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Dassler K, Zurfluh K, Stephan R, Willi B. Educational intervention to improve infection prevention and control practices in four companion animal clinics in Switzerland. J Hosp Infect 2023; 139:121-133. [PMID: 37302754 DOI: 10.1016/j.jhin.2023.06.002] [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: 04/13/2023] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND Infection prevention and control (IPC) practices vary among companion animal clinics, and outbreaks with carbapenemase-producing Enterobacterales (CPE) have been described. AIM To investigate the effect of an IPC intervention (introduction of IPC protocols, IPC lectures, hand hygiene campaign) in four companion animal clinics. METHODS IPC practices, environmental and hand contamination with antimicrobial-resistant micro-organisms (ARM) and hand hygiene (HH) were assessed at baseline, and 1 and 5 months after the intervention. RESULTS Median IPC scores (% maximum score) improved from 57.8% (range 48.0-59.8%) to 82.9% (range 81.4-86.3%) at 1-month follow-up. Median cleaning frequency assessed by fluorescent tagging increased from 16.7% (range 8.9-18.9%) to 30.6% (range 27.8-52.2%) at 1-month follow-up and 32.8% (range 32.2-33.3%) at 5-month follow-up. ARM contamination was low in three clinics at baseline and undetectable after the intervention. One clinic showed extensive contamination with ARM including CPE before and after the intervention (7.5-16.0% ARM-positive samples and 5.0-11.5% CPE-positive samples). Mean HH compliance improved from 20.9% [95% confidence interval (CI) 19.2-22.8%] to 42.5% (95% CI 40.4-44.7%) at 1-month follow-up and 38.7% (95% CI 35.7-41.7%) at 5-month follow-up. Compliance was lowest in the pre-operative preparation area at baseline (11.8%, 95% CI 9.3-14.8%) and in the intensive care unit after the intervention (28.8%, 95% CI 23.3-35.1%). HH compliance was similar in veterinarians (21.5%, 95% CI 19.0-24.3%) and nurses (20.2%, 95% CI 17.9-22.7%) at baseline, but was higher in veterinarians (46.0%, 95% CI 42.9-49.1%) than nurses (39.0%, 95% CI 36.0-42.1%) at 1-month follow-up. CONCLUSION The IPC intervention improved IPC scores, cleaning frequency and HH compliance in all clinics. Adapted approaches may be needed in outbreak situations.
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Affiliation(s)
- K Dassler
- Institute for Food Safety and Hygiene, University of Zurich, Zurich, Switzerland; Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - K Zurfluh
- Institute for Food Safety and Hygiene, University of Zurich, Zurich, Switzerland
| | - R Stephan
- Institute for Food Safety and Hygiene, University of Zurich, Zurich, Switzerland
| | - B Willi
- Clinic for Small Animal Internal Medicine, University of Zurich, Zurich, Switzerland.
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Ratti G, Facchin A, Stranieri A, Giordano A, Paltrinieri S, Scarpa P, Maragno D, Gazzonis A, Penati M, Luzzago C, Dall’Ara P, Lauzi S. Fecal Carriage of Extended-Spectrum β-Lactamase-/AmpC-Producing Escherichia coli in Pet and Stray Cats. Antibiotics (Basel) 2023; 12:1249. [PMID: 37627669 PMCID: PMC10451524 DOI: 10.3390/antibiotics12081249] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/21/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023] Open
Abstract
Dogs have been reported as potential carriers of antimicrobial-resistant bacteria, but the role of cats has been poorly studied. The aim of this study was to investigate the presence and the risk factors associated with the fecal carriage of extended-spectrum β-lactamase and AmpC (ESBL/AmpC)-producing Escherichia coli (E. coli) in pet and stray cats. Fecal samples were collected between 2020 and 2022 from healthy and unhealthy cats and screened for ESBL/AmpC-producing E. coli using selective media. The presence of ESBL/AmpC-producing E. coli was confirmed by phenotypic and molecular methods. The evaluation of minimum inhibitory concentrations (MICs) was performed on positive isolates. Host and hospitalization data were analyzed to identify risk factors. A total of 97 cats' samples were collected, and ESBL/AmpC-producing E. coli were detected in 6/97 (6.2%), supported by the detection of blaCTX-M (100%), blaTEM (83.3%), and blaSHV (16.7%) genes and the overexpression of chromosomal ampC (1%). All E. coli isolates were categorized as multidrug-resistant. Unhealthy status and previous antibiotic therapy were significantly associated with ESBL/AmpC-producing E. coli fecal carriage. Our results suggest that cats may be carriers of ESBL/AmpC-producing E. coli, highlighting the need for antimicrobial stewardship in veterinary medicine and an antimicrobial-resistance surveillance program focusing on companion animals, including stray cats.
