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Background: Prolonged antimicrobial drug (AMD) treatment is associated with antimicrobial resistance development. Biomarker measurement may aid treatment decision‐making. Objectives: Investigate temporal changes in blood biomarker concentrations in dogs undergoing treatment for pulmonary and intra‐abdominal infections; compare time to biomarker concentration normalization with duration of clinician‐directed AMD treatment. Animals: Forty‐two client‐owned dogs with pneumonia (n = 22), septic peritonitis (n = 10), or pyometra (n = 10). Methods: Plasma concentrations of C‐reactive protein (CRP), serum amyloid A (SAA), haptoglobin, procalcitonin, nucleosomes, cell‐free DNA (cfDNA), high‐mobility group box‐1 (HMGB1), CC‐motif chemokine ligand‐2 (CCL2), CXC‐motif chemokine ligand‐8 (CXCL8), and keratinocyte chemoattractant‐like (KC‐Like) were quantitated in samples collected on days 1, 3, 7, 14, 28, and 60. Treatment was directed by clinicians blinded to biomarker concentrations. Results: Concentrations of CCL2, CRP, and KC‐Like were maximal on D1, concentrations of SAA, cfDNA, HMGB1, and nucleosomes were maximal on D3 and haptoglobin concentrations were maximal on D7. These maximal concentrations were significantly different from those on D60. Concentrations of CRP and SAA decreased by 80% from peak and into respective reference intervals before AMDs were discontinued. For CRP, the median (interquartile range [IQR]) times to 20% peak and normal were 7 (6‐9) and 7 (6‐12) days, respectively, and for SAA they were 4 (4, 5) and 6 (5‐8) days, respectively, compared to a median (IQR) duration of AMD prescribing of 16 (12‐23) days (all P <.0001). Conclusions and Clinical Importance: Biomarker concentrations normalized within 7 to 14 days. Serial measurements of CRP and SAA might aid identification of disease resolution and could help guide AMD prescription decision‐making. [ABSTRACT FROM AUTHOR]

Background: Combatting antimicrobial resistance requires a One Health approach to antimicrobial stewardship including antimicrobial drug (AMD) use evaluation. Current veterinary AMD prescribing data are limited. Objectives: To quantify companion animal AMD prescribing in primary care and specialty practice across 3 academic veterinary hospitals with particular focus on third‐generation cephalosporins, fluoroquinolones, and carbapenems. Animals Dogs and cats presented to 3 academic veterinary hospitals from 2012 to 2017. Methods: In this retrospective study, AMD prescribing data from 2012 to 2017 were extracted from electronic medical records at each hospital and prescriptions classified by service type: primary care, specialty practice or Emergency/Critical Care (ECC). Hospital‐level AMD prescribing data were summarized by species, service type, AMD class, and drug. Multivariable logistic full‐factorial regression models were used to estimate hospital, year, species, and service‐type effects on AMD prescribing. Estimated marginal means and confidence intervals were plotted over time. Results: The probability of systemic AMD prescribing for any indication ranged between 0.15 and 0.28 and was higher for dogs than cats (P <.05) apart from 2017 at hospital 1. Animals presented to primary care were least likely to receive AMDs (dogs 0.03‐0.15, cats 0.03‐0.18). The most commonly prescribed AMD classes were aminopenicillins/β‐lactamase inhibitors (0.02‐0.15), first‐generation cephalosporins (0.00‐0.09), fluoroquinolones (0.00‐0.04), nitroimidazoles (0.01‐0.06), and tetracyclines (0.00‐0.03). Among the highest priority classes, fluoroquinolones (dogs 0.00‐0.09, cats 0.00‐0.08) and third‐generation cephalosporins (dogs 0.00‐0.04, cats 0.00‐0.05) were most frequently prescribed. Conclusions and Clinical Importance: Antimicrobial drug prescribing frequencies were comparable to previous studies. Additional stewardship efforts might focus on fluoroquinolones and third‐generation cephalosporins. [ABSTRACT FROM AUTHOR]

