte D, Singer E, Rimmington L, Rubio-Martínez L. Prevalence and antimicrobial susceptibility of bacterial isolates from horses with synovial sepsis: A cross-sectional study of 95 cases. Vet J 2016; 216:117-21. [DOI: 10.1016/j.tvjl.2016.07.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 07/01/2016] [Accepted: 07/12/2016] [Indexed: 10/21/2022]
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10
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Cuny C, Witte W. MRSA in equine hospitals and its significance for infections in humans. Vet Microbiol 2016; 200:59-64. [PMID: 26869097 DOI: 10.1016/j.vetmic.2016.01.013] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 01/13/2016] [Accepted: 01/16/2016] [Indexed: 11/18/2022]
Abstract
MRSA infections in equine clinics were reported from Northern America, Europe, Australia, and Japan. The majority of nosocomial infections in horses is obviously associated with particular MRSA clonal lineages. As already observed for epidemic MRSA in human hospitals more than 10 years ago, a dynamics of MRSA clonal lineages is also observed in European equine clinics: clonal lineages belonging to clonal complex (CC) 8 are on the retreat whereas MRSA attributed to CC398 become increasingly prevalent. The majority of CC398 isolates belong to a subpopulation which is particularly associated with equine hospitals as indicated by molecular typing. When emerging in equine clinics, MRSA from horses were also found as nasal colonizers of veterinary personnel. MRSA exhibiting the typing characteristics of MRSA known from equine clinics are obviously rare among MRSA from infections in humans. Although rare so far epidemic MRSA from human hospitals (HA-MRSA, e.g., ST22, ST225) have been isolated from nosocomial infections in horses and need particular attention in further surveillance.
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Affiliation(s)
- Christiane Cuny
- Robert Koch Institute, Wernigerode Branch Burgstrasse, 3738855 Wernigerode, Germany.
| | - Wolfgang Witte
- Robert Koch Institute, Wernigerode Branch Burgstrasse, 3738855 Wernigerode, Germany
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11
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Prevalence and risk factors for colonization with methicillin resistant Staphylococcus aureus and other Staphylococci species in hospitalized and farm horses in Israel. Prev Vet Med 2015; 122:135-44. [DOI: 10.1016/j.prevetmed.2015.09.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Revised: 09/09/2015] [Accepted: 09/14/2015] [Indexed: 11/20/2022]
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12
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Maddox TW, Clegg PD, Williams NJ, Pinchbeck GL. Antimicrobial resistance in bacteria from horses: Epidemiology of antimicrobial resistance. Equine Vet J 2015; 47:756-65. [DOI: 10.1111/evj.12471] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 06/14/2015] [Indexed: 11/30/2022]
Affiliation(s)
- T. W. Maddox
- Department of Musculoskeletal Biology; Institute of Ageing and Chronic Disease; Neston UK
| | - P. D. Clegg
- Department of Musculoskeletal Biology; Institute of Ageing and Chronic Disease; Neston UK
| | - N. J. Williams
- National Consortium for Zoonosis Research; School of Veterinary Sciences; Neston UK
| | - G. L. Pinchbeck
- Department of Epidemiology and Population Health; Institute of Infection and Global Health; School of Veterinary Sciences; Leahurst Campus; University of Liverpool Neston UK
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13
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López C, Álvarez ME, Carmona JU. Effect of Equine Leukocyte-Reduced Platelet Concentrates on Methicillin-Resistant Staphylococcus aureus Cultures and Measurement of Temporal Growth Factor Degradation. J Equine Vet Sci 2015. [DOI: 10.1016/j.jevs.2015.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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14
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Weese JS. Infection control and biosecurity in equine disease control. Equine Vet J 2014; 46:654-60. [PMID: 24802183 PMCID: PMC7163522 DOI: 10.1111/evj.12295] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 04/27/2014] [Indexed: 11/29/2022]
Abstract
Infectious diseases are an important cause of morbidity and mortality in horses, along with economic costs and broader impacts associated with the loss of members of a species that generates income, acts as a working animal and is a companion. Endemic diseases continue to challenge, emerging diseases are an ever‐present threat and outbreaks can be both destructive and disruptive. While infectious diseases can never be completely prevented, measures can be introduced to restrict the entry of pathogens into a population or limit the implications of the presence of a pathogen. Objective research regarding infection control and biosecurity in horses is limited, yet a variety of practical infection prevention and control measures can be used. Unfortunately, infection control can be challenging, because of the nature of the equine industry (e.g. frequent horse movement) and endemic pathogens, but also because of lack of understanding or motivation to try to improve practices. Recognition of the basic concepts of infection control and biosecurity, and indeed the need for measures to control infectious diseases, is the foundation for successful infection prevention and control.
