Extended Spectrum β-Lactamase-Producing Enterobacterales of Shrimp and Salmon Available for Purchase by Consumers in Canada-A Risk Profile Using the Codex Framework

The extended-spectrum β-lactamase (ESBL)-producing Enterobacterales (ESBL-EB) encompass several important human pathogens and are found on the World Health Organization (WHO) priority pathogens list of antibiotic-resistant bacteria. They are a group of organisms which demonstrate resistance to third-generation cephalosporins (3GC) and their presence has been documented worldwide, including in aquaculture and the aquatic environment. This risk profile was developed following the Codex Guidelines for Risk Analysis of Foodborne Antimicrobial Resistance with the objectives of describing the current state of knowledge of ESBL-EB in relation to retail shrimp and salmon available to consumers in Canada, the primary aquacultured species consumed in Canada. The risk profile found that Enterobacterales and ESBL-EB have been found in multiple aquatic environments, as well as multiple host species and production levels. Although the information available did not permit the conclusion as to whether there is a human health risk related to ESBLs in Enterobacterales in salmon and shrimp available for consumption by Canadians, ESBL-EB in imported seafood available at the retail level in Canada have been found. Surveillance activities to detect ESBL-EB in seafood are needed; salmon and shrimp could be used in initial surveillance activities, representing domestic and imported products.

Combining analytical epidemiology and genomic surveillance to identify risk factors associated with the spread of antimicrobial resistance in Salmonella enterica subsp. enterica serovar Heidelberg

Antimicrobial resistance (AMR) has become a critical threat to public health worldwide. The use of antimicrobials in food and livestock agriculture, including the production of poultry, is thought to contribute to the dissemination of antibiotic resistant bacteria (ARB) and the genes and plasmids that confer the resistant phenotype (ARG). However, the relative contribution of each of these processes to the emergence of resistant pathogens in poultry production and their potential role in the transmission of resistant pathogens in human infections, requires a deeper understanding of the dynamics of ARB and ARG in food production and the factors involved in the increased risk of transmission.

Carbapenem-resistant Escherichia coli from shrimp and salmon available for purchase by consumers in Canada: a risk profile using the Codex framework

Resistance to carbapenems in human pathogens is a growing clinical and public health concern. The carbapenems are in an antimicrobial class considered last-resort, they are used to treat human infections caused by multidrug-resistant Enterobacterales, and they are classified by the World Health Organization as 'High Priority Critically Important Antimicrobials'. The presence of carbapenem-resistant Enterobacterales (CREs) of animal-origin is of concern because targeted studies of Canadian retail seafood revealed the presence of carbapenem resistance in a small number of Enterobacterales isolates. To further investigate this issue, a risk profile was developed examining shrimp and salmon, the two most important seafood commodities consumed by Canadians and Escherichia coli, a member of the Enterobacterales order. Carbapenem-resistant E. coli (CREc) isolates have been identified in shrimp and other seafood products. Although carbapenem use in aquaculture has not been reported, several classes of antimicrobials are utilised globally and co-selection of antimicrobial-resistant microorganisms in an aquaculture setting is also of concern. CREs have been identified in retail seafood purchased in Canada and are currently thought to be uncommon. However, data concerning CRE or CREc occurrence and distribution in seafood are limited, and argue for implementation of ongoing or periodic surveillance.

Resistance to extended-spectrum cephalosporins in Escherichia coli and other Enterobacterales from Canadian turkeys

The goal of this study was to determine the frequency of resistance to extended-spectrum cephalosporins (ESCs) in Escherichia coli and other Enterobacterales from turkeys in Canada and characterize the associated resistance determinants. Pooled fecal samples were collected in 77 turkey farms across British Columbia, Québec, and Ontario. Isolates were obtained with and without selective enrichment cultures and compared to isolates from diagnostic submissions of suspected colibacillosis cases in Ontario. Isolates were identified using MALDI-TOF and susceptibility to ESCs was assessed by disk diffusion. The presence of bla_CMY, bla_CTX-M, bla_TEM, and bla_SHV was tested by PCR. Transformation experiments were used to characterize bla_CMY plasmids. Genome sequencing with short and long reads was performed on a representative sample of bla_CTX-M-positive isolates to assess isolates relatedness and characterize bla_CTX-M plasmids. For the positive enrichment cultures (67% of total samples), 93% (587/610) were identified as E. coli, with only a few other Enterobacterales species identified. The frequency of ESC resistance was low in E. coli isolates from diagnostic submission (4%) and fecal samples without selective enrichment (5%). Of the ESC-resistant Enterobacterales isolates from selective enrichments, 71%, 18%, 14%, and 8% were positive for bla_CMY, bla_TEM,bla_CTX-M, and bla_SHV, respectively. IncI1 followed by IncK were the main incompatibility groups identified for bla_CMY plasmids. The bla_CTX-M-1 gene was found repeatedly on IncI1 plasmids of the pMLST type 3, while bla_CTX-M-15, bla_CTX-M-55, and bla_CTX-M-65 were associated with a variety of IncF plasmids. Clonal spread of strains carrying bla_CTX-M genes between turkey farms was observed, as well as the presence of an epidemic bla_CTX-M-1 plasmid in unrelated E. coli strains. In conclusion, Enterobacterales resistant to ESCs were still widespread at low concentration in turkey feces two years after the cessation of ceftiofur use. Although bla_CMY-2 is the main ESC resistance determinant in E. coli from Canadian turkeys, bla_CTX-M genes also occur which are often carried by multidrug resistance plasmids. Both clonal spread and horizontal gene transfer are involved in parallel in the spread of bla_CTX-M genes in Enterobacterales from Canadian turkeys.

Epidemiology of Campylobacter, Salmonella and antimicrobial resistant Escherichia coli in free-living Canada geese (Branta canadensis) from three sources in southern Ontario

Antimicrobial resistant bacteria and zoonotic pathogens have previously been isolated from Canada geese. We examined the prevalence of three enteric bacteria (i.e. Campylobacter, Salmonella, Escherichia coli) among Canada geese from three sampling sources in southern Ontario from 2013 through 2015. Samples were obtained by convenience from hunting groups, diagnostic birds submitted for post-mortem, and fresh faeces from live birds in parks. Escherichia coli isolates were isolated and tested for susceptibility to 15 antimicrobials using the Canadian Integrated Program for Antimicrobial Resistance Surveillance test panel. The prevalences of Salmonella, Campylobacter and E. coli were 0%, 11.2% and 72.6%, respectively. Among E. coli isolates, 7.9% were resistant to ≥1 class of antimicrobials and 5.6% were resistant to ≥2 classes of antimicrobials, with some including resistance to antimicrobials of highest importance in human medicine. A significant association between season and E. coli resistance among samples from live birds was noted; summer samples had no resistant E. coli isolates, whereas spring samples demonstrated the highest prevalence of E. coli resistant to ≥1 class of antimicrobials (20.0%) among all sources. In addition, Campylobacter coli were only isolated from the spring faecal samples. Flock-level clustering was an important statistical consideration, as flock was a significant random effect in all but two of our models. Detection of Campylobacter and antimicrobial resistant E. coli from Canada geese suggests that these birds may play a role in disseminating these organisms within the environment.

