Abstract
The present study describes the prevalence of bacterial cross-contamination in a veterinary ophthalmology setting, a serious issue that can result in healthcare-associated (or nosocomial) infections among patients and staff. Retrospective (n = 5 patients) and prospective (n = 23 patients) studies evaluated bacterial isolates in companion animals presenting with ulcerative keratitis, sampling the patients' cornea and surrounding examination room, including the environment (exam table, countertop, floor) and ophthalmic equipment (slit lamp, transilluminator, direct ophthalmoscope, indirect headset, tonometer). Results of bacterial culture and antibiotic susceptibility testing were recorded, and degree of genetic relatedness was evaluated in six pairs of isolates (cornea + environment or equipment) using pulse-field gel electrophoresis (PFGE). Overall contamination rate of ophthalmic equipment, environment, and examination rooms (equipment + environment) was 42.9% (15/35 samples), 23.7% (9/38 samples) and 32.9% (24/73 samples), respectively. Methicillin-resistant Staphylococcus pseudintermedius (MRSP), a multi-drug resistant (MDR) pathogen with zoonotic potential, was isolated in 8.2% (6/73) of samples. The patient's cornea was likely the source of cross-contamination in 50% (3/6) of MRSP pairs as evaluated by PFGE; notably, two of the three similar bacterial strains did not have an exact match of their antibiotic susceptibility profiles, highlighting the importance of advanced diagnostics such as PFGE to assess cross-contamination in healthcare facilities. Future work could examine the contamination prevalence of specific equipment or the efficacy of cleaning protocols to mitigate cross-contamination in veterinary practice.
Highlights
Cross-contamination, or the transfer of pathogens from patients to the environment and vice versa, is a serious concern in veterinary and human medicine
For dogs and cats evaluated by the ophthalmology service, the standard operating protocol (SOP) consisted of using a moistened sterile culturette swab for each of the following sites where the patient was examined: (i) Environment swabs, including the front aspect of the countertop, the front aspect of the examination table, the floor area in front of the examination table, and the inside and door of the cage housing the patient if the patient was hospitalized overnight; and (ii) Equipment swabs, including the handheld slit lamp (SL-15 or SL-17, Kowa Company Ltd.; magnification and illumination dials), rebound tonometer (TonoVet, ICare Finland; measuring and selector buttons), and indirect headset (Keeler Vantage Plus)
The present study evaluated the contamination rate of examination rooms in a veterinary ophthalmology setting, identifying the patients’ corneal infection as the likely source of contamination in selected cases
Summary
Cross-contamination, or the transfer of pathogens from patients to the environment and vice versa, is a serious concern in veterinary and human medicine. Contaminated eyedrops resulted in 13 cases of post-operative endophthalmitis after uneventful cataract surgery in one report [2], and development of bacterial keratitis in three patients in another report [3]. On both occasions, indistinguishable pathogens were cultured from the patient’s eyes and the contaminated environmental source
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call