Poor infection prevention and control standards are associated with environmental contamination with carbapenemase-producing Enterobacterales and other multidrug-resistant bacteria in Swiss companion animal clinics

Schmidt, Janne S.; Kuster, Stefan P.; Nigg, Aurélien; Dazio, Valentina; Brilhante, Michael; Rohrbach, Hélène; Bernasconi, Odette Joëlle; Büdel, Thomas; Campos-Madueno, Edgar I.; Brawand, Stefanie Gobeli; Schüller, Simone; Endimiani, Andrea; Perreten, Vincent; Willi, Barbara

doi:10.1186/s13756-020-00742-5

Cited by 36 publications

(48 citation statements)

References 56 publications

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“…An extrapolation of our results to ICU settings of other veterinary clinics is thus not possible. Of note, the companion animal clinic included in this study showed the lowest environmental ARM contamination and the highest IPC standards among three large referral clinics in Switzerland in a recent study, suggesting that the frequency of ESBL-E transmission chains observed in this study might not be overestimated [40]. However, the present study also showed considerable variations in the ESBL-E detection between sampling days.…”

Section: Discussionsupporting

confidence: 43%

“…Such long carriage periods could additionally contribute to the risk of spreading of ESBL-E in the household environment [28]. Of note, environmental contamination in household 1 for ESBL-E was much higher than at most of the sampling days in the ICU in the investigated clinic (3%, range: 0-24%), and higher than recently reported for environmental samples collected in seven companion animal clinics and practices in Switzerland (0-2% of the environmental specimens were ESBL-E positive) [40]. Although only two households were investigated in this study, our results are alarming and highlight the need to develop evidence-based recommendations for the handling of ESBL-E colonized animals in the household environment.…”

Section: Discussionmentioning

confidence: 67%

“…Data on environmental contamination by ESBL-E in veterinary facilities are scarce. A recent study reported a prevalence of ESBL-E on high-touch surfaces ranging from 0-2% across seven Swiss veterinary clinics and practices [40] and areas with high patient traffic and utensils were most contaminated with ARM [40]. In this study, environmental contamination with ESBL-E in a high-risk setting was detected in 3% of the high-touch surfaces, but contamination varied considerably between the sampling days: seven of 10 isolates were found on sampling day 22 and six of these seven specimens yielded K. pneumoniae ST310 bla CTX-M-15 .…”

Section: Discussionmentioning

confidence: 99%

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Transmission Chains of Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae at the Companion Animal Veterinary Clinic–Household Interface

et al. 2021

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Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) among animals and humans are a public health threat. This study analyzed the occurrence of ESBL-E in a high-risk environment in a companion animal clinic and two animal patients’ households. In an intensive care unit (ICU), rectal swabs from 74 dogs and cats, 74 hand swabs from staff and 298 swabs from surfaces were analyzed for ESBL-E. Seventeen hospitalized patients (23%) and ten (3%) surfaces in the ICU tested ESBL-E positive. Transmission chains for Klebsiella pneumoniae ST307 blaCTX-M-15 and Escherichia coli ST38 blaCTX-M-14, ST88 blaCTX-M-14 and ST224 blaCTX-M-1 were observed over extended periods of time (14 to 30 days) with similar strains isolated from patients and the clinical environment. After discharge, two colonized dogs (dogs 7 and 12) and their household contacts were resampled. Dog 7 tested repeatedly positive for 77 days, dog 12 tested negative; six (24%) surfaces in the household of the persistently colonized dog tested ESBL-E positive. The owner of dog 7 and one of the owners of dog 12 were colonized. Based on whole genome sequencing, isolates from the owners, their dogs and other ICU patients belonged to the same clusters, highlighting the public health importance of ESBL-E in companion animal clinics.

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Section: Discussionsupporting

confidence: 43%

Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

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Transmission Chains of Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae at the Companion Animal Veterinary Clinic–Household Interface

et al. 2021

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“…It is not fully understood how nosocomial infections are caused by K. pneumoniae. The possible reasons for the spread of nosocomial infections in general and those caused by K. pneumoniae, in particular, is related to the health setting and its hygienic measures [21] and secondly due to the ability of K. pneumoniae to acquire resistant genes via horizontal gene transfer facilitated by plasmids and mobile genetic elements [22].…”

Section: Discussionmentioning

confidence: 99%

Rising Klebsiella pneumoniae Infections and Its Expanding Drug Resistance in the Intensive Care Unit of a Tertiary Healthcare Hospital, Saudi Arabia

