Shedding of OXA-181 carbapenemase-producing Escherichia coli from companion animals after hospitalisation in Switzerland: an outbreak in 2018

Abstract

BackgroundCarbapenem-resistant Enterobacteriaceae pose a serious threat to public health worldwide, and the role of companion animals as a reservoir is still unclear.AimsThis 4-month prospective observational study evaluated carriage of carbapenem-resistant Enterobacteriaceae at admission and after hospitalisation in a large referral hospital for companion animals in Switzerland.MethodsRectal swabs of dogs and cats expected to be hospitalised for at least 48 h were taken from May to August 2018 and analysed for the presence of carbapenem-resistant Enterobacteriaceae using selective agar plates. Resistant isolates were further characterised analysing whole genome sequences for resistance gene and plasmid identification, and ad hoc core genome multilocus sequence typing.ResultsThis study revealed nosocomial acquisition of Escherichia coli harbouring the carbapenemase gene bla OXA-181, the pAmpC cephalosporinase gene bla CMY-42 as well as quinolone resistance associated with qnrS1 and mutations in the topoisomerases II (GyrA) and IV (ParC). The bla OXA-181 and qnrS1 genes were identified on a 51 kb IncX3 plasmid and bla CMY-42 on a 47 kb IncI1 plasmid. All isolates belonged to sequence type ST410 and were genetically highly related. This E. coli clone was detected in 17 of 100 dogs and four of 34 cats after hospitalisation (21.6%), only one of the tested animals having tested positive at admission (0.75%). Two positive animals were still carriers 4 months after hospital discharge, but were negative after 6 months.ConclusionsCompanion animals may acquire carbapenemase-producing E. coli during hospitalisation, posing the risk of further dissemination to the animal and human population and to the environment.

Poor infection prevention and control standards are associated with environmental contamination with carbapenemase-producing Enterobacterales and other multidrug-resistant bacteria in Swiss companion animal clinics

“…The results of the study suggest that insufficient IPC standards in companion animal clinics are associated with environmental contamination with MDROs and may increase the risk of potential transfer of MDR bacteria between the clinical environment, patients and employees. In this context, two employees in this study were found to be colonized with CP E. coli closely related to environmental or patient-derived isolates [43], and two staff members carried MRSA and MRSP of the same sequence type as found in the environment in the according institution, respectively; some of these results have been published [11,42]. CPE have been classified as an "urgent" public health threat by the US Centers for Disease Control and Prevention because nosocomial infections in humans have been associated with a case fatality rate of up to 50% [44,45].…”

“…Although not licensed for use in animals, they have been reported to be used occasionally in dogs and cats [5]. Interestingly, carbapenems have never been used in patients of Clinic B, suggesting that the development and clonal spread of the CPE in the environment of this clinic was not driven by selection pressure exerted by carbapenems [11].…”

“…isolates in small animal clinics in Europe have been documented [7][8][9][10]. Most recently, an outbreak involving CP Escherichia coli was reported in a large companion animal clinic in Switzerland [11]. Because of the close contact of dogs and cats with their owners [12], the acquisition of MDROs by companion animals could pose a considerable risk to humans [13][14][15].…”

Surveillance of OXA-244-producing Escherichia coli and epidemiologic investigation of cases, Denmark, January 2016 to August 2019

“…Among the 15 patients interviewed by phone, 12 reported contacts to dogs and four to cats. To our knowledge, OXA-244-producing E. coli isolates have neither been reported from dogs nor cats, but a recent study reported on OXA-181-producing E. coli isolates obtained from dogs and cats after hospitalisation in a veterinary clinic in Switzerland [21].…”

OXA-181-Like Carbapenemases in Klebsiella pneumoniae ST14, ST15, ST23, ST48, and ST231 from Septicemic Neonates: Coexistence with NDM-5, Resistome, Transmissibility, and Genome Diversity

“…Reports of emergence or outbreak in neonatal units from Middle Eastern countries have also surfaced ( 14 ). Detection of OXA-48-producing microorganisms is not limited to clinical settings and is often detected in environmental surface samples, companion animals, livestock, production animals, and wild animals ( 11 , 15 , 16 ).…”