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Urinary tract infection in companion animals : does the treatment influences transmission and colonization by Esbl, AmpC and Carbapenemase producing Enterobacterales to human?

Publication . Silva, Inês Cunha e; Pomba, Maria Constança Matias Ferreira

ABSTRACT - Currently the dissemination of antimicrobial resistance has become a major public health concern worldwide. The pressure they exert on the bacterial microbiota enables a preferential selection of resistant bacteria. Urinary tract infection (UTI) is a frequent clinical problem in companion animals and among the most common reasons for antimicrobial therapy. The present study aimed to evaluate the influence of antimicrobial therapy in companion animals on colonization by extended spectrum β-lactamase ESBL, cephalosporinases (AmpC) and carbapenemases – producing Enterobacterales and to verify if antimicrobial resistance is transmitted to the pet owners with whom they share a home. The study sample included 14 animals (11 dogs and 3 cats) with UTI and 25 humans belonging to 14 families. Dog and cat owners were asked to deliver fecal samples from themselves and their animals at specific times since diagnosis of infection up to two months after its resolution. Cultures of fecal samples in MacConkey medium with cefotaxime and meropenem were performed to select resistant bacteria, followed by PCR to detect β lactamase producing genes. No carbapenemase-producing Enterobacterales were found, however, in 24.2% of the fecal samples ESBL and AmpC-producing Escherichia coli or Klebsiella pneumoniae were identified. TEM-1 β-Lactamase was the most identified in animals (23.5%) and humans (28.6%). ESBL-producing genes of the CTX-M type were the most detected, in particular blaCTX-M-15. Approximately 9% of the resistance genes detected were cephalosporinases (blaCMY-2). The administration of antibiotics to pets has been reflected in an increase in antimicrobial resistance not only in themselves but also in humans. In two families, both human and animal were colonized at the same time with an ESBL/AmpC-producing bacteria. In one of this families, transmission of a bacteria, or a plasmid carrying the blaCTX-M-15 gene, may have occurred from a cat to a human, and from this to another human from the same household. Further studies are needed to ascertain the presence of interspecies transmission of AMR in this study.

2021-05-14Master thesis

Open access

Human and companion animal proteus mirabilis sharing

Publication . Marques, Cátia Filipa Saraiva; Belas, Adriana; Menezes, Juliana; da Silva, Joana Moreira; Cavaco-Silva, Patrícia; Trigueiro, Graça; Gama, Luis; Pomba, C.

Proteus mirabilis is an important pathogen that is associated with urinary tract infections. This study aims to determine the colonization and sharing of P. mirabilis between healthy companion animals and humans that are living together and to evaluate the clonal relatedness of the fecal and clinical stains. Eighteen households (24 humans, 18 dogs, 8 cats) with at least one human–animal pair were studied. Fecal samples were plated onto MacConkey and Hektoen agar and P. mirabilis PFGE analysis (NotI; Dice/UPGMA; 1.5% tolerance) was conducted for the households with multiple positive participants. Antimicrobial-resistance was tested according to CLSI. The fecal P. mirabilis pulse-types were compared with uropathogenic clinical strains (n = 183). Forty-nine P. mirabilis were isolated from eight households. The percentage of colonization in the dogs (44.4%, n = 8/18) was significantly higher (p = 0.0329) than in the humans (12.5%, n = 3/24). Three households had multiple colonized participants. One human–dog pair shared related P. mirabilis strains, which clustered with a clinical strain of animal origin (82.5%). One fecal P. mirabilis strain, from a dog, clustered with two human community-acquired clinical strains (80.9%, 88.9%). To our knowledge, this is the first report of dogs and humans living in close contact and sharing related P. mirabilis strains. The high frequency of colonization in the dogs underlines their possible role as P. mirabilis reservoirs for humans and other dogs.

2022-03Journal article

Open access

Sharing more than friendship : dynamics of direct transmission of antimicrobial resistance between human families and their companion animals

Publication . Menezes, Juliana Cruz de Oliveira de; Pomba, Maria Constança Matias Ferreira; Fonseca, Andreia de Jesus Amaral Gomes Barbosa

