Multidrug-Resistant <i>Campylobacter jejuni</i> Outbreak Linked to Puppy Exposure — United States, 2016–2018

Montgomery, Martha P.; Robertson, Scott; Koski, Lia; Salehi, Ellen; Stevenson, Lauren; Silver, Rachel; Sundararaman, Preethi; Singh, Amber; Joseph, Lavin A.; Weisner, Mary Beth; Brandt, Eric; Prarat, Melanie; Bokanyi, Rick; Chen, Jessica C.; Folster, Jason P.; Bennett, Christy; Watkins, Louise Francois; Aubert, Rachael D.; Chu, Alvina; Jackson, Jennifer; Blanton, Jason; Ginn, Amber; Ramadugu, Kirtana; Stanek, Danielle; DeMent, Jamie; Cui, Jing; Zhang, Yan; Basler, Colin; Friedman, Cindy R.; Geissler, Aimee; Crowe, Samuel J.; Dowell, Natasha; Dixon, Staci; Whitlock, Laura; Williams, Ian T.; Jhung, Michael A.; Nichols, Megin; Fijter, Sietske de; Laughlin, Mark

doi:10.15585/mmwr.mm6737a3

Cited by 73 publications

(62 citation statements)

References 5 publications

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“…Direct contact with dogs is a common exposure among the human population, and previous work indicates that zoonotic transmission of C. jejuni can occur through contact with the faeces of infected dogs (Damborg et al, ; Mughini Gras et al, ). Campylobacter isolates from the 2016 to 2018 outbreak traced to contact with pet store puppies were resistant to azithromycin, ciprofloxacin, clindamycin, erythromycin, nalidixic acid, telithromycin, and tetracycline; resistance to gentamicin and florfenicol was also evident in some isolates (Montgomery et al, ). In the United States, the incidence of human campylobacteriosis, as well as the number of Campylobacter outbreaks, has increased over the period since 2004 (Geissler et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…Exposure to dogs is a potential risk factor for Campylobacter infections (Damborg, Olsen, Moller Nielsen, & Guardabassi, ; Mughini Gras et al, ). A recent multistate outbreak of multidrug‐resistant Campylobacter , with dates of illness ranging from January 2016 to February 2018, was traced to contact with pet store puppies (Montgomery et al, ).…”

Section: Introductionmentioning

confidence: 99%

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Ciprofloxacin resistance among Campylobacter jejuni isolates obtained from shelter dogs in Texas

LaLonde‐Paul

Cummings

Rodriguez‐Rivera

et al. 2018

Zoonoses and Public Health

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There are few epidemiologic studies on the shedding of Campylobacter among dogs in the United States, despite the potential public health implications. Our objectives were to estimate the prevalence of faecal Campylobacter shedding among Texas shelter dogs as detected by culture methods and to characterize the isolates by species and antimicrobial susceptibility. Using a cross‐sectional study design, faecal samples were collected from 185 dogs in six animal shelters throughout Texas between May and December 2014. Four culture methods were used to isolate Campylobacter from samples, and isolates were characterized. The prevalence of Campylobacter shedding was 45.4% (84/185; 95% CI, 38.1%–52.9%). Of 294 isolates from the 84 positive dogs, 26 (8.8%) isolates from seven dogs were identified as Campylobacter jejuni. Two of the isolates from one dog demonstrated resistance to ciprofloxacin and nalidixic acid. Direct plating on mCCDA‐CAT agar without enrichment identified the highest number of positive dogs (62%; 52/84). Incidence of ciprofloxacin‐resistant Campylobacter infections among humans has increased over the last several years. Canine shedding of Campylobacter is a potential source of zoonotic transmission.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ciprofloxacin resistance among Campylobacter jejuni isolates obtained from shelter dogs in Texas

LaLonde‐Paul

Cummings

Rodriguez‐Rivera

et al. 2018

Zoonoses and Public Health

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“…For example, exposure to puppies can introduce resistant Campylobacter spp. infections to humans . Additionally, humans with MRSA infections should consider having their pets examined as potential MRSA reservoirs .…”

