76 results on '"Broens EM"'
Search Results
2. Towards harmonized laboratory methodologies in veterinary clinical bacteriology: outcomes of a European survey.
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Koritnik T, Cvetkovikj I, Zendri F, Blum SE, Chaintoutis SC, Kopp PA, Hare C, Štritof Z, Kittl S, Gonçalves J, Zdovc I, Paulshus E, Laconi A, Singleton D, Allerton F, Broens EM, Damborg P, and Timofte D
- Abstract
Introduction: Veterinary clinical microbiology laboratories play a key role in antimicrobial stewardship, surveillance of antimicrobial resistance and prevention of healthcare associated-infections. However, there is a shortage of international harmonized guidelines covering all steps of veterinary bacterial culture from sample receipt to reporting., Methods: In order to gain insights, the European Network for Optimization of Veterinary Antimicrobial Treatment (ENOVAT) designed an online survey focused on the practices and interpretive criteria used for bacterial culture and identification (C&ID), and antimicrobial susceptibility testing (AST) of animal bacterial pathogens., Results: A total of 241 microbiology laboratories in 34 European countries completed the survey, representing a mixture of academic (37.6%), governmental (27.4%), and private (26.5%) laboratories. The C&ID turnaround varied from 1 to 2 days (77.8%) to 3-5 days (20%), and 6- 8 days (1.6%), with similar timeframes for AST. Individual biochemical tests and analytical profile index (API) biochemical test kits or similar were the most frequent tools used for bacterial identification (77% and 56.2%, respectively), followed by PCR (46.6%) and MALDI-TOF MS (43.3%). For AST, Kirby-Bauer disk diffusion (DD) and minimum inhibitory concentration (MIC) determination were conducted by 43.8% and 32.6% of laboratories, respectively, with a combination of EUCAST and CLSI clinical breakpoints (CBPs) preferred for interpretation of the DD (41.2%) and MIC (47.6%) results. In the absence of specific CBPs, laboratories used human CBPs (53.3%) or veterinary CBPs representing another body site, organism or animal species (51.5%). Importantly, most laboratories (47.9%) only report the qualitative interpretation of the result (S, R, and I). As regards testing for AMR mechanisms, 48.5% and 46.7% of laboratories routinely screened isolates for methicillin resistance and ESBL production, respectively. Notably, selective reporting of AST results (i.e. excluding highest priority critically important antimicrobials from AST reports) was adopted by 39.5% of laboratories despite a similar proportion not taking any approach (37.6%) to guide clinicians towards narrower-spectrum or first-line antibiotics., Discussion: In conclusion, we identified a broad variety of methodologies and interpretative criteria used for C&ID and AST in European veterinary microbiological diagnostic laboratories. The observed gaps in veterinary microbiology practices emphasize a need to improve and harmonize professional training, innovation, bacterial culture methods and interpretation, AMR surveillance and reporting strategies., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Koritnik, Cvetkovikj, Zendri, Blum, Chaintoutis, Kopp, Hare, Štritof, Kittl, Gonçalves, Zdovc, Paulshus, Laconi, Singleton, Allerton, Broens, Damborg and Timofte.)
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- 2024
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3. ENOVAT: the European Network for Optimization of Veterinary Antimicrobial Treatment.
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Damborg P, Allerton F, Bousquet-Mélou A, Britt C, Cagnardi P, Carmo LP, Cvetkovikj I, Erhard M, Heuvelink A, Jessen LR, Overesch G, Pelligand L, Gómez Raja J, Scahill K, Timofte D, Vale AP, Veldman K, and Broens EM
- Abstract
The global antimicrobial resistance crisis has been the driver of several international strategies on antimicrobial stewardship. For their implementation at the field level, the veterinary sector encounters several specific challenges and in particular: (i) a shortage of experts in key disciplines related to antimicrobial stewardship, (ii) a lack of evidence-based antimicrobial treatment guidelines, and (iii) inferior diagnostic tests available compared to human medicine. The present white paper describes how the COST Action ENOVAT (the European Network for Optimization of Veterinary Antimicrobial Treatment, CA18217), comprising 332 persons from 51 countries, worked towards solutions to these challenges. Initially, surveys were conducted to explore the present state in Europe in terms of existing antimicrobial use guidelines and microbiology practices performed. Concurrently, various research activities were launched to optimize diagnostics, including development of epidemiological cut-offs, clinical breakpoints and matrix-assisted laser desorption ionization time of flight mass spectrometry interpretive criteria. Also, guidelines drafting groups working towards evidence-based antimicrobial treatment guidelines for six conditions in food-producing and companion animals were established. The processes and outcomes, also in terms of capacity building, are summarized in this white paper where emphasis is placed on sustainability of the activities. Although several ENOVAT initiatives and spin-off projects will continue beyond the Action, we recommend that a new European veterinary research agenda is launched focusing on research and funding leading to long-term impacts on veterinary antimicrobial use., Competing Interests: No competing interests were disclosed., (Copyright: © 2024 Damborg P et al.)
