Schmidt Vanessa M, Pinchbeck Gina, Nuttall Tim, Shaw Steve, McIntyre K Marie, McEwan Neil, Dawson Susan, Williams Nicola J
Institute of Veterinary Science, The University of Liverpool, Leahurst Campus Chester High Road, Neston, CH64 7TE, UK.
Department of Epidemiology and Population Health, Institute of Infection and Global Health, The University of Liverpool, Leahurst Campus Chester High Road, Neston, CH64 7TE, UK.
Vet Dermatol. 2018 Jun;29(3):192-e70. doi: 10.1111/vde.12538. Epub 2018 Apr 17.
Antimicrobial-resistant bacteria are increasingly isolated from veterinary patients.
To determine risk factors for antimicrobial resistance (AMR) among canine mucosal staphylococci following routine antimicrobial treatment with cefalexin (CFX), clavulanate-amoxicillin (AC), cefovecin (CVN), clindamycin (CD) or a fluoroquinolone (FQ).
Mucosal swab samples (n = 463) were collected from 127 dogs pre-treatment, immediately, and at one- and three-months post-treatment.
Staphylococci were identified phenotypically and biochemically as coagulase negative (CoNS) or coagulase positive (CoPS); CoPS were speciated by nuc gene PCR. Antimicrobial susceptibility was determined using disc diffusion and mecA gene carriage by PCR. Multilevel, multivariable models examined associations between risk factors and presence/absence of CoPS, meticillin resistance (MR), multidrug-resistance (MDR) and fluoroquinolone resistance (FQR).
The percentage of samples with CoNS increased and with CoPS (including S. pseudintermedius) decreased immediately post-treatment with CFX, CVN and CD (P ≤ 0.001) and one month post-treatment with CD (P = 0.003). By three months post-treatment, there was no significant difference compared to pre-treatment samples. Immediately post-treatment with FQs there was significantly increased risk of isolating MRS (P = 0.002), MDR (P = 0.002) or FQR (P = 0.013) staphylococci and of MDR following CFX treatment (P = 0.019). The percentage of samples with AMR staphylococci declined from immediately to three months post-treatment and there was no significant difference between resistance prevalence at one or three months post-treatment for most AMR traits and treatment groups. Exceptions include increased MDR following FQ (P = 0.048) or CFX (P = 0.021), at one and three months post-treatment, respectively.
Systemic antimicrobials impact on mucosal staphylococci. Immediately after therapy, the mucosa may be a reservoir for AMR staphylococci that are a source of mobile genetic elements carrying AMR genes.
越来越多从兽医治疗的患者中分离出耐药细菌。
确定犬黏膜葡萄球菌在接受头孢氨苄（CFX）、克拉维酸 - 阿莫西林（AC）、头孢维星（CVN）、克林霉素（CD）或氟喹诺酮（FQ）常规抗菌治疗后发生抗菌药物耐药性（AMR）的风险因素。
从127只犬收集治疗前、治疗即刻、治疗后1个月和3个月的黏膜拭子样本（n = 463）。
通过表型和生化方法将葡萄球菌鉴定为凝固酶阴性（CoNS）或凝固酶阳性（CoPS）；通过nuc基因PCR对CoPS进行种属鉴定。采用纸片扩散法测定抗菌药物敏感性，通过PCR检测mecA基因携带情况。多级多变量模型研究风险因素与CoPS的存在与否、耐甲氧西林（MR）、多重耐药（MDR）和氟喹诺酮耐药（FQR）之间的关联。
CFX、CVN和CD治疗后即刻以及CD治疗后1个月，CoNS样本百分比增加，CoPS（包括中间型葡萄球菌）样本百分比下降（P≤0.001）；治疗后3个月，与治疗前样本相比无显著差异。FQ治疗后即刻，分离出耐甲氧西林葡萄球菌（MRS）、多重耐药葡萄球菌（MDR）或氟喹诺酮耐药葡萄球菌（FQR）的风险显著增加（P = 0.002），CFX治疗后出现MDR的风险增加（P = 0.019）。治疗后即刻至3个月，AMR葡萄球菌样本百分比下降，大多数AMR特征和治疗组在治疗后1个月和3个月的耐药率无显著差异。例外情况包括治疗后1个月和3个月时，FQ（P = 0.048）或CFX（P = 0.021）治疗后MDR增加。
全身用抗菌药物会影响黏膜葡萄球菌。治疗后即刻，黏膜可能是AMR葡萄球菌的储存库，这些葡萄球菌是携带AMR基因的可移动遗传元件的来源。
