A Retrospective Study of Antimicrobial Resistant Bacteria Associated with Feline and Canine Urinary Tract Infection in Hong Kong SAR, China—A Case Study on Implication of First-Line Antibiotics Use

Urinary tract infection (UTI) is a common clinical diagnosis for which empirical antibiotics are used in veterinary medicine. For veterinarians, the description of canine and feline antibiograms can help with making prudent use decisions and guideline formulation. For public health officers and epidemiologists, a urinary antibiogram overview helps track and trend antimicrobial resistance (AMR). There is currently a knowledge gap in AMR prevalence associated with urinary tract infection in feline and canine patients and the resistance percentage of these microbes against some of the over-the-counter antibiotics available to local pet owners. This study has two aims. First, it aims to investigate the frequency of the bacteria and bacterial-resistance pattern in urine samples obtained from feline and canine patients. Second, it aims to determine the resistance of Escherichia coli (E. coli), the most frequently isolated bacteria, to first-line antibiotics. Results: We identified the five most-frequently isolated bacterial species and determined these isolates’ antibiotic sensitivity and resistance. The most-frequently isolated bacteria in feline and canine patients was Escherichia coli (E. coli). E. coli was identified, on average, in 37.2% of canine and 46.5% of feline urine samples. Among feline urinary samples, Enterococcus (14.7%) and Staphylococcus (14.5%) spp. were isolated more frequently, followed by Pseudomonas (4.8%) and Klebsiella (5.2%) spp. (). In canine samples, Proteus (17.9%) and Staphylococcus (13.2%) spp. were isolated more frequently, followed by Enterococcus (10.0%) and Klebsiella (8.59%) spp. Among these isolates, 40 to 70% of Staphylococcus spp. bacterial isolates from feline and canine patients were resistant to amoxicillin and ampicillin. During the three-year study period, among canine patients, 10 to 20% of Staphylococcus spp. bacterial isolates were resistance to fluoroquinolones, other quinolones, and third-generation cephalosporins. Among feline patients, 10% of Staphylococcus spp., 15 to 20% of E. coli, 50 to 60% of Klebsiella spp., and 90% of Pseudomonas spp. were resistant to cefovecin, a commonly used antibiotic.

Engulfment, persistence and fate of Bdellovibrio bacteriovorus predators inside human phagocytic cells informs their future therapeutic potential

In assessing the potential of predatory bacteria, such as Bdellovibrio bacteriovorus, to become live therapeutic agents against bacterial infections, it is crucial to understand and quantify Bdellovibrio host cell interactions at a molecular level. Here, we quantify the interactions of live B. bacteriovorus with human phagocytic cells, determining the uptake mechanisms, persistence, associated cytokine responses and intracellular trafficking of the non-growing B. bacteriovorus in PMA-differentiated U937 cells. B. bacteriovorus are engulfed by U937 cells and persist for 24 h without affecting host cell viability and can be observed microscopically and recovered and cultured post-uptake. The uptake of predators is passive and depends on the dynamics of the host cell cytoskeleton; the engulfed predators are eventually trafficked through the phagolysosomal pathway of degradation. We have also studied the prevalence of B. bacteriovorus specific antibodies in the general human population. Together, these results quantify a period of viable persistence and the ultimate fate of B. bacteriovorus inside phagocytic cells. They provide new knowledge on predator availability inside hosts, plus potential longevity and therefore potential efficacy as a treatment in humans and open up future fields of work testing if predators can prey on host-engulfed pathogenic bacteria.

Antimicrobial stewardship: Australia

Purpose

– The purpose of this paper is to provide an overview of the context for strategies to overcome antimicrobial resistance in Australia, which may provide valuable learnings for other jurisdictions.

Design/methodology/approach

– Non-systematic review of literature from websites of national, state and territory health departments and interviews with key stakeholders for Australian strategies to reduce antimicrobial resistance.

Findings

– In July 2015 all states and territories in Australia adopted the National Antimicrobial Resistance Strategy 2015-2019, which is built on the World Health Organization policy package to combat antimicrobial resistance. This strategy represents “the collective, expert views of stakeholders on how best to combat antimicrobial resistance in Australia. It will also support global and regional efforts, recognising that no single country can manage the threat of antimicrobial resistance alone”. It combines quantitative and qualitative monitoring strategies with frameworks and guidelines to improve management of the use of antimicrobial resistant drugs. Prior to this, health services and states developed and implemented initiatives aimed at monitoring and improving prescribing practices. Development of the national strategy has encouraged and fostered debate within the Australian health system and a raft of new policy initiatives.

Research limitations/implications

– Surveillance strategies are in place to monitor impact and trends at jurisdictional and sector levels. However, actual impact on antimicrobial resistance and prescribing practices remains to be seen as existing initiatives are expanded and new initiatives implemented.

Practical implications

– This overview of key Australian initiatives balancing quantitative and qualitative surveillance, accreditation, research, education, community awareness and price signals on antibiotic prescribing practices may be valuable to health systems in developing local strategies.

Originality/value

– The authors provide an up to date overview of the context, strategies and aims of antimicrobial stewardship in Australia.