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A recent epidemic has shown that puppies can be a source of Campylobacter human infections – including multidrug-resistant infections – and emphasized that clinicians should consider this exposure in their patients.
Write in MMWR, Martha P. Montgomery, MD, CDC Epidemiological Intelligence Officer and colleagues summarize multi-year epidemic Campylobacter infections related to the commercial dog industry.
"This evidence, combined with the prolonged nature of the epidemic and the potential for mixing pups, indicates a potential for continued transmission of multidrug-resistant diseases. Campylobacter in the whole industry, including among breeders, distributors, transporters and stores, and finally among customers, "they wrote.
Every year in the United States, Campylobacter causes about 1.3 million diarrheal diseases. Montgomery and his colleagues investigated an epidemic of Campylobacter Between January 5, 2016 and February 4, this year, 118 people, including 29 employees in pet stores, were sick. There were 26 hospitalizations but no deaths in the epidemic.
According to the report, the CDC was alerted in August 2017 to six Campylobacter jejuni infections that the Florida Department of Health has linked to a national pet shop chain based in Ohio. During the survey, State and local health departments used a standardized supplemental questionnaire to collect information on the exposure of dogs with Campylobacter.
Puppy mingling in pet stores is a potential reason why the transmission of Campylobacter exist.
Source: Adobe Photo
The CDC has defined a confirmed case as any patient with symptoms of campylobacteriosis that occurred between January 1, 2016 and February 28, 2018; with a clinical isolate closely related to the epidemic strain; or with other laboratory evidence of infection and work history, visit or contact with a puppy from an animal facility.
Of the 118 reported cases, 12 had unknown exposure to dogs. Of the 106 patients for whom questions about dog exposure were answered, 99% (n = 105) reported exposure in the dog and 95% (n = 101) reported contact with a pet. company. In addition, eight people reported having contact with puppies from five pet store companies that did not cause the initial outbreak. Montgomery and his colleagues stated that this indicates that the puppies were infected before reaching the pet stores.
Investigators conducted traceability surveys that included file collection, transportation information, and microchip identification numbers for puppies owned by infected individuals and those sampled in stores. They did not identify a single source of infection among breeders, distributors or transporters. Rather, they said that the mix of puppies from different breeders at distributors, during transport and in stores could lead Campylobacter transmission.
Investigators also collected data on the administration of antibiotics in 20 pet stores in Kentucky, Ohio, Pennsylvania and Wisconsin for 149 puppies. Of these, 95% (n = 142) received at least one antibiotic prior to arrival or at the store and 94% (n = 134) had available treatment indications, reported Montgomery and colleagues. According to the report, 55% (n = 78) of treated puppies received antibiotics only for prophylaxis and 38% (n = 54) received antibiotics for prophylaxis and treatment, while 1% (n = 2) have received antibiotics only.
Metronidazole, sulfadimethoxine, doxycycline and azithromycin accounted for 81% of all antibiotics administered, the authors reported. Broad spectrum antibiotics such as tetracyclines, quinolones, aminoglycosides and chloramphenicol have also been used.
"The investigation into this outbreak revealed a widespread administration of several classes of antibiotics, including all classes of Campylobacter the strains were resistant, "wrote Montgomery and his colleagues. "Adherence to antibiotic management practices in these settings could reduce the choice of highly drug-resistant drugs. Campylobacter. The implementation of antibiotic management principles and practices in the commercial dog industry is necessary. "- by Marley Ghizzone
Disclosure: The authors do not report any relevant financial information.
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