β-Hemolytic Streptococcus (BHS) species are important pathogens with both human and veterinary significance. In human medicine, BHS are considered universally susceptible to β-lactams while BHS of veterinary origin have been reported with up to 8% β-lactam resistance. Recently, veterinary diagnostic laboratories were made aware of significant variability of test method performance for BHS among laboratories. This article explores potential sources of error in antimicrobial susceptibility test performance and result interpretation that may have contributed to the unusual rates of resistance to β-lactams observed in this bacterial species. In addition, potential impacts to research, clinical practice, surveillance, and public health will be discussed.
Antibiograms are important tools for antimicrobial stewardship that are often underutilized in veterinary medicine. Antibiograms summarize cumulative antimicrobial susceptibility testing (AST) data for specific pathogens over a defined time period; in veterinary medicine, they are often stratified by host species and site of infection. They can aid practitioners with empiric therapy choices and assessment of antimicrobial resistance trends within a population in support of one-health goals for antimicrobial stewardship. For optimal application, consideration must be given to the number of isolates used, the timeframe of sample collection, laboratory analytical methodology, and the patient population contributing to the data (eg, treatment history, geographic region, and production type). There are several limitations to veterinary antibiograms, including a lack of breakpoint availability for bacterial species, a lack of standardization of laboratory methodology and technology for culture and AST, and a lack of funding to staff veterinary diagnostic laboratories at a level that supports antibiogram development and education. It is vital that veterinarians who use antibiograms understand how to apply them in practice and receive relevant information pertaining to the data to utilize the most appropriate antibiogram for their patients. This paper explores the benefits and challenges of developing and using veterinary antibiograms and proposes strategies to enhance their applicability and accuracy. Further detail regarding the application of veterinary antibiograms by privately practicing clinicians is addressed in the companion Currents in One Health article by Lorenz et al (JAVMA, September 2023).