Demonstrating the importance of local culture and susceptibility data: antibiograms from dogs at a veterinary tertiary care center

Kendall Leet-Otley Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA

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 DVM
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Claire L. Fellman Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA

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 DVM, PhD, DACVIM (SAIM), DACVCP
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Annie S. Wayne Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA

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 DVM, MPH, DACVECC
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Kirthana Beaulac Department of Pharmacy, Emerson Hospital, Concord, MA

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Ian M. DeStefano Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA

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Kelly Chambers Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA

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Kady B. Marino Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA

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Shira Doron Division of Infectious Diseases and Geographic Medicine, Tufts Medical Center, Boston, MA

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 MD

Abstract

OBJECTIVE

To create antibiograms for commonly cultured organisms in a small animal tertiary care hospital following Clinical and Laboratory Standards Institute guidelines and to compare these local resistance patterns to published first-tier antimicrobial recommendations.

SAMPLE

Urine (n = 429), respiratory (41), and skin (75) isolates cultured from dogs between January 1, 2019, and December 31, 2020, at the Tufts University Foster Hospital for Small Animals.

PROCEDURES

MIC and susceptibility interpretations were recorded for multiple sites for 2 years. Sites with greater than 30 isolates for at least 1 organism were included. Urinary, respiratory, and skin antibiograms were created using Clinical and Laboratory Standards Institute breakpoints and guidelines.

RESULTS

Urinary Escherichia coli had a higher susceptibility percentage for amoxicillin–clavulanate (80% [221/275]) than amoxicillin alone (64% [175/275]). Respiratory E coli were greater than 80% susceptible to only 2 antimicrobials (imipenem, amikacin). Of skin Staphylococcus pseudintermedius isolates, 40% (30/75) were methicillin-resistant and frequently also displayed resistance to non-beta lactam antimicrobials. Susceptibility to recommended first-line antimicrobials varied and was greatest for gram-negative urinary isolates and lowest for methicillin-resistant S pseudintermedius skin isolates and respiratory E coli.

CLINICAL RELEVANCE

Local antibiogram creation identified frequent resistance that may preclude the use of guideline-recommended first-line therapy. High levels of resistance identified in methicillin-resistant S pseudintermedius isolates supports growing concern for methicillin-resistant staphylococci in veterinary patients. This project highlights the need for population-specific resistance profiles to be used in conjunction with national guidelines.

Abstract

OBJECTIVE

To create antibiograms for commonly cultured organisms in a small animal tertiary care hospital following Clinical and Laboratory Standards Institute guidelines and to compare these local resistance patterns to published first-tier antimicrobial recommendations.

SAMPLE

Urine (n = 429), respiratory (41), and skin (75) isolates cultured from dogs between January 1, 2019, and December 31, 2020, at the Tufts University Foster Hospital for Small Animals.

PROCEDURES

MIC and susceptibility interpretations were recorded for multiple sites for 2 years. Sites with greater than 30 isolates for at least 1 organism were included. Urinary, respiratory, and skin antibiograms were created using Clinical and Laboratory Standards Institute breakpoints and guidelines.

RESULTS

Urinary Escherichia coli had a higher susceptibility percentage for amoxicillin–clavulanate (80% [221/275]) than amoxicillin alone (64% [175/275]). Respiratory E coli were greater than 80% susceptible to only 2 antimicrobials (imipenem, amikacin). Of skin Staphylococcus pseudintermedius isolates, 40% (30/75) were methicillin-resistant and frequently also displayed resistance to non-beta lactam antimicrobials. Susceptibility to recommended first-line antimicrobials varied and was greatest for gram-negative urinary isolates and lowest for methicillin-resistant S pseudintermedius skin isolates and respiratory E coli.

CLINICAL RELEVANCE

Local antibiogram creation identified frequent resistance that may preclude the use of guideline-recommended first-line therapy. High levels of resistance identified in methicillin-resistant S pseudintermedius isolates supports growing concern for methicillin-resistant staphylococci in veterinary patients. This project highlights the need for population-specific resistance profiles to be used in conjunction with national guidelines.

Supplementary Materials

    • Supplementary Material S1 (PDF 191 KB)
    • Supplementary Material S2 (PDF 189 KB)
  • 1.

    Jacob ME, Hoppin JA, Steers N, et al. Opinions of clinical veterinarians at a US veterinary teaching hospital regarding antimicrobial use and antimicrobial-resistant infections. J Am Vet Med Assoc. 2015;247(8):938-944.

    • Search Google Scholar
    • Export Citation
  • 2.