Characteristics of Programs Involving Canine Visitation of Hospitalized People in Ontario

Objective.

To determine the distribution of canine-visitation programs in Ontario and to characterize the nature of the programs the dogs are affiliated with.

Design.

A cross-sectional survey of hospitals in Ontario was used to determine whether they permitted dogs to visit patients and, if so, where the dogs originated. On the basis of this information, dog owners were then contacted through their respective associations and interviewed using a standardized questionnaire.

Setting.

A cross-section of hospitals in Ontario.

Participants.

A total of 223 (97%) of the 231 hospitals surveyed responded. Ninety owners of 102 visitation dogs were interviewed.

Results.

A total of 201 (90%) of the 223 hospitals indicated that dogs were permitted in their facilities. Origins ranged from national therapy-dog agencies to the patients' families. Acute care wards were 5.1 times as likely than other wards to disallow animals (95% confidence interval, 2.2-12.2; P<.001). According to the 90 dog owners included in the study, the screening protocols that dogs were required to pass to participate in their respective visitation programs were highly variable, as were the owners' infection control practices. Eighteen owners (20%) said they did not practice any infection control. Sixty-six owners (73%) allowed their dogs on patients' beds, and 71 (79%) let their dogs lick patients. Thirty-six owners (40%) were unable to name one zoonotic disease that may be transmitted from their dog.

Conclusions.

Although canine-visitation programs have become standard practice in nonacute human healthcare facilities, infection control and dog-screening practices are highly variable and potentially deficient. Hospital staff, visitation groups, pet owners, and veterinarians need to work together to protect both people and pets.

Estimated antimicrobial dispensing frequency and preferences for lactating cow therapy by Ontario dairy veterinarians

In this cross-sectional study, data were collected from responses to a questionnaire on dispensing frequencies of antimicrobials used by dairy practitioners in Ontario in dairy cattle in 2001. Data were validated through clinical case scenarios. Respondents reported using antimicrobials across all categories of importance to human medicine (medically important, Categories I to III) with a diversity of treatment combinations and routes of administration. Respondents anticipated that a request for direct veterinary supervision by producers was dependent on case severity, highlighting the importance of on-farm diagnostic and treatment protocols. Knowledge of the antimicrobials used in lactating cow therapy, and their frequency and reasons for use, will provide baseline information and contribute to antimicrobial stewardship in this food-animal production sector.

World Health Organization Ranking of Antimicrobials According to Their Importance in Human Medicine: A Critical Step for Developing Risk Management Strategies to Control Antimicrobial Resistance From Food Animal Production

Antimicrobial use in food animals selects for antimicrobial resistance in bacteria, which can spread to people. Reducing use of antimicrobials-particularly those deemed to be critically important for human medicine-in food production animals continues to be an important step for preserving the benefits of these antimicrobials for people. The World Health Organization ranking of antimicrobials according to their relative importance in human medicine was recently updated. Antimicrobials considered the highest priority among the critically important antimicrobials were quinolones, third- and fourth-generation cephalosporins, macrolides and ketolides, and glycopeptides. The updated ranking allows stakeholders in the agriculture sector and regulatory agencies to focus risk management efforts on drugs used in food animals that are the most important to human medicine. In particular, the current large-scale use of fluoroquinolones, macrolides, and third-generation cephalosporins and any potential use of glycopeptides and carbapenems need to be addressed urgently.

Antimicrobial dispensing by Ontario dairy veterinarians

This questionnaire-based cross-sectional study was designed to capture the demographics of dairy practitioners in Ontario and to describe aspects of antimicrobial dispensing on-farm and over-the-counter by these veterinarians. The information collected revealed that the prescription status of a drug and the level of veterinary-client-patient relationship were important elements of dispensing policies. Over-the-counter dispensing records were incomplete, while only a small proportion of on-farm dispensing records contained pertinent information and directions as required by the Veterinarians Act. While respondents recognized that antimicrobial use in dairy herds could lead to resistance in cattle, few indicated that this was a significant public health issue. Veterinarians can play a key role in antimicrobial stewardship, part of which is the provision of complete written dispensing instructions to producers for antimicrobial use in dairy cattle.

The distribution of Salmonella enterica serovars and subtypes in surface water from five agricultural regions across Canada

Serovar prevalence of the zoonotic pathogen, Salmonella enterica, was compared among 1624 surface water samples collected previously from five different Canadian agricultural watersheds over multiple years. Phagetyping, pulsed field gel electrophoresis (PFGE), and antimicrobial resistance subtyping assays were performed on serovars Enteritidis, Typhimurium, and Heidelberg. Serovars and subtypes from surface water were compared with those from animal feces, human sewage, and serovars reported to cause salmonellosis in Canadians. Sixty-five different serovars were identified in surface water; only 32% of these were isolated from multiple watersheds. Eleven of the 13 serovars most commonly reported to cause salmonellosis in Canadians were identified in surface water; isolates of these serovars constituted >40% of the total isolates. Common phagetypes and PFGE subtypes of serovars associated with illness in humans such as S. Enteritidis and S. Typhimurium were also isolated from surface water and animal feces. Antimicrobial resistance was generally low, but was highest among S. Typhimurium. Monitoring of these rivers helps to identify vulnerable areas of a watershed and, despite a relatively low prevalence of S. enterica overall, serovars observed in surface water are an indication of the levels of specific S. enterica serovars present in humans and animals.

The scourge of antibiotic resistance: the important role of the environment

Antibiotic resistance and associated genes are ubiquitous and ancient, with most genes that encode resistance in human pathogens having originated in bacteria from the natural environment (eg, β-lactamases and fluoroquinolones resistance genes, such as qnr). The rapid evolution and spread of "new" antibiotic resistance genes has been enhanced by modern human activity and its influence on the environmental resistome. This highlights the importance of including the role of the environmental vectors, such as bacterial genetic diversity within soil and water, in resistance risk management. We need to take more steps to decrease the spread of resistance genes in environmental bacteria into human pathogens, to decrease the spread of resistant bacteria to people and animals via foodstuffs, wastes and water, and to minimize the levels of antibiotics and antibiotic-resistant bacteria introduced into the environment. Reducing this risk must include improved management of waste containing antibiotic residues and antibiotic-resistant microorganisms.