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Affiliation(s)
- J S Weese
- Department of Pathobiology and Centre for Public Health and Zoonoses, Ontario Veterinary College, University of Guelph, Ontario, Canada
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15
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Roberts M. Biosecurity and Equine Infectious Diseases. ENCYCLOPEDIA OF AGRICULTURE AND FOOD SYSTEMS 2014. [PMCID: PMC7152246 DOI: 10.1016/b978-0-444-52512-3.00135-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
The article provides an overview of biosecurity measures that apply to all potential pathogens in the horse exemplified by the control and management of equine herpesvirus myeloencephalopathy (an emergent disease), methicillin-resistant Staphylococcus aureus (a zoonotoc disease), and strangles in horses, an ancient disease that remains a scourge of susceptible Equidae. The emphasis is on infectious disease within the United States, although the principles of biosecurity in limiting infectious disease spread are not restricted by boundaries.
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Weese JS, Yu AA. Infectious Folliculitis and Dermatophytosis. Vet Clin North Am Equine Pract 2013; 29:559-75. [DOI: 10.1016/j.cveq.2013.09.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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17
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Boyen F, Smet A, Hermans K, Butaye P, Martens A, Martel A, Haesebrouck F. Methicillin resistant staphylococci and broad-spectrum β-lactamase producing Enterobacteriaceae in horses. Vet Microbiol 2013; 167:67-77. [PMID: 23759364 DOI: 10.1016/j.vetmic.2013.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 05/03/2013] [Accepted: 05/04/2013] [Indexed: 12/29/2022]
Abstract
The use of β-lactam antibiotics results in the selection of bacteria showing resistance toward this class of antibiotics. The review focuses on the increasing importance of methicillin resistant staphylococci and broad-spectrum β-lactamase-producing Enterobacteriaceae in horses. Diagnostic protocols that optimize accurate identification of these bacteria from both clinical samples and samples obtained from putative carrier animals are described. In addition, the opportunities and pitfalls for preventive and curative measures are discussed.
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Affiliation(s)
- Filip Boyen
- Department of Pathology, Bacteriology and Avian Diseases, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.
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18
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Akridge HD, Rankin SC, Griffeth GC, Boston RC, Callori NE, Morris DO. Evaluation of the affinity of various species and strains ofStaphylococcusto adhere to equine corneocytes. Vet Dermatol 2013; 24:525-e124. [DOI: 10.1111/vde.12061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Heather D. Akridge
- Department of Clinical Studies - Philadelphia; School of Veterinary Medicine; University of Pennsylvania; 3900 Delancey Street; Philadelphia; PA; 19104; USA
| | - Shelley C. Rankin
- Department of Pathobiology - Philadelphia; School of Veterinary Medicine; University of Pennsylvania; 3900 Delancey Street; Philadelphia; PA; 19104; USA
| | - Gregory C. Griffeth
- Red Bank Veterinary Hospital; 197 Hance Avenue; Tinton Falls; NJ; 07724; USA
| | - Raymond C. Boston
- Department of Clinical Studies - New Bolton Center; School of Veterinary Medicine; University of Pennsylvania; 382 West Street Road; Kennett Square; PA; 19348; USA
| | - Nancy E. Callori
- Department of Clinical Studies - Philadelphia; School of Veterinary Medicine; University of Pennsylvania; 3900 Delancey Street; Philadelphia; PA; 19104; USA
| | - Daniel O. Morris
- Department of Clinical Studies - Philadelphia; School of Veterinary Medicine; University of Pennsylvania; 3900 Delancey Street; Philadelphia; PA; 19104; USA
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19
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Morley P. Evidence-Based Infection Control In Clinical Practice: If You Buy Clothes for the Emperor, Will He Wear Them? J Vet Intern Med 2013; 27:430-8. [DOI: 10.1111/jvim.12060] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 01/07/2013] [Accepted: 01/22/2013] [Indexed: 11/30/2022] Open
Affiliation(s)
- P.S. Morley
- From the department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; James L. Voss Veterinary Teaching Hospital; Fort Collins CO
