Puppies make people sick – and it's people's fault

Antibiotic-resistant bacteria that have infected more than 100 people and have been associated with pet puppies appear to have spread at least in part because healthy dogs have received antibiotics.

"It's shocking," said Lance Price, director of the Antibiotic Resistance Action Center at George Washington University. "This is an important study that highlights something we need to spend more time on."

According to a new study released Thursday, more than half of the puppies of a sample of about 150 dogs studied as part of the epidemic survey received antibiotics not because they were sick, but to prevent them from becoming so. The technique, called prophylaxis, has been widely used in the production of food animals and is accused of fueling antibiotic resistance.

"We just need to change the way we think about antibiotics," said Matthew Wellington, director of the US PIRG's antibiotic program, the public interest research group.

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The outbreak of the bacteria Campylobacter jejuni, responsible for diarrheal diseases, began in early 2016 and continued until February of this year. People from 18 states fell ill, including 29 employees in pet shops. The survey, which began in August 2017, found that puppies were at the root of the problem.

Thursday's study was published in the Morbidity and Mortality Weekly Report, a journal produced by the Centers for Disease Control and Prevention. He revealed how many antibiotics the dogs had been administered as well as the results of testing bacterial samples – known as isolates – of 10 patients and 8 puppies to see which drugs could kill the bacteria.

The authors reported that "hatch isolates were resistant to antibiotic susceptibility testing to all antibiotics commonly used to treat Campylobacter infections."

"This outbreak demonstrates that puppies can be a source of multidrug-resistant Campylobacter infections in humans, which warrants further study of the use of antimicrobials in the commercial dog industry."

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The study showed that the outbreak involved six chains of pet stores, but the problem is probably wider. Officials from four states visited 20 pet stores and collected records on the administration of antibiotics for approximately 150 puppies. Of these, 95% had received at least one drug treatment –
and many have received more than one – before arriving at the store or at the store. Sixteen different types of antibiotics were used. And about half of the dogs treated were not sick – they were given the drugs to prevent the disease.

Lead author Mark Laughlin, a veterinarian with the CDC's Division of Foodborne Diseases, Water and Environmental, said researchers were surprised by the extent of antibiotic use in the sector.

"We were surprised to see the large number of different types of drugs and the large number of courses in which the dogs were exposed. These are very young animals in general, "he told STAT.

Initially, the CDC thought it might be able to trace infections to a single source – a farmer or a commercial breeding establishment where the bacteria had spread. But as investigators learned more about the Byzantine world of raising and distributing dogs sold in pet shops, it became clear that there was not a single source.

Indeed, the system created the problem. "These dogs came from a wide variety of sources," Laughlin said.

Price was not impressed. "If your system requires a constant or regular dose of antibiotics to keep the animals healthy, your system is broken. You have designed a system that makes animals sick, "he said.

Wellington is in agreement. "Antibiotics should only be used to treat diseases, not to compensate for bad practices – whether it's about transporting dogs over long distances and being unhygienic along the way," he said. declared. "These are medicines that save lives that should only be used to treat sick animals or sick people."

Campylobacter jejuni is a common infection; The CDC estimates that about 1.3 million cases occur each year in the United States. Fortunately, most people recover without needing medical attention.

Wellington and Price have both strongly criticized the misuse of antibiotics in the production of food animals. But the use of drugs in the commercial dog industry was not on their radar.

Price was surprised by the report. "For me, this indicates that they have to raise these animals differently. They are creating this terrible distribution system for multidrug-resistant bacteria, "he said.

The reality is that although the epidemic appears to have ended, there may well be ongoing cases because the practices that led puppies to become infected with multidrug-resistant drugs are still being used.

Laughlin said the CDC was working with veterinary associations and the commercial dog industry, which he said was troubling and eager to make changes.

They must, insisted Wellington.

"This is one of the clearest examples I have seen where resistant bacteria come from animals from overuse of antibiotics, and they pass directly to people and spread quickly," he said. "So, I think it's one of those situations where it's incredibly clear that this is a problem we need to solve."

This article is reproduced with the permission of STAT. It was first published on September 20, 2018. Find the original story here.