Objective: To investigate associations among care errors, staffing, and workload in small animal ICUs. Design: Multicenter observational cohort study conducted between January 2017 and September 2018. Setting: Three small animal teaching hospital ICUs. Animals: None. Interventions: None. Measurements and main results: Data on patient numbers, illness severity (assesed via the acute patient physiologic and laboratory evaluation [APPLE] score), care burden, staffing levels, technician experience/education level, and care errors were collected at each study site. Care errors were categorized as major (unanticipated arrest or death; patient endangerment through IV line, arterial catheter, chest tube or other invasive device mismanagement, or errors in drug calculation/administration) or minor. Median patient:technician ratio was 4.3 (range: 1–18). Median patient illness severity was 15.1 (4.7–27.1) APPLE score units. A total of 221 major and 3,317 minor errors were observed over the study period. The odds of a major error increased by an average of 11% (odds ratio [OR] = 1.11; 95% confidence interval [CI], 1.02–1.20; P = 0.012) for each 1 patient increase in the patient:technician ratio after averaging by ICU location. The major error incident rate ratio was 2.53 (95% CI, 1.84–3.54; P < 0.001) for patient:technician ratios of >4.0 compared with ≤4.0. The odds of a major error increased by 0.5% per total unit APPLE score increase (OR = 1.005; 95% CI, 1.002–1.007; P < 0.001). The major error incident rate ratio was 1.71 (95% CI, 1.30–2.25; P < 0.001) for APPLEfast:technician ratios of >73 compared with ≤73. The odds of a major error decreased by 2% (OR = 0.98; 95% CI, 0.97–0.99; P = 0.01) for each year increase in total technician years of ICU work experience. Conclusions: Substantial reductions in major care errors may be achieved by maintaining ICU patient:technician ratios at ≤4. Technician experience and total unit burden of patient illness severity are also associated with error incidence, and should be taken into consideration when scheduling staff. [ABSTRACT FROM AUTHOR]

Objectives: To investigate veterinary technician burnout and associations with frequency of self‐reported medical error, resilience, and depression and job‐related risk factors. Design: Cross‐sectional observational study using an anonymous survey conducted between November 2017 and June 2018. Setting: Four referral teaching hospitals in the United States and Canada. Subjects: A total of 344 veterinary technicians were invited to participate. Response rate was 95%. Overall 256 surveys were ultimately analyzed. Interventions: Burnout, depression, and resilience were measured using validated instruments. Respondents reported perceptions of workload, working environment, and medical error frequency. Associations between burnout and factors related to physical work environment, workload and schedule, compensation package, interpersonal relationships, intellectual enrichment, and exposure to ethical conflicts were analyzed. Measurements and Main Results: Burnout, characterized by high emotional exhaustion, depersonalization, and low sense of personal accomplishment was common, and was positively associated with perceived medical errors, desire to change career, and depression. Burnout levels on all 3 burnout subscales were higher in this population than previously reported for a contemporaneous group of trauma nurses working with human patients (P < 0.05). Burnout was negatively associated with resilience. Respondents' feelings of fear or anxiety around supervisor communications, perception that patient load was too high to allow for excellent patient care, and perceived lack of available assistance during sudden workload increases were all associated with burnout. Conclusions: Burnout in veterinary technicians is common and is associated with numerous undesirable outcomes. Work‐related interventions to reduce burnout should focus on improving supervisor relationships and maintaining an appropriate patient:caregiver ratio. [ABSTRACT FROM AUTHOR]

There are few epidemiologic studies on the shedding of Campylobacter among dogs in the United States, despite the potential public health implications. Our objectives were to estimate the prevalence of faecal Campylobacter shedding among Texas shelter dogs as detected by culture methods and to characterize the isolates by species and antimicrobial susceptibility. Using a cross‐sectional study design, faecal samples were collected from 185 dogs in six animal shelters throughout Texas between May and December 2014. Four culture methods were used to isolate Campylobacter from samples, and isolates were characterized. The prevalence of Campylobacter shedding was 45.4% (84/185; 95% CI, 38.1%–52.9%). Of 294 isolates from the 84 positive dogs, 26 (8.8%) isolates from seven dogs were identified as Campylobacter jejuni. Two of the isolates from one dog demonstrated resistance to ciprofloxacin and nalidixic acid. Direct plating on mCCDA‐CAT agar without enrichment identified the highest number of positive dogs (62%; 52/84). Incidence of ciprofloxacin‐resistant Campylobacter infections among humans has increased over the last several years. Canine shedding of Campylobacter is a potential source of zoonotic transmission. [ABSTRACT FROM AUTHOR]