Enterobacterales that produce extended-spectrum β-lactamases (ESBLs), AmpC cephalosporinases and carbapenemases (CPE), as well as colistin-resistant strains, are important pathogens raising public health concerns due to their increasing prevalence. The prospective longitudinal study focusing on households in Portugal (PT) and the United Kingdom (UK), showed that ESBL/AmpC-producing Enterobacterales strains carriage in healthy companion animals occur at a significantly lower frequency (p-value <0.0001) compared to animals with active infections under antibiotic therapy. Whole genome sequencing (WGS) analysis identified the sharing of ESBL/AmpC-producing Enterobacterales strains between healthy companion animals and humans in two households from Portugal (n=41), involving Escherichia coli human pandemics lineages ST93, ST410 and ST457. Among companion animals undergoing antibiotic treatment due to urinary tract infection (UTI) or skin and soft tissue infection (SSTI), and their cohabiting humans, sharing of faecal ESBL/AmpC producing E. coli strains was observed in four households (PT= 2/43; UK= 2/22), with strains belonging to ST2015, ST617 and ST963. Additionally, one Portuguese household shared a multidrug-resistant (MDR) ACT-24-producing Enterobacter hormaechei subsp. hoffmannii strain. Notably, three other animals shared the clinical strains with their cohabiting humans: a ST556 Klebsiella pneumoniae, the high-risk clonal lineage ST131 E. coli strain and a ST2179 E. coli classified as Avian Pathogenic (APEC). CPE strains were only detected in animals under antibiotic treatment. These strains were positive for blaOXA-181 and blaNDM-5 genes, present in plasmids virtually identical to those found in isolates from humans, food, and the environment in other countries. MDR E. coli strains harbouring the plasmid-mediated colistin resistant gene, mcr-1, were recovered from faecal samples of companion animals and humans in Portugal, with no significant difference between healthy and infected groups (p-value=0.257). In two households with dogs diagnosed with SSTIs, sharing of mcr-1-positive ST744 E. coli strains with the owner were observed. The detection of MDR bacteria sharing between companion animals and their cohabiting humans, especially when it matched the animal's UTI/SSTI clinical strain, highlights the importance of considering household-level interventions in response to the spread of antimicrobial resistance in the community, reinforcing the need for active monitoring and stringent hygiene practices under a One Health approach

2025-02-28Doctoral thesis

Open access

Extended–spectrum–beta-lactamases, cephalosporinases and carbapenemase-producing Escherichia coli in the human-dog interface

Publication . Belas, Adriana; Pomba, Maria Constança Matias Ferreira; Carriço, João André Nogueira Custódio

Extended–spectrum–beta-lactamases (ESBLs), cephalosporinases (encoded by the ESBLs and Ampc genes, respectively) and carbapenemase–producing Escherichia coli have become a major public health concern to both human and animal health. Urinary tract infections (UTI) are one of the most frequent bacterial infections in both human and companion animals. Uropathogenic E. coli (UPEC), belonging to extraintestinal pathogenic E. coli (ExPEC), is the most common bacterium isolated from companion animals. Moreover, the close contact of companion animals with humans creates opportunities for interspecies transmission of resistant bacteria and genes. E. coli from companion animals with UTI were found to harbour important antimicrobial resistance mechanisms and to belong to high-risk human clonal lineages, namely third-generation cephalosporin (3GC)-resistant E. coli O25b:H4-B2-ST131-H30/H30Rx, CC23 and ST648. In this work E. coli O25b:H4-ST131-H30/H30Rx was described for the first time in Europe in companion animals. Furthermore, the blaCMY-2 producing E. coli ST648 is the most common high-risk clonal lineage causing UTI in companion animals from the Lisbon area. Companion animals also seem to be reservoirs of bacteria and clinically important resistance genes, such β-lactams genes (classe A and C) which supports their role as reservoirs. The detection of faecal high-risk clone OXA-181-producing- E. coli ST410 strains that were closely related to uropathogenic clinical human strains was also an important finding and to our best knowledge was the first description in Portugal and Europe. These studies highligth the importance of companion animals as reservoirs of pathogenic E. coli harbouring important antimicrobial resistant genes. The emergence and spread of multidrug-resistant (MDR) E. coli in the natural environment by companion animal faecal contamination is also a concern towards animal and human health. These results point to need for control measures to prevent the dissemination of MDR ESBLs/AmpC and carbapenemases – producing bacteria from companion animals.

2021-03-17Doctoral thesis

Open access

Oxa-181-producing extraintestinal pathogenic escherichia coli sequence type 410 isolated from a dog in Portugal

Publication . Brilhante, Michael; Menzes, Juliana; Belas, Adriana; Feudi, Claudia; Schwarz, Stefan; Pomba, C.; Perretena, Vincent

Two multidrug-resistant and carbapenemase-producing Escherichia coli clones of sequence type 410 were isolated from fecal samples of a dog with skin infection on admission to an animal hospital in Portugal and 1 month after discharge. Whole-genome sequencing revealed a 126,409-bp Col156/IncFIA/IncFII multidrug resistance plasmid and a 51,479-bp IncX3 blaOXA-181-containing plasmid. The chromosome and plasmids carried virulence genes characteristic for uropathogenic E. coli, indicating that dogs may carry multidrug-resistant E. coli isolates related to those causing urinary tract infections in humans.

2020-03-24Journal article

Open access