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22
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Herdan CL, Acke E, Dicken M, Archer RM, Forsyth SF, Gee EK, Pauwels FET. Multi-drug-resistantEnterococcusspp. as a cause of non-responsive septic synovitis in three horses. N Z Vet J 2012; 60:297-304. [DOI: 10.1080/00480169.2011.651702] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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23
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Aslantas Ö, Türkyilmaz S, Yilmaz MA, Erdem Z, Demir C. Isolation and molecular characterization of methicillin-resistant staphylococci from horses, personnel and environmental sites at an equine hospital in Turkey. J Vet Med Sci 2012; 74:1583-8. [PMID: 22820519 DOI: 10.1292/jvms.12-0124] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The present study was carried out to assess the frequency of methicillin-resistant staphylococci (MRS) among racehorses (n=209) and veterinary personnel (n=13) as well as environmental surfaces (n=14) at an equine hospital in Adana, Turkey. In addition, species distribution, antimicrobial susceptibility, resistance genes, staphylococcal chromosomal cassette mec (SCCmec) type and clonality of these isolates were also investigated. MRS were identified by 16S rRNA sequencing, and typed by pulsed-field gel electrophoresis (PFGE). As a result, MRS was isolated in horses (48.3%), clinic staff (92.3%) and environmental samples (71.4%). Of the 123 MRS isolates, 118 isolates were identified as Staphylococcus lentus, and the remaining ones were found to be S. sciuri (n=3), S. intermedius (n=1) and S. fleuretti (n=1). All isolates were found to be susceptible against vancomycin, quinupristin-dalfopristin and rifampicin. Additionally, single or various combinations of resistance genes were detected among MRS isolates. SCCmec type II was identified in all isolates. Similar PFGE patterns were observed among MRS isolated from horses, humans, and environmental samples. Since MRS were concurrently isolated from horses and humans it is suggested that cross-transmission of MRS between horses and humans might occur. However, it cannot be ruled out that transmission is human to animal or animal to human.
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Affiliation(s)
- Özkan Aslantas
- Department of Microbiology, Faculty of Veterinary Medicine, University of Mustafa Kemal, Hatay, Turkey.
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Peterson AE, Davis MF, Awantang G, Limbago B, Fosheim GE, Silbergeld EK. Correlation between animal nasal carriage and environmental methicillin-resistant Staphylococcus aureus isolates at U.S. horse and cattle farms. Vet Microbiol 2012; 160:539-43. [PMID: 22795260 DOI: 10.1016/j.vetmic.2012.06.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Revised: 06/22/2012] [Accepted: 06/23/2012] [Indexed: 11/19/2022]
Abstract
Animals on farms may be a potential reservoir and environmental source of methicillin-resistant Staphylococcus aureus (MRSA). Expanded surveillance methods for animal-associated MRSA are needed. To develop an environmental sampling method and to determine the correlation between animal and environmental MRSA positivity in the farm setting, we sampled horses, cattle, and their local environments at several farms in the mid-Atlantic United States. We obtained nasal swabs from 13 racehorses at first visit, and 11 racehorses at the same farm eight weeks later. We also sampled 26 pleasure horses and 26 beef cattle from two additional farm sites. Sterilized electrostatic cloths were used to collect dry dust samples from environmental surfaces in proximity to animals; cloths were cultured using a broth enrichment protocol. We described isolates by genotype and antimicrobial susceptibility phenotype. None of the samples (nasal or environmental) were positive from the pleasure horse farm or the cattle farm. On the racehorse farm, 8/13 (61%) nasal and 5/7 (71%) environmental samples were positive for MRSA at the first visit. Isolates found were indistinguishable by pulsed-field gel electrophoresis (PFGE) genotype. We observed significant positive correlation between nasal carriage of MRSA in animals and our ability to isolate MRSA from dry surface samples of their local environments. The methods presented here may aid in surveillance efforts for equine and other animal MRSA. This study successfully applies existing MRSA surveillance methods for indoor, high animal density settings to outdoor and low-density farms.
