Clinical staff MRSA carriage and environmental contamination by other “superbugs” found in Portuguese veterinary practices
**Note: the release below is from the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID 2023, Copenhagen, 15-18 April). Please credit the conference if you use this story**
Examination tables, scales and other surfaces in small animal veterinary practices are frequently contaminated with multidrug-resistant “superbugs”, the results of a Portuguese study suggest.
The research, which is being presented at this year’s European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) in Copenhagen, Denmark, (15-18 April) found that 19% of surfaces harboured at least one multidrug-resistant bacterium.
Dogs, cats and other pets are known to contribute to the spread of multidrug-resistant pathogens that can cause human disease. Small animal veterinary practices (SAVPs) are a potentially important link in the spread of these pathogens and, with numbers of SAVPs growing in Portugal, it is important to determine the prevalence of multidrug-resistant bacteria in this part of the veterinary sector.
Joana Moreira da Silva and colleagues from the Antibiotic Resistance Lab at Centre for Interdisciplinary Research in Animal Health (CIISA), Faculty of Veterinary Medicine, University of Lisbon, Portugal studied eight SAVPs, all of which were in Lisbon and the outskirts.
Critical surfaces, including surgical tables, shearing blades, examination tables and weighing scales were swabbed and nasal swabs were obtained from the vets, veterinary nurses and other staff.
The swabs were tested for the presence of multidrug-resistant bacteria.
At least one multidrug-resistant bacterium was found on 18.9% (34/182) of the surfaces tested. These include Acinetobacter spp. and Staphylococci, including S. pseudintermedius. These bacteria are responsible for highly resistant clinical infections in both human and veterinary medicine.
In one of the veterinary practices, 18.2% of the tested surfaces (4/22) were positive for OXA-23-producing Acinetobacter spp. These bacteria, which were found on several different surfaces, are resistant to carbapenem antibiotics. Carbapenems are prohibited in veterinary medicine by the European Medicines Agency (EMA)1 and play vital role in human medicine, where they are part of the last line of treatment when other antibiotics have failed.
Together with previous studies which found carbapenem-resistant infections in pets2, this highlights the possibility that SAVPs may play a role in the dissemination of multidrug-resistant bacteria into the community.
No methicillin-resistant Staphylococcus aureus (MRSA) was found on any of the surfaces tested.
Approximately 23% of workers were carrying MRSA. While MRSA is not common in veterinary medicine, nasal carriage is common in human healthcare settings and in the community.
However, if MRSA gets deeper into the body, via wounds or catheters, for example, it cause lung, skin and other infections, some of which can be life-threatening. The bacterium is on the World Health Organisation’s list of antibiotic-resistant “priority pathogens” – meaning it is among the bacteria judged to pose the greatest risk to human health.3
Ms Moreira da Silva, a PhD student, says: “Our findings highlight the need to implement and monitor infection, prevention and control (IPC) guidelines in small animal veterinary practices.
“The inclusion of monitoring of workers for the nasal carriage of MRSA is also important to consider when designing IPC guidelines. Such measures might prevent the dissemination of multidrug-resistant bacteria into the community.
“People should not be afraid to take pets to the vet – it is still by far the best place for them to receive care.”
Joana Moreira da Silva, Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Portugal T) +351 21 365 2837 E) jmsilva@fmv.ulisboa.pt
Professor Constança Pomba, Team leader of the Antibiotic Resistance Lab at the Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Portugal. T) +351 21 365 2837 E) cpomba@fmv.ulisboa.pt
Alternative contact: Tony Kirby in the ECCMID Media Centre. T) +44 7834 385827 E) tony@tonykirby.com
Notes to editors:
References:
1. European Medicines Agency (EMA). (2019). Categorisation of antibiotics in the European Union. 31(12 December 2019). https://www.ema.europa.eu/en/documents/report/categorisation-antibiotics-european-union-answer-request-european-commission-updating-scientific_en.pdf
2. Moreira da Silva, J., Menezes, J., Mendes, G., Santos Costa, S., Caneiras, C., Poirel, L., Amaral, A. J., & Pomba, C. (2022). KPC-3-Producing Klebsiella pneumoniae Sequence Type 392 from a Dog’s Clinical Isolate in Portugal. Microbiology Spectrum, 10(4). https://doi.org/10.1128/spectrum.00893-22
Conflicts of interest: institutional grants and research support.
This project was funded by CIISA and FCT Project UIDB/00276/2020 and LA/P/0059/2020 – AL4AnimalS. This project was funded by national funds through FCT - Fundação para a Ciência e Tecnologia I.P., within the project 2022.08669.PTDC. JMS, JM and LF were supported by a Fundação para a Ciência e Tecnologia (FCT) PhD fellowship (2020.06540.BD; 2020.07562.BD; UI/BD/153070/2022, respectively).
This press release is based on abstract 279 at the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) annual meeting. The material has been peer reviewed by the congress selection committee. There is no full paper at this stage.
