Massive Spread of OXA-48 Carbapenemase-Producing Enterobacteriaceae in the Environment of a Swiss Companion Animal Clinic

• Published in: Antibiotics (Basel) Vol. 11; no. 2; p. 213
• Main Authors: Schmitt, Kira, Biggel, Michael, Stephan, Roger, Willi, Barbara
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01-02-2022; MDPI
• Subjects: Animals; Antibiotic resistance; Antiinfectives and antibacterials; Antimicrobial agents; Bacteria; Carbapenemase; Citrobacter; Clinics; Cloning; Co-trimoxazole; CPE; CTX-M15; Disinfection; Drug resistance; Drug resistance in microorganisms; E coli; Enterobacteriaceae; ESBL; Gene sequencing; Genes; Genomes; Hand; hand hygiene; Health risks; Hygiene; Imipenem; IPC; Klebsiella; Methicillin; Microorganisms; Oxalic acid; Personal hygiene; Plasmids; Public health; Tetracycline; Tetracyclines; Vancomycin; Veterinary services; Whole genome sequencing; β Lactamase; United Kingdom; Switzerland; ESBL; plasmid; CPE; hand hygiene; carbapenemase; IncL; OXA-48; CTX-M15; IPC
• ISSN: 2079-6382; 2079-6382
• DOI: 10.3390/antibiotics11020213

Companion animal clinics contribute to the spread of antimicrobial resistant microorganisms (ARM) and outbreaks with ARM of public health concern have been described.
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).
A total of 22 (11.0%) environmental specimen yielded CPE, 14 (7.0%) ESBL-E, and 7 (3.5%) MRS; MR
were isolated from two (10.0%) hand swabs. The CPE isolates comprised
,
,
,
, and
. Whole genome sequencing revealed that all CPE carried closely related
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
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.