A Canadian application of one health: integration of Salmonella data from various Canadian surveillance programs (2005-2010)

Most bacterial pathogens associated with human enteric illness have zoonotic origins and can be transmitted directly from animals to people or indirectly through food and water. This multitude of potential exposure routes and sources makes the epidemiology of these infectious agents complex. To better understand these illnesses and identify solutions to reduce human disease, an integrative approach like One Health is needed. This article considers the issue of Salmonella in Canada and interprets data collected by several Canadian surveillance and research programs. We describe recovery of Salmonella from various samples collected along the exposure pathway and compare the serovars detected in the different components under surveillance (animal, food, environment, and human). We then present three examples to illustrate how an approach that interprets multiple sources of surveillance data together is able to address issues that transcend multiple departments and jurisdictions. First, differences observed in recovery of Salmonella from different cuts of fresh chicken collected by different programs emphasize the importance of considering the surveillance objectives and how they may influence the information that is generated. Second, the high number of Salmonella Enteritidis cases in Canada is used to illustrate the importance of ongoing, concurrent surveillance of human cases and exposure sources to information domestic control and prevention strategies. Finally, changing patterns in the occurrence of ceftiofur-resistant Salmonella Heidelberg in retail meats and humans demonstrates how integrated surveillance can identify an issue in an exposure source and link it to a trend in human disease. Taken together, surveillance models that encompass different scales can leverage infrastructure, costs, and benefits and generate a multidimensional picture that can better inform disease prevention and control programs.

The scourge of antibiotic resistance: the important role of the environment

Antibiotic resistance and associated genes are ubiquitous and ancient, with most genes that encode resistance in human pathogens having originated in bacteria from the natural environment (eg, β-lactamases and fluoroquinolones resistance genes, such as qnr). The rapid evolution and spread of "new" antibiotic resistance genes has been enhanced by modern human activity and its influence on the environmental resistome. This highlights the importance of including the role of the environmental vectors, such as bacterial genetic diversity within soil and water, in resistance risk management. We need to take more steps to decrease the spread of resistance genes in environmental bacteria into human pathogens, to decrease the spread of resistant bacteria to people and animals via foodstuffs, wastes and water, and to minimize the levels of antibiotics and antibiotic-resistant bacteria introduced into the environment. Reducing this risk must include improved management of waste containing antibiotic residues and antibiotic-resistant microorganisms.

Community-level risk factors for notifiable gastrointestinal illness in the Northwest Territories, Canada, 1991-2008

BACKGROUND

Enteric pathogens are an important cause of illness, however, little is known about their community-level risk factors (e.g., socioeconomic, cultural and physical environmental conditions) in the Northwest Territories (NWT) of Canada. The objective of this study was to undertake ecological (group-level) analyses by combining two existing data sources to examine potential community-level risk factors for campylobacteriosis, giardiasis and salmonellosis, which are three notifiable (mandatory reporting to public health authorities at the time of diagnosis) enteric infections.

METHODS

The rate of campylobacteriosis was modeled using a Poisson distribution while rates of giardiasis and salmonellosis were modeled using a Negative Binomial distribution. Rate ratios (the ratio of the incidence of disease in the exposed group to the incidence of disease in the non-exposed group) were estimated for infections by the three major pathogens with potential community-level risk factors.

RESULTS

Significant (p≤0.05) associations varied by etiology. There was increased risk of infection with Salmonella for communities with higher proportions of 'households in core need' (unsuitable, inadequate, and/or unaffordable housing) up to 42% after which the rate started to decrease with increasing core need. The risk of giardiasis was significantly higher both with increased 'internal mobility' (population moving between communities), and also where the community's primary health facility was a health center rather than a full-service hospital. Communities with higher health expenditures had a significantly decreased risk of giardiasis. Results of modeling that focused on each of Giardia and Salmonella infections separately supported and expanded upon previous research outcomes that suggested health disparities are often associated with socioeconomic status, geographical and social mobility, as well as access to health care (e.g. facilities, services and professionals). In the campylobacteriosis model, a negative association was found between food prices in communities and risk of infection. There was also a significant interaction between trapping and consumption of traditional foods in communities. Higher rates of community participation in both activities appeared to have a protective effect against campylobacteriosis.

CONCLUSIONS

These results raise very interesting questions about the role that traditional activities might play in infectious enteric disease incidence in the NWT, but should be interpreted with caution, recognizing database limitations in collection of case data and risk factor information (e.g. missing data). Given the cultural, socioeconomic, and nutritional benefits associated with traditional food practices, targeted community-based collaborative research is necessary to more fully investigate the statistical correlations identified in this exploratory research. This study demonstrates the value of examining the role of social determinants in the transmission and risk of infectious diseases.

A descriptive analysis of notifiable gastrointestinal illness in the Northwest Territories, Canada, 1991-2008

OBJECTIVES

To describe the major characteristics of reported notifiable gastrointestinal illness (NGI) data in the Northwest Territories (NWT) from January 1991 through December 2008.

DESIGN

Descriptive analysis of 708 reported cases of NGI extracted from the Northwest Territories Communicable Disease Registry (NWT CDR).

SETTING

Primary, secondary and tertiary health care centres across all 33 communities of the NWT.

POPULATION

NWT residents of all ages with confirmed NGI reported to the NWT CDR from January 1991 through December 2008.

MAIN OUTCOME MEASURE

Laboratory-confirmed NGI, with a particular emphasis on campylobacteriosis, giardiasis and salmonellosis.

RESULTS

Campylobacteriosis, giardiasis and salmonellosis were the most commonly identified types of NGI in the territory. Seasonal peaks for all three diseases were observed in late summer to autumn (p<0.01). Higher rates of NGI (all 15 diseases/infections) were found in the 0-9-year age group and in men (p<0.01). Similarly, rates of giardiasis were higher in the 0-9-year age group and in men (p<0.02). A disproportionate burden of salmonellosis was found in people aged 60 years and older and in women (p<0.02). Although not significant, the incidence of campylobacteriosis was greater in the 20-29-years age group and in men (p<0.07). The health authority with the highest incidence of NGI was Yellowknife (p<0.01), while for salmonellosis and campylobacteriosis, it was Tlicho (p<0.01) and for giardiasis, the Sahtu region (p<0.01). Overall, disease rates were higher in urban areas (p<0.01). Contaminated eggs, poultry and untreated water were believed by health practitioners to be important sources of infection in cases of salmonellosis, campylobacteriosis and giardiasis, respectively.

CONCLUSIONS

The general patterns of these findings suggest that environmental and behavioural risk factors played key roles in infection. Further research into potential individual and community-level risk factors is warranted.