For full abstract click here
For full poster click here
ARTICLE PUBLICATION DATE
14-Apr-2023
COI STATEMENT
Conflicts of interest: institutional grants and research support. This project was funded by CIISA and FCT Project UIDB/00276/2020 and LA/P/0059/2020 – AL4AnimalS. This project was funded by national funds through FCT - Fundação para a Ciência e Tecnologia I.P., within the project 2022.08669.PTDC. JMS, JM and LF were supported by a Fundação para a Ciência e Tecnologia (FCT) PhD fellowship (2020.06540.BD; 2020.07562.BD; UI/BD/153070/2022, respectively).
UK-Portuguese study shows antibiotic-resistant “superbugs” are being passed between dogs and cats and their owners, study strongly suggests
People in UK and Portugal carrying same multidrug-resistant bacteria as their pets; call for dogs and cats to be included in assessments of antibiotic resistance
Reports and Proceedings**Note: the release below is from the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID 2023, Copenhagen, 15-18 April). Please credit the conference if you use this story**
Evidence that multidrug-resistant bacteria are being passed between pet cats and dogs and their owners will be presented at this year’s European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) in Copenhagen, Denmark (15-18 April).
Six pets in Portugal and one in the UK were carrying antibiotic-resistant bacteria similar to those found in their owners, a Portuguese study found.
The finding underlines the importance of including pet-owning households in programmes to reduce the spread of antimicrobial resistance.
Antibiotic resistance is reaching dangerously high levels around the world. Drug-resistant infections kill an estimated 700,000 people a year globally and, with the figure projected to rise to 10 million by 2050 if no action is taken, the World Health Organisation (WHO) classes antibiotic resistance as one of the greatest public health threats facing humanity.
Dogs, cats and other pets are known to contribute to the spread of antibiotic-resistant pathogens that can cause human disease. Juliana Menezes and colleagues from the Antibiotic Resistance Lab at the Centre of Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Portugal wanted to find out if pets being treated with antibiotics for infections are sharing such pathogens with their owners.
The researchers tested faecal samples from dogs and cats and their owners for Enterobacterales (a large family of bacteria which includes E. coli and Klebsiella pneumoniae) resistant to common antibiotics.
They focused on bacteria resistant to third generation cephalosporins (used to treat a broad range of conditions, including meningitis, pneumonia and sepsis, they are classed among the most critically important antibiotics for human medicine by the World Health Organisation) and carbapenems (part of the last line of defence when other antibiotics have failed).The prospective longitudinal study involved five cats, 38 dogs and 78 humans from 43 households in Portugal and seven dogs and eight humans from seven households in the UK.
In Portugal, one dog (1/43 pets, 2.3%) was colonised by a strain of multidrug-resistant OXA-181-producing Escherichia coli. OXA-181 is an enzyme that confers resistance to carbapenems.
Three cats and 21 dogs (24/43 pets, 55.8%) and 28 owners (28/78, 35.9%) harboured ESBL/Amp-C producing Enterobacterales. These are resistant to third generation cephalosporins.
In eight households, two houses with cats and six with dogs, both pet and owner were carrying ESBL/AmpC-producing bacteria. In six of these homes, the DNA of the bacteria isolated from the pets (one cat and five dogs) and their owners was similar, meaning these bacteria were probably passed between the animals and humans. It is not known whether they were transferred from pet to human or vice versa.
In the UK, one dog (1/7,14.3%) was colonised by multidrug-resistant E. coli producing NDM-5 and CTX-M-15 beta-lactamases. These E. coli are resistant to third generation cephalosporins, carbapenems and several other families of antibiotics.
ESBL/AmpC-producing Enterobacterales were isolated from five dogs (5/7, 71.4%) and three owners (3/8, 37.5%).
In two households with dogs, both pet and owner were carrying ESBL/AmpC-producing bacteria. In one of these homes, the DNA of the bacteria isolated from the dog and owner was similar, suggesting the bacteria probably passed from one to the other. The direction of transfer is unclear.
All of the dogs and cats were successfully treated for their skin, soft tissue and urinary tract infections.
The owners did not have infections and so did not need treatment.
Ms Menezes, a PhD student, says: “In this study, we provide evidence that bacteria resistant to a third generation cephalosporins, critically important antibiotics, are being passed from pets to their owners.
“Dogs and cats may aid the spread and persistence of such bacteria in the community and it is vitally important that they are included in assessments of antimicrobial resistance.
“Owners can reduce the spread of multidrug-resistant bacteria by practising good hygiene, including washing their hands after collecting their dog or cat’s waste and even after petting them.”
Juliana Menezes, Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Portugal. T) +351 21 365 2837 E) julianamenezes@fmv.ulisboa.pt
Professor Constança Pomba, Team leader of the Antibiotic Resistance Lab at the Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Portugal. T) +351 21 365 2837 E) cpomba@fmv.ulisboa.pt
Alternative contact: Tony Kirby in the ECCMID Media Centre. T) +44 7834 385827 E) tony@tonykirby.com
Notes to editors:
The authors declare no conflicts of interest.
The work was supported by JPIAMR/0002/2016 Project—PET-Risk Consortium and by FCT – Fundação para a Ciência e Tecnologia IP (UIDB/00276/2020); JM and JMS were supported by a PhD fellowship (2020.07562.BD; 2020.06540.BD, respectively).
This press release is based on oral presentation 208 at the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) annual meeting. The material has been peer reviewed by the congress selection committee. There is no full paper at this stage and, as it is an oral presentation, there is no poster.