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- 2024
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4. The world health organization pandemic agreement draft: considerations by the European Society of Clinical Microbiology and Infectious Diseases Emerging Infections Task Force.
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Granata G, Astorri R, Broens EM, Callaby H, Cunha F, Di Caro A, Fusco FM, Greub G, Grobusch MP, Koopmans M, Pereira do Vale A, Pisapia R, Rovers CP, Tostmann A, Tunali V, de Valdoleiros SR, and Petersen E
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- Humans, Communicable Diseases, Emerging epidemiology, Communicable Diseases, Emerging prevention & control, Europe epidemiology, COVID-19 epidemiology, Advisory Committees, Communicable Diseases epidemiology, World Health Organization, Pandemics
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- 2024
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5. Methicillin-resistant Staphylococcus aureus outbreak in a Dutch equine referral clinic.
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Kannekens-Jager MM, Duim B, der Graaf-van Bloois LV, Zomer AL, Broekhuizen-Stins MJ, Boswinkel M, Wagenaar JA, and Broens EM
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- Animals, Horses, Netherlands epidemiology, Retrospective Studies, Polymorphism, Single Nucleotide, Microbial Sensitivity Tests, Anti-Bacterial Agents pharmacology, Surgical Wound Infection microbiology, Surgical Wound Infection epidemiology, Surgical Wound Infection veterinary, Hospitals, Animal, Virulence Factors genetics, Methicillin-Resistant Staphylococcus aureus genetics, Methicillin-Resistant Staphylococcus aureus isolation & purification, Methicillin-Resistant Staphylococcus aureus classification, Staphylococcal Infections epidemiology, Staphylococcal Infections veterinary, Staphylococcal Infections microbiology, Staphylococcal Infections transmission, Disease Outbreaks veterinary, Horse Diseases microbiology, Horse Diseases epidemiology, Phylogeny, Whole Genome Sequencing
- Abstract
In 2020 and 2022, nine cases of surgical site infections with a methicillin-resistant Staphylococcus aureus (MRSA) were diagnosed in horses in an equine referral clinic. Sixteen isolates (horses, n =9; environment, n =3; and staff members, n =4) were analysed retrospectively using Nanopore whole-genome sequencing to investigate the relatedness of two suspected MRSA outbreaks (2020 and 2022). The MRSA isolates belonged to ST398 and ST612. ST398 genomes from 2020 and 2022 formed three phylogenetic clusters. The first ST398 cluster from 2020 consisted of isolates from five horses and one staff member, and we suspected within clinic transmission. The second cluster of ST398 isolates from 2022 originated from two horses and two staff members but showed higher single nucleotide polymorphism (SNP) distances. One ST398 isolate from an individual staff member was not related to the other two clusters. The ST612 isolates were isolated in 2022 from two horses and three environmental samples and showed very low SNP distances (<7 SNPs), indicating the transmission of MRSA ST612 in this clinic in 2022. Molecular characterization revealed an abundant set of virulence genes and plasmids in the ST612 isolates in comparison to ST398 isolates. Phenotypic antimicrobial susceptibility showed that differences between the two sequence types were consistent with the genetic characteristics. MRSA ST612 has not been reported in Europe before, but it is a dominant clone in African hospitals and has been described in horses and people working with horses in Australia, indicating the importance of surveillance.
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- 2024
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6. Azole Resistance in Veterinary Clinical Aspergillus fumigatus Isolates in the Netherlands.
