Department of Population Medicine, University of Guelph, Ontario Veterinary College, Guelph, Ontario, Canada.
Department of Epidemiology, University of Guelph, Ontario Veterinary College, Guelph, Ontario, Canada.
J Vet Intern Med. 2024 Sep-Oct;38(5):2642-2653. doi: 10.1111/jvim.17171. Epub 2024 Aug 17.
Carbapenem-resistant Enterobacterales (CRE) are a concern in both human and animal medicine globally. Despite extensive research in humans, limited data exist on CRE in companion animals, with a lack of nationwide prevalence estimates.
HYPOTHESIS/OBJECTIVES: To assess the occurrence and trends of CRE in cats and dogs across the United States by analyzing 4 years of commercial antimicrobial susceptibility testing (AST) data.
Between 2019 and 2022, 477 426 ASTs were conducted on Enterobacterales isolates against imipenem. Isolates were derived from 379 598 dogs and 97 828 cats. Animal origin was not disclosed.
In this retrospective study, antimicrobial susceptibility test data from IDEXX Laboratories were analyzed. Analysis included resistance estimations to imipenem stratified by sampling site, an assessment of resistance patterns over time and location, and the application of space-time cluster analysis to identify potential outbreaks. Antibiograms were produced for carbapenem-resistant isolates.
Susceptibility to imipenem was high, at 98.86%. Temporal analysis indicated stability in susceptibility, with an unexplained reduction in susceptible isolates in June 2019. Spatial analysis identified 2 high-risk clusters along the Western Coast (relative risk [RR]: 23.26; P < .001) and in Texas (RR: 10.72; P < .001) in that month. Three other clusters were found, in Missouri (RR: 39.55; P = .038), Florida (RR: 4.53; P < .001), and New York (RR: 9.20; P < .001).
CRE are present at a low prevalence in dogs and cats across the United States. Variations in prevalence across patient-level and environmental factors highlight the need for tailored stewardship programs.
全球范围内，耐碳青霉烯肠杆菌科（CRE）不仅在人类医学中备受关注，在动物医学中亦是如此。尽管在人类中进行了广泛的研究，但有关伴侣动物中 CRE 的数据有限，缺乏全国流行率估计。
假设/目的：通过分析 4 年的商业抗菌药物敏感性测试（AST）数据，评估美国猫和狗中 CRE 的发生和趋势。
2019 年至 2022 年间，对 379598 只狗和 97828 只猫的肠杆菌科分离株进行了 477426 次针对亚胺培南的 AST。未公开动物来源。
在这项回顾性研究中，分析了 IDEXX 实验室的抗菌药物敏感性测试数据。分析包括按采样部位分层对亚胺培南的耐药估计、随时间和地点评估耐药模式，以及应用时空聚类分析识别潜在的暴发。为耐碳青霉烯的分离株制作抗生素图。
对亚胺培南的敏感性很高，为 98.86%。时间分析表明敏感性稳定，2019 年 6 月敏感分离株数量不明原因减少。空间分析在当月沿西海岸（相对风险 [RR]：23.26；P<.001）和德克萨斯州（RR：10.72；P<.001）发现 2 个高风险集群。当月还发现了另外 3 个集群，分别位于密苏里州（RR：39.55；P=.038）、佛罗里达州（RR：4.53；P<.001）和纽约州（RR：9.20；P<.001）。
在美国，狗和猫中 CRE 的流行率很低。患者水平和环境因素的流行率差异突出表明需要制定有针对性的管理计划。