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Affiliation(s)
- Gabriele Ratti
- Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, 26900 Lodi, Italy; (G.R.); (A.F.); (A.S.); (A.G.); (S.P.); (P.S.); (D.M.); (A.G.); (M.P.); (C.L.); (S.L.)
| | - Alessia Facchin
- Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, 26900 Lodi, Italy; (G.R.); (A.F.); (A.S.); (A.G.); (S.P.); (P.S.); (D.M.); (A.G.); (M.P.); (C.L.); (S.L.)
| | - Angelica Stranieri
- Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, 26900 Lodi, Italy; (G.R.); (A.F.); (A.S.); (A.G.); (S.P.); (P.S.); (D.M.); (A.G.); (M.P.); (C.L.); (S.L.)
| | - Alessia Giordano
- Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, 26900 Lodi, Italy; (G.R.); (A.F.); (A.S.); (A.G.); (S.P.); (P.S.); (D.M.); (A.G.); (M.P.); (C.L.); (S.L.)
| | - Saverio Paltrinieri
- Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, 26900 Lodi, Italy; (G.R.); (A.F.); (A.S.); (A.G.); (S.P.); (P.S.); (D.M.); (A.G.); (M.P.); (C.L.); (S.L.)
| | - Paola Scarpa
- Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, 26900 Lodi, Italy; (G.R.); (A.F.); (A.S.); (A.G.); (S.P.); (P.S.); (D.M.); (A.G.); (M.P.); (C.L.); (S.L.)
| | - Deborah Maragno
- Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, 26900 Lodi, Italy; (G.R.); (A.F.); (A.S.); (A.G.); (S.P.); (P.S.); (D.M.); (A.G.); (M.P.); (C.L.); (S.L.)
| | - Alessia Gazzonis
- Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, 26900 Lodi, Italy; (G.R.); (A.F.); (A.S.); (A.G.); (S.P.); (P.S.); (D.M.); (A.G.); (M.P.); (C.L.); (S.L.)
| | - Martina Penati
- Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, 26900 Lodi, Italy; (G.R.); (A.F.); (A.S.); (A.G.); (S.P.); (P.S.); (D.M.); (A.G.); (M.P.); (C.L.); (S.L.)
- Laboratory of Animal Infectious Diseases (MiLab), University of Milan, 26900 Lodi, Italy
| | - Camilla Luzzago
- Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, 26900 Lodi, Italy; (G.R.); (A.F.); (A.S.); (A.G.); (S.P.); (P.S.); (D.M.); (A.G.); (M.P.); (C.L.); (S.L.)
| | - Paola Dall’Ara
- Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, 26900 Lodi, Italy; (G.R.); (A.F.); (A.S.); (A.G.); (S.P.); (P.S.); (D.M.); (A.G.); (M.P.); (C.L.); (S.L.)
| | - Stefania Lauzi
- Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, 26900 Lodi, Italy; (G.R.); (A.F.); (A.S.); (A.G.); (S.P.); (P.S.); (D.M.); (A.G.); (M.P.); (C.L.); (S.L.)