Bshabshe¹,

Al‐Hakami²,

Alshehri³

et al. 2020

Cureus

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Nosocomial infections caused by Klebsiella pneumoniae and other Gram-negative organisms have emerged as a significant health problem especially in intensive care units (ICU). This study aims to examine K. pneumoniae infections in the ICU of Aseer Central Hospital and to determine their antimicrobial susceptibility and their relationship to patients' clinical outcomes. This is a retrospective observational study done in a tertiary care center in the Aseer region in Saudi Arabia. The study spanned from January 2018 to December 2019. Demographic, microbiologic, and patient outcomes were collected from 276 patients with various infections. Identification of isolates and in vitro susceptibility to 32 antimicrobial agents were done by the Vitek 2 automated system (bioMérieux, Marcy-l'Étoile, France). Prevalence of K. pneumoniae bacteria, their susceptibility to antimicrobials, and effect on clinical outcome were studied. Two hundred seventy-six K. pneumoniae were recovered from ICU patients with various infections. K. pneumoniae isolates (n=276) were collected mainly from the respiratory tract (61%) and K. pneumoniae represented 39% of the major causal agents of ICU infections, followed by Acinetobacter spp. (30%), Pseudomonas aeruginosa (10.0%), Escherichia coli (7%), and others (14%). The mortality among the 276 ICU patients was 33.3%; K. pneumoniae was connected to 42% of the cases and 67% of the total deaths were between 50 and 90 years of age. K. pneumoniae demonstrated high sensitivity and hence can be recommended for in vivo treatment for tigecycline (81%), cefazolin (77.2%), colistin (64.9%), and to a lesser extent norfloxacin (60%) and imipenem (55.5%). High resistance was detected for ampicillin (100%), extended-spectrum β-lactamases-sulbactam (ESBL-SCM) (100%), piperacillin (100%), and ceftazidime (92.5%). Resistance to carbapenems was elevated in ertapenem (65.2%) and meropenem (61.7%). The increase of K. pneumoniae represents a threat to ICU patients, although K. pneumoniae infections were results rather than the causes, as it was connected to almost half of the ICU mortalities. Tigecycline alone or in combination with colistin on high-dose regimens could be a more effective therapy for treating carbapenem-resistant K. pneumoniae infections.

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“…Enterobacteriaceae producing carbapenemase ( bla NDM-1 and bla OXA-48 ) have been isolated from companion animals like dogs, cats, and horses in the USA, Germany, Greece and UK [ 66 , 72 , 73 , 74 , 75 ]. Another recent study in Switzerland reported the isolation of various carbapenemase-producing Enterobacteriales in companion animal clinics mainly associated with poor clinical practices [ 76 ]. The isolation of CRE in companion animals brings the attention to reconsider the use of any off-label use of carbapenems in the veterinary medicines.…”

Section: Companion Animalsmentioning

confidence: 99%

Molecular Epidemiology of Carbapenemases in Enterobacteriales from Humans, Animals, Food and the Environment

et al. 2020

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The Enterobacteriales order consists of seven families including Enterobacteriaceae, Erwiniaceae, Pectobacteriaceae, Yersiniaceae, Hafniaceae, Morganellaceae, and Budviciaceae and 60 genera encompassing over 250 species. The Enterobacteriaceae is currently considered as the most taxonomically diverse among all seven recognized families. The emergence of carbapenem resistance (CR) in Enterobacteriaceae caused by hydrolytic enzymes called carbapenemases has become a major concern worldwide. Carbapenem-resistant Enterobacteriaceae (CRE) isolates have been reported not only in nosocomial and community-acquired pathogens but also in food-producing animals, companion animals, and the environment. The reported carbapenemases in Enterobacteriaceae from different sources belong to the Ambler class A (blaKPC), class B (blaIMP, blaVIM, blaNDM), and class D (blaOXA-48) β-lactamases. The carbapenem encoding genes are often located on plasmids or associated with various mobile genetic elements (MGEs) like transposons and integrons, which contribute significantly to their spread. These genes are most of the time associated with other antimicrobial resistance genes such as other β-lactamases, as well as aminoglycosides and fluoroquinolones resistance genes leading to multidrug resistance phenotypes. Control strategies to prevent infections due to CRE and their dissemination in human, animal and food have become necessary. Several factors involved in the emergence of CRE have been described. This review mainly focuses on the molecular epidemiology of carbapenemases in members of Enterobacteriaceae family from humans, animals, food and the environment.

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Poor infection prevention and control standards are associated with environmental contamination with carbapenemase-producing Enterobacterales and other multidrug-resistant bacteria in Swiss companion animal clinics

Cited by 36 publications

References 56 publications

Transmission Chains of Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae at the Companion Animal Veterinary Clinic–Household Interface

Transmission Chains of Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae at the Companion Animal Veterinary Clinic–Household Interface

Rising Klebsiella pneumoniae Infections and Its Expanding Drug Resistance in the Intensive Care Unit of a Tertiary Healthcare Hospital, Saudi Arabia

Molecular Epidemiology of Carbapenemases in Enterobacteriales from Humans, Animals, Food and the Environment

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