Antimicrobial susceptibility testing and successful treatment of hospitalised patients with extensively drug-resistant Campylobacter jejuni infections linked to a pet store puppy outbreak

Goyal, Dheeraj; Watkins, Louise Francois; Montgomery, Martha P.; Jones, Sonya M. Bodeis; Caidi, Hayat; Friedman, Cindy R.

doi:10.1016/j.jgar.2021.04.029

Cited by 11 publications

(6 citation statements)

References 26 publications

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“…Goyal et al demonstrated an outbreak of pet store puppy-associated extensively drug-resistant C. jejuni infections (Goyal et al, 2021 ). In addition, Thépault et al reported that genotype comparison with previously characterized isolates revealed a partial overlap among C. jejuni isolates from pets, chickens, cattle, and clinical cases (Thépault et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Prevalence, genomic characterization and antimicrobial resistance of Campylobacter spp. isolates in pets in Shenzhen, China

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et al. 2023

Front. Microbiol.

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The prevalence of Campylobacter spp.in pets is a potential concern for human health. However, little is known about the pet-related Campylobacter spp. in China. A total of 325 fecal samples were collected from dogs, cats, and pet foxes. Campylobacter spp. were isolated by culture, and MALDI-TOF MS was used to identify 110 Campylobacter spp. isolates in total. C. upsaliensis (30.2%, 98/325), C. helveticus (2.5%, 8/325), and C. jejuni (1.2%, 4/325) were the three found species. In dogs and cats, the prevalence of Campylobacter spp. was 35.0% and 30.1%, respectively. A panel of 11 antimicrobials was used to evaluate the antimicrobial susceptibility by the agar dilution method. Among C. upsaliensis isolates, ciprofloxacin had the highest rate of resistance (94.9%), followed by nalidixic acid (77.6%) and streptomycin (60.2%). Multidrug resistance (MDR) was found in 55.1% (54/98) of the C. upsaliensis isolates. Moreover, 100 isolates, including 88 C. upsaliensis, 8 C. helveticus, and 4 C. jejuni, had their whole genomes sequenced. By blasting the sequence against the VFDB database, virulence factors were identified. In total, 100% of C. upsaliensis isolates carried the cadF, porA, pebA, cdtA, cdtB, and cdtC genes. The flaA gene was present in only 13.6% (12/88) of the isolates, while the flaB gene was absent. By analyzing the sequence against the CARD database, we found that 89.8% (79/88) of C. upsaliensis isolates had antibiotic target alteration in the gyrA gene conferring resistance to fluoroquinolone, 36.4% (32/88) had the aminoglycoside resistance gene, and 19.3% (17/88) had the tetracycline resistance gene. The phylogenetic analysis using the K-mer tree method obtained two major clades among the C. upsaliensis isolates. All eight isolates in subclade 1 possessed the gyrA gene mutation, the aminoglycoside and tetracycline resistance genes, and were phenotypically resistant to six classes of antimicrobials. It has been established that pets are a significant source of Campylobacter spp. strains and a reservoir for them. This study is the first to have documented the presence of Campylobacter spp. in pets in Shenzhen, China. In this study, C. upsaliensis of subclade 1 required additional attention due to its broad MDR phenotype and relatively high flaA gene prevalence.

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Section: Discussionmentioning

confidence: 99%

Prevalence, genomic characterization and antimicrobial resistance of Campylobacter spp. isolates in pets in Shenzhen, China

Bi³

et al. 2023

Front. Microbiol.