    Aslam B, Wang W, Arshad MI, et al. Antibiotic resistance: a rundown of a global crisis. Infect Drug Resist. 2018;11:1645-1658.

  • 3.

    Morency-Potvin P, Schwartz DN, Weinstein RA. Antimicrobial stewardship: how the microbiology laboratory can right the ship. Clin Microbiol Rev. 2016;30:381-407.

    • Search Google Scholar
    • Export Citation
  • 4.

    AVMA Task Force for Antimicrobial Stewardship in Companion Animal Practice. Antimicrobial stewardship in companion animal practice. J Am Vet Med Assoc. 2015;246(3):287-288.

    • Search Google Scholar
    • Export Citation
  • 5.

    Hillier A, Lloyd DH, Weese JS, et al. Guidelines for the diagnosis and antimicrobial therapy of canine superficial bacterial folliculitis (Antimicrobial Guidelines Working Group of the International Society for Companion Animal Infectious Diseases). Vet Dermatol. 2014;25(3):163-e43.

    • Search Google Scholar
    • Export Citation
  • 6.

    Lappin MR, Blondeau J, Boothe D, et al. Antimicrobial use Guidelines for Treatment of Respiratory Tract Disease in Dogs and Cats: Antimicrobial Guidelines Working Group of the International Society for Companion Animal Infectious Diseases. J Vet Intern Med. 2017;31(2):279-294.

    • Search Google Scholar
    • Export Citation
  • 7.

    Weese JS, Blondeau J, Boothe D, et al. International Society for Companion Animal Infectious Diseases (ISCAID) guidelines for the diagnosis and management of bacterial urinary tract infections in dogs and cats. Vet J. 2019;247:8-25.

    • Search Google Scholar
    • Export Citation
  • 8.

    CLSI. Analysis and Presentation of Cumulative Antimicrobial Susceptibility Test Data. 5th ed. CLSI Document M39-A5. Clinical and Laboratory Standards Institute; 2022.

    • Search Google Scholar
    • Export Citation
  • 9.

    CLSI. Understanding Susceptibility Test Data as a Component of Antimicrobial Stewardship in Veterinary Settings. 1st ed. CLSI report VET09. Clinical and Laboratory Standards Institute; 2019.

    • Search Google Scholar
    • Export Citation
  • 10.

    CLSI. Performance Standards for Antimicrobial Susceptibility Testing. 31st ed. CLSI Supplement M100. Clinical and Laboratory Standards Institute; 2021.

    • Search Google Scholar
    • Export Citation
  • 11.

    CLSI. Performance Standards for Antimicrobial Disk and Dilution Susceptibility Tests for Bacteria Isolated From Animals. 5th ed. CLSI supplement VET01S. Clinical and Laboratory Standards Institute; 2020.

    • Search Google Scholar
    • Export Citation
  • 12.

    Chai MH, Sukiman MZ, Liew YW, et al. Detection, molecular characterization, and antibiogram of multi-drug resistant and methicillin-resistant Staphylococcus aureus (MRSA) isolated from pets and pet owners in Malaysia. Iran J Vet Res. 2021;22(4):277-287.

    • Search Google Scholar
    • Export Citation
  • 13.

    Frey E, Jacob M. Development of a method for creating antibiograms for use in companion animal private practices. J Am Vet Med Assoc. 2020;257(9):950-960.

    • Search Google Scholar
    • Export Citation
  • 14.

    Hartmann FA, White DG, West SE, Walker RD, Deboer DJ. Molecular characterization of Staphylococcus intermedius carriage by healthy dogs and comparison of antimicrobial susceptibility patterns to isolates from dogs with pyoderma. Vet Microbiol. 2005;108(1-2):119-131.

    • Search Google Scholar
    • Export Citation
  • 15.

    KuKanich K, Lubbers B, Salgado B. Amoxicillin and amoxicillin-clavulanate resistance in urinary Escherichia coli antibiograms of cats and dogs from the Midwestern United States. J Vet Intern Med. 2020;34(1):227-231.

    • Search Google Scholar
    • Export Citation
  • 16.

    Punia M, Kumar A, Charaya G, Kumar T. Pathogens isolated from clinical cases of urinary tract infection in dogs and their antibiogram. Vet World. 2018;11(8):1037-1042.

    • Search Google Scholar
    • Export Citation
  • 17.

    Ravens PA, Vogelnest LJ, Ewen E, Bosward KI, Norris JM. Canine superficial bacterial pyoderma: evaluation of skin surface sampling methods and antimicrobial susceptibility of causal Staphylococcus isolates. Aust Vet J. 2014;92(5):149-155.

    • Search Google Scholar
    • Export Citation
  • 18.