A spatial and temporal analysis of notifiable gastrointestinal illness in the Northwest Territories, Canada, 1991-2008

Background

This is the first study to describe the geographical and temporal distribution of notifiable gastrointestinal illness (NGI) in the Northwest Territories (NWT), Canada. Understanding the distribution of NGI in space and time is important for identifying communities at high risk. Using data derived from the Northwest Territories Communicable Disease Registry (NWT CDR), a number of spatial and temporal techniques were used to explore and analyze NGI incidence from the years 1991 to 2008. Relative risk mapping was used to investigate the variation of disease risk. Scan test statistics were applied to conduct cluster identification in space, time and space-time. Seasonal decomposition of the time series was used to assess seasonal variation and trends in the data.

Results

There was geographic variability in the rates of NGI with higher notifications in the south compared to the north. Incidence of NGI exhibited seasonality with peaks in the fall months for most years. Two possible outbreaks were detected in the fall of 1995 and 2001, of which one coincided with a previously recognized outbreak. Overall, incidence of NGI fluctuated from 1991 to 2001 followed by a tendency for rates to decrease from 2002 to 2008.

Conclusions

The distribution of NGI notifications varied widely according to geographic region, season and year. While the analyses highlighted a possible bias in the surveillance data, this information is beneficial for generating hypotheses about risk factors for infection.

Prevalence and molecular characterization of Clostridium difficile isolated from feedlot beef cattle upon arrival and mid-feeding period

BACKGROUND

The presence of indistinguishable strains of Clostridium difficile in humans, food animals and food, as well as the apparent emergence of the food-animal-associated ribotype 078/toxinotype V as a cause of community-associated C. difficile infection have created concerns about the potential for foodborne infection. While studies have reported C. difficile in calves, studies of cattle closer to the age of harvest are required. Four commercial feedlots in Alberta (Canada) were enrolled for this study. Fecal samples were collected at the time of arrival and after acclimation (< 62, 62-71 or > 71 days on feed). Selective culture for Clostridium difficile was performed, and isolates were characterized by ribotyping and pulsed-field gel electrophoresis. A logistic regression model was built to investigate the effect of exposure to antimicrobial drugs on the presence of C. difficile.

RESULTS

Clostridium difficile was isolated from 18 of 539 animals at the time of feedlot arrival (CI = 2.3-6.1) and from 18 of 335 cattle at mid-feeding period (CI = 2.9-13.1). Overall, there was no significant difference in the prevalence of C. difficile shedding on arrival versus mid-feeding period (P = 0.47). No association between shedding of the bacterium and antimicrobial administration was found (P = 0.33). All the isolates recovered were ribotype 078, a toxinotype V strain with genes encoding toxins A, B and CDT. In addition, all strains were classified as NAP7 by pulsed field gel electrophoresis (PFGE) and had the characteristic 39 base pairs deletion and upstream truncating mutation on the tcdC gene.

CONCLUSIONS

It is apparent that C. difficile is carried in the intestinal tracts of a small percentage of feedlot cattle arriving and later in the feeding period and that ribotype 078/NAP7 is the dominant strain in these animals. Herd management practices associated with C. difficile shedding were not identified, however further studies of the potential role of antimicrobials on C. difficile acquisition and shedding are required.

Clostridium difficile in seafood and fish

The objective of this study was to determine the prevalence of Clostridium difficile contamination in retail seafood and fish from Canadian grocery stores. C. difficile was found in 4.8% (5/119) of the samples. This study, combined with studies of other food sources, suggests that widespread contamination of food is common.

Prevalence and antimicrobial resistance in Campylobacter spp. isolated from retail chicken in two health units in Ontario

Campylobacter is an important enteric pathogen of humans and can cause diarrhea, fever, and abdominal pain. Campylobacter infections have frequently been associated with the handling and consumption of raw and undercooked poultry. Antimicrobial resistance among Campylobacter strains is of concern in the treatment of campylobacteriosis in vulnerable populations. A 2-year multidisciplinary study was conducted in the Perth and Wellington-Dufferin-Guelph public health units in Ontario, Canada, to investigate the prevalence and antimicrobial resistance of Campylobacter spp. in retail chicken. Retail chicken samples were collected from randomly selected stores in these health units. Resulting Campylobacter isolates were tested for susceptibility to amoxicillin-clavulanic acid (AMC), ampicillin (AMP), chloramphenicol (CHL), ciprofloxacin (CIP), clindamycin (CLI), erythromycin (ERY), gentamicin (GEN), nalidixic acid (NAL), tetracycline (TCY), and trimethoprim-sulfamethoxazole (SXT) using the E test. The prevalence of Campylobacter in 1,256 retail chicken samples was 59.6%. Of these positive samples, 9% contained Campylobacter coli, 1% contained Campylobacter lari, and 90% contained Campylobacter jejuni. Of the chicken isolates that were resistant to one or more antimicrobial agents, 301 isolates (40%) were resistant to one agent, 374 (50%) were resistant to two, 39 (5%) were resistant to three, 20 (3%) were resistant to four, and 6 (1%) were resistant to five. Nine isolates (1%) were susceptible to all antimicrobial agents tested. All isolates were susceptible to AMC, CHL, and GEN. Less than 10% of isolates were resistant to NAL, CIP, CLI, ERY, and AMP. Resistance to TCY was common (56%). No isolates had a resistance pattern that included all three antimicrobials important in the treatment of human campylobacteriosis (CIP, ERY, and TCY); however, 24 isolates (3.2%) were resistant to at least two of these antimicrobials.

Methicillin-resistant Staphylococcus aureus (MRSA) contamination of retail pork

Recent reports of isolation of methicillin-resistant Staphylococcus aureus (MRSA) from food animals have raised concern about the potential for foodborne transmission. This study evaluated the prevalence of MRSA contamination of retail pork from 4 Canadian provinces. Methicillin-resistant Staphylococcus aureus was isolated from 31/402 [7.7%, 95% confidence interval (CI): 5.5% to 10.7%] of samples. Adjusted for clustering at the provincial level, the prevalence was 5.8% (95% CI% 2.2% to 14.4%). The most common clone was Canadian epidemic MRSA (CMRSA)-5 (12/31, 39%), which has been widely identified in horses and horse personnel, but not in pigs. Ten of the 31 (32%) isolates were nontypable by pulsed-field gel electrophoresis (PFGE) and belonged to spa 539/t034, a clone that is associated with food animals internationally. Nine (29%) isolates were CMRSA-2, a common human epidemic clone that has been found in pigs in Canada. While the relevance of contamination of retail meat is currently unclear, further study is required to determine if food may be a source of infection.

