Long-lasting nosocomial persistence of chlorhexidine-resistant Serratia marcescens in a veterinary hospital

Keck, Nicolas; Dunié‐Mérigot, Antoine; Dazas, Mélody; Hirchaud, Edouard; Laurence, Stéphanie; Gervais, Béatrice; Madec, Jean‐Yves; Haenni, Marisa

doi:10.1016/j.vetmic.2020.108686

Cited by 18 publications

(25 citation statements)

References 29 publications

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“…While S . marcescens infections have been reported in dogs and cats [ 6 ], S . ureilytica is mainly considered as an environmental organism [ 44 ] and little is known on its virulence on domestic or wild animals.…”

Section: Discussionmentioning

confidence: 99%

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Healthcare-associated infections caused by chlorhexidine-tolerant Serratia marcescens carrying a promiscuous IncHI2 multi-drug resistance plasmid in a veterinary hospital

et al. 2022

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The bacterium Serratia marcescens can cause opportunistic infections in humans and in animals. In veterinary settings, the diversity, reservoirs and modes of transmission of this pathogen are poorly understood. The phenotypes and genotypes of Serratia spp. isolated from dogs, cats, horses, a bird and a rabbit examined at an Australian veterinary hospital between 2008 and 2019 were characterised. The isolates were identified as S. marcescens (n = 15) or S. ureilytica (n = 3) and were placed into four distinct phylogenetic groups. Nine quasi-clonal isolates associated with post-surgical complications in different patients displayed high levels of resistance to the antimicrobials fluoroquinolones, cephalosporins, aminoglycosides, and to the disinfectant chlorhexidine. A Serratia sp. with a similar resistance profile was also isolated from chlorhexidine solutions used across the Hospital, suggesting that these infections had a nosocomial origin. A genomic island encoding a homolog of the Pseudomonas MexCD-OprJ biocide efflux system was detected in the chlorhexidine-tolerant Serratia. The nine multi-drug resistant Serratia isolates also possessed a Ser-83-Ile mutation in GyrA conferring fluoroquinolone resistance, and carried a large IncHI2 conjugative plasmid encoding antimicrobial and heavy metal resistances. This replicon was highly similar to a plasmid previously detected in a strain of Enterobacter hormaechei recovered from the Hospital environment. IncHI2 plasmids are commonly found in Enterobacteriaceae, but are rarely present in Serratia spp., suggesting that this plasmid was acquired from another organism. A chlorhexidine-tolerant Serratia isolate which lacked the IncHI2 plasmid was used in mating experiments to demonstrate the transfer of multi-drug resistance from a E. hormaechei donor. This study illustrates the importance of environmental surveillance of biocide-resistance in veterinary hospitals.

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Section: Discussionmentioning

confidence: 99%

“…Outbreaks of S . marcescens infections have been attributed to chlorhexidine solutions in human hospitals [ 4 , 5 ], and more recently in veterinary hospitals [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Healthcare-associated infections caused by chlorhexidine-tolerant Serratia marcescens carrying a promiscuous IncHI2 multi-drug resistance plasmid in a veterinary hospital

et al. 2022

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“…Even though the epidemic success of the IncHI2 plasmid carrying bla CTX–M– 9 , mcr-9 and bla SHV– 12 can be highlighted, the causes of such a wide dissemination of ESBL-producing bacteria inside the rescue center also remain unknown and may warrant investigation. Antibiotherapy was not common practice in this center (antibiotics were only prescribed in case of open fracture; M-PP, personal communication) but, as demonstrated in a recent study, a single source, such as the use of contaminated disinfectants, may be sufficient for a large and long-term contamination by resistant bacteria ( Keck et al, 2020 ). Other hypotheses include frequent handling of animals, different birds kept in the same cage, difficulties to disinfect surfaces (often in wood) or inadequate hygiene procedures in often crowded settings, such as animal rescue centers.…”

Section: Discussionmentioning

confidence: 99%

Wide Spread of blaCTX–M–9/mcr-9 IncHI2/ST1 Plasmids and CTX-M-9-Producing Escherichia coli and Enterobacter cloacae in Rescued Wild Animals

Haenni

Métayer

Jarry³

et al. 2020

Front. Microbiol.

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“…On the other hand, the results of our study showed that dog skin is also a possible source of HAIs, and therefore limiting animal movement, cleaning dogs when possible, and using disposable supplies with each patient could reduce the potential for HAI spread. Moreover, the development of a surveillance program for early HAI identification in veterinary practices is required 21 .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of nosocomial infections through contact patterns in a small animal hospital using social network analysis and genotyping techniques

Churak

Poolkhet

Tsutsumi

et al. 2021

Sci Rep

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Nosocomial infections or hospital-acquired infections (HAIs) are common health problems affecting patients in human and animal hospitals. Herein, we hypothesised that HAIs could be spread through human and animal movement, contact with veterinary medical supplies, equipment, or instruments. We used a combination of social network analysis and genotyping techniques to find key players (or key nodes) and spread patterns using Escherichia coli as a marker. This study was implemented in the critical care unit, outpatient department, operation room, and ward of a small animal hospital. We conducted an observational study used for key player determination (or key node identification), then observed the selected key nodes twice with a one-month interval. Next, surface swabs of key nodes and their connecting nodes were analysed using bacterial identification, matrix-assisted laser desorption/ionisation-time of flight mass spectrometry, and pulsed-field gel electrophoresis. Altogether, our results showed that veterinarians were key players in this contact network in all departments. We found two predominant similarity clusters; dendrogram results suggested E. coli isolates from different time points and places to be closely related, providing evidence of HAI circulation within and across hospital departments. This study could aid in limiting the spread of HAIs in veterinary and human hospitals.

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Long-lasting nosocomial persistence of chlorhexidine-resistant Serratia marcescens in a veterinary hospital

Cited by 18 publications

References 29 publications

Healthcare-associated infections caused by chlorhexidine-tolerant Serratia marcescens carrying a promiscuous IncHI2 multi-drug resistance plasmid in a veterinary hospital

Healthcare-associated infections caused by chlorhexidine-tolerant Serratia marcescens carrying a promiscuous IncHI2 multi-drug resistance plasmid in a veterinary hospital

Wide Spread of blaCTX–M–9/mcr-9 IncHI2/ST1 Plasmids and CTX-M-9-Producing Escherichia coli and Enterobacter cloacae in Rescued Wild Animals

Evaluation of nosocomial infections through contact patterns in a small animal hospital using social network analysis and genotyping techniques

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