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Affiliation(s)
- Amy E Peterson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
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Bergström K, Nyman G, Widgren S, Johnston C, Grönlund-Andersson U, Ransjö U. Infection prevention and control interventions in the first outbreak of methicillin-resistant Staphylococcus aureus infections in an equine hospital in Sweden. Acta Vet Scand 2012; 54:14. [PMID: 22401493 PMCID: PMC3325856 DOI: 10.1186/1751-0147-54-14] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Accepted: 03/08/2012] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The first outbreak of methicillin-resistant Staphylococcus aureus (MRSA) infection in horses in Sweden occurred in 2008 at the University Animal Hospital and highlighted the need for improved infection prevention and control. The present study describes interventions and infection prevention control in an equine hospital setting July 2008 - April 2010. METHOD This descriptive study of interventions is based on examination of policy documents, medical records, notes from meetings and cost estimates. MRSA cases were identified through clinical sampling and telephone enquiries about horses post-surgery. Prospective sampling in the hospital environment with culture for MRSA and genotyping of isolates by spa-typing and pulsed-field gel electrophoresis (PFGE) were performed. RESULTS Interventions focused on interruption of indirect contact spread of MRSA between horses via staff and equipment and included: Temporary suspension of elective surgery; and identification and isolation of MRSA-infected horses; collaboration was initiated between authorities in animal and human public health, human medicine infection control and the veterinary hospital; extensive cleaning and disinfection was performed; basic hygiene and cleaning policies, staff training, equipment modification and interior renovation were implemented over seven months.Ten (11%) of 92 surfaces sampled between July 2008 and April 2010 tested positive for MRSA spa-type 011, seven of which were from the first of nine sampling occasions. PFGE typing showed the isolates to be the outbreak strain (9 of 10) or a closely related strain. Two new cases of MRSA infection occurred 14 and 19 months later, but had no proven connections to the outbreak cases. CONCLUSIONS Collaboration between relevant authorities and the veterinary hospital and formation of an infection control committee with an executive working group were required to move the intervention process forward. Support from hospital management and the dedication of staff were essential for the development and implementation of new, improved routines. Demonstration of the outbreak strain in the environment was useful for interventions such as improvement of cleaning routines and interior design, and increased compliance with basic hygienic precautions. The interventions led to a reduction in MRSA-positive samples and the outbreak was considered curbed as no new cases occurred for over a year.
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Affiliation(s)
- Karin Bergström
- Department of Animal Environment and Health, Faculty of Veterinary Medicine and Animal Husbandry, Swedish University of Agricultural Sciences, SE 750 07 Uppsala, Sweden
- Department of Animal Health and Antimicrobial Strategies, SVA, SE 750 89 Uppsala, Sweden
| | - Görel Nyman
- Department of Animal Environment and Health, Faculty of Veterinary Medicine and Animal Husbandry, Swedish University of Agricultural Sciences, SE 750 07 Uppsala, Sweden
| | - Stefan Widgren
- Department of Disease Control and Epidemiology, SVA, SE 750 89 Uppsala, Sweden
| | - Christopher Johnston
- Equine Clinics, University Animal Hospital, University of Agricultural Sciences, SE 750 07 Uppsala, Sweden
| | | | - Ulrika Ransjö
- Department of Clinical Microbiology, Uppsala University Hospital, SE 751 85 Uppsala, Sweden
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Bergström K, Aspan A, Landén A, Johnston C, Grönlund-Andersson U. The first nosocomial outbreak of methicillin-resistant Staphylococcus aureus in horses in Sweden. Acta Vet Scand 2012; 54:11. [PMID: 22316072 PMCID: PMC3348035 DOI: 10.1186/1751-0147-54-11] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2011] [Accepted: 02/08/2012] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) in animals is a rare finding in Sweden. In horses, MRSA was first detected in a screening survey in 2007. In 2008, six clinical cases occurred in an equine hospital, indicating an outbreak. METHOD All MRSA isolates detected, 11 spa-type t011 and one t064 (n = 12), in infected horses (n = 10) and screening of horses (n = 2) in Sweden from December 2007 to March 2010 were retrospectively analysed with pulsed-field gel electrophoresis (PFGE) using Cfr9I and ApaI restriction enzymes, to study relationship between the isolates. Medical records of infected horses and outbreak investigation notes were scrutinised to monitor the clinical outcome and other aspects of the outbreak. RESULTS Eight of the 10 infected horses were linked to one equine hospital and two to another hospital in the same region. The six horses infected with MRSA in 2008 underwent surgery during the period 22 May-7 July in one of the hospitals. Four more infections linked to the two hospitals were notified between 2009 and March 2010.Nine of the 11 spa-type t011 isolates had identical Cfr9I and ApaI PFGE pattern. All six infected horses from 2008 presented with this MRSA. Two t011 isolates differed in one and two bands, respectively, in PFGE.Nine horses suffered from surgical site infections (SSI). No antimicrobials were used following the MRSA diagnosis and the infections cleared. The time from surgery to MRSA diagnosis differed greatly between the horses (range 15-52 days). CONCLUSIONS Association in time and space of six horses infected with an identical MRSA strain of spa-type t011 confirmed an outbreak. Two isolates found in 2009 and 2010 in the outbreak hospital were closely related to the outbreak strain, indicating one circulating strain. Both spa-type t011 and t064 have been reported in horses in Europe prior to these findings. The observation that the infections cleared although antimicrobials were not used is encouraging for future prudent use of antimicrobials. The time from surgery to bacteriological diagnosis was not acceptable in most cases, as contagious spread was a risk. Sampling when symptoms of infection are noticed and accurate analysis are thus important.