Longitudinal investigation of methicillin-resistant Staphylococcus aureus in piglets

Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as an important public health concern and pigs have been implicated in human infections. Cross-sectional studies have demonstrated that MRSA can be commonly found in pigs internationally, but little is known about age-related changes in MRSA colonization. This study evaluated MRSA colonization in piglets in a longitudinal manner. Serial nasal swabs were collected from piglets born to 10 healthy sows. The prevalence of MRSA colonization on days 1, 3, 7, 14 and 21 was 1% (1/100), 6.2% (3/97), 8.5% (8/94), 4.4% (4/91) and 20% (18/91) respectively, with an overall pre-weaning prevalence of 34.5%. The prevalence on days 28, 42, 56 and 70 was 34% (31/91), 65% (57/88), 50% (44/88) and 42% (36/87) respectively, with an overall post-weaning prevalence of 85%. Eighty-four percent of piglets from negative sows and 100% of piglets from positive sows that survived at least until the time of weaning were colonized with MRSA at one or more times during the study. There was a significant association between sow and piglet colonization. The age of the piglet was significantly associated with the probability of colonization. No piglets or sows received antimicrobials during the study period. These results indicate that age must be considered when designing surveillance programmes and interpreting results of different studies on MRSA.

Burden of acute gastrointestinal illness in Gálvez, Argentina, 2007

This study evaluated the magnitude and distribution of acute gastrointestinal illness (GI) in Gálvez, Argentina, and assessed the outcome of a seven-day versus 30-day recall period in survey methodology. A cross-sectional population survey, with either a seven-day or a 30-day retrospective recall period, was conducted through door-to-door visits to randomly-selected residents during the 'high' and the 'low' seasons of GI in the community. Comparisons were made between the annual incidence rates obtained using the seven-day and the 30-day recall period. Using the 30-day recall period, the mean annual incidence rates was 0.43 (low season of GI) and 0.49 (high season of GI) episodes per person-year. Using the seven-day recall period, the mean annual incidence rate was 0.76 (low season of GI) and 2.66 (high season of GI) episodes per person-year. This study highlights the significant burden of GI in a South American community and confirms the importance of seasonality when investigating GI in the population. The findings suggest that a longer recall period may underestimate the burden of GI in retrospective population surveys of GI.

Clostridium perfringens in retail chicken

Clostridium perfringens isolates were recovered by enrichment from retail grocery chicken samples (n = 88) in Ontario, Canada, with one sample per site. The gene associated with necrotic enteritis in chickens, netB, was found in 21% of the isolates. The tpeL gene was found in 2% and the cpb2 gene in 68% (95% "atypical" genes) of isolates. This study suggests that netB-positive C. perfringens can reach people through retail chicken.

Prevalence of methicillin-resistant Staphylococcus aureus colonization in horses in Saskatchewan, Alberta, and British Columbia

This study estimated the prevalence of methicillin resistant Staphylococcus aureus (MRSA) in nasal swabs of 458 horses in western Canada. The rate of colonization was 1.3% +/- 5.84% [95% confidence interval (CI)], a rate similar to those reported elsewhere. Colonization tended to be transient and seemed unrelated to stress or administration of antimicrobials. Five of the 6 isolates were Canadian epidemic MRSA-5, a human clone that appears to predominate in horses in North America. The other isolate was spa type 539 (t034), a sequence type 398 strain, and this is the first report of this clone in horses in North America. Surveillance is warranted because of the potential of MRSA to cause disease in horses and humans.

Increase in seroprevalence of canine leptospirosis and its risk factors, Ontario 1998-2006

Canine leptospirosis has been described as having re-emerged in North America around the mid-1990s, with a change in the epidemiology of the infecting serovars responsible for the disease emergence. A retrospective case-control study was conducted to examine the re-emergence of seroprevalent cases of canine leptospirosis in Ontario using serology submission records from 1406 dogs from January 1, 1998 to December 31, 2006. The data collected [results of the microscopic agglutination test (MAT), veterinary clinic postal code, age, sex, neutering status, and breed] were analyzed by multivariable logistic regression, generalized linear mixed modeling, and Cochran-Armitage test for trends in proportions. Dogs in urban areas appeared to be at significantly higher risk than dogs in rural areas for the entire study period [odds ratio (OR) = 1.6, confidence interval (CI) = 1.2-2.3], though this was not as marked as in other studies. Results indicated that canine leptospirosis in Ontario is a disease of all breeds and ages, regardless of gender. No geographic clustering was noted, but clustering of cases by clinic within geographic areas suggested differences in awareness or in diagnosis by veterinarians. A distinctive seasonal pattern of leptospirosis, with more cases occurring during the summer and fall, as found in previous studies, was also observed in this study. The temporal trend analysis was consistent with an increasing proportion or re-emergence of seroprevalent cases of canine leptospirosis since 1998, suggesting that the putative increase in canine leptospirosis has been genuine.

Antimicrobial resistance in Campylobacter, Salmonella, and Escherichia coli isolated from retail turkey meat from southern Ontario, Canada

This study estimated the prevalence of Campylobacter, Salmonella, and Escherichia coli isolated from fresh retail turkey purchased at grocery stores in Ontario, Canada. The antimicrobial susceptibility patterns were determined and assessed for potential public health risk. From February 2003 to May 2004, 465 raw turkey meat samples were collected. Antimicrobial susceptibility testing was performed for Campylobacter isolates with a concentration gradient test and for Salmonella and E. coli isolates with a broth microdilution assay. Campylobacter isolates were recovered from 188 (46%) of 412 samples. The prevalence of resistance to one or more antimicrobials was 168 (81%) of 208. For antimicrobials of very high human health importance (category I of Health Canada's antimicrobial categorization), 12 (6%) of 208 Campylobacter isolates were ciprofloxacin resistant. Salmonella isolates were recovered from 95 (24%) of 397 samples. The prevalence of resistance to one or more antimicrobials was 50 (49%) of 102, and 13 (13%) of 102 samples were resistant to five or more antimicrobials. For category I antimicrobials, 14 (14%) of 102 and 1 (1%) of 102 isolates were resistant to ceftiofur and ceftriaxone, respectively. E. coli isolates were recovered from 392 (95%) of 412 turkey samples. The prevalence of resistance to one or more antimicrobials was 906 (71%) of 1,281, and 225 (18%) of 1,281 samples were resistant to five or more antimicrobials. For category I antimicrobials, 30 (2%) of 1,281 samples were resistant to ceftiofur. This study demonstrated that raw turkey pieces are a potential source of human exposure to enteric pathogens, including antimicrobial-resistant bacteria, if undercooked or improperly handled.

The occurrence and antimicrobial susceptibility of salmonellae isolated from commercially available canine raw food diets in three Canadian cities

The purpose of the present study was to evaluate the prevalence and antimicrobial resistance patterns of Salmonella isolated from commercially available canine raw food diets in Canada. A total of 166 commercial frozen raw food diet samples were purchased from randomly selected local pet stores in three Canadian cities for a period of 8 months. All samples were evaluated for the presence of Salmonella, serotyped and tested for antimicrobial susceptibility. There was an overall Salmonella prevalence of 21%; chicken was an ingredient for 67% of the Salmonella-positive diets. Eighteen different Salmonella serotypes were recovered, and resistance was observed to 12 of the 16 antimicrobials tested, with the majority of Ontario isolates exhibiting resistance to ampicillin and Calgary isolates to tetracycline. This study demonstrates the potential risk of raw food diets, especially for immunocompromised individuals, and stresses the need for implementing regulatory guidelines for the production of these diets in order to help control and ideally eliminate the bacterial risks associated with their use and consumption.

