PMID- 32576281 OWN - NLM STAT- MEDLINE DCOM- 20210401 LR - 20210401 IS - 2047-2994 (Electronic) IS - 2047-2994 (Linking) VI - 9 IP - 1 DP - 2020 Jun 23 TI - Poor infection prevention and control standards are associated with environmental contamination with carbapenemase-producing Enterobacterales and other multidrug-resistant bacteria in Swiss companion animal clinics. PG - 93 LID - 10.1186/s13756-020-00742-5 [doi] LID - 93 AB - BACKGROUND: Intensive medical care in companion animal clinics could pose a risk for the selection and dissemination of multidrug-resistant organisms (MDROs). Infection prevention and control (IPC) concepts are key measures to reduce the spread of MDROs, but data on IPC standards in companion animal clinics is sparse. The study assessed IPC standards in seven companion animal clinics and practices in Switzerland by structured IPC audits and combined results with environmental MDRO contamination and MDRO carriage of the personnel. METHODS: IPC audits were held between August 2018 and January 2019. The observations in 34 IPC areas were scored based on predefined criteria (not fulfilled/partially fulfilled/fulfilled = score 0/1/2). Environmental swabs and nasal and stool samples from veterinary personnel were tested for methicillin-resistant (MR) staphylococci and macrococci and for colistin-resistant, extended-spectrum beta-lactamase- and carbapenemase-producing (CP) Enterobacterales (CPE). Species was identified by MALDI-TOF MS, antimicrobial resistance determined by microdilution and beta-lactam resistance gene detection, and genetic relatedness assessed by REP-/ERIC-PCR and multilocus sequence typing. RESULTS: Of a maximum total IPC score of 68, the institutions reached a median (range) score of 33 (19-55). MDROs were detected in median (range) 8.2% (0-33.3%) of the sampling sites. Clinics with low IPC standards showed extensive environmental contamination, i.e. of intensive care units, consultation rooms and utensils. CPE were detected in two clinics; one of them showed extensive contamination with CP Klebsiella pneumoniae (ST11, bla(OXA-48)) and MR Staphylococcus pseudintermedius (ST551, mecA). Despite low IPC scores, environmental contamination with MDROs was low in primary opinion practices. Three employees were colonized with Escherichia coli ST131 (bla(CTX-M-15), bla(CTX-M-27), bla(CTX-M-14)). Two employees carried CP E. coli closely related to environmental (ST410, bla(OXA-181)) and patient-derived isolates (ST167, bla(NDM-5)). MR Staphylococcus aureus (ST225, mecA) and MR S. pseudintermedius (ST551, mecA) of the same sequence types and with similar resistance profiles were found in employees and the environment in two clinics. CONCLUSIONS: The study indicates that IPC standards in companion animal clinics are variable and that insufficient IPC standards could contribute to the evolution of MDROs which can be transferred between the environment and working personnel. The implementation of IPC concepts in companion animal clinics should urgently be promoted. FAU - Schmidt, Janne S AU - Schmidt JS AD - Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland. FAU - Kuster, Stefan P AU - Kuster SP AD - Division of Infectious Diseases and Hospital Epidemiology, University and University Hospital of Zurich, Zurich, Switzerland. FAU - Nigg, Aurelien AU - Nigg A AD - Institute of Veterinary Bacteriology, Vetsuisse Faculty, University of Bern, Bern, Switzerland. FAU - Dazio, Valentina AU - Dazio V AD - Division of Small Animal Internal Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland. FAU - Brilhante, Michael AU - Brilhante M AD - Institute of Veterinary Bacteriology, Vetsuisse Faculty, University of Bern, Bern, Switzerland. AD - Graduate School of Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland. FAU - Rohrbach, Helene AU - Rohrbach H AD - Small Animal Clinic, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland. FAU - Bernasconi, Odette J AU - Bernasconi OJ AD - Institute for Infectious Diseases, Faculty of Medicine, University of Bern, Bern, Switzerland. FAU - Budel, Thomas AU - Budel T AD - Institute for Infectious Diseases, Faculty of Medicine, University of Bern, Bern, Switzerland. FAU - Campos-Madueno, Edgar I AU - Campos-Madueno EI AD - Institute for Infectious Diseases, Faculty of Medicine, University of Bern, Bern, Switzerland. FAU - Gobeli Brawand, Stefanie AU - Gobeli Brawand S AD - Institute of Veterinary Bacteriology, Vetsuisse Faculty, University of Bern, Bern, Switzerland. FAU - Schuller, Simone AU - Schuller S AD - Division of Small Animal Internal Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland. FAU - Endimiani, Andrea AU - Endimiani A AD - Institute for Infectious Diseases, Faculty of Medicine, University of Bern, Bern, Switzerland. FAU - Perreten, Vincent AU - Perreten V AD - Institute of Veterinary Bacteriology, Vetsuisse Faculty, University of Bern, Bern, Switzerland. FAU - Willi, Barbara AU - Willi B AUID- ORCID: 0000-0002-8010-1180 AD - Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland. bwilli@vetclinics.uzh.ch. LA - eng PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20200623 PL - England TA - Antimicrob Resist Infect Control JT - Antimicrobial resistance and infection control JID - 101585411 SB - IM MH - Animal Technicians MH - Animals MH - Carbapenem-Resistant Enterobacteriaceae/*isolation & purification MH - Commission on Professional and Hospital Activities MH - Drug Resistance, Multiple, Bacterial MH - Equipment Contamination MH - Equipment and Supplies/*microbiology MH - Feces/*microbiology MH - Hospitals, Animal MH - Humans MH - Infection Control/*standards MH - Nose/*microbiology MH - Pets/*microbiology MH - Prospective Studies MH - Switzerland MH - Veterinarians PMC - PMC7310346 OTO - NOTNLM OT - Antimicrobial resistant pathogens OT - Colonization OT - Enterobacteriaceae OT - Infection prevention and control OT - Multidrug-resistant pathogens OT - Small animal clinic OT - Zoonosis COIS- The authors declare that they have no competing interests. EDAT- 2020/06/25 06:00 MHDA- 2021/04/02 06:00 PMCR- 2020/06/23 CRDT- 2020/06/25 06:00 PHST- 2020/01/15 00:00 [received] PHST- 2020/05/29 00:00 [accepted] PHST- 2020/06/25 06:00 [entrez] PHST- 2020/06/25 06:00 [pubmed] PHST- 2021/04/02 06:00 [medline] PHST- 2020/06/23 00:00 [pmc-release] AID - 10.1186/s13756-020-00742-5 [pii] AID - 742 [pii] AID - 10.1186/s13756-020-00742-5 [doi] PST - epublish SO - Antimicrob Resist Infect Control. 2020 Jun 23;9(1):93. doi: 10.1186/s13756-020-00742-5.