Department of Clinical Veterinary Medicine, University of Bern, Bern, Switzerland.
Institute of Veterinary Bacteriology, University of Bern, Bern, Switzerland.
J Vet Intern Med. 2021 Mar;35(2):970-979. doi: 10.1111/jvim.16038. Epub 2021 Feb 1.
The emergence and spread of multidrug-resistant organisms (MDRO) present a threat to human and animal health.
To assess acquisition, prevalence of and risk factors for MDRO carriage in dogs and cats presented to veterinary clinics or practices in Switzerland.
Privately owned dogs (n = 183) and cats (n = 88) presented to 4 veterinary hospitals and 1 practice.
Prospective, longitudinal, observational study. Oronasal and rectal swabs were collected at presentation and 69% of animals were sampled again at discharge. Methicillin-resistant (MR) staphylococci and macrococci, cephalosporinase-, and carbapenemase-producing (CP) Enterobacterales were isolated. Genetic relatedness of isolates was assessed by repetitive sequence-based polymerase chain reaction and multilocus sequence typing. Risk factors for MDRO acquisition and carriage were analyzed based on questionnaire-derived and hospitalization data.
Admission prevalence of MDRO carriage in pets was 15.5% (95% confidence interval [CI], 11.4-20.4). The discharge prevalence and acquisition rates were 32.1% (95% CI, 25.5-39.3) and 28.3% (95% CI, 22-35.4), respectively. Predominant hospital-acquired isolates were extended spectrum β-lactamase-producing Escherichia coli (ESBL-E coli; 17.3%) and β-lactamase-producing Klebsiella pneumoniae (13.7%). At 1 institution, a cluster of 24 highly genetically related CP (bla and bla ) was identified. Multivariate analysis identified hospitalization at clinic 1 (odds ratio [OR], 5.1; 95% CI, 1.6-16.8) and days of hospitalization (OR 3-5 days, 4.4; 95% CI, 1.8-10.9; OR > 5 days, 6.2; 95% CI, 1.3-28.8) as risk factors for MDRO acquisition in dogs.
Veterinary hospitals play an important role in the selection and transmission of MDRO among veterinary patients.
多药耐药菌(MDRO)的出现和传播对人类和动物的健康构成了威胁。
评估瑞士兽医诊所或医院就诊的犬和猫携带 MDRO 的获得、流行率和危险因素。
183 只私人拥有的犬和 88 只猫就诊于 4 家兽医医院和 1 家诊所。
前瞻性、纵向、观察性研究。在就诊时采集口鼻和直肠拭子,69%的动物在出院时再次采样。分离耐甲氧西林(MR)葡萄球菌和大葡萄球菌、产头孢菌素酶和碳青霉烯酶(CP)肠杆菌。通过重复序列基聚合酶链反应和多位点序列分型评估分离株的遗传相关性。根据问卷调查和住院数据分析 MDRO 获得和携带的危险因素。
宠物 MDRO 携带的入院流行率为 15.5%(95%置信区间 [CI],11.4-20.4)。出院流行率和获得率分别为 32.1%(95% CI,25.5-39.3)和 28.3%(95% CI,22-35.4)。主要的医院获得性分离株为产超广谱β-内酰胺酶的大肠埃希菌(ESBL-E coli;17.3%)和产β-内酰胺酶的肺炎克雷伯菌(13.7%)。在 1 家机构中,鉴定出 24 株高度遗传相关的 CP(bla 和 bla )。多变量分析确定在诊所 1 住院(优势比 [OR],5.1;95% CI,1.6-16.8)和住院天数(OR 3-5 天,4.4;95% CI,1.8-10.9;OR>5 天,6.2;95% CI,1.3-28.8)是犬 MDRO 获得的危险因素。
兽医医院在兽医患者中 MDRO 的选择和传播中发挥着重要作用。