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van Dijk MAM, Buil JB, Tehupeiory-Kooreman M, Broekhuizen MJ, Broens EM, Wagenaar JA, and Verweij PE
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- Animals, Netherlands epidemiology, Retrospective Studies, Fungal Proteins genetics, Birds microbiology, Cats, Dogs, Cytochrome P-450 Enzyme System, Aspergillus fumigatus drug effects, Aspergillus fumigatus genetics, Aspergillus fumigatus isolation & purification, Azoles pharmacology, Drug Resistance, Fungal genetics, Aspergillosis microbiology, Aspergillosis veterinary, Antifungal Agents pharmacology, Microbial Sensitivity Tests
- Abstract
Aspergillus fumigatus is a saprophytic fungal pathogen that causes opportunistic infections in animals and humans. Azole resistance has been reported globally in human A. fumigatus isolates, but the prevalence of resistance in isolates from animals is largely unknown. A retrospective resistance surveillance study was performed using a collection of clinical A. fumigatus isolates from various animal species collected between 2015 and 2020. Agar-based azole resistance screening of all isolates was followed by in vitro antifungal susceptibility testing and cyp51A gene sequencing of the azole-resistant isolates. Over the 5 year period 16 (11.3%) of 142 A. fumigatus culture-positive animals harbored an azole-resistant isolate. Resistant isolates were found in birds (15%; 2/13), cats (21%; 6/28), dogs (8%; 6/75) and free-ranging harbor porpoise (33%; 2/6). Azole-resistance was cyp51A mediated in all isolates: 81.3% (T-67G/)TR
34 /L98H, 12.5% TR46 /Y121F/T289A. In one azole-resistant A. fumigatus isolate a combination of C(-70)T/F46Y/C(intron7)T/C(intron66)T/M172V/E427K single-nucleotide polymorphisms in the cyp51A gene was found. Of the animals with an azole-resistant isolate and known azole exposure status 71.4% (10/14) were azole naive. Azole resistance in A. fumigatus isolates from animals in the Netherlands is present and predominantly cyp51A TR-mediated, supporting an environmental route of resistance selection. Our data supports the need to include veterinary isolates in resistance surveillance programs. Veterinarians should consider azole resistance as a reason for therapy failure when treating aspergillosis and consider resistance testing of relevant isolates., (© 2024. The Author(s).)- Published
- 2024
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7. Companion Animal Owners' Knowledge, Attitudes and Perceptions Regarding Antibiotic Use in Portugal.
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Dias MC, Alpizar-Jara R, Lavrador C, Marques C, Broens EM, and Duarte EL
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While multiple studies have focused on the motivations surrounding antibiotic prescription among veterinarians, little is known about companion animal owners' knowledge, attitude and perception (KAP) regarding the topic. A nationwide survey directed toward Portuguese dog and cat owners was conducted online and at veterinary practices to characterize their KAP regarding antibiotics. After database curation, a total of 423 valid submissions were considered. Although 97.9% of respondents stated that they knew what an antibiotic was, 23.5% and 19.2% answered that they were used to treat viral and fungal infections, respectively. Antimicrobial effectiveness was favored over cost when 87.7% of owners agreed they would prefer to spend more money to identify the appropriate antibiotic. Around 87% of respondents recognized antibiotic resistance as a significant health problem and 74.6% strongly agreed/somewhat agreed that antibiotic use in pets may contribute to resistance development. However, only 25.3% recognized that this could promote resistance dissemination, showing little awareness of the interconnection between human and animal health. Moreover, 55.6% of respondents were neutral when asked whether antibiotics used in veterinary medicine were also important for humans. These findings suggest that communication between veterinarians and pet owners can still be improved to further clarify the impact that antibiotic use has in pets from a One-Health perspective, also enabling antimicrobial stewardship interventions.
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- 2024
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8. Antimicrobial prophylaxis in companion animal surgery: A scoping review for European Network for Optimization of Antimicrobial Therapy (ENOVAT) guidelines.