The occurrence and anti-microbial susceptibility of Salmonellae isolated from commercially available pig ear pet treats

In Canada, there have been reported outbreaks of human salmonellosis related to exposure to animal-derived pet treats, involving pig ear treats, beef steak patty dog treats and pet treats of seafood origin. As a follow-up to recommendations made to the pig ear treat industry in 1999, a total of 245 pig ear treats were purchased in two Canadian cities to provide evidence of adoption of the recommendations and to determine the current levels of Salmonella contamination of pig ear treats available at pet stores. An overall prevalence of 4% was observed, with isolates exhibiting resistance to up to seven anti-microbials. Serotypes recovered included S. Bovismorbificans, S. Give, S. Derby and S. Typhimurium var. Copenhagen. Although the prevalence observed during this study is lower than the prevalence observed in 1999, pig ear treats should still be considered as a possible source of Salmonella and anti-microbial resistant bacteria to humans and dogs in Canada.

Evaluation of the risks of shedding Salmonellae and other potential pathogens by therapy dogs fed raw diets in Ontario and Alberta

Dogs that participate in animal-assisted interventions (AAIs), often called 'therapy dogs', commonly interact with humans whose immune systems are not functioning optimally. The advisability of feeding raw meat (including poultry) to these animals remains a highly contentious issue, in spite of increasing evidence that raw meat is frequently contaminated with Salmonella. We set out to determine if consuming raw meat influences the risk of therapy dogs shedding Salmonella and other pathogens. Two hundred healthy therapy dogs from Ontario and Alberta were enrolled. Between May 2005 and November 2006, fecal specimens were collected from each dog every 2 months for 1 year, along with a log of places visited, antimicrobial use within the home, dog health status and diet. Specimens were cultured for Salmonella, methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), extended-spectrum cephalosporinase (ESC) Escherichia coli and Clostridium difficile. Forty (20%) of the dogs were reported to have been fed raw meat at some point during the year. The incidence rate of Salmonella shedding in the raw meat-fed dogs was 0.61 cases/dog-year, compared with 0.08 cases/dog-year in dogs that were not fed raw meat (P<0.001). Controlling for therapy dog group, the repeated measures, and pig ear consumption and diarrhoea in the 2 months prior to specimen submission, dogs that consumed raw meat were significantly more likely to test positive for Salmonella at least once during the year than dogs that did not eat raw meat [odds ratio (OR) 22.7; 95% confidence interval (CI) 3.1-58.8; P<0.001]. Specific Salmonella serovars were more common among dogs that consumed raw meat versus those that did not include S. Typhimurium, S. Heidelberg and S. Kentucky. Raw meat consumption was also significantly associated with shedding ESC E. coli (OR 17.2; 95% CI 9.4-32.3). No associations between C. difficile, MRSA or VRE and consumption of raw meat were detected. We recommend that dogs fed raw meat should be excluded from AAI programmes, particularly when the programmes involve interaction with humans at high risk of infection or adverse sequelae attributable to infection. Furthermore, although AAI dogs may not be representative of the general population of dogs, we also recommend that feeding of raw meat to dogs is to be avoided in homes where immunocompromised people live.

Staphylococcus aureus colonization in healthy horses in Atlantic Canada

Methicillin-resistant Staphylococcus aureus (MRSA) colonization was not identified in any of 497 horses from Atlantic Canada. Methicillin-susceptible S. aureus (MSSA) was isolated from a subsample of 19/242 (7.9%) horses. Colonization with MSSA is relatively common in healthy horses in Atlantic Canada, but MRSA is currently rare or absent.

Prevalence of antimicrobial resistance in fecal generic Escherichia coil isolated in western Canadian cow-calf herds. Part I--beef calves

The objective of this study was to describe antimicrobial resistance patterns in fecal generic Escherichia coli obtained from calves in western Canadian cow-calf herds. Susceptibility testing was completed on 1677 isolates obtained from 480 beef calves in 91 herds in the spring, and from 1187 isolates obtained from 394 calves in 45 herds in the fall of 2002. Resistance was rare to antimicrobials classified as being of very high importance to human health. Isolates were most commonly resistant to tetracycline, sulphamethoxazole, and streptomycin. Resistance to at least one antimicrobial was identified in 48.8% of the isolates collected in the spring, and 7.0% of those collected in the fall. Spring or fall calf resistance status was not associated with calf gender, breed, age of the dam, or if the calf was treated before sample collection. Calves < or = 3 days of age were less likely to be resistance positive than calves > 10 days of age.

Antimicrobial resistance in generic fecal Escherichia coli from 29 beef farms in Ontario

The occurrence of antimicrobial resistance in generic Escherichia coli can serve as an indicator of the pool of resistance genes potentially available for transfer to pathogenic organisms. This study was conducted on 29 volunteer beef farms in Ontario to describe the prevalence and patterns of antimicrobial resistance in E. coli, and to describe changes in the prevalence of resistance during the feedlot stage of production. From the pooled fecal samples on 28 of the 29 farms, 31% of isolates from feedlots (n = 993) and 12% of isolates from cow-calf farms (n = 807) were resistant to one or more of 16 antimicrobials tested. No isolates were resistant to ceftriaxone, ciprofloxacin, gentamicin, or nalidixic acid, and < 1% of the pooled isolates were resistant to ceftiofur. Two percent of both feedlot and cow-calf isolates were resistant to > or = 5 antimicrobials. Cow-calf farms were at significantly lower risk than feedlots for having E. coli isolates that were resistant to streptomycin, sulfamethoxazole, and tetracycline. On average, the prevalence of sulfamethoxazole resistant E. coli isolates was significantly higher in calves than in cows. No resistance was observed to ceftriaxone or ciprofloxacin among isolates (n = 1265) obtained from individually sampled feedlot animals on 2 farms. Less than 1% of these isolates were resistant to gentamicin, nalidixic acid, and ceftiofur. From the individually sampled feedlot animals, resistance to streptomycin (on 1 farm), sulfamethoxazole, and tetracycline increased significantly from arrival to mid-point during the feeding period, and these levels persisted until market-readiness.

