Abstract

Microbial sharing between humans and animals has been demonstrated in a variety of settings. However, the extent of microbial sharing that occurs within the healthcare setting during animal-assisted intervention programs is unknown. Understanding microbial transmission between patients and therapy dogs can provide important insights into potential health benefits for patients, in addition to addressing concerns regarding potential pathogen transmission that limits program utilization. This study evaluated for potential microbial sharing between pediatric patients and therapy dogs and tested whether patient–dog contact level and a dog decolonization protocol modified this sharing. Patients, therapy dogs, and the hospital environment were sampled before and after every group therapy session and samples underwent 16S rRNA sequencing to characterize microbial communities. Both patients and dogs experienced changes in the relative abundance and overall diversity of their nasal microbiome, suggesting that the exchange of microorganisms had occurred. Increased contact was associated with greater sharing between patients and therapy dogs, as well as between patients. A topical chlorhexidine-based dog decolonization was associated with decreased microbial sharing between therapy dogs and patients but did not significantly affect sharing between patients. These data suggest that the therapy dog is both a potential source of and a vehicle for the transfer of microorganisms to patients but not necessarily the only source. The relative contribution of other potential sources (e.g., other patients, the hospital environment) should be further explored to determine their relative importance.

Highlights

  • Animal-assisted intervention (AAI) therapy, the involvement of animals in alternative or complementary treatment, can improve the physical, mental, and social functions of patients within the healthcare setting

  • We further explored the effect of contact level between patients and therapy dogs on the alteration of nasal microbial communities following visits, and logically found that higher contact was associated with increased sharing between subjects and therapy dogs, and among subjects

  • Such longitudinal studies are especially important when considering the exposure to rare dog taxa, given that early-life exposure to pets is associated with decreased incidence of allergic and atopic diseases in children [46,47], and having a diverse microbiome is protective against numerous health outcomes and can be protective against colonization from pathogens [48,49]. If such data suggest that exposure to therapy dogs, even briefly during AAI programs, can benefit microbial diversity and microbial community resilience over the longer term, this will be a previously undescribed benefit of AAI and may increase its utilization in patient care. These findings indicate that, while there is presumed microbial sharing between pediatric patients and therapy dogs, and while the therapy dog has the potential to serve as an intermediary vector of microbial spread, other potential transmission pathways appear to contribute to microbial sharing during group AAI visits

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Summary

Introduction

Animal-assisted intervention (AAI) therapy, the involvement of animals in alternative or complementary treatment, can improve the physical, mental, and social functions of patients within the healthcare setting. AAI has been widely implemented in a range of physio-social conditions in various settings in healthcare facilities and is becoming increasingly popular, especially for pediatric patients. The potential risks of incorporating animals into a hospital setting, where patients with decreased immune function are treated, must be considered. Many common nosocomial pathogens, including MRSA and Clostridioides difficile, are zoonotic, in that they can be carried on animals and transmitted to humans [7,8,9]. While it is clear that therapy dogs can carry common hospital-associated pathogens [10,11,12], evidence is lacking on whether dogs transmit these microbiota to patients

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