Prudent Use of Antimicrobials in Exotic Animal Medicine

Bacterial Diversity in Pet Rabbits: Implications for Public Health, Zoonotic Risks, and Antimicrobial Resistance

This study examined epidemiological aspects of rabbit pathologies, identified bacterial strains, and assessed their antimicrobial resistance, emphasizing rabbits as potential reservoirs for zoonotic multidrug resistant (MDR) bacteria and the need for continuous monitoring and antimicrobial stewardship. Samples from rabbits were cultivated and then identified using Vitek® 2 and MALDI-TOF. Antimicrobial susceptibility was assessed by disk diffusion testing. This study analyzed 170 individuals with various pathologies, with males (58.24%) outnumbering females (41.76%). Dental abscesses (35.29%) and respiratory infections (28.24%) were most common. Antibiotic exposure was noted in 47.06% of cases, primarily involving trimethoprim (35.56%). Of the total samples, 91.18% tested positive, revealing 200 isolates from 23 bacterial genera, with Staphylococcus spp. (31%) and Escherichia coli (12%) being most frequently identified as well as species with zoonotic potential, such as Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumoniae, Proteus mirabilis, and Enterococcus faecium. Antimicrobial susceptibility testing showed high efficacy for florfenicol (75%), ciprofloxacin (74.12%), and amikacin (68.65%), while significant resistance was found for kanamycin, neomycin, and trimethoprim. Nearly 49% of strains were MDR, with Gram-positive cocci, Enterobacteriaceae, and non-Enterobacteriaceae showing varying resistance, across 18 MDR genera. In conclusion, pet rabbits are potential reservoirs of zoonotic and MDR bacterial species, posing a risk for their owners.

Exploring pet owners' attitudes toward compounded and human approved medicines: a questionnaire based pilot study

With the growing global pet population and increased spending on veterinary care, compounded medications offer customized, often more suitable and affordable treatment options compared to the limited available veterinary medications. This research aims to understand pet owners' attitudes towards compounded medications, focusing on their challenges and needs. A total of 300 respondents from the territory of Novi Sad, province of Vojvodina, Republic of Serbia completed the questionnaire, through face-to-face interviews at veterinary clinics. Pet owners stated that the majority of companion animals were dogs (66.7%), followed by cats (22.8%). A significant portion of them received medication in the past five years (70.7%), while nearly half of them were human-approved (47.9%) out of which more than half (55%) of the pets received antimicrobials for systemic use. Although the majority of pets did not receive compounded medication (79.8%), respondents believed that both they and their pets would benefit from it. Only small fraction of respondents knew that local pharmacies had the ability to compound medications for pets (14.5%). In the era of personalized medicine, compounded medication for specialized needs play an important role providing optimum therapy for veterinary patients. However, limitations persist, including variability in formulation quality, limited regulatory oversight, and challenges in ensuring consistency in potency and stability, as well as decreased efficacy for certain drugs and the challenges related to the lack of pharmacokinetic data for some administration routes. By customizing treatments for individual veterinary patients, we can optimize antimicrobial use, reduce the selective pressure that drives resistance, and enhance patient outcomes, while acknowledging the need for careful oversight and quality control in compounding practices to ensure safety and efficacy.

Non-traditional small companion mammals in Spain as reservoirs of antimicrobial-resistant Staphylococci

Introduction

The increasing prevalence of antimicrobial resistance (AMR) and multidrug resistance (MDR) in microorganisms poses a significant concern in both human and veterinary medicine. Non-traditional companion animals (NTCAs), particularly popular amongst households with children, play a crucial role in AMR epidemiology due to their rising population. Indeed, it is known that some of these animals may act as reservoirs of zoonotic pathogens and thus be able to spread and transmit them to family members, along with their AMR, through their shared environment. It is therefore imperative to address this concern with the involvement of human, animal and environmental health professionals. This pilot study aimed to assess the prevalence and AMR patterns of Staphylococcus spp. strains obtained from commensal mucosal and skin infection samples in NTC small mammals, with a focus on strains like methicillin-resistant Staphylococcus spp. (MRS) that are critical in public health.

Methods

For this purpose, 81 animals of different small mammal species were sampled, assessing antimicrobial susceptibility to 27 relevant antimicrobial agents (AMAs) in human health using minimum inhibitory concentration assays, and interpreting them according to EUCAST and CLSI guidelines. The isolated Staphylococci strains were identified by MALDI-TOF, with the predominant species being Mammalicoccus sciuri and Staphylococcus aureus.