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Affiliation(s)
- Karin Bergström
- Faculty of Veterinary Medicine and Animal Husbandry, Swedish University of Agricultural Sciences, 750 07 Uppsala, Sweden
- Department of Animal Health and Antimicrobial Strategies, SVA, 750 89 Uppsala, Sweden
| | - Anna Aspan
- Department of Bacteriology, SVA, 751 89 Uppsala, Sweden
| | - Annica Landén
- Department of Animal Health and Antimicrobial Strategies, SVA, 750 89 Uppsala, Sweden
| | - Christopher Johnston
- Equine Clinics, University Animal Hospital, University of Agricultural Sciences, 750 07 Uppsala, Sweden
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Griffeth GC, Callori N, Rankin SC, Boston RC, Morris DO. Optimization of a Staphylococcus aureus adhesion assay for equine corneocytes. Vet Dermatol 2011; 23:57-60, e13. [PMID: 21992593 DOI: 10.1111/j.1365-3164.2011.01012.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Meticillin-resistant Staphylococcus aureus (MRSA) causes serious skin and soft-tissue infections of humans and animals. Multiple strains of MRSA have been characterized, and one in particular, designated as strain USA 500, causes infections predominantly of horses and the people who work with them. The purpose of this study was to optimize an assay which could subsequently be used to compare the relative avidity of different S. aureus strains for equine corneocytes. Corneocytes were collected from the perineal skin of 10 healthy horses onto adhesive discs. The discs were then incubated at 37°C with an S. aureus field strain at each of three concentrations [10(7), 10(8) and 10(9) colony forming units (CFU)/mL] and for each of three incubation periods (45, 90 and 180 min). After standardized rinsing and staining procedures, discs were examined at ×1,000 magnification and areas containing confluent corneocytes photographed. The percentage of surface area occupied by adherent bacteria was analysed using image processing and analysis software. Significant colour space image processing was required to distinguish bacteria from the ubiquitous melanin granules present within equine corneocytes. Objective and subjective methods were used to determine optimal conditions for specific adherence without introducing confounding factors. A bacterial concentration of 10(8) CFU/mL incubated with corneocytes for 45 min produced maximal bacterial adhesion with the least amount of interbacterial clumping. Future studies should utilize these conditions for optimal assay performance.
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Affiliation(s)
- Gregory C Griffeth
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA 19104, USA
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Axon JE, Carrick JB, Barton MD, Collins NM, Russell CM, Kiehne J, Coombs G. Methicillin-resistant Staphylococcus aureus in a population of horses in Australia. Aust Vet J 2011; 89:221-5. [DOI: 10.1111/j.1751-0813.2011.00711.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cohn LA, Middleton JR. A veterinary perspective on methicillin-resistant staphylococci. J Vet Emerg Crit Care (San Antonio) 2010; 20:31-45. [PMID: 20230433 DOI: 10.1111/j.1476-4431.2009.00497.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To familiarize the reader with the epidemiology, diagnosis, and infectious and zoonotic potential of methicillin-resistant staphylococci. DATA SOURCES Original research publications, scientific reviews and abstracts, case reports, and conference proceedings. HUMAN DATA SYNTHESIS Staphylococcus aureus is a common human commensal organism; acquisition of genes encoding an altered penicillin-binding protein confers resistance to beta-lactam antimicrobial drugs. Methicillin-resistant S. aureus (MRSA) are often resistant to non-beta-lactam antimicrobial drugs as well. Originally described as an important cause of nosocomial infection, MRSA colonization and infection are now often identified in humans outside healthcare settings. Like other S. aureus, MRSA may be present without clinical illness. However, when they do cause infection the consequences can be extremely serious. VETERINARY DATA SYNTHESIS The major domestic animal species, including pets and livestock, may become contaminated, colonized, or infected with methicillin-resistant staphylococci, including MRSA. Dogs and cats are more likely to be colonized/infected with Staphylococcus pseudintermedius than S. aureus, but this pathogen can acquire genes encoding methicillin resistance (ie, MRSP). Diagnosis of MRSA or MRSP has implications not only for treatment of infected animals, but for potential zoonotic transmission. CONCLUSIONS MRSA infection is an important cause of morbidity and mortality in humans. Animals may be contaminated, colonized, or infected with MRSA, with implications for the animal's health and as a potential reservoir for human infection. Staphylococci other than S. aureus may also acquire genes for methicillin resistance, and these species can also result in animal and occasionally human morbidity or mortality.
