Extended-Spectrum β-Lactamase-Producing Enterobacterales Shedding by Dogs and Cats Hospitalized in an Emergency and Critical Care Department of a Veterinary Teaching Hospital

Abstract

Extended-spectrum β-lactamase-producing Enterobacterales (ESBL-PE) gut shedding in human medicine is considered as a major reservoir for ESBL-associated infections in high risk patients. In veterinary medicine, data regarding ESBL-PE gut shedding on admission to emergency and critical care department is scarce. We aimed to determine ESBL-PE shedding rates by dogs and cats in this setting and to determine the risk factors for shedding, at two separate periods, three-years apart. Rectal swabs were collected from animals, on admission and 72 h post admission, enriched and plated on Chromagar ESBL plates, followed by bacterial identification. ESBL phenotype was confirmed and antibiotic susceptibility profiles were determined (Vitek 2). Medical records were reviewed for risk factor analysis (SPSS). Overall, 248 animals were sampled, including 108 animals on period I (2015–2016) and 140 animals on period II (2019). In both periods combined, 21.4% of animals shed ESBL-PE on admission, and shedding rates increased significantly during hospitalization (53.7%, p-value < 0.001). The main ESBL-PE species were Escherichia coli and Klebsiella pneumoniae, accounting for more than 85% of the isolates. In a multivariable analysis, previous hospitalization was a risk factor for ESBL-PE gut shedding (p-value = 0.01, Odds ratio = 3.05, 95% Confidence interval 1.28–7.27). Our findings demonstrate significant ESBL-PE gut shedding among small animals in the emergency and critical care department, posing the necessity to design and implement control measures to prevent transmission and optimize antibiotic therapy in this setting.

Transmission Chains of Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae at the Companion Animal Veterinary Clinic–Household Interface

“…Additionally, a match in the core genome between the owner and the dog specimen was only found in 5% of the exposed households [ 28 ]. A previous study found that dog ownership was not a risk factor for ESBL-E carriage [ 29 ], however, dogs are often colonized with ESBL-E after hospitalization [ 27 ]. E. coli ST38 bla CTX-M 14 originally detected in two ICU patients was isolated from the owner of one of these animal patients after the dog’s discharge.…”

“…Transmission chains for several closely related ESBL-E isolates were detected within the ICU over extended periods of time. K. pneumoniae ST307 bla CTX-M-15 was isolated for the first time from dog 4 on day 15 and thereafter from different hospitalized patients (dogs 6 and 8; cats 1, 4 and 5; days [22][23][24][25][26][27][28][29] and environmental surfaces (days 22 and 45, Figure 1), which indicates an ongoing transmission chain for this strain. Some of these isolates (dog 4, day 15; cat 5, day 29; environmental specimens, days 22 and 45) were characterized by whole genome sequencing (WGS) and core genome multi-locus sequence typing (cgMLST) analysis which revealed that all selected isolates belonged to the same cluster.…”

“…In addition to their plasmid-mediated resistance to penicillins and cephalosporins, ESBL-E are often resistant to antibiotics such as fluoroquinolones, aminoglycosides, and sulfamethoxazole/trimethoprim [ 26 ]. Previous hospitalization, a raw food diet, elderly age, urinary or intra-abdominal infections, hepatic cirrhosis, residence in overcrowded household districts and antimicrobial therapy are known risk factors for ESBL-E colonization of dogs and cats [ 27 , 28 , 29 ]. In a recently published study, 21.4% of dogs and cats carried ESBL-E on admission to veterinary hospitals, whereas 53.7% were colonized after 72 h of hospitalization [ 27 ].…”

“…Previous hospitalization, a raw food diet, elderly age, urinary or intra-abdominal infections, hepatic cirrhosis, residence in overcrowded household districts and antimicrobial therapy are known risk factors for ESBL-E colonization of dogs and cats [ 27 , 28 , 29 ]. In a recently published study, 21.4% of dogs and cats carried ESBL-E on admission to veterinary hospitals, whereas 53.7% were colonized after 72 h of hospitalization [ 27 ]. This points towards an important role of companion animal clinics in the transmission of ESBL-E [ 1 , 10 , 11 , 12 , 13 , 30 ].…”

Antimicrobial Resistance in Escherichia coli Strains Isolated from Humans and Pet Animals

“…Cases of infections in which ESBLs are produced usually have quite an unpredictable course. E. coli is an example of a multidrug-resistant and ESBL-producing bacterium that can be the source of extremely severe infections [ 72 , 73 , 74 ]. As has previously been stated, some strains of E. coli can also cause very serious medical conditions connected with urinary and gastrointestinal tract and central nervous system [ 75 ].…”