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      Risk factors for methicillin-resistant Staphylococcus aureus (MRSA) infection in dogs and cats: a case-control study

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          Abstract

          Risk factors for methicillin-resistant Staphylococcus aureus (MRSA) infection in dogs and cats were investigated in an unmatched case-control study. A total of 197 animals from 150 veterinary practices across the United Kingdom was enrolled, including 105 MRSA cases and 92 controls with methicillin-susceptible S. aureus (MSSA) infection. The association of owners and veterinarian staff with the human healthcare sector (HCS) and animal-related characteristics such as signalment, antimicrobial and immunosuppressive therapy, and surgery were evaluated as putative risk factors using logistic regression. We found that significant risk factors for MRSA infection were the number of antimicrobial courses ( p = 0.005), number of days admitted to veterinary clinics ( p = 0.003) and having received surgical implants ( p = 0.001). In addition, the odds of contact with humans which had been ill and admitted to hospital ( p = 0.062) were higher in MRSA infected pets than in MSSA controls. The risk factors identified in this study highlight the need to increase vigilance towards identification of companion animal groups at risk and to advocate responsible and judicious use of antimicrobials in small animal practice.

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          The impact of methicillin resistance in Staphylococcus aureus bacteremia on patient outcomes: mortality, length of stay, and hospital charges.

          Sara E Cosgrove, Youlin Qi, Keith S. Kaye … (2005)
          To evaluate the impact of methicillin resistance in Staphylococcus aureus on mortality, length of hospitalization, and hospital charges. A cohort study of patients admitted to the hospital between July 1, 1997, and June 1, 2000, who had clinically significant S. aureus bloodstream infections. A 630-bed, urban, tertiary-care teaching hospital in Boston, Massachusetts. Three hundred forty-eight patients with S. aureus bacteremia were studied; 96 patients had methicillin-resistant S. aureus (MRSA). Patients with methicillin-susceptible S. aureus (MSSA) and MRSA were similar regarding gender, percentage of nosocomial acquisition, length of hospitalization, ICU admission, and surgery before S. aureus bacteremia. They differed regarding age, comorbidities, and illness severity score. Similar numbers of MRSA and MSSA patients died (22.9% vs 19.8%; P = .53). Both the median length of hospitalization after S. aureus bacteremia for patients who survived and the median hospital charges after S. aureus bacteremia were significantly increased in MRSA patients (7 vs 9 days, P = .045; 19,212 dollars vs 26,424 dollars, P = .008). After multivariable analysis, compared with MSSA bacteremia, MRSA bacteremia remained associated with increased length of hospitalization (1.29 fold; P = .016) and hospital charges (1.36 fold; P = .017). MRSA bacteremia had a median attributable length of stay of 2 days and a median attributable hospital charge of 6916 dollars. Methicillin resistance in S. aureus bacteremia is associated with significant increases in length of hospitalization and hospital charges.
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            Pet animals as reservoirs of antimicrobial-resistant bacteria.

            Stefan Schwarz, David H. Lloyd, Luca Guardabassi (2004)
            Pet animal numbers have substantially increased in modern society and attention is increasingly devoted to pet welfare. Because of these changes, antimicrobial agents are frequently used in small animal veterinary practice, often including antimicrobial preparations used in human medicine, with heavy use of broad-spectrum agents such as aminopenicillins plus clavulanic acid, cephalosporins and fluoroquinolones. Several longitudinal studies conducted at veterinary hospitals have indicated that resistance to various antimicrobial agents has emerged amongst pet animal isolates of Staphylococcus intermedius, Escherichia coli and other bacteria, including species with a potential for zoonotic transmission and resistance phenotypes of clinical interest, such as methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci and multidrug-resistant Salmonella Typhimurium DT104. Based on a review of the current literature, the role of pets in the dissemination of antimicrobial resistance has been given little attention when compared with that of food animals. A marked contrast is evident between the current policies on antimicrobial usage in food and companion animals. Apart from a few countries where limited data on antimicrobial usage and occurrence of resistance in bacteria from pet animals are provided, national surveillance programmes only focus on food animals. However, data on pet animals are clearly needed for guiding antimicrobial use policy in small animal veterinary practice as well as for assessing the risk of transmission of antimicrobial resistance to humans.
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              Risk factors for colonization with methicillin-resistant Staphylococcus aureus (MRSA) in patients admitted to an urban hospital: emergence of community-associated MRSA nasal carriage.