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Sørensen TM, Scahill K, Ruperez JE, Olejnik M, Swinbourne F, Verwilghen DR, Nolff MC, Baines S, Marques C, Vilen A, Duarte EL, Dias M, Dewulf S, Wichtowska A, Valencia AC, Pelligand L, Broens EM, Toutain PL, Alishani M, Brennan ML, Weese JS, Jessen LR, and Allerton F
- Abstract
Surgical antimicrobial prophylaxis (SAP) is widely used to reduce the risk of surgical site infections (SSI), but there is uncertainty as to what the proportion of SSI reduction is. Therefore, it is difficult for surgeons to properly weigh the costs, risks and benefits for individual patients when deciding on the use of SAP, making it challenging to promote antimicrobial stewardship in primary practice settings. The objective of this study was to map the veterinary evidence focused on assessing the effect of SAP on SSI development and in order to identify surgical procedures with some research evidence and possible knowledge gaps. In October 2021 and December 2022, Scopus, CAB Abstracts, Web of Science Core Collection, Embase and MEDLINE were systematically searched. Double blinded screening of records was performed to identify studies in companion animals that reported on the use of SAP and SSI rates. Comparative data were available from 34 out of 39123 records screened including: eight randomised controlled trials (RCT), 23 cohort studies (seven prospective and 16 retrospective) and three retrospective case series representing 12476 dogs and cats in total. Extracted data described peri- or post-operative SAP in nine, and 25 studies, respectively. In the eight RCTs evaluating SAP in companion animals, surgical procedure coverage was skewed towards orthopaedic stifle surgeries in referral settings and there was large variation in SAP protocols, SSI definitions and follow-up periods. More standardized data collection and agreement of SSI definitions is needed to build stronger evidence for optimized patient care., Competing Interests: Conflict of interest statement This article was based upon work by investigators from the COST Action European Network for Optimization of Veterinary Antimicrobial Treatment (CA18217), supported by European Cooperation in Science and Technology (COST); see: www.enovat.eu and www.cost.eu. None of the authors has any other financial or personal relationships that could inappropriately influence or bias the content of the paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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- 2024
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9. Equine ulcerative keratitis in the Netherlands (2012-2021): Bacterial and fungal isolates and antibiotic susceptibility.
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Verdenius CY, Slenter IJM, Hermans H, Broens EM, and Djajadiningrat-Laanen SC
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Background: Ulcerative keratitis is a common ophthalmic disease in horses which can be complicated by microbial infection and requires immediate, accurate treatment to prevent loss of visual function or the eye., Objectives: To report the results of microbial cultures, antibiotic susceptibility tests and corneal cytology in horses with ulcerative keratitis presented to a referral clinic, to assess agreement between cytology and culture results, to investigate whether previous topical treatment affected microbial culture results and whether the incidence of antimicrobial resistance changed during the study period., Study Design: Retrospective analysis., Methods: Case characteristics and results of cytology and microbial cultures were retrieved. Statistical analyses included descriptive statistics, χ
2 or Fisher's exact test and McNemar test., Results: Samples for bacterial culturing (n = 187), fungal culturing (n = 153) and cytology (n = 153) were collected from 178 horses. Bacterial and fungal cultures were positive in 36% (n = 67) and 20% (n = 30), respectively. Staphylococcus (n = 35/67; 48%), Streptococcus (n = 12/67; 16%) and Aspergillus species (n = 22/30; 81%) were most frequently found. Microorganisms were observed in 14% of cytology samples (n = 22/153). Acquired antibiotic resistance was commonly observed amongst Streptococcus and Staphylococcus species. Acquired antibiotic resistance to gentamicin was more common in cases previously treated with gentamicin (p < 0.001). The incidence of acquired antibiotic resistance did not increase significantly between Cohort 2012-2017 and Cohort 2018-2021. Neither bacterial nor fungal culturing results were in agreement with cytology findings (p < 0.001 and p = 0.02, respectively). In 6 of 104 samples that were negative on fungal culturing, cytology revealed fungal elements., Main Limitations: Due to the retrospective nature of this study, some case characteristics and test results were unavailable., Conclusions: Acquired resistance was commonly observed amongst Streptococcus and Staphylococcus species, and in bacteria previously exposed to topical gentamicin. The incidence of acquired antibiotic resistance did not increase over time. When fungal cultures prove negative, cytology may have some added benefit in identifying keratomycosis., (© 2024 EVJ Ltd.)- Published
- 2024
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10. Corneal stromal ulcerations in a referral population of dogs and cats in the Netherlands (2012-2019): Bacterial isolates and antibiotic resistance.
