Abstract
Background: Companion animal clinics contribute to the spread of antimicrobial resistant microorganisms (ARM) and outbreaks with ARM of public health concern have been described. Methods: As part of a project to assess infection prevention and control (IPC) standards in companion animal clinics in Switzerland, a total of 200 swabs from surfaces and 20 hand swabs from employees were collected during four days in a medium-sized clinic and analyzed for extended spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E), carbapenemase-producing Enterobacteriaceae (CPE), vancomycin-resistant enterococci (VRE), and methicillin-resistant staphylococci (MRS). Results: A total of 22 (11.0%) environmental specimen yielded CPE, 14 (7.0%) ESBL-E, and 7 (3.5%) MRS; MR Staphylococcus aureus were isolated from two (10.0%) hand swabs. The CPE isolates comprised Escherichia coli, Klebsiella pneumoniae, Enterobacter hormaechei, Citrobacter braakii, and Serratia marcescens. Whole genome sequencing revealed that all CPE carried closely related blaOXA-48 plasmids, suggesting a plasmidic spread within the clinic. The clinic exhibited major deficits in surface disinfection, hand hygiene infrastructure, and hand hygiene compliance. CPE were present in various areas, including those without patient contact. The study documented plasmidic dissemination of blaOXA-48 in a companion animal clinic with low IPC standards. This poses a worrisome threat to public health and highlights the need to foster IPC standards in veterinary clinics to prevent the spread of ARM into the community.
Highlights
Publisher’s Note: MDPI stays neutralAntimicrobial resistance has been declared as one of “the greatest and most urgent global risks” by the United Nations General Assembly [1]
The dissemination of resistant bacteria was identified in a medium-sized clinic in Switzerland that comprised 45 staff members, offered a 24/7 emergency service and an intensive care unit (ICU), and treated around 13,000 ambulatory and stationary dogs and cats per year
Our results indicate that plasmidic dissemination of blaOXA-48 in companion animal clinics may occur and poses a worrisome threat to public health
Summary
Publisher’s Note: MDPI stays neutralAntimicrobial resistance has been declared as one of “the greatest and most urgent global risks” by the United Nations General Assembly [1]. Antimicrobial resistant microorganisms (ARM) are estimated to cause the death of over 700,000 people per year and pose a threat to the healthcare system [2]. Carbapenem resistance encoded by blaOXA-48 is often located on transferable L/M complex plasmids. These plasmids can possess derepressed transfer properties, allowing them to efficiently spread horizontally [4]. CPE have caused outbreaks and hospital-acquired infections in human healthcare worldwide [5,6,7,8,9,10,11]. The use of carbapenems in companion animal medicine is restricted to special indications and has not with regard to jurisdictional claims in published maps and institutional affiliations
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