    Scarborough R, Bailey K, Galgut B, et al. Use of local antibiogram data and antimicrobial importance ratings to select optimal empirical therapies for urinary tract infections in dogs and cats. Antibiotics (Basel). 2020;9(12):924.

    • Search Google Scholar
    • Export Citation
  • 19.

    Wong C, Epstein SE, Westropp JL. Antimicrobial susceptibility patterns in urinary tract infections in dogs (2010-2013). J Vet Intern Med. 2015;29(4):1045-1052.

    • Search Google Scholar
    • Export Citation
  • 20.

    Lord J, Millis N, Jones RD, et al. Patterns of antimicrobial, multidrug and methicillin resistance among Staphylococcus spp. isolated from canine specimens submitted to a diagnostic laboratory in Tennessee, USA: a descriptive study. BMC Vet Res. 2022;18(1):91.

    • Search Google Scholar
    • Export Citation
  • 21.

    Morris DO, Rook KA, Shofer FS, et al. Screening of Staphylococcus aureus, Staphylococcus intermedius, and Staphylococcus schleiferi isolates obtained from small companion animals for antimicrobial resistance: a retrospective review of 749 isolates (2003-04). Vet Dermatol. 2006;17(5):332-337.

    • Search Google Scholar
    • Export Citation
  • 22.

    Baron EJ. Chapter 18. Specimen collection, transport, and processing: bacteriology. In: Jorgenson JH, Pfaller MA, eds. Manual of Clinical Microbiology; 11th Ed. American Society for Microbiology, 2015.

    • Search Google Scholar
    • Export Citation
  • 23.

    Bader MS, Loeb M, Brooks AA. An update on the management of urinary tract infections in the era of antimicrobial resistance. Postgrad Med. 2017;129(2):242-258.

    • Search Google Scholar
    • Export Citation
  • 24.

    Gupta K, Hooton TM, Stamm WE. Increasing antimicrobial resistance and the management of uncomplicated community-acquired urinary tract infections. Ann Intern Med. 2001;135(1):41-50.

    • Search Google Scholar
    • Export Citation
  • 25.

    Dowling PM. Bacterial urinary tract infections. Merck Veterinary Manual Online. Accessed December 6, 2022. https://www.merckvetmanual.com/pharmacology/systemic-pharmacotherapeutics-of-the-urinary-system/bacterial-urinary-tract-infections.

    • Search Google Scholar
    • Export Citation
  • 26.

    Lynch SA, Helbig KJ. The complex diseases of Staphylococcus pseudintermedius in canines: where to next? Vet Sci. 2021;8(1):11.

  • 27.

    European Committee on Antimicrobial Susceptibility Testing. Data from the EUCAST MIC distribution website. Accessed December 6, 2022. https://www.eucast.org..

    • Search Google Scholar
    • Export Citation
  • 28.

    Howard J, Reinero CR, Almond G, Vientos-Plotts A, Cohn LA, Grobman M. Bacterial infection in dogs with aspiration pneumonia at 2 tertiary referral practices. J Vet Intern Med. 2021;35(6):2763-2771.

    • Search Google Scholar
    • Export Citation
  • 29.

    Rheinwald M, Hartmann K, Hähner M, Wolf G, Straubinger RK, Schulz B. Antibiotic susceptibility of bacterial isolates from 502 dogs with respiratory signs. Vet Rec. 2015;176(14):357.

    • Search Google Scholar
    • Export Citation
  • 30.

    Lee SO, Cho YK, Kim SY, et al. Comparison of trends of resistance rates over 3 years calculated from results for all isolates and for the first isolate of a given species from a patient. J Clin Microbiol. 2004;42(10):4776-4779.

    • Search Google Scholar
    • Export Citation
  • 31.

    Lee K, Lee MA, Lee CH, et al. Increase of ceftazidime- and fluoroquinolone-resistant Klebsiella pneumoniae and imipenem-resistant Acinetobacter spp. in Korea: analysis of KONSAR study data from 2005 and 2007. Yonsei Med J. 2010;51(6):901-911.

    • Search Google Scholar
    • Export Citation
  • 32.

    Toutain PL, Ferran A, Bousquet-Mélou A. Species differences in pharmacokinetics and pharmacodynamics. Handb Exp Pharmacol. 2010;199:19-48.

    • Search Google Scholar
    • Export Citation
  • 33.

    Humphries RM, Abbott AN, Hindler JA. Understanding and addressing CLSI breakpoint revisions: a primer for clinical laboratories. J Clin Microbiol. 2019;57(6):e00203-19.

    • Search Google Scholar
    • Export Citation

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