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Verdenius CY, Broens EM, Slenter IJM, and Djajadiningrat-Laanen SC
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- Humans, Cats, Animals, Dogs, Retrospective Studies, Netherlands epidemiology, Microbial Sensitivity Tests veterinary, Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents therapeutic use, Streptococcus, Staphylococcus, Drug Resistance, Bacterial, Pseudomonas, Referral and Consultation, Chloramphenicol therapeutic use, Cat Diseases drug therapy, Cat Diseases epidemiology, Cat Diseases microbiology, Dog Diseases drug therapy, Dog Diseases epidemiology, Dog Diseases microbiology, Corneal Ulcer drug therapy, Corneal Ulcer epidemiology, Corneal Ulcer veterinary
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Objective: To evaluate bacterial isolates from corneal stromal ulcerations in dogs and cats in the Netherlands, review their antibiotic susceptibility, determine whether recent topical treatment affected bacterial culture results, and investigate whether (multi-drug) resistance patterns changed over time., Animals Studied: Client-owned dogs and cats were diagnosed with corneal stromal ulceration at the Utrecht University Clinic for Companion Animals between 2012 and 2019., Procedures: Retrospective analysis., Results: In total, 163 samples were collected from 122 dogs (130 samples) and 33 cats. Positive cultures were obtained from 76 canine and 13 feline samples (59% and 39%, respectively) and included Staphylococcus (42 in dogs, 8 in cats), Streptococcus (22 in dogs, 2 in cats), and Pseudomonas (9 in dogs, 1 in cats) species. Significantly fewer positive cultures were found in dogs and cats previously treated with topical antibiotics (χ
2 = 6.52, p = .011 and χ2 = 4.27, p = .039, respectively). Bacterial resistance to chloramphenicol was more common in dogs previously treated with chloramphenicol (χ2 = 5.24, p = .022). The incidence of acquired antibiotic resistance did not increase significantly over time. In dogs, the incidence of multi-drug-resistant isolates increased significantly between 2012-2015 and 2016-2019 (9.4% vs. 38.6%, p = .0032)., Conclusions: Staphylococcus, Streptococcus, and Pseudomonas species were the most common bacteria associated with canine and feline corneal stromal ulcerations. Previous treatment with antibiotics affected bacterial culture results and antibiotic sensitivity. Although the overall incidence of acquired antibiotic resistance did not change over time, the incidence of multi-drug-resistant isolates in dogs increased over an 8-year period., (© 2023 The Authors. Veterinary Ophthalmology published by Wiley Periodicals LLC on behalf of American College of Veterinary Ophthalmologists.)- Published
- 2024
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11. Seroprevalence of SARS-CoV-2 antibodies among healthcare workers in Dutch hospitals after the 2020 first wave: a multicentre cross-sectional study with prospective follow-up.
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Recanatini C, GeurtsvanKessel CH, Pas SD, Broens EM, Maas M, van Mansfeld R, Mutsaers-van Oudheusden AJG, van Rijen M, Schippers EF, Stegeman A, Tami A, Veldkamp KE, Visser H, Voss A, Wegdam-Blans MCA, Wertheim HFL, Wever PC, Koopmans MPG, Kluytmans JAJW, and Kluytmans-van den Bergh MFQ
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- Humans, Cross-Sectional Studies, Diabetes Mellitus, Fatigue, Follow-Up Studies, Health Personnel, Hospitals, Pain, Prospective Studies, Retrospective Studies, Seroepidemiologic Studies, Netherlands, Antibodies, Viral blood, COVID-19 epidemiology
- Abstract
Background: We aimed to estimate the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence and describe its determinants and associated symptoms among unvaccinated healthcare workers (HCWs) after the first wave of the pandemic., Methods: HCWs from 13 Dutch hospitals were screened for antibodies against the spike protein of SARS-CoV-2 in June-July 2020 and after three months. Participants completed a retrospective questionnaire on determinants for occupational and community exposure to SARS-CoV-2 and symptoms suggestive of COVID-19 experienced since January 2020. The seroprevalence was calculated per baseline characteristic and symptom at baseline and after follow-up. Adjusted odds ratios (aOR) for seropositivity were determined using logistic regression., Results: Among 2328 HCWs, 323 (13.9%) were seropositive at enrolment, 49 of whom (15%) reported no previous symptoms suggestive of COVID-19. During follow-up, only 1% of the tested participants seroconverted. Seroprevalence was higher in younger HCWs compared to the mid-age category (aOR 1.53, 95% CI 1.07-2.18). Nurses (aOR 2.21, 95% CI 1.34-3.64) and administrative staff (aOR 1.87, 95% CI 1.02-3.43) had a higher seroprevalence than physicians. The highest seroprevalence was observed in HCWs in the emergency department (ED) (aOR 1.79, 95% CI 1.10-2.91), the lowest in HCWs in the intensive, high, or medium care units (aOR 0.47, 95% CI 0.31-0.71). Chronic respiratory disease, smoking, and having a dog were independently associated with a lower seroprevalence, while HCWs with diabetes mellitus had a higher seroprevalence. In a multivariable model containing all self-reported symptoms since January 2020, altered smell and taste, fever, general malaise/fatigue, and muscle aches were positively associated with developing antibodies, while sore throat and chills were negatively associated., Conclusions: The SARS-CoV-2 seroprevalence in unvaccinated HCWs of 13 Dutch hospitals was 14% in June-July 2020 and remained stable after three months. A higher seroprevalence was observed in the ED and among nurses, administrative and young staff, and those with diabetes mellitus, while a lower seroprevalence was found in HCWs in intensive, high, or medium care, and those with self-reported lung disease, smokers, and dog owners. A history of altered smell or taste, fever, muscle aches and fatigue were independently associated with the presence of SARS-CoV-2 antibodies in unvaccinated HCWs., (© 2023. The Author(s).)
