Usage patterns of carbapenem antimicrobials in dogs and cats at a veterinary tertiary care hospital

Smith, Alison M.; Wayne, Annie; Fellman, Claire; Rosenbaum, Marieke

doi:10.1111/jvim.15522

Cited by 27 publications

(34 citation statements)

References 24 publications

(46 reference statements)

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“…A recent retrospective study describing the usage of carbapenem in a similar institution demonstrated a similar low prescription rate. However, de-escalation to a lower tier antimicrobial or no antimicrobial was rarely performed in that study (59). The WHO has classified carbapenems on the "Watch" group of antimicrobials (60), which overlaps with the highest priority agents on the list of critically important antimicrobial drugs for human medicine.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Prescribing Practices in Small Animal Emergency and Critical Care

et al. 2020

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Background: Antimicrobial use contributes to emergence of antimicrobial resistance. It was hypothesized that antimicrobial prescribing behavior varies between the emergency (ER) and critical care (CC) services in a veterinary teaching hospital. This study aimed to: (i) describe antimicrobial prescribing patterns in the ER and CC services; (ii) assess adherence to stewardship principles; (iii) evaluate the prevalence of multidrug resistant (MDR) bacterial isolates. Methods: Institution electronic medical records were queried for all antimicrobial prescriptions from the ER and CC services between 1/1/2017 and 12/31/2017. Prescriptions were manually reviewed, and the following data recorded: drug, dosage, duration, diagnosis, outcome, hospitalization duration, culture submission, and susceptibility results. Results: There were 5,091 ER visits, of which 3,125 were not transferred to another service. Of these emergency visits, 516 (16.5%) resulted in 613 antimicrobial drug prescriptions. The most commonly prescribed drugs for the ER were amoxicillin/clavulanate (n = 243, 39.6%), metronidazole (n = 146, 23.8%), and ampicillin/sulbactam (n = 55, 9.0%). The most common reasons for antimicrobial prescriptions were skin disease (n = 227, 37.0%), gastrointestinal disease (n = 173, 28.2%), and respiratory disease (n = 50, 8.2%). For ER patients 18 cultures were submitted, equivalent to a 3.5% submission rate. The CC service managed 311 case visits for 822 patient days. Of these, 133 case visits (42.7%) resulted in 340 prescriptions. The most commonly prescribed drugs for the CC service were ampicillin/sulbactam (n = 103, 30.3%), enrofloxacin (n = 75, 22.1%), and metronidazole (n = 59, 17.4%). The most common reasons for antimicrobial prescriptions were gastrointestinal disease (n = 106, 31.2%), respiratory disease (n = 71, 20.9%), and sepsis (n = 61, 17.9%). On the CC service, 46 patients had ≥1 culture submitted, equivalent to a 34.6% submission rate. Of patients prescribed antimicrobials, 13/38 (34%) with urinary tract disease, 2/28 (7%) with pneumonia, 1/11 (9%) with canine infectious respiratory disease complex and 2/8 (25%) with feline upper respiratory infection were compliant with published guidelines. Robbins et al. Antimicrobial Prescribing Emergency Critical Care Conclusions: Antimicrobial prescription was common in both ER and CC services and followed similar patterns. Adherence to published guidelines for urinary and respiratory infections was poor.

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Section: Discussionmentioning

confidence: 99%

Antimicrobial Prescribing Practices in Small Animal Emergency and Critical Care

et al. 2020

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“…Another significant finding in this study is, to our knowledge the first isolation of a CTX-M-15 and NDM-1, together with OXA 1, TEM producing Enterobacter cloacae ST114 from a vaginal swab of a dog from Serbia (strain ESBL40). Carbapenems-resistance in bacteria of animal origin is a subject of great concern due to their importance in therapy of life-threatening infections in human and in veterinary medicine [26,43,46]. Although several publications state that the risk of carbapenem resistance in animals is low due to the limited use of this class in veterinary medicine [26,43,46], this is the second report on the detection of carbapenemases carrying bacteria associated with canine UGI from Serbia [36] and bla NDM , bla VIM , bla IMP , bla OXA and bla KPC carbapenemases have been detected worldwide in companion animals.…”

Section: Discussionmentioning

confidence: 99%

“…Carbapenems-resistance in bacteria of animal origin is a subject of great concern due to their importance in therapy of life-threatening infections in human and in veterinary medicine [26,43,46]. Although several publications state that the risk of carbapenem resistance in animals is low due to the limited use of this class in veterinary medicine [26,43,46], this is the second report on the detection of carbapenemases carrying bacteria associated with canine UGI from Serbia [36] and bla NDM , bla VIM , bla IMP , bla OXA and bla KPC carbapenemases have been detected worldwide in companion animals. Unlike carbapenemases, CTX-M-15 is highly prevalent in Enterobacter cloacae and CTX-M-15-producing ST114 Enterobacter cloacae has been recently reported as a high-risk clone for public health which was predominant in cats, dogs and horses [47,48].…”

