1 / 37

Community associated MRSA in animals

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?

Download Presentation

Community associated MRSA in animals

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.


Presentation Transcript

  1. Community associated MRSA in animals J Scott Weese DVM DVSc DipACVIM

  2. We are not a population of people, in populations of dogs, cats, horses… We are a population of animals.

  3. 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?

  4. 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

  5. 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?

  6. 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

  7. 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

  8. MRSA in horses

  9. 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

  10. Skin Infections in Equine NICU Personnel

  11. 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

  12. MRSA infection and colonization in household pets

  13. 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)

  14. 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)

  15. 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)

  16. 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

  17. Intra- and inter-species transmission Weese et al, Vet Microbiol 2006

  18. Washington Clinic + +

  19. Clinic + + +

  20. Clinic + + Home + + + + + +

  21. Animal Rescue + Clinic + + Home + + + + + +

  22. New York Clinic +

  23. Clinic + +

  24. Clinic A + Clinic B + + Home + + + +

  25. Recent Case • March: MRSA infection in foot of a cat • In veterinary hospital for amputation

  26. 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

  27. 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?

  28. 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

  29. MRSA colonization of veterinary personnel

  30. Recent studies from Canada, UK and Ireland reporting colonization of veterinary personnel • Is veterinary medicine an occupational risk factor?

  31. Veterinary Internal Medicine Conference

  32. 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

  33. 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

  34. 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

  35. 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…

  36. 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?

  37. The End

More Related