A Retrospective Study of Antimicrobial Resistant Bacteria Associated with Feline and Canine Urinary Tract Infection in Hong Kong SAR, China—A Case Study on Implication of First-Line Antibiotics Use

Abstract

Urinary tract infection (UTI) is a common clinical diagnosis for which empirical antibiotics are used in veterinary medicine. For veterinarians, the description of canine and feline antibiograms can help with making prudent use decisions and guideline formulation. For public health officers and epidemiologists, a urinary antibiogram overview helps track and trend antimicrobial resistance (AMR). There is currently a knowledge gap in AMR prevalence associated with urinary tract infection in feline and canine patients and the resistance percentage of these microbes against some of the over-the-counter antibiotics available to local pet owners. This study has two aims. First, it aims to investigate the frequency of the bacteria and bacterial-resistance pattern in urine samples obtained from feline and canine patients. Second, it aims to determine the resistance of Escherichia coli (E. coli), the most frequently isolated bacteria, to first-line antibiotics. Results: We identified the five most-frequently isolated bacterial species and determined these isolates’ antibiotic sensitivity and resistance. The most-frequently isolated bacteria in feline and canine patients was Escherichia coli (E. coli). E. coli was identified, on average, in 37.2% of canine and 46.5% of feline urine samples. Among feline urinary samples, Enterococcus (14.7%) and Staphylococcus (14.5%) spp. were isolated more frequently, followed by Pseudomonas (4.8%) and Klebsiella (5.2%) spp. (). In canine samples, Proteus (17.9%) and Staphylococcus (13.2%) spp. were isolated more frequently, followed by Enterococcus (10.0%) and Klebsiella (8.59%) spp. Among these isolates, 40 to 70% of Staphylococcus spp. bacterial isolates from feline and canine patients were resistant to amoxicillin and ampicillin. During the three-year study period, among canine patients, 10 to 20% of Staphylococcus spp. bacterial isolates were resistance to fluoroquinolones, other quinolones, and third-generation cephalosporins. Among feline patients, 10% of Staphylococcus spp., 15 to 20% of E. coli, 50 to 60% of Klebsiella spp., and 90% of Pseudomonas spp. were resistant to cefovecin, a commonly used antibiotic.

Prevalence and Risk Factors Associated with Multidrug Resistance and Extended-Spectrum β-lactamase Producing E. coli Isolated from Healthy and Diseased Cats

“…Several studies have investigated the public health risks associated with the transfer of antimicrobial-resistant bacteria from cats [1,22]; however, studies investigated the risk factors associated with antimicrobial-resistant bacteria colonization are scarce. In the present study, 41.3% of cats were E. coli carriers, which is consistent with the E. coli isolation rates reported in Canada [23] and Hong Kong [24]. However, it was higher than the isolation rate (8.7%) reported in cats in South Korea [25].…”

Prevalence and Characterization of Extended-Spectrum β-Lactamase-Producing Escherichia coli Isolated from Dogs and Cats in South Korea

“…In the present study, 18.1% and 12.1% of the E. coli isolated from dogs and cats were resistant to cefovecin. The cefovecin resistance rate in this study agreed with earlier studies from Hong Kong (20%) [ 13 ] and Australia (17%) [ 14 ]. However, it was lower than other reports in the UK (31%) [ 15 ] and Poland (28%) [ 16 ].…”

Antimicrobial susceptibility patterns from urinary isolates obtained from cats (2013‐2020)

“…No antimicrobial tested achieved a >90% effectiveness designation for all bacteria isolated. This finding is similar to most studies of antimicrobial susceptibility of bacterial urinary tract pathogens in cats 28,46‐48 . The percentage susceptibility of all bacterial isolates to amoxicillin/clavulanic acid, trimethoprim/sulfamethoxazole and enrofloxacin, 3 commonly prescribed antimicrobials, was similar to what was previously reported in cats from Norway, but differed from a study evaluating urinary isolates from cats in Taiwan where all isolates had significantly lower susceptibility to these same antimicrobials 28,49 .…”

“…Escherichia coli isolates in our study had higher overall susceptibility to the antimicrobials tested compared to other studies, 25,28,47,49 particularly when comparing ampicillin and amoxicillin/clavulanic acid. However, other studies reported slightly higher susceptibility to amoxicillin/clavulanic acid 46,48 . At our institution, we frequently submit ABUC and susceptibility testing for cats with suspected UTI versus starting empirical treatment with antimicrobials, which might help decrease inappropriate antimicrobial administration and potential resistance.…”

“…However, other studies reported slightly higher susceptibility to amoxicillin/clavulanic acid. 46 , 48 At our institution, we frequently submit ABUC and susceptibility testing for cats with suspected UTI versus starting empirical treatment with antimicrobials, which might help decrease inappropriate antimicrobial administration and potential resistance. Thus, geographical differences for antimicrobial prescribing patterns are likely the reason for the different susceptibilities found in the various studies.…”