Section: Transmission Of Antimicrobial Resistance Among Domesticated mentioning

confidence: 99%

“…infections to humans. 83 Additionally, humans with MRSA infections should consider having their pets examined as potential MRSA reservoirs. 84 Even though MRSA is not adapted to dogs, cats, and other animals, these animals can become colonized with MRSA and then serve as vectors for spread to humans in the same household.…”

Section: What Can Be Learned From Companion Animals?mentioning

confidence: 99%

Complexities in understanding antimicrobial resistance across domesticated animal, human, and environmental systems

Graham

Bergeron

Bourassa

et al. 2019

Annals of the New York Academy of Sciences

136

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Antimicrobial resistance (AMR) is a significant threat to both human and animal health. The spread of AMR bacteria and genes across systems can occur through a myriad of pathways, both related and unrelated to agriculture, including via wastewater, soils, manure applications, direct exchange between humans and animals, and food exposure. Tracing origins and drivers of AMR bacteria and genes is challenging due to the array of contexts and the complexity of interactions overlapping health practice, microbiology, genetics, applied science and engineering, as well as social and human factors. Critically assessing the diverse and sometimes contradictory AMR literature is a valuable step in identifying tractable mitigation options to stem AMR spread. In this article we review research on the nonfoodborne spread of AMR, with a focus on domesticated animals and the environment and possible exposures to humans. Attention is especially placed on delineating possible sources and causes of AMR bacterial phenotypes, including underpinning the genetics important to human and animal health.

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“…The small number of puppies in each litter and the limited number of litters with colonized and non-colonized puppies precluded us from establishing whether the effect was statistically significant, but microbial community signatures that were consistent with what has been observed in people suggest that the microbiome has a role to play in colonization resistance. The protective role of the gut microbiome is particularly important when considering the fact that many puppies sold in pet stores (up to 95%) receive prophylactic antibiotics prior to shipping, as was recognized in a recent outbreak of Campylobacteriosis associated with puppies in pet stores (55). This could result in gastrointestinal dysbiosis and a resultant predisposition to harboring pathogens such as C. difficile .…”

Section: Discussionmentioning

confidence: 99%

Gut microbiome features associated withClostridium difficilecolonization in puppies

Berry

Barnhart

Kelly

et al. 2019

Preprint

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27In people, colonization with Clostridium difficile, the leading cause of antibiotic-associated diarrhea, has been shown to be 28 associated with distinct gut microbial features, including reduced bacterial community diversity and depletion of key taxa. In dogs, 29 the gut microbiome features that define C. difficile colonization are less well understood. We sought to define the gut microbiome 30 features associated with C. difficile colonization in puppies, a population where the prevalence of C. difficile has been shown to be 31 elevated, and to define the effect of puppy age and litter upon these features and C. difficile risk. We collected fecal samples from 32 weaned (n=27) and unweaned (n=74) puppies from 13 litters and analyzed the effects of colonization status, age and litter on 33 microbial diversity using linear mixed effects models. 34 Colonization with C. difficile was significantly associated with younger age, and colonized puppies had significantly decreased 35 bacterial community diversity and differentially abundant taxa compared to non-colonized puppies, even when adjusting for age. C. 36 difficile colonization remained associated with decreased bacterial community diversity, but the association did not reach statistical 37 significance in a mixed effects model incorporating litter as a random effect. 38 Even though litter explained a greater proportion (67%) of the variability in microbial diversity than colonization status, we 39 nevertheless observed heterogeneity in gut microbial community diversity and colonization status within more than half of the 40 litters, suggesting that the gut microbiome contributes to colonization resistance against C. difficile. The colonization of puppies with 3 41 C. difficile has important implications for the potential zoonotic transfer of this organism to people. The identified associations point 42 to mechanisms by which C. difficile colonization may be reduced. 43 44 45 46

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Multidrug-Resistant Campylobacter jejuni Outbreak Linked to Puppy Exposure — United States, 2016–2018

Cited by 73 publications

References 5 publications

Ciprofloxacin resistance among Campylobacter jejuni isolates obtained from shelter dogs in Texas

Ciprofloxacin resistance among Campylobacter jejuni isolates obtained from shelter dogs in Texas

Complexities in understanding antimicrobial resistance across domesticated animal, human, and environmental systems

Gut microbiome features associated withClostridium difficilecolonization in puppies

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