Results and discussion

Including all strains isolated, AMR was observed against all 27 AMAs, including six last-resort AMAs in human medicine. Additionally, over 85% of the strains exhibited MDR. These findings underscore the need to monitor AMR and MDR trends in companion animals and emphasise the potential role of NTCAs in spreading resistance to humans, other animals, and their shared environment, calling for a comprehensive "One Health" approach.

Survey of antimicrobial and probiotic use practices in wildlife rehabilitation in the United States

Antimicrobial resistance is a global health concern. As such, there have been increased efforts to monitor and standardize antimicrobial prescribing practices in humans and domestic animals. In contrast, there is relatively little known about specific prescribing practices in wild animals despite the wide use of antimicrobials and other microbial interventions, such as probiotics to treat captive wildlife. Therefore, the goal of this study was to examine current antimicrobial and probiotic use from a cross-section of wildlife rehabilitation facilities in the United States. An anonymous electronic survey was sent to 105 United States permitted wildlife facilities to collect information about admissions, current antimicrobial and probiotic use practices, and current staff knowledge and attitudes surrounding antimicrobial resistance and probiotic effectiveness. Respondents from over 50% of facilities participated in the survey (54/105), including 45 facilities that treated birds. All facilities reported using antimicrobials, including some from groups considered critically important for human medicine, for a wide range of medical conditions and prophylaxis. Among antibiotics, enrofloxacin and amoxicillin-clavulanic acid were the most commonly used. Antifungals were not as widespread, but itraconazole was the most commonly used. Over 75% of respondents said that their facilities would benefit from having standardized antimicrobial guidelines in place. Probiotics were also used in more than 50% of facilities, but there was notable disparity in opinions regarding their efficacy. The results of this survey are a first step towards understanding antimicrobial and probiotic use practices in the treatment of captive wildlife and developing an antimicrobial stewardship program for wildlife rehabilitation.

Drug prescription pattern in exotic pet and wildlife animal practice: a retrospective study in a Spanish veterinary teaching hospital from 2018 to 2022

Exotic companion animals have had an important role in our society since ancient times. Preserving animal health is necessary to do a responsible use of veterinary medicines. This study aimed to describe the prescription patterns of drugs in exotic pets and wildlife animals attending the Veterinary Teaching Hospital of the University of León (HVULE). A retrospective study was carried out between 2018 and 2022. Birds were the largest group of exotic animals attending the HVULE. Visits were related to emergency reasons and for musculoskeletal disorders. One-third of the animals were eventually euthanised. Regarding pharmacological treatments, the most frequently active ingredients used were pentobarbital, isoflurane, meloxicam, and within antibiotics, marbofloxacin (category B in the classification of European Medicines Agency).

Salmonella in reptiles: a review of occurrence, interactions, shedding and risk factors for human infections

Salmonella are considered a part of the normal reptile gut microbiota, but have also been associated with disease in reptiles. Reptile-associated salmonellosis (RAS) can pose a serious health threat to humans, especially children, and an estimated 6% of human sporadic salmonellosis cases have been attributed to direct or indirect contact with reptiles, although the exact number is not known. Two literature searches were conducted for this review. The first evaluated reports of the prevalence of Salmonella in the intestinal tracts of healthy reptiles. Salmonella were most commonly detected in snakes (56.0% overall), followed by lizards (36.9%) and tortoises (34.2%), with lower detection rates reported for turtles (18.6%) and crocodilians (9%). Reptiles in captivity were significantly more likely to shed Salmonella than those sampled in the wild. The majority of Salmonella strains described in reptiles belonged to subspecies I (70.3%), followed by subspecies IIIb (29.7%) and subspecies II (19.6%). The second literature search focused on reports of RAS, revealing that the highest number of cases was associated with contact with turtles (35.3%), followed by lizards (27.1%) and snakes (20.0%). Reptiles associated with RAS therefore did not directly reflect prevalence of Salmonella reported in healthy representatives of a given reptile group. Clinical symptoms associated with RAS predominantly involved the gastrointestinal tract, but also included fever, central nervous symptoms, problems with circulation, respiratory symptoms and others. Disease caused by Salmonella in reptiles appears to be dependent on additional factors, including stress, inadequate husbandry and hygiene, and other infectious agents. While it has been suggested that reptile serovars may cause more severe disease than human-derived strains, and some data is available on invasiveness of individual strains in cell culture, limited information is available on potential mechanisms influencing invasiveness and immune evasion in reptiles and in RAS. Strategies to mitigate the spread of Salmonella through reptiles and to reduce RAS focus mostly on education and hygiene, and have often been met with some success, but additional efforts are needed. Many aspects regarding Salmonella in reptiles remain poorly understood, including the mechanisms by which Salmonella persist in reptile hosts without causing disease.

