Stewardship / Resistance Scan for Jul 05, 2018

Carbapenem-resistant E coli in dogs, humans
UK AMR diagnostics group launches

Investigation suggests carbapenemase-producing E coli passed from humans to dogs

Finnish researchers are reporting the first transmission of carbapenemase-producing Escherichia coli between humans and dogs.

In an article today in Eurosurveillance, the researchers report that a strain of carbapenemase-producing E coli—ST167 NDM-5—was found in two dogs and one human from the family that owned the dogs. The E coli was originally identified in the ears of the two dogs, both of which had histories of ear infections, and later in rectal swabs from the family member. Molecular analysis and whole-genome sequencing of 10 of the isolates (7 from the dogs, 3 from the human) revealed that the isolates were nearly identical. The dogs and additional family members also carried an identical strain of extended-spectrum beta-lactamase (ESBL)-producing E coli, ST69 CTX-M-9.

These findings suggest interspecies transmission, with the pathogen likely being passed from the humans to the dogs. While carbapenemase-producing E coli is rare in humans in Finland, the authors of the article note that carbapenem-resistant bacteria had not been observed in dogs in Finland before this report. In addition, carbapenems are not authorized for veterinary use in Finland, and the investigation did not reveal any use of carbapenems in the two dogs in the study. But they suggest that the dogs' frequent exposure to other antibiotics to treat their ear infections probably sustained and facilitated the propagation of the NDM-producing E coli after it had been acquired.

"The widespread use of antimicrobials in companion animals could thus enable them to act as reservoirs for CPE [carbapenemase-producing Enterobacteriaceae] isolates and other resistant bacteria," they write.

The authors conclude that veterinary laboratories should remain alert and should screen Enterobacteriaceae for carbapenem resistance, and that the veterinary community should continue to emphasize the importance of prudent antimicrobial use.
Jul 5 Eurosurveill research article


UK groups launch AMR diagnostics collaborative

To help support antimicrobial stewardship efforts in the United Kingdom, health officials today announced the formal launch of the UK Antimicrobial Resistance (AMR) Diagnostic Collaborative.

The group brings together partners from the National Health Service, academic institutions, industry, and other national groups to coordinate the development of guidance and evaluation of interventions to integrate high-quality diagnostics.

Fiona Carragher, MSc, chair of the new UK AMR Diagnostic Collaborative, who is also deputy chief science officer with NHS England, said in post on Global Cause, a global health news site, said diagnostics are a crucial weapon in the battle against antimicrobial resistance, "but they can only deliver their true potential if we get right the what, when, where and how of diagnostic use."

Rapid point-of-care testing has the potential to help guide appropriate treatment decisions, and as new technology, but the new devices need to meet high expectations, she said, adding that effective evaluation will need a coordinated approach at all steps, from innovation to implementation. Carragher also said a structured approach is needed for education and training for staff that will be involved in using the new tests.
Global Cause report

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