Charité - Universitätsmedizin Berlin, corporate member of Freie Unitversität Berlin and Humboldt-Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany.
Institute of Microbiology and Epizootics, Centre of Infection Medicine, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany.
J Antimicrob Chemother. 2021 May 12;76(6):1392-1405. doi: 10.1093/jac/dkab058.
MDR organisms (MDROs) pose a relevant risk for patients in modern healthcare. Although ownership of pet animals is common and owners and pets commonly live in close contact, it is still unclear whether pet ownership may be considered as a risk factor for MDRO acquisition prior to hospitalization.
We performed three separate meta-analyses in accordance with the PRISMA guidelines, assessing contact to pets as a risk factor for acquisition of MRSA, VRE and MDR Gram-negatives [namely third-generation cephalosporin-resistant Enterobacterales (3GCRE) and carbapenem-resistant Enterobacterales (CRE)].
We calculated an increased risk of MRSA carriage for dog owners [risk ratio (RR) 2.28, 95% CI 1.47-3.56]. Meta-analysis did not show a significantly higher risk for 3GCRE colonization among owners of different pet species compared with non-pet owners (RR 1.18, 95% CI 0.83-1.68 for pet owners in general, RR 0.88, 95% CI 0.56-1.40 for dog owners, RR 1.16, 95% CI 0.58-2.34 for cat owners, RR 1.34, 95% CI 0.43-4.18 for rodent owners, RR 0.91, 95% CI 0.38-2.18 for bird owners, and RR 2.34, 95% CI 0.33-16.63 for lizard/frog owners). For VRE, there were insufficient data to perform a meta-analysis.
Our analyses suggest contact to pet animals is a risk factor for MRSA, but not for 3GCRE/CRE acquisition. Evaluation of the underlying literature suggested a possible role of pet animals as: (i) vectors for the transmission of MDROs between livestock and humans; as well as (ii) a reservoir for MDROs. Pets, therefore, may promote transmission and reinfection of humans.
耐多药菌（MDROs）对现代医疗保健中的患者构成了重大风险。尽管拥有宠物动物很常见，而且主人和宠物通常生活在密切接触中，但宠物拥有是否可被视为住院前获得 MDRO 的危险因素仍不清楚。
我们根据 PRISMA 指南进行了三项独立的荟萃分析，评估与宠物接触是否为耐甲氧西林金黄色葡萄球菌（MRSA）、耐万古霉素肠球菌（VRE）和耐多药革兰氏阴性菌（即第三代头孢菌素耐药肠杆菌科（3GCRE）和碳青霉烯耐药肠杆菌科（CRE））获得的危险因素。
我们计算出狗主人携带 MRSA 的风险增加[风险比（RR）2.28，95%置信区间（CI）1.47-3.56]。荟萃分析并未显示与非宠物主人相比，不同宠物物种的主人中 3GCRE 定植的风险显著更高（一般宠物主人 RR 1.18，95%CI 0.83-1.68，狗主人 RR 0.88，95%CI 0.56-1.40，猫主人 RR 1.16，95%CI 0.58-2.34，啮齿动物主人 RR 1.34，95%CI 0.43-4.18，鸟类主人 RR 0.91，95%CI 0.38-2.18，蜥蜴/青蛙主人 RR 2.34，95%CI 0.33-16.63）。对于 VRE，没有足够的数据进行荟萃分析。
我们的分析表明，与宠物动物接触是 MRSA 的危险因素，但不是 3GCRE/CRE 获得的危险因素。对基础文献的评估表明，宠物动物可能起到以下作用：（i）在牲畜和人类之间传播 MDRO 的媒介；以及（ii）MDRO 的储库。因此，宠物可能促进 MDRO 在人类中的传播和再感染。