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Santamarina SC, Heredia DA, Durantini AM, Durantini EN. Porphyrin Polymers Bearing N, N'-Ethylene Crosslinkers as Photosensitizers against Bacteria. Polymers (Basel) 2022; 14:polym14224936. [PMID: 36433062 PMCID: PMC9696963 DOI: 10.3390/polym14224936] [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: 10/10/2022] [Revised: 11/04/2022] [Accepted: 11/11/2022] [Indexed: 11/18/2022] Open
Abstract
The appearance of microbes resistant to antibiotics requires the development of alternative therapies for the treatment of infectious diseases. In this work two polymers, PTPPF16-EDA and PZnTPPF16-EDA, were synthesized by the nucleophilic aromatic substitution of 5,10,15,20-tetrakis(pentafluorophenyl)porphyrin and its Zn(II) complex with ethylenediamine, respectively. In these structures, the tetrapyrrolic macrocycles were N,N'-ethylene crosslinked, which gives them greater mobility. The absorption spectra of the polymers showed a bathochromic shift of the Soret band of ~10 nm with respect to the monomers. This effect was also found in the red fluorescence emission peaks. Furthermore, both polymeric materials produced singlet molecular oxygen with high quantum yields. In addition, they were capable of generating superoxide anion radicals. Photodynamic inactivation sensitized by these polymers was tested in Staphylococcus aureus and Escherichia coli bacteria. A decrease in cell viability greater than 7 log (99.9999%) was observed in S. aureus incubated with 0.5 μM photosensitizer upon 30 min of irradiation. Under these conditions, a low inactivation of E. coli (0.5 log) was found. However, when the cells were treated with KI, the elimination of the Gram-negative bacteria was achieved. Therefore, these polymeric structures are interesting antimicrobial photosensitizing materials for the inactivation of pathogens.
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Puvača N. Optimization of Veterinary Antimicrobial Treatment in Companion and Food Animals. Antibiotics (Basel) 2022; 11:antibiotics11081137. [PMID: 36010005 PMCID: PMC9405314 DOI: 10.3390/antibiotics11081137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 08/18/2022] [Indexed: 11/16/2022] Open
Abstract
Several international strategies for antimicrobial stewardship have been developed in response to the global crisis of antimicrobial resistance [...].
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Affiliation(s)
- Nikola Puvača
- Department of Engineering Management in Biotechnology, Faculty of Economics and Engineering Management in Novi Sad, University Business Academy in Novi Sad, Cvećarska 2, 21000 Novi Sad, Serbia;
- Faculty of Biomedical and Health Sciences, Jaume I University, Avinguda de Vicent Sos Baynat, s/n, 12071 Castelló de la Plana, Spain
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Prevalence and Molecular Characterization of Extended-Spectrum β-Lactamase Producing Enterobacterales in Healthy Community Dogs in Israel. Antibiotics (Basel) 2022; 11:antibiotics11081069. [PMID: 36009938 PMCID: PMC9404856 DOI: 10.3390/antibiotics11081069] [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: 07/03/2022] [Revised: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 11/17/2022] Open
Abstract
Background: antimicrobial resistance is a global problem in human and veterinary medicine. We aimed to investigate the extended spectrum β-lactamase-producing Enterobacterales (ESBL-PE) gut colonization in healthy community dogs in Israel. Methods: Rectal swabs were sampled from 145 healthy dogs, enriched, plated on selective plates, sub-cultured to obtain pure cultures, and ESBL production was confirmed. Bacterial species and antibiotic susceptibility profiles were identified. WGS was performed on all of the ESBL-PE isolates and their resistomes were identified in silico. Owners’ questionnaires were collected for risk factor analysis. Results: ESBL-PE gut colonization rate was 6.2% (n = 9/145, 95% CI 2.9–11.5). Overall, ten isolates were detected (one dog had two isolates); the main species was Escherichia coli (eight isolates), belonging to diverse phylogenetic groups—B1, A and C. Two isolates were identified as Citrobacter braakii, and C. portucalensis. A phylogenetic analysis indicated that all of the isolates were genetically unrelated and sporadic. The isolates possessed diverse ESBL genes and antibiotic-resistance gene content, suggesting independent ESBL spread. In a multivariable risk factor analysis, coprophagia was identified as a risk factor for ESBL-PE gut colonization (p = 0.048, aOR = 4.408, 95% CI 1.014–19.169). Conclusions: healthy community dogs may be colonized with ESBL-PE MDR strains, some of which were previously reported in humans, that carry wide and diverse resistomes and may serve as a possible source for AMR.