              Sue J Halvosa, M. King, H Blumberg … (2005)
              Surveillance cultures performed at hospital admission have been recommended to identify patients colonized with methicillin-resistant Staphylococcus aureus (MRSA) but require substantial resources. We determined the prevalence of and risk factors for MRSA colonization at the time of hospital admission among patients cared for at a public urban hospital. Anterior nares cultures were obtained within 48 h after admission during a 1-month period. A case-control study and molecular typing studies were performed. A total of 53 (7.3%) of 726 patients had a nares culture positive for MRSA, and 119 (16.4%) had a nares culture that was positive for methicillin-susceptible S. aureus. In multivariate analysis, risk factors for MRSA colonization included antibiotic use within 3 months before admission (odds ratio [OR], 2.5; 95% confidence interval [CI], 1.2-5.0), hospitalization during the past 12 months (OR, 4.0; 95% CI, 2.0-8.2), diagnosis of skin or soft-tissue infection at admission (OR, 3.4; 95% CI, 1.5-7.9), and HIV infection. A total of 47 (89%) of 53 case patients colonized with MRSA had at least 1 of these independent risk factors, in contrast to 343 (51%) of 673 control patients (OR, 7.5; 95% CI, 3.2 -17.9). Molecular typing demonstrated that 16 (30%) of 53 MRSA nares isolates (2.2% of the 726 isolates) belonged to the USA300 community-associated MRSA (CA-MRSA) genotype. The prevalence of MRSA colonization at the time of patient admission was high (>7%). Limiting surveillance cultures to patients with >or=1 of the identified risk factors may allow for targeted screening. The emergence of CA-MRSA colonization represents a new, unrecognized reservoir of MRSA within hospitals, potentially increasing the risk for horizontal transmission.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Vet Res
                Journal ID (publisher-id): vetres
                Title: Veterinary Research
                Publisher: EDP Sciences
                ISSN (Print): 0928-4249
                ISSN (Electronic): 1297-9716
                Publication date (Electronic): 29 April 2010
                Publication date (Print): Sep-Oct 2010
                Publication date PMC-release: 29 April 2010
                Volume: 41
                Issue: 5 ( publisher-idID: vetres/2010/05 )
                Electronic Location Identifier: 55
                Affiliations
                [1 ] Department of Veterinary Clinical Sciences, The Royal Veterinary College, University of London Hawkshead Lane North Mymms, Hatfield Hertfordshire AL9 7TA United Kingdom
                [2 ] Present address: School of Population Health, University of Queensland Public Health Building Herston Road Herston QLD 40006 Australia
                [3 ]simpleDepartment of Cellular and Molecular Medicine, St. George’s, University of London , Cranmer Terrace London SW17 0RE United Kingdom
                [4 ]simpleIDEXX Laboratories Wetherby , Grange House, Sandbeck Way Wetherby West Yorkshire LS22 7DN United Kingdom
                [5 ] 4 Teringie Drive Teringie SA 5065 Australia
                Author notes
                [* ]Corresponding author: r.magalhaes@ 123456sph.uq.edu.au
                Article
                Publisher ID: v09533 Other ID: 10.1051/vetres/2010028
                DOI: 10.1051/vetres/2010028
                PMC ID: 2879574
                PubMed ID: 20423695
                SO-VID: 86f62899-c8b8-4ae6-8604-72453e438322
                Copyright © © The authors, published by INRA/EDP Sciences, 2010
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial License ( http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted use, distribution, and reproduction in any noncommercial medium, provided the original work is properly cited.

                History
                Date received : 06 October 2009
                Date accepted : 26 April 2010
                Page count
                Figures: 1, Tables: 3, Equations: 0, References: 51, Pages: 12
                Categories
                Subject: Original Article

                ScienceOpen disciplines: Veterinary medicine
                Keywords: risk factor,methicillin-resistant staphylococcus aureus infection,case-control study,dog,cat
                Data availability:
                ScienceOpen disciplines: Veterinary medicine
                Keywords: risk factor, methicillin-resistant staphylococcus aureus infection, case-control study, dog, cat

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