The Use of Antibiotics and Antimicrobial Resistance in Veterinary Medicine, a Complex Phenomenon: A Narrative Review

As warned by Sir Alexander Fleming in his Nobel Prize address: “the use of antimicrobials can, and will, lead to resistance”. Antimicrobial resistance (AMR) has recently increased due to the overuse and misuse of antibiotics, and their use in animals (food-producing and companion) has also resulted in the selection and transmission of resistant bacteria. The epidemiology of resistance is complex, and factors other than the overall quantity of antibiotics consumed may influence it. Nowadays, AMR has a serious impact on society, both economically and in terms of healthcare. This narrative review aimed to provide a scenario of the state of the AMR phenomenon in veterinary medicine related to the use of antibiotics in different animal species; the impact that it can have on animals, as well as humans and the environment, was considered. Providing some particular instances, the authors tried to explain the vastness of the phenomenon of AMR in veterinary medicine due to many and diverse aspects that cannot always be controlled. The veterinarian is the main reference point here and has a high responsibility towards the human–animal–environment triad. Sharing such a burden with human medicine and cooperating together for the same purpose (fighting and containing AMR) represents an effective example of the application of the One Health approach.

Antimicrobial Resistance in Bacteria Isolated from Exotic Pets: The Situation in the Iberian Peninsula

Simple Summary

Antimicrobial resistance in exotic pets has not been widely studied. The close contact of this type of animal with the human population increases the risk of untreatable bacterial infections, which represent a veterinary and human public health challenge. We analyze the database of microbiological diagnoses and the bacterial susceptibility to antimicrobials in exotic pets from the Iberian Peninsula. We found that the most prevalent bacteria in birds and mammals were Staphylococcus spp., while in reptiles, they were the Pseudomonas spp. In addition, Pseudomonas showed the highest levels of resistance among the three animal groups, and on the other hand, the multidrug resistance level was significant in Enterobacterales. Most of the bacteria we found have zoonotic importance. The prevalent bacteria are resistant to antimicrobials that have been described as critical for human use, implying that the threat of antimicrobial resistance extends not only to domestic and companion animals but also to humans due to the potential transmission of resistant genes. Once seen from the lens of the One-Health paradigm, these findings are concerning, as they highlight the risk of spreading antibiotic-resistant genes between different individuals and their environments. In order to prevent antibiotic resistance, we encourage the development of joint work between animal and human health specialists.

Abstract

Literature related to antimicrobial resistant (AMR) bacteria in exotic pets is minimal, being essential to report objective data on this topic, which represents a therapeutic challenge for veterinary medicine and public health. Between 2016 and 2020, laboratory records of 3156 exotic pet specimens’ microbiological diagnoses and antibiotic susceptibility testing (AST) results were examined. The samples were classified into three animal classes: birds (n = 412), mammalia (n = 2399), and reptilian (n = 345). The most prevalent bacteria in birds and mammals were Staphylococcus spp. (15% and 16%), while in reptiles they were Pseudomonas spp. (23%). Pseudomonas was the genus with the highest levels of AMR in all animal groups, followed by Enterococcus spp. By contrast, Gram-positive cocci and Pasteurella spp. were the most sensitive bacteria. Moreover, in reptiles, Stenotrophomonas spp., Morganella spp., and Acinetobacter spp. presented high levels of AMR. Multidrug-resistant (MDR) bacteria were isolates from reptiles (21%), birds (17%), and mammals (15%). The Enterobacterales had the highest MDR levels: S. marcescens (94.4%), C. freundii (50%), M. morganii (47.4%), K. pneumoniae (46.6%), E. cloacae (44%), and E. coli (38.3%). The prevalence of MDR P. aeruginosa strains was 8%, detecting one isolate with an XDR profile. Regarding antimicrobial use, many antibiotics described as critically important for human use had significant AMR prevalence in bacteria isolated from exotic pets. Under the One-Health approach, these results are alarming and of public health concern since potential transmission of AMR bacteria and genes can occur from exotic pets to their owners in both senses. For this reason, the collaboration between veterinarians and public health professionals is crucial.