Section: Discussionmentioning

confidence: 99%

“…In the European Union, including Austria, especially at the University of Veterinary Medicine, Vienna, veterinarians are advised to follow strict guidelines for the use of antibiotics. Except for few countries including the Netherlands and France, veterinarians are allowed to use human-related antibiotics in companion animals, even carbapenems, but only in strictly defined and justified cases [25][26][27][28]. Despite carbapenems have no legal indication in some countries and are not used in routine practice, ISCAID and other relevant institutions have included carbapenems in their official documentation related to animals [18,29].…”

Section: Introductionmentioning

confidence: 99%

“…Close contact between humans and companion animals contributes to the propagation and exchange of resistance genes between bacteria as well as the direct transmission of all ExPEC subcategories including UPECs, so human-related clones have already been detected in companion animals [27,[30][31][32]. As a consequence, companion animals are more and more considered an important source of human infections both by ExPEC/UPEC and by multidrug-resistant bacteria (MDR) in general [20,26,[33][34][35][36].…”

Section: Introductionmentioning

confidence: 99%

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Broad-Spectrum Cephalosporin-Resistant and/or Fluoroquinolone-Resistant Enterobacterales Associated with Canine and Feline Urogenital Infections

et al. 2020

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The aim of the present study was to characterize Enterobacterales resistant to 3rd and 4th generation cephalosporins, carbapenems and/or fluoroquinolones, isolated from dogs and cats with urogenital infections. In total, 36 strains (Escherichia coli (n = 28), Klebsiella pneumoniae (n = 3), Serratia marcescens, Raoultella ornithinolytica, Proteus mirabilis, Citrobacter portucalensis and Enterobacter cloacae (each n = 1)) were included in the present study, 28 from Austria and 8 from Serbia. Isolates were characterized by a polyphasic approach including susceptibility pheno- and genotyping and microarray-based assays. Escherichia (E.) coli isolates were additionally characterized by two-locus (fumC and fimH) sequence phylotyping and multi-locus sequence typing (MLST) of selected isolates. MLST of carbapenem-resistant Enterobacter cloacae isolates was also performed. Among E. coli, the most dominant phylogenetic group was B1 (27.8%), followed by C, (16.6%), A and Clade II (5.5% each), B2 and F (2.77% each). The most predominant β-lactam resistance genes were blaTEM (70%) and blaCTX-M (38.8%), blaCMY (25%). blaNDM was detected in one carbapenem-resistant Enterobacter cloacae ST114. The most common ST among selected E. coli was 744 (10.7% isolates). The pandemic clones ST131 and ST648 carrying CTX-M-15 were also detected. Remaining STs belonged to 469, 1287, 1463 and 1642. E. coli clonotyping revealed 20 CH types. Based on the presence of certain virulence genes, three isolates were categorized as ExPEC/UPEC. The most prevalent virulence factors were fimH detected in 61%, iucD and iss both in 55%, iroN in 27.8%, papC in 13.8% and sat in 8.3% isolates.

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Antimicrobial susceptibility of bacterial isolates from urinary tract infections in companion animals in Spain

Darwich

Seminati

Burballa³

et al. 2021

Veterinary Record

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Background The increasing emergence of multidrug‐resistant bacteria, causing urinary tract infections (UTI) in dogs and cats, represents a great therapeutic challenge and a public health concern. Methods Laboratory records of 4943 urinary microbiological diagnosis results and antimicrobial resistance profiles of suspected UTI cases in dogs and cats were analysed from 2016 to 2018 in Spain. Results This study showed a higher percentage of positive microbiological diagnoses in dogs (42%, 1368/3270) than in cats (27%, 457/1673). Although Escherichia coli was the most frequently isolated bacterium, the frequency of antimicrobial susceptibility of E. coli isolates was lower compared to other bacterial species like Enterococcus spp., Staphylococcus spp., Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterobacter (E. cloacae), and Proteus mirabilis. The antimicrobial susceptibility testing of Gram‐positive cocci showed higher levels of resistance in cats to common beta‐lactams used for the treatment of complicated UTIs, as well as to fluoroquinolones, aminoglycosides, and carbapenems. Moreover, enterobacteria (E. coli, K. pneumoniae, and P. mirabilis) from cats presented high resistance frequencies to beta‐lactams, including third‐ and fourth‐generation cephalosporins and fluoroquinolones. Conclusion This study updates data on the current antimicrobial resistance in UTI bacteria from companion animals in Spain, which may help to guide clinicians for the appropriate use of antimicrobials.

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Usage patterns of carbapenem antimicrobials in dogs and cats at a veterinary tertiary care hospital

Cited by 27 publications

References 24 publications

Antimicrobial Prescribing Practices in Small Animal Emergency and Critical Care

Antimicrobial Prescribing Practices in Small Animal Emergency and Critical Care

Broad-Spectrum Cephalosporin-Resistant and/or Fluoroquinolone-Resistant Enterobacterales Associated with Canine and Feline Urogenital Infections

Antimicrobial susceptibility of bacterial isolates from urinary tract infections in companion animals in Spain

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