Laboratory of Veterinary Internal Medicine, Tottori University, Minami 4-101, Koyama, Tottori, 680-8550, Japan.
Miyamoto Animal Hospital, 2265-8, Kurokawa, Yamaguchi, 753-0851, Japan.
J Infect Chemother. 2024 Sep;30(9):938-941. doi: 10.1016/j.jiac.2024.02.013. Epub 2024 Feb 16.
Carbapenemase-producing Enterobacterales (CPE) are a serious concern in human clinical settings. Companion animal-origin CPE have been only rarely identified in several countries, but they have not yet been identified in Japan. In this study, we present the first case of a canine infected with CPE in Japan. The patient was hospitalized due to pyometra. The pus discharged from the patient's uterus was subjected to bacteriological analysis. As a result, E. coli was identified in the pus and exhibited resistance to piperacillin, amoxicillin-clavulanic acid, cefazolin, ceftazidime, cefepime, meropenem, amikacin, and sulfamethoxazole-trimethoprim and susceptibility to aztreonam, minocycline, and levofloxacin. Results of the sodium mercaptoacetic acid double-disk synergy test showed that the E. coli isolate was positive for metallo-β-lactamases. Next-generation sequencing identified the bla gene, which was located in the IncFII-type plasmid together with bla, rmtB, aadA2, bleMBL, sul1, qacE, and dfrA12. The case was treated successfully with doxycycline and orbifloxacin. Our finding emphasizes that close attention should be paid to the significance of CPE harboring multidrug-resistance plasmid in companion animals, based on the perspective of One Health approach in Japan as well as in other countries.
产碳青霉烯酶肠杆菌科(CPE)在人类临床环境中是一个严重的问题。在几个国家中,仅在少数情况下发现了源自伴侣动物的 CPE,但在日本尚未发现。在本研究中,我们报告了日本首例犬感染 CPE 的病例。该患者因子宫积脓而住院。从患者子宫排出的脓液进行了细菌学分析。结果,脓液中鉴定出大肠杆菌,对哌拉西林、阿莫西林克拉维酸、头孢唑林、头孢他啶、头孢吡肟、美罗培南、阿米卡星和磺胺甲恶唑-甲氧苄啶具有耐药性,对氨曲南、米诺环素和左氧氟沙星敏感。巯基醋酸钠双碟协同试验结果表明,该大肠杆菌分离株产金属β-内酰胺酶。下一代测序鉴定出 bla 基因,该基因位于 IncFII 型质粒上,与 bla、rmtB、aadA2、bleMBL、sul1、qacE 和 dfrA12 一起。该病例成功地用多西环素和奥比沙星治疗。我们的发现强调,从日本以及其他国家的“同一健康”方法的角度出发,应密切关注携带多药耐药质粒的伴侣动物中 CPE 的重要性。