The drugged puppies responsible for the spread of diarrhea

Puppies who have received an astonishing amount of antibiotics have triggered a multi-state outbreak of bacterial infections that cause diarrhea and are highly resistant to drugs, state and federal health officials reported this week.

The results, published in the Centers for Disease Control and Prevention's September 21 report on morbidity and mortality, suggest that the dog industry is in serious need of training and obedience classes. The widespread administration of multiple antibiotic classes to puppies, including all classes commonly used to treat diarrheal infections in humans, is an alarming conclusion, suggested officials. They called for fairly simple solutions, including better hygiene and husbandry practices, as well as a veterinary control of the use of antibiotics.

"The implementation of antibiotic management principles and practices in the commercial dog industry is needed," they concluded bluntly.

Critics limit a multi-state survey on an epidemic of Campylobacter infections in humans. It is estimated that this intestinal bacterial infection causes more than a million diarrheal diseases in the United States each year, but it's usually not related to puppies or dogs. Instead, it is usually linked to undercooked meat, unpasteurized milk or contaminated water.

But the latest data found a new trend. Between January 2016 and February 2018, health officials monitored 118 specific cases in 18 states. (These cases led to 26 hospitalizations and no deaths.) It turned out that of the 118 cases, 29 were pet shop employees. Officials collected additional survey data to learn about exposures, obtaining good data from 106 of the 118 cases. Of these 106 people, 105 reported exposure to dogs, and 101 cases reported specific exposure to puppies in pet stores. The other person on whom the officials had data stated that they did not remember any contact with a dog.

By digging deeper, officials from four of the affected states (Kentucky, Ohio, Pennsylvania, and Wisconsin) visited 20 pet stores. They sniffed drug registers for 149 puppies, finding that many had received antibiotics without getting sick – a big no for antibiotic management and prevention of drug resistance.

Records indicated that of the 149 puppies, pet stores had given at least 142 antibiotics (95%). More than half (78 puppies, or 55%) had received these antibiotics only for prophylaxis – that is, they were not sick and had not received these drugs only as a precaution. In addition, almost 40% (54 puppies) received antibiotics for prophylaxis and treatments for real infections. Only two puppies took drugs simply because they were sick. (The other eight pups out of the 142 who received antibiotics had no records indicating Why they took the drugs.)

The pet stores gave the puppies a wide range of antibiotics, noting 16 different drugs, including antibiotics belonging to the same classes of antibiotics. Campylobacter infections in humans.

Meanwhile, health authorities in six of the states affected by the outbreak (Florida, Kansas, Kentucky, Ohio, Pennsylvania and Wisconsin) collected 51 stool samples from sick men and 23 puppy samples. Whole genome sequencing analyzes related Campylobacter isolate in 45 human samples to those of 11 puppy samples.

The researchers took 18 of these Campylobacter isolate (10 in the man and 8 in the puppy) and subjected them to antibiotic resistance tests. All were resistant to at least seven antibiotics (azithromycin, ciprofloxacin, clindamycin, erythromycin, nalidixic acid, telithromycin and tetracycline).

Officials then tried to trace the origin of these infectious puppies, but could not find a single breeder or distributor as a common source. Instead, puppies seemed to exchange infectious germs throughout the breeding, distribution and transportation processes of the commercial dog industry.

In the end, officials conclude that the dog industry and pet stores must relentlessly work to deal with the threat to public health. This includes the responsible use of antibiotics, training pet shop employees and customers with best practices for hygiene and housing puppies during transportation and distribution to reduce the risk of transmission.

"Although the investigation is over," write the officials, "the risk of multidrug resistance to drugs Campylobacter transmission to employees and consumers continues.