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Pumphrey SA, Wayne AS. Patterns of bacterial culture and antimicrobial susceptibility test results for dogs with retrobulbar abscesses: 133 cases (2002-2019). J Am Vet Med Assoc 2022; 260:1-9. [PMID: 35175928 DOI: 10.2460/javma.21.04.0180] [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: 11/20/2022]
Abstract
OBJECTIVE To evaluate patterns of bacterial culture and antimicrobial susceptibility test results for dogs with retrobulbar abscesses and generate recommendations for empirical antimicrobial selection. ANIMALS 133 dogs examined between 2002 and 2019. PROCEDURES Records were retrospectively reviewed to determine type of bacterial culture, number and type of bacterial isolates, antimicrobial susceptibility test results, concurrent and recent antimicrobial exposure, effect of culture results on antimicrobial regimen, and outcome. RESULTS Aerobic culture alone was performed in 37 dogs, and aerobic and anaerobic culture was performed in 96 dogs. Isolates were recovered from 96 dogs, with multiple isolates recovered from 54 (56%) of those dogs. Of the 69 dogs for which both aerobic and anaerobic culture was performed and at least 1 isolate was obtained, 34 (49%) had purely aerobic infections, 15 (22%) had mixed aerobic and anaerobic infections, and 20 (29%) had purely anaerobic infections. Pasteurella spp (n = 26), Streptococcus spp (20), and Escherichia coli (12) were the most common aerobic isolates. Bacteroides spp (n = 22), Actinomyces spp (10), and Fusobacterium (10) spp were the most common anaerobic isolates. Susceptibility test results led to changes in the antimicrobial regimen in 37 of 80 (46%) dogs. Of the 76 dogs for which outcome information was available, 78 (97%) recovered. CLINICAL RELEVANCE Multipathogen and anaerobic infections were common in dogs with retrobulbar abscesses. Susceptibility data supported the use of amoxicillin-clavulanate or a combination of clindamycin and enrofloxacin as first-line treatments. Additional study is needed to characterize anaerobic antimicrobial susceptibilities and to compare results of susceptibility testing with in vivo responses to antimicrobial administration.
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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.
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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;
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Puvača N, de Llanos Frutos R. Antimicrobial Resistance in Escherichia coli Strains Isolated from Humans and Pet Animals. Antibiotics (Basel) 2021; 10:69. [PMID: 33450827 PMCID: PMC7828219 DOI: 10.3390/antibiotics10010069] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/06/2021] [Accepted: 01/12/2021] [Indexed: 12/12/2022] Open
Abstract
Throughout scientific literature, we can find evidence that antimicrobial resistance has become a big problem in the recent years on a global scale. Public healthcare systems all over the world are faced with a great challenge in this respect. Obviously, there are many bacteria that can cause infections in humans and animals alike, but somehow it seems that the greatest threat nowadays comes from the Enterobacteriaceae members, especially Escherichia coli. Namely, we are witnesses to the fact that the systems that these bacteria developed to fight off antibiotics are the strongest and most diverse in Enterobacteriaceae. Our great advantage is in understanding the systems that bacteria developed to fight off antibiotics, so these can help us understand the connection between these microorganisms and the occurrence of antibiotic-resistance both in humans and their pets. Furthermore, unfavorable conditions related to the ease of E. coli transmission via the fecal-oral route among humans, environmental sources, and animals only add to the problem. For all the above stated reasons, it is evident that the epidemiology of E. coli strains and resistance mechanisms they have developed over time are extremely significant topics and all scientific findings in this area will be of vital importance in the fight against infections caused by these bacteria.
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Affiliation(s)
- Nikola Puvača
- Faculty of Biomedical and Health Sciences, Jaume I University, Avinguda de Vicent Sos Baynat, s/n, 12071 Castelló de la Plana, Spain;
- Department of Engineering Management in Biotechnology, Faculty of Economics and Engineering Management in Novi Sad, University Business Academy in Novi Sad, Cvećarska 2, 21000 Novi Sad, Serbia
| | - Rosa de Llanos Frutos
- Faculty of Biomedical and Health Sciences, Jaume I University, Avinguda de Vicent Sos Baynat, s/n, 12071 Castelló de la Plana, Spain;
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