Abstract
Campylobacter causes an estimated 1.3 million diarrheal illnesses in the United States annually (1). In August 2017, the Florida Department of Health notified CDC of six Campylobacter jejuni infections linked to company A, a national pet store chain based in Ohio. CDC examined whole-genome sequencing (WGS) data and identified six isolates from company A puppies in Florida that were highly related to an isolate from a company A customer in Ohio. This information prompted a multistate investigation by local and state health and agriculture departments and CDC to identify the outbreak source and prevent additional illness. Health officials from six states visited pet stores to collect puppy fecal samples, antibiotic records, and traceback information. Nationally, 118 persons, including 29 pet store employees, in 18 states were identified with illness onset during January 5, 2016-February 4, 2018. In total, six pet store companies were linked to the outbreak. Outbreak isolates were resistant by antibiotic susceptibility testing to all antibiotics commonly used to treat Campylobacter infections, including macrolides and quinolones. Store record reviews revealed that among 149 investigated puppies, 142 (95%) received one or more courses of antibiotics, raising concern that antibiotic use might have led to development of resistance. Public health authorities issued infection prevention recommendations to affected pet stores and recommendations for testing puppies to veterinarians. This outbreak demonstrates that puppies can be a source of multidrug-resistant Campylobacter infections in humans, warranting a closer look at antimicrobial use in the commercial dog industry.
Highlights
By the European Committee on Antimicrobial Susceptibility Testing
Employees, and clinicians should be aware of the risk for disease transmission from puppies, including the possibility of exposure to multidrug-resistant pathogens
Campylobacter jejuni isolates were obtained for 51 persons and 23 puppies
Summary
Multidrug-Resistant Campylobacter jejuni Outbreak Linked to Puppy Exposure — United States, 2016–2018. MHS3,5; Rachel Silver, MPH3,4; Preethi Sundararaman, MPH3,6; Amber Singh, DVM1; Lavin A. PhD3; Alvina Chu, MHS9; Jennifer Jackson, MPH9; Jason Blanton, PhD10; Amber Ginn[10]; Kirtana Ramadugu, MPH10; Danielle Stanek, DVM10; Jamie DeMent, MNS10; Jing Cui, DVM7; Yan Zhang, DVM, PhD7; Colin Basler, DVM3; Cindy R. CDC examined whole-genome sequencing (WGS) data and identified six isolates from company A puppies in Florida that were highly related to an isolate from a company A customer in Ohio This information prompted a multistate investigation by local and state health and agriculture departments and CDC to identify the outbreak source and prevent additional illness. Public health authorities issued infection prevention recommendations to affected pet stores and recommendations for testing puppies to veterinarians This outbreak demonstrates that puppies can be a source of multidrug-resistant Campylobacter infections in humans, warranting a closer look at antimicrobial use in the commercial dog industry
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