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

Abstract

Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) among animals and humans are a public health threat. This study analyzed the occurrence of ESBL-E in a high-risk environment in a companion animal clinic and two animal patients’ households. In an intensive care unit (ICU), rectal swabs from 74 dogs and cats, 74 hand swabs from staff and 298 swabs from surfaces were analyzed for ESBL-E. Seventeen hospitalized patients (23%) and ten (3%) surfaces in the ICU tested ESBL-E positive. Transmission chains for Klebsiella pneumoniae ST307 blaCTX-M-15 and Escherichia coli ST38 blaCTX-M-14, ST88 blaCTX-M-14 and ST224 blaCTX-M-1 were observed over extended periods of time (14 to 30 days) with similar strains isolated from patients and the clinical environment. After discharge, two colonized dogs (dogs 7 and 12) and their household contacts were resampled. Dog 7 tested repeatedly positive for 77 days, dog 12 tested negative; six (24%) surfaces in the household of the persistently colonized dog tested ESBL-E positive. The owner of dog 7 and one of the owners of dog 12 were colonized. Based on whole genome sequencing, isolates from the owners, their dogs and other ICU patients belonged to the same clusters, highlighting the public health importance of ESBL-E in companion animal clinics.

One Health or Three? Transmission modelling ofKlebsiellaisolates reveals ecological barriers to transmission between humans, animals and the environment

“…The isolation of the widespread healthcare associated clone ST307 from companion animals, the recovery of highly virulent strains from dogs, and the putative transmission of strains and plasmids between humans and invertebrates in the hospital environment are pertinent examples. Combined with multiple examples from the literature [59][60][61][62][63] , our data therefore underlines the importance of basic hygiene measures, particularly with respect to contact with animals.…”

Massive Spread of OXA-48 Carbapenemase-Producing Enterobacteriaceae in the Environment of a Swiss Companion Animal Clinic

“…After discharge, the animal owners showed colonization with closely related ESBL-E strains and extensive contamination of the household environment with ESBL-E was documented. Transmission of CPE and ESBL-E between owners and their pets was also reported in other studies [ 27 , 28 ], which underlines the public health concern of ARM dissemination by companion animal veterinary institutions [ 25 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ].…”

“…Contamination in companion animal clinics may vary across sampling days, as has been previously reported [ 25 ]. This was also evident in the present study, where ARM contamination rates ranged from 10.0–18.0% over the 4 sampling days.…”

“…A recent study in five Swiss companion animal clinics found ESBL-E contamination in 0–2% of the environmental specimens [ 23 ]. ESBL-E were the most common ARM acquired by dogs and cats during hospitalization in four clinics in Switzerland [ 26 ] and were recently shown to spread to the household environment and to the animal owners after patient discharge [ 25 ]. In the latter study, transmission chains for four different high-risk human pathogenic strains of ESBL-E were documented over a 45-day observation period in a companion animal ICU.…”

Characterisation of and risk factors for extended-spectrum β-lactamase producing Enterobacterales (ESBL-E) in an equine hospital with a special reference to an outbreak caused by Klebsiella pneumoniae ST307:CTX-M-1

“…This strain of K. pneumoniae is known to have caused outbreaks in human hospitals, e.g. a neonatal intensive care unit [ 10 , 11 ], and occurrence and transmission of this strain have also been reported in small animal veterinary practices [ 12 , 13 ]. However, no outbreak of ESBL - K. pneumoniae ST307 has been reported in horses previously.…”