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“…complications 1 ; several patients had prolonged hospital admission after multiple courses of antibiotics to which their strain was resistant. 32 These strains were circulating in the US for several years before health officials in Florida connected illnesses to pet store puppies through patient interviews. Challenges with public health surveillance and laboratory testing likely contributed to the delay in detection.…”

Section: Discussionmentioning

confidence: 99%

“…Antibiotic treatment of extensively drug-resistant C jejuni infection requires intravenous antibiotics, such as carbapenems, which are costly and normally reserved for hospital-associated infections. Failure of traditional antibiotics can lead to complications; several patients had prolonged hospital admission after multiple courses of antibiotics to which their strain was resistant …”

Section: Discussionmentioning

confidence: 99%

Ongoing Outbreak of Extensively Drug-ResistantCampylobacter jejuniInfections Associated With US Pet Store Puppies, 2016-2020

et al. 2021

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Key Points Question Are pet store puppies a source of extensively drug-resistant Campylobacter jejuni infection in the US? Findings This survey study identified 168 cases from public health reports of Campylobacter infections with an epidemiologic or molecular link to pet store puppies from 2011 to 2020; 97% of patients reported contact with a dog, of whom 88% reported contact with a pet store puppy. Isolates were resistant to 7 antibiotic classes, including all recommended treatment agents. Meaning Extensively drug-resistant C jejuni strains have emerged as a cause of illness among pet store customers, employees, and visitors; infections caused by these strains cannot be treated with commonly recommended oral antibiotics.

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“…In these reported cases, epidemiological investigation and the use of genetic typing methods confirmed human-to-pet or pet-to-human transmission. Of particular note are the recent reports on a large outbreak associated with extensively drug-resistant C. jejuni that occurred in the U.S. from 2016 to 2021 [95][96][97]. Over the course, more than 160 people were infected, and multiple patients were hospitalized.…”

Section: Sharing Of Multidrug Resistant Campylobacter Between Compani...mentioning

confidence: 99%

Zoonotic and antibiotic-resistant Campylobacter: a view through the One Health lens

2023

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As a pathogen of a major public health concern with animal health importance, Campylobacter constitutes a clear and present threat to One Health. This organism colonizes the intestinal tract and is widely distributed among various animal species, including livestock and poultry, companion animals, and wildlife. As a result of its broad distribution, Campylobacter is exposed to antibiotics used in both human and veterinary medicine, which creates antibiotic selection pressure that has driven the development and rising prevalence of antibiotic resistant Campylobacter. This is particularly evident with the resistance to fluoroquinolone (FQ), which has become a great concern for public health. However, the increased prevalence of antibiotic-resistant Campylobacter cannot be solely attributed to antibiotic usage, as interspecies transmission and subsequent clonal expansion also contribute to the dissemination of antibiotic-resistant Campylobacter. This is exemplified by the emergence and expansion of FQ-resistant Campylobacter clones in animal production systems where FQ antibiotics were never used, the transmission of extensively drug resistant Campylobacter from dogs to human patients, and the spread of antibiotic-resistant and hypervirulent Campylobacter from ruminants to humans. Another notable finding from recently published work is the emergence of antibiotic resistance genes of Gram-positive origin in Campylobacter, suggesting that genetic exchange between Campylobacter and Gram-positive bacteria occurs in the natural environment and is more frequent than previously realized. Once these “foreign” antibiotic resistance genes are presented in Campylobacter, they can further disseminate by clonal expansion or horizontal gene transfer among different Campylobacter species/strains. These findings indicate that the emergence and transmission of antibiotic-resistant Campylobacter in the ecosystem are complex and multidirectional, and are affected by multiple factors. Thus, a holistic and One Health approach is necessary to fully comprehend and mitigate antibiotic resistant Campylobacter.

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Antimicrobial susceptibility testing and successful treatment of hospitalised patients with extensively drug-resistant Campylobacter jejuni infections linked to a pet store puppy outbreak

Cited by 11 publications

References 26 publications

Prevalence, genomic characterization and antimicrobial resistance of Campylobacter spp. isolates in pets in Shenzhen, China

Prevalence, genomic characterization and antimicrobial resistance of Campylobacter spp. isolates in pets in Shenzhen, China

Ongoing Outbreak of Extensively Drug-ResistantCampylobacter jejuniInfections Associated With US Pet Store Puppies, 2016-2020

Zoonotic and antibiotic-resistant Campylobacter: a view through the One Health lens

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