Antimicrobial use on 24 beef farms in Ontario

Understanding risk factors for antimicrobial resistance requires knowledge of antimicrobial selection pressure. The objectives of this research were to develop methodology for collecting quantitative antimicrobial use information from beef producers in Ontario, to document the types and quantities of antimicrobials reported (for a minimum of 12 mo), and to compare 2 metrics for injectable use reporting. Twenty-four volunteer beef producers were asked to complete a questionnaire, document drug use in a treatment diary, and retain empty medication containers. For injectable antimicrobials, producers recorded approximately 60% of the total use in the treatment diaries; oxytetracycline, penicillin, macrolides, florfenicol, and spectinomycin were used in the greatest quantities. Based on estimated weights of active ingredients (calculated according to number of animals exposed, duration, and average dose per day) the antimicrobials most commonly used in feed were monensin, tylosin, lasalocid, and tetracyclines. The antimicrobials most commonly used in water were lincomycin-spectinomycin, chlortetracycline, and oxytetracycline. Based on estimated weights and measured quantities, < 1% of antimicrobials used were in the Canadian category of highest importance to human medicine. A comparison of animal daily dosages to kilograms of active ingredient demonstrated that the relative ranking of use of antimicrobials varied with the chosen metric, and that further investigation into the best measure in relation to antimicrobial resistance is warranted.

Prevalence of antimicrobial resistance in fecal generic Escherichia coil isolated in western Canadian beef herds. Part II--cows and cow-calf pairs

The objective of this study was to describe antimicrobial resistance in fecal generic Escherichia coli isolated from cows and cow-calf pairs from western Canadian beef herds. Susceptibility testing was completed on 1555 E. coli isolates (n = 533 cows from 69 herds) harvested from fresh fecal samples in the spring of 2002, and 630 isolates (n = 105 cow-calf pairs from 10 herds) collected in the spring of 2003. Only 1 cow isolate was resistant to an antimicrobial classified by Health Canada as being of very high importance to human medicine. Resistance to at least 2 antimicrobials was detected in 7.1% of the 2002 cow isolates, in 3.4% of the 2003 cow isolates, and 23.2% of the 2003 calf isolates. In the cows, resistance to at least 1 antimicrobial was not associated with cow breed (P = 0.16), cow age (P = 0.14), or previous cow treatment (P = 0.56). In the calves, resistance to at least 1 antimicrobial was not predicted by whether or not its dam was resistant to at least 1 antimicrobial (P = 0.36).

Salmonella Infections in Ninety Alberta Swine Finishing Farms: Serological Prevalence, Correlation Between Culture and Serology, and Risk Factors for Infection

The aim of this study was to determine serological prevalence for Salmonella in 90 Alberta finishing swine farms over a 5-month period; to evaluate the correlation between the detection of Salmonella by bacteriological culture and serology; and to identify risk factors for Salmonella seroprevalence. Participating farms were visited 3 times. A total of 30 blood and 15 fecal samples were collected from finishing pigs on each farm. VetScreen Salmonella covalent mix-ELISA (Svanovir) and conventional culture were performed. The apparent Salmonella seroprevalences at the sample and farm level were 13.2% (95% confidence interval [CI], 10.5-15.5%) and 83.3% (95% CI, 74-90.4%), respectively. Most of the farms had within-farm seroprevalence of <or=20%, indicating that pigs on these farms had a low exposure to Salmonella. The Salmonella farm status changed frequently across 3 visits. The correlation between fecal prevalence and seroprevalence at the farm and farm visit level was 0.71 (P < 0.0001) and 0.47 (P < 0.0001), respectively. The use of meal feed and the reported use of antimicrobials through water were associated with a lower farm seroprevalence for Salmonella. Longitudinal sampling and testing are required to properly evaluate Salmonella on-farm status. The interpretation of existing serological and culture tests for Salmonella in swine should take into consideration their imperfect sensitivity, what these tests actually measure (previous exposure vs. current shedding), and the Salmonella serovar distribution within the targeted population. Further work is necessary to demonstrate the effectiveness of on-farm interventions against Salmonella in swine.

Novel Campylobacter isolation method using hydrophobic grid membrane filter and semisolid medium

Culture procedures for isolation of thermophilic campylobacters from food matrices are complex, labor intensive, and time-consuming. Most available methods include the use of antibiotics as selective agents to prevent the growth of competing microflora. A simple procedure for isolation of thermophilic campylobacters after enrichment in Rosef's enrichment broth was developed using a hydrophobic grid membrane filter (HGMF) on semisolid medium (SSM). SSM contains no antibiotics, and the HGMF physically separates Campylobacter from the enrichment broth, allowing isolation based on differential motility. The HGMF-SSM method was compared to the Agriculture and Agri-Food Canada Food Safety Procedures Manual (FSPM-10) method (Isolation of Thermophilic Campylobacters from Fresh Pork, Beef Veal, Poultry and Ready-to-Eat Meat Products), which includes the use of selective antibiotics. During the initial study, after enrichment the HGMF-SSM method yielded pure cultures of campylobacters after 16 to 18 h (overnight) compared with 48 h for the FSPM-10 method. Ninety-four turkey samples collected at local retail stores and 38 frozen pig fecal samples were processed by both methods. Thirty-five samples (26.5%) were positive by the HGMF-SSM method; 24 (18.2%) of these positive samples contained Campylobacter jejuni and 11 (8.3%) contained Campylobacter coli. With the FSPM-10 method, 25 samples (18.9%) were positive: 21 (15.9%) with C. jejuni and 4 (3%) with C. coli. For a subsequent field study, only the HGMF-SSM method was used to isolate Campylobacter from 1,200 chicken samples and 454 turkey samples sold at retail. Analysis of five subisolates from various samples indicated that only one type of Campylobacter was recovered by the HGMF-SSM method, as ascertained by MICs for 10 antimicrobials, sequencing of the short variable region of the flaA gene, and fingerprinting based on amplified fragment length polymorphism. The absence of antibiotics in the SSM may explain the higher recovery of thermophilic campylobacters. The HGMF-SSM method resulted in improved isolation of campylobacters and is simpler, faster, cheaper, and less labor intensive than the FSPM-10 method. The recovery of one type of Campylobacter from the chicken samples may have important implications, particularly in epidemiological studies.

The risk of salmonellae shedding by dogs fed Salmonella-contaminated commercial raw food diets

Twenty-eight research dogs were enrolled to determine the prevalence of salmonellae shedding after consumption of 1 Salmonella-contaminated commercial raw food diet meal. Sixteen dogs were exposed to Salmonella-contaminated commercial raw food diets and 12 to Salmonella-free commercial raw food diets. Seven of the exposed dogs shed salmonellae 1-7 days after consumption of Salmonella-contaminated raw food diets. None of the dogs fed Salmonella-free diets shed salmonellae. No clinical signs were observed in either group. Five of the 7 dogs shed the same serotypes as those recovered from food samples used for feeding. Results showed the same serotypes and antimicrobial resistance pattern in 2 of the 7 shedders. Dogs fed Salmonella-contaminated raw food diets can shed salmonellae and may, therefore, be a source of environmental contamination potentially leading to human or animal illness.

