Community associated mrsa in animals
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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

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Community associated mrsa in animals

Community associated MRSA in animals

J Scott Weese DVM DVSc DipACVIM


Community associated mrsa in animals

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?


Community associated mrsa in animals

  • 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


Community associated mrsa in animals

  • 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


Mrsa in horses

MRSA in horses


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


Skin infections in equine nicu personnel

Skin Infections in Equine NICU Personnel


Community associated mrsa in animals

  • 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


Mrsa infection and colonization in household pets

MRSA infection and colonization in household pets


Community associated mrsa in animals

  • 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)


Community associated mrsa in animals

  • 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

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Community associated mrsa in animals

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Community associated mrsa in animals

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Community associated mrsa in animals

Animal Rescue

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New york

New York

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Community associated mrsa in animals

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Community associated mrsa in animals

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Recent case

Recent Case

  • March: MRSA infection in foot of a cat

    • In veterinary hospital for amputation


Community associated mrsa in animals

  • 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


Community associated mrsa in animals

  • 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


Mrsa colonization of veterinary personnel

MRSA colonization of veterinary personnel


Community associated mrsa in animals

  • Recent studies from Canada, UK and Ireland reporting colonization of veterinary personnel

  • Is veterinary medicine an occupational risk factor?


Veterinary internal medicine conference

Veterinary Internal Medicine Conference


Community associated mrsa in animals

  • 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


Community associated mrsa in animals

  • 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…


Community associated mrsa in animals

  • 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?


The end

The End


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