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Affiliation(s)
- Leah A Cohn
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211, USA.
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Reflection paper on MRSA in food-producing and companion animals: epidemiology and control options for human and animal health. Epidemiol Infect 2010; 138:626-44. [DOI: 10.1017/s0950268810000014] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
SUMMARYThe scope of this reflection paper was to review the latest research on the risk of MRSA infection and colonization in animals. Attention focused on occurrence, risk factors for colonization and infection, and human contact hazard for livestock, horses, and companion animals. Whereas the clonal relationship between MRSA strains of CC398 is straightforward in livestock this is less obvious in horses. Small companion animals typically share MRSA strains that seem to exchange with a human reservoir. Management and therapeutic options have been suggested for livestock, horses, companion animals, as well as instructions on safety measures for persons in contact with animals. Conclusions were drawn with emphasis on future research activities, especially to confirm the apparent evolution of the organism and to demonstrate efficiency of control strategies.
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Faires MC, Traverse M, Tater KC, Pearl DL, Weese JS. Methicillin-resistant and -susceptible Staphylococcus aureus infections in dogs. Emerg Infect Dis 2010; 16:69-75. [PMID: 20031045 PMCID: PMC2874348 DOI: 10.3201/eid1601.081758] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Risk factors for MRSA include intravenous catheterization and receipt of certain antimicrobial drugs. Methicillin-resistant Staphylococcus aureus (MRSA) has become a pathogen of animals. To compare types of infections, clinical outcomes, and risk factors associated with MRSA in dogs with those associated with methicillin-susceptible Staphylococcus aureus (MSSA) infections, we conducted a case–control study at 3 veterinary referral hospitals in the United States and Canada during 2001–2007. Risk factors analyzed were signalment, medical and surgical history, and infection site. Among 40 dogs with MRSA and 80 with MSSA infections, highest prevalence of both infections was found in skin and ears. Although most (92.3%) dogs with MRSA infections were discharged from the hospital, we found that significant risk factors for MRSA infection were receipt of antimicrobial drugs (odds ratio [OR] 3.84, p = 0.02), β-lactams (OR 3.58, p = 0.04), or fluoroquinolones (OR 5.34, p = 0.01), and intravenous catheterization (OR 3.72, p = 0.02). Prudent use of antimicrobial drugs in veterinary hospitals is advised.
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Affiliation(s)
- Meredith C Faires
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.
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Maddox TW, Scantlebury CE, Clegg PD, Dawson S, Pinchbeck GL, Williams NJ. A review of the characteristics and treatment of methicillin-resistant Staphylococcus aureus (MRSA) in the horse and a case series of MRSA infection in four horses. EQUINE VET EDUC 2010. [DOI: 10.1111/j.2042-3292.2009.00026.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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CARON JOHNP, BOLIN CAROLEA, HAUPTMAN JOSEPHG, JOHNSTON KIMBERLYA. Minimum Inhibitory Concentration and Postantibiotic Effect of Amikacin for Equine Isolates of Methicillin-ResistantStaphylococcus aureusIn Vitro. Vet Surg 2009; 38:664-9. [DOI: 10.1111/j.1532-950x.2009.00551.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Weese JS, van Duijkeren E. Methicillin-resistant Staphylococcus aureus and Staphylococcus pseudintermedius in veterinary medicine. Vet Microbiol 2009; 140:418-29. [PMID: 19246166 DOI: 10.1016/j.vetmic.2009.01.039] [Citation(s) in RCA: 333] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2008] [Revised: 01/09/2009] [Accepted: 01/27/2009] [Indexed: 10/21/2022]
Abstract
Staphylococci are important opportunistic pathogens in most animal species. Among the most relevant species are the coagulase positive species Staphylococcus aureus and Staphylococcus pseudintermedius. Methicillin resistance has emerged as an important problem in both of these organisms, with significant concerns about animal and public health. The relative importance of these staphylococci on different animal species varies, as do the concerns about zoonotic transmission, yet it is clear that both present a challenge to veterinary medicine.
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Affiliation(s)
- J Scott Weese
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, Ontario, N1G2W1, Canada.
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