Chloramphenicol and kanamycin resistance among porcine Escherichia coli in Ontario

OBJECTIVES

The purpose of this study was to compare the distribution of chloramphenicol and kanamycin resistance genes across three populations of porcine Escherichia coli.

METHODS

PCR was used to assess the distribution of the major chloramphenicol and kanamycin resistance genes catA1, cmlA and floR, and aphA1, aphA2 and aadB in enterotoxigenic E. coli (ETEC), non-ETEC isolates from cases of diarrhoea and commensal E. coli from healthy pigs. Associations between these genes and resistance genes for other antimicrobials or virulence genes were assessed.

RESULTS

The chloramphenicol and kanamycin resistance genes were distributed differently among the three E. coli populations. While aphA1, aphA2 and aadB were evenly distributed among resistant ETEC, non-ETEC and commensals, the catA1 gene was significantly more frequent in ETEC than in non-ETEC and commensals. Transformation experiments confirmed statistical associations by demonstrating that elt, estB, astA, aadA and sul1 were located with catA1 on a large ETEC plasmid. Plasmids carrying cmlA also carried sul3 and aadA. Other plasmids carrying floR and aadB also carried tet(A), sul2, strA/strB, bla(CMY-2) and occasionally aac(3)IV.

CONCLUSIONS

The clustering of genes observed is a likely cause for chloramphenicol resistance persistence. Similar to tetracycline, chloramphenicol resistance genes are physically linked to virulence genes. This is not the case for kanamycin resistance determinants, which were linked to other resistance genes only.

Reported antibiotic use in 90 swine farms in Alberta

Antibiotic use was described using a convenience sample of 90 Alberta swine farms representing approximately 25% of the Alberta market swine production. Data on the use of antibiotics were collected through an on-farm interview questionnaire. The vast majority of antibiotics were used in feed. The chlortetracycline/sulfamethazine/penicillin combination and tylosin were the most frequently used in-feed antibiotics in weaners and growers/finishers, respectively. The use of antibiotics through water was reported mostly occasionally in all categories. The use of injectable antibiotics was reported mostly in sick pigs. Penicillin was the most common in-water and injectable antibiotic in all categories. The apparent low frequency of critically important antimicrobials for use in humans (quinolones and 3rd generation cephalosporins) is an encouraging finding from a public health perspective. The widespread and frequently reported use of penicillin and tetracycline are of public health concern considering that both antimicrobials are also used for therapeutic purposes in human medicine.

Prevalence of zoonotic agents in dogs visiting hospitalized people in Ontario: implications for infection control

Visitation of hospitalized people by dogs is becoming commonplace, but little is known about the potential health risks of introducing dogs to healthcare settings. This cross-sectional study evaluated the prevalence of zoonotic agents in a group of 102 visitation dogs from a variety of sources across Ontario. Between May and July 2004, owners were interviewed by a standardized questionnaire while dogs underwent a standardized physical examination. One specimen of faeces, hair-coat brushings and one rectal, aural, nasal, oral and pharyngeal swab were collected from each dog and tested for 18 specific pathogens. All dogs were judged to be in good health. Zoonotic agents were isolated from 80 out of 102 (80%) dogs. The primary pathogen was Clostridium difficile, which was isolated from 58 (58%) faecal specimens. Seventy-one percent (41/58) of these isolates were toxigenic. Extended-spectrum beta-lactamase Escherichia coli was isolated from one (1%) dog, extended-spectrum cephalosporinase E. coli was isolated from three (3%) dogs, and organisms of the genus Salmonella were isolated from three (3%) dogs. Pasteurella multocida or Pasteurella canis was isolated from 29 (29%) oral swabs, and Malassezia pachydermatis was isolated from eight (8%) aural swabs. Giardia antigen was present in the faeces of seven (7%) dogs, while Toxocara canis and Ancylostoma caninum were detected in two (2%) dogs and one (1%) dog, respectively. Methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, Campylobacter spp., Microsporum canis, group A streptococci, Pseudomonas aeruginosa and Cryptosporidium spp. were not detected. Further information is needed before the full implications of these findings for infection control can be assessed properly.

Human Health Implications of Salmonella-Contaminated Natural Pet Treats and Raw Pet Food

Human salmonellosis occurs mainly as a result of handling or consuming contaminated food products, with a small percentage of cases being related to other, less well-defined exposures, such as contact with companion animals and natural pet treats. The increasing popularity of raw food diets for companion animals is another potential pet-associated source of Salmonella organisms; however, no confirmed cases of human salmonellosis have been associated with these diets. Pets that consume contaminated pet treats and raw food diets can be colonized with Salmonella organisms without exhibiting clinical signs, making them a possible hidden source of contamination in the household. Pet owners can reduce their risk of acquiring Salmonella organisms by not feeding natural pet treats and raw food diets to their pets, whereas individuals who investigate cases of salmonellosis or interpret surveillance data should be aware of these possible sources of Salmonella organisms.

Stakeholder position paper: Companion animal veterinarian

The total quantity of use in companion animals is generally believed to be relatively small in comparison with antimicrobial use in food animals. Use in companion animals is principally for treatment, whereas the greater proportion of use in food animals is for prophylaxis, metaphylaxis and growth promotion. Therefore, it is important to collect data on end use in companion animals so that overall estimates of use in companion animals can be generated and separated from estimates for food animals. However, data from antimicrobial use in companion animals are extremely limited and no serious attempts to collect such data have ever been made in the United States. The lack of usage data in is concomitant with the dearth of information on antimicrobial resistance in companion animals. Companion animals have been involved in the transmission to humans of, or become infected with, foodborne zoonotic bacteria such as Salmonella and Campylobacter. Companion animals are an integral part of the ecology of antimicrobial resistance through their contact with food animals and exposure to antimicrobials for disease treatment and through contact with humans and the environment. In the practice of companion animal medicine, antimicrobial use data are important for understanding the potential impact on companion animal heath posed by antimicrobial resistance transferred from food animals, humans and the environment, and the threat to humans and other companion animals posed by antimicrobial use in companion animals. Basic information on the patterns and quantities of antimicrobial use in combination with resistance surveillance data, could help companion animal veterinarians understand the potential for development, or evidence of, an antimicrobial resistance problem in their practices, the role of companion animals in the overall epidemiology of antimicrobial resistance, and for comparison with local, regional, or national data. The combination of data from either a sentinel site system of clinics or a use survey with national data from the pharmaceutical industry should provide sufficient data to credibly estimate the total volume and patterns of antimicrobial use in companion animal medicine. The time and effort for use monitoring or to complete a survey would likely become burdensome. Practice management software now utilized at most companion animal clinics could be used to generate antimicrobial use data as well as patient population data as surrogate for the true population at risk for patient encounters in a companion animal practice.