Antibacterial treatment for exotic species, backyard ruminants and small flocks: a narrative review highlighting barriers to effective and appropriate antimicrobial treatment

Antimicrobial resistance is a complex One Health issue that exists in both human and veterinary medicine. To mitigate this ever-growing problem, efforts have been made to develop guidelines for appropriate antimicrobial use (AMU) across sectors. In veterinary medicine, there are notable literature gaps for proper AMU in minor species. We conducted a structured narrative review covering the years of July 2006 - July 2021 to find antimicrobial treatments for common bacterial infections in exotic (birds, rodents, reptiles, and others), small flock (chickens, turkeys, and other fowl), and backyard small ruminant (sheep and goats) species. We retrieved a total of 4728 articles, of which 21 articles met the criteria for our review. Studies were grouped according to species, syndrome, and body system affected. Other data extracted included the bacterial pathogen(s), treatment (active ingredient), and geographical origin. Body systems reported included: intra-oral (n = 4), gastrointestinal (n = 1), respiratory (n = 2), reproductive (n = 1), skin (n = 3), aural (n = 1), ocular (n = 4), and other/multisystem (n = 5). By species, our search resulted in: rabbit (n = 5), rat (n = 2), guinea pig (n = 1), chinchilla (n = 1), guinea pig and chinchilla (n = 1), avian species (n = 1), psittacine birds (n = 2), loris and lorikeets (n = 1), turtles (n = 2), lizards (n = 1), goats (n = 2) and sheep (n = 2). The results of our findings identified a distinct gap in consistent antimicrobial treatment information for commonly encountered bacterial conditions within these species. There is a persisting need for clinical trials that focus on antibacterial treatment to strengthen the evidence base for AMU within exotic, small flock, and backyard small ruminant species.

Disposition of Cefquinome in Turkeys (Meleagris gallopavo) Following Intravenous and Intramuscular Administration

The bioavailability and pharmacokinetics in turkeys of cefquinome (CFQ), a broad-spectrum 4th-generation cephalosporin antibiotic, were explored after a single injection of 2 mg/kg body weight by intravenous (IV) and intramuscular (IM) routes. In a crossover design and 3-weeks washout interval, seven turkeys were assigned for this objective. Blood samples were collected prior to and at various time intervals following each administration. The concentration of CFQ in plasma was measured using HPLC with a UV detector set at 266 nm. For pharmacokinetic analysis, non-compartmental methods have been applied. Following IV administration, the elimination half-life (t1/2ʎz), distribution volume at steady state (Vdss), and total body clearance (Cltot) of CFQ were 1.55 h, 0.54 L/kg, and 0.32 L/h/kg, respectively. Following the IM administration, CFQ was speedily absorbed with an absorption half-life (t1/2ab) of 0.25 h, a maximum plasma concentration (Cmax) of 2.71 μg/mL, attained (Tmax) at 0.56 h. The bioavailability (F) and in vitro plasma protein binding of CFQ were 95.56% and 11.5%, respectively. Results indicated that CFQ was speedily absorbed with a considerable bioavailability after IM administration. In conclusion, CFQ has a favorable disposition in turkeys that can guide to estimate optimum dosage regimes and eventually lead to its usage to eradicate turkey's susceptible bacterial infections.

Turning Negatives into Positives for Pet Trading and Keeping: A Review of Positive Lists

Simple Summary

In regulating the trading and keeping of exotic pets, lawmakers seek to protect animal welfare, prevent species declines, and safeguard biodiversity. The public also requires protection from pet-related injuries and animal-to-human diseases. Most legislation concerning exotic pet trading and keeping involves restricting or banning problematic species, a practice known as “negative listing”. However, an alternative approach adopted by some governments permits only those species that meet certain scientifically proven criteria to be sold and kept as pets. Thus, governments may “positively list” only those species that are suitable to keep in domestic settings and that do not present a disproportionate risk to people or the environment. We reviewed international, national, and regional legislation in Europe, the United States, and Canada and found that largely unpublished and often inconsistent criteria are used for the development of negative and positive lists. We also conducted online surveys of governments, which received limited responses, although telephone interviews with governments either considering or developing positive lists revealed insights regarding their interest and motivation towards positive lists. We discuss key issues raised by civil servants including the perceived advantages of positive lists and challenges they anticipate in drawing up suitable lists of species. We compare functions of negative and positive lists and offer recommendations to governments concerning the development and implementation of positive lists.

