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Community associated MRSA in animals. J Scott Weese DVM DVSc DipACVIM. We are not a population of people, in populations of dogs, cats, horses… We are a population of animals. FAQ’s. I have diagnosed a dog/cat/horse with MRSA infection… What does this mean? Where did it come from?

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community associated mrsa in animals

Community associated MRSA in animals

J Scott Weese DVM DVSc DipACVIM

slide2
We are not a population of people, in populations of dogs, cats, horses…

We are a population of animals.

faq s
FAQ’s
  • I have diagnosed a dog/cat/horse with MRSA infection…
    • What does this mean?
    • Where did it come from?
    • What should I tell the owners?
    • Are there any precautions that should be taken?
    • Might I be infected?
slide4
I was diagnosed with MRSA. My physician…
    • Said it came from my dog/cat…
    • Told me to get rid of my pet
    • Said it is of no concern for my pets
    • Told me to bath my cat in triclosan daily for a week
    • Told me to treat my dog/cat with ___
    • Has no clue that I have pets
slide5
My dog is involved with therapeutic visitation…what are the risks?
  • During visitation at a long term care facility, my dog interacted with someone with an MRSA infection…what does this mean to my dog/me?
  • Animals regularly visit our hospital…is there anything we should be doing?
mrsa in animals
MRSA in Animals
  • Emerging problem
  • Concerns
    • Transmission of MRSA from infected animals to humans
    • Colonized animals as reservoirs of MRSA in the community
      • Human / animal origin
    • Animal disease
different species different issues
Different species…different issues
  • Horses
    • Nasal/facial contact
    • Fecal contamination
    • International movement
  • Household pets
    • Degree/duration/intensity of contact
  • Pet birds
    • Fecal contact / aerosolization of fecal matter
  • Food animals
key points
Key Points
  • Appears to be endemic in certain horse populations worldwide
    • Readily moves between horses and humans
  • CMRSA-5/USA500 predominates internationally
    • Reason unclear
    • Does not appear to be related to commensal equine S. aureus
  • Infection control measures can eradicate MRSA from farms
slide11
Skin infections in equine NICU personnel(Weese et al, Vet Microbiol 2005)
    • 3/36 (8.3%) personnel developed skin infections after 4 hour ‘barriered’ contact
    • 10/107 (9.7%) of other screened individuals colonized
    • 19% colonization rate in Foal Watch personnel
slide13
Initial reports
    • Sporadic infections or small clusters in US, UK, Canada, Australia, Korea (Pak et al J Vet Med Sci 1999, Tomlin et al Vet Rec 1999, Weese et al ISSSI Proc 2004)
slide14
Rapid increase in reported cases
    • 95 infections in pets in UK(Kearns et al ISSSI Proc 2004)
    • 106 small animal infections in UK(Boag et al Vet Rec 2004, Rich et al Vet Rec 2004)
    • 17 infected or colonized dogs, cat, rabbit, seal from Ireland(O’Mahoney et al 2005)
    • PVL + MRSA from 11 dogs, cats, rabbit, parrot with SSTI, pneumonia in US (Rankin et al 2005)and transmission of PVL+ strain in household(van Duijkeren et al 2005)
colonization
Colonization
  • Uncommon in general pet population
    • 2/203 (1%) dogs admitted to academic referral centre (Hanselman et al, ACVIM abstract 2005)
    • 0/139 dogs and 0/39 cats at primary care veterinary clinics in Ontario (Murphy et al ACVIM abstract 2005)
    • 2/131 (1.5%) dogs and 0/250 cats in the community (Unpublished data)
  • Sporadically high in veterinary clinics
    • 8.9% of dogs housed in a UK referral clinic (Loeffler et al 2005)
typing
Typing
  • Pet isolates indistinguishable from common human clones (Rich and Roberts 2004, Weese et al 2004/2006, Kearns et al 2004, Loeffler et al 2005, Baptiste et al 2005, Leonard et al 2006)
  • Initially, USA 100/CMRSA-2 predominated in Canada, United States, UK EMRSA-15 in UK, Ireland
  • Recent identification of USA300/CMRSA-10 in pets
    • First in California, now more widespread
intra and inter species transmission

Intra- and inter-species transmission

Weese et al, Vet Microbiol 2006

washington
Washington

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Clinic

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Animal Rescue

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new york
New York

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Clinic A

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Clinic B

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recent case
Recent Case
  • March: MRSA infection in foot of a cat
    • In veterinary hospital for amputation
slide26
Jan
    • female owner: MRSA abscess on hand, negative nasal screen
  • Late Feb
    • male owner: open heart surgery
  • Early March
    • female owner: MRSA ocular infection, negative nasal screen
  • Late March
    • infection in cat
slide27
Where did MRSA originate?
  • Was the cat involved in transmission?
  • What to do with the cat in this household?
  • Has there been subsequent transmission within the vet clinic?
  • Is there a household cycle that needs to be broken?
broader picture
Broader Picture
  • Is intra-household/inter-species transmission of bacteria common?
  • Concurrent colonization of people and pets with S. aureus in 8.3% of households and S. intermedius in 5% of households
slide30
Recent studies from Canada, UK and Ireland reporting colonization of veterinary personnel
  • Is veterinary medicine an occupational risk factor?
slide32
MRSA from 27/417 (6.5%) personnel
    • 13/94 (13.8%) equine veterinarians
      • US, UK, Denmark
    • 9/239 (3.8%) small animal veterinarians
      • US, Germany
    • 5/34 (14.7%) technicians
      • US
    • Equine personnel
      • 87% CMRSA-5/USA500 (including UK, Denmark)
    • Small animal personnel
      • 92% CMRSA-2/USA100
animal assisted therapy
Animal Assisted Therapy
  • Cross-sectional study in Ontario
    • 0/102 (Lefebvre et al, J Hosp Infect 2006)
  • Prospective study (ongoing)
    • MRSA acquisition by 3 dogs following start of visitation careers
      • 2: USA300
  • Hand contamination with MRSA after petting dog that had performed visitation
questions
Questions
  • Are pets important sources of community associated MRSA infection in humans?
  • Do pets become colonized when an infected/colonized person returns from hospital?
    • Impact on recurrence
  • Are pets of healthcare workers more likely to become colonized?
    • Source of recurrent colonization
slide35
Should pets be screened in cases of CA-MRSA or recurrent MRSA infection?
    • When, how, by whom?
  • What precautions should be taken in households with infected/colonized people or pets?
  • What about therapeutic visitation dogs?
    • Screening, contacts, IC protocols…
slide36
Should people that routinely contact horses be considered high risk and be screened upon admission to hospital?
  • Is MRSA a concern for therapeutic riding facilities?
  • Do people and their pets routinely ‘share’ a variety of pathogens?
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