Has the use of antibiotics in puppies caused multidrug-resistant infections in humans?



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An epidemic of multidrug resistance Campylobacter jejuni has been linked to pet puppies, and could warrant a look at the use of antimicrobials in the dog breeding industry, the researchers found.

Of the 149 puppies studied, 142 had received one or more antibiotic treatments, reported Martha P. Montgomery, MD, of the Ohio Department of Health and the CDC, as well as colleagues.

In addition, the epidemic isolates were resistant to the antibiotics commonly used to treat Campylobacter, including macrolides and quinolones, the authors wrote in the Weekly report on morbidity and mortality.

They characterized associate dog Campylobacter Outbreaks as "uncommon", and although they have already been reported, they did not contain resistant isolates and were linked to fewer diseases, investigators said.

"This evidence, combined with the prolonged nature of the outbreak and the possibility of puppy mixing, indicate a potential for continued transmission of Campylobacter the industry as a whole, including among breeders, distributors, transporters and stores, and finally among customers. "

The researchers added that clinicians should consider that patients can acquire Campylobacter puppy infections, and "if antibiotics are indicated, consider stool culture and antibiotic susceptibility testing."

Montgomery and his co-authors said that the multi-state outbreak had sickened 118 people, including 29 employees in pet stores, in 18 states. Of the 115 people with available information, the median age was 26 (ranging from 1 to 85) and almost two-thirds were women. It is not surprising that almost all reported exposure to a dog, as well as contact with a puppy from an animal facility. In total, six pet-house companies have been associated with the outbreak, the authors said.

Among puppies treated with antibiotics for which treatment information was available, 55% received prophylactic antibiotics, while 38% received prophylactic antibiotics for prophylaxis and treatment. The median duration of antibiotics was 15 days and metronidazole, sulfadimethoxine, doxycycline and azithromycin accounted for 81% of the antibiotics administered. However, the authors noted that dogs had also been exposed to broad-spectrum antibiotics.

In response to the outbreak, the CDC has developed educational materials on the prevention of campylobacteriosis, including hand washing, separation of areas of human consumption from animals and the use of drugs. personal protective equipment. The agency also published an epidemiological opinion, which included information for clinicians and veterinarians "recommending culture and antibiotic sensitivity tests to guide antibiotic treatment decisions".

The authors did not reveal any conflict of interest.

2018-09-20T17: 30: 00-0400

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