Abstract

The trading and keeping of exotic pets are associated with animal welfare, conservation, environmental protection, agricultural animal health, and public health concerns and present serious regulatory challenges to legislators and enforcers. Most legislation concerning exotic pet trading and keeping involves restricting or banning problematic species, a practice known as “negative listing”. However, an alternative approach adopted by some governments permits only the keeping of animals that meet certain scientifically proven criteria as suitable in respect of species, environmental, and public health and safety protections. We conducted an evaluation of positive lists for the regulation of pet trading and keeping within the context of the more prevalent system of restricting or prohibiting species via negative lists. Our examination of international, national, and regional regulations in Europe, the United States, and Canada found that criteria used for the development of both negative and positive lists were inconsistent or non-specific. Our online surveys of governments received limited responses, although telephone interviews with officials from governments either considering or developing positive lists provided useful insights into their attitudes and motivations towards adopting positive lists. We discuss key issues raised by civil servants including perceived advantages of positive lists and anticipated challenges when developing lists of suitable species. In addition, we compare functions of negative and positive lists, and recommend key principles that we hope will be helpful to governments concerning development and implementation of regulations based on positive lists.

Frequency of Owner-Reported Bacterial Infections in Pet Guinea Pigs

Domestic guinea pigs suffer morbidity and mortality due to a range of bacterial infections amongst other causes. Microorganisms such as Bordetella bronchiseptica and Streptococcus pneumoniae are commonly implicated in respiratory disease; however, there is a lack of research surrounding the prevalence of these bacterial infections. The aim of this study was to investigate the frequency with which owners reported bacterial infections in pet guinea pigs and to assess owner knowledge of correct husbandry practices to inform prevention of the development of bacterial infections. An online questionnaire, consisting of 30 questions was promoted to guinea pig owners. Of all respondents (n = 524), 39.39% reported that their guinea pig(s) had been clinically diagnosed with a bacterial infection, with upper respiratory tract infections the most commonly reported (46.95%), followed by urinary tract (15.49%) and then gastrointestinal infections (11.73%). Owners demonstrated knowledge of correct husbandry practices and there was no significant effect (p = 0.475) of owner knowledge on having owned a guinea pig with a bacterial infection. Bacterial infections may be more common in guinea pigs than was previously thought. Further research is required to understand why bacterial infections are common in pet guinea pigs and to help owners to prevent and recognize these infections.

Time trends, seasonal differences and determinants of systemic antimicrobial use in companion animal clinics (2012-2015)

Any antimicrobial use (AMU) in humans and animals selects for antimicrobial resistance (AMR) and responsible AMU should therefore be promoted both in human and veterinary medicine. Insight into current AMU in companion animal clinics is necessary to be able to optimise antimicrobial (AM) prescribing behaviour. The objective of this study was to describe systemic AMU in 44 Dutch companion animal clinics over a 3-year time period (2012-2015), using retrospectively collected data. The number of Defined Daily Doses for Animals (DDDAs) per month and per clinic were calculated from prescription data for total, 1st, 2nd and 3rd choice AMU (classification according to Dutch policy on veterinary AMU). Time trends, seasonality and the influence of potential determinants (e.g., the number of dogs, cats and rabbits per clinic and other clinic characteristics) were explored using statistical modelling. Overall, the findings show that total AMU decreased over time and a shift in used classes of antimicrobials towards more 1st choice AMs was visible. Mean total AMU decreased from 1.82 DDDA/year in 2012-2013 to 1.56 DDDA/year in 2014-2015. Aminopenicillins, with and without clavulanic acid, accounted for the largest group of antimicrobials used; 38.7% (2012-2013), 40.2% (2013-2014) and 39.3% (2014-2015) of total AMU, respectively. Strong seasonal differences in AMU were found, with highest AMU in July-August and lowest in February-March. The distribution of different animal species per clinic appeared to affect AMU as well. In clinics with a larger proportion of dogs, 2nd choice AMU was significantly higher, whereas in clinics with a larger proportion of rabbits, 2nd choice AMU was significantly lower. Despite the decrease of AMU during the study period, there is still room for improvement left, especially with regard to the antimicrobial classes prescribed. According to Dutch classification of veterinary AMU, 1st choice AMs should be used as empirical therapy. A decrease in 2nd (might select for ESBL-producing bacteria) and 3rd choice AMU (i.e. fluoroquinolones and 3rd generation cephalosporins) should be aimed for.