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- 2023
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12. Contribution of cats and dogs to SARS-CoV-2 transmission in households.
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Fischer EAJ, Broens EM, Kooistra HS, De Rooij MMT, Stegeman JA, and De Jong MCM
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Introduction: SARS-CoV-2 is known to jump across species. The occurrence of transmission in households between humans and companion animals has been shown, but the contribution of companion animals to the overall transmission within a household is unknown. The basic reproduction number ( R
0 ) is an important indicator to quantify transmission. For a pathogen with multiple host species, such as SARS-CoV-2, the basic reproduction number needs to be calculated from the partial reproduction numbers for each combination of host species., Method: In this study, the basic and partial reproduction numbers for SARS-CoV-2 were estimated by reanalyzing a survey of Dutch households with dogs and cats and minimally one SARS-CoV-2-infected human., Results: For households with cats, a clear correlation between the number of cats and the basic reproduction number (Spearman's correlation: p 0.40, p -value: 1.4 × 10-5 ) was identified, while for dogs, the correlation was smaller and not significant (Spearman's correlation: p 0.12, p -value: 0.21). Partial reproduction numbers from cats or dogs to humans were 0.3 (0.0-2.0) and 0.3 (0.0-3.5) and from humans to cats or dogs were 0.6 (0.4-0.8) and 0.6 (0.4-0.9)., Discussion: Thus, the estimations of within-household transmission indicated the likelihood of transmission from these companion animals to humans and vice versa, but the observational nature of this study limited the ability to establish conclusive evidence. This study's findings support the advice provided during the pandemic to COVID-19 patients to maintain distance from companion animals as a precautionary measure and given the possibility of transmission, although there is an overall relatively limited impact on the pandemic when compared to human-to-human transmission., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Fischer, Broens, Kooistra, De Rooij, Stegeman and De Jong.)- Published
- 2023
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13. Quantifying topical antimicrobial use before and during participation in an antimicrobial stewardship programme in Dutch companion animal clinics.
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Kardomatea N, Hopman NEM, van Geijlswijk IM, Portengen L, Wagenaar JA, Heederik DJJ, and Broens EM
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- Humans, Animals, Dogs, Pets, Prescriptions, Antimicrobial Stewardship, Anti-Infective Agents therapeutic use, Anti-Infective Agents, Local
- Abstract
The emergence of bacterial strains resistant to topical antimicrobials in both human and veterinary medicine has raised concerns over retaining the efficacy of these preparations. Yet, little information is available regarding the use of topical antimicrobials in either sector for planning targeted interventions. This study aims to quantify the use of topical antimicrobials in 44 Dutch companion animal clinics before and during their participation in an antimicrobial stewardship programme (ASP), to explore the effect of the intervention on topical antimicrobial use (AMU). Hence, prescription and clinic animal population data, collected from July 2012 until June 2018 were used. Specifically, the period from July 2012 until June 2015 was defined as pre-intervention period, whereas clinics started to participate in the ASP from March 2016 onwards. As quantification metric, the Defined Daily Dose for Animals (DDDA) was used and a mixed effect times series model with auto-regression was applied to monthly topical AMU data. The intervention effect was modelled using a step function with a change in (linear) time trend and clinic characteristics, as potential determinants of topical AMU, were assessed using a multivariable regression model. A seasonal pattern was identified, in the pre-intervention period, where topical AMU was highest in July-August and lowest in February-March. In addition, total topical AMU appeared to significantly decrease over time in the pre-intervention period and the proportion of dogs in the clinic was positively associated with topical AMU. The intervention effect was significant only for second line and for skin product AMU. This study demonstrates that during participation in an ASP, second line and skin product AMU decreased in Dutch companion animal clinics. Additionally, this study demonstrates the existence of a seasonal effect and a decrease in topical AMU over time already before introduction of a targeted intervention., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Kardomatea et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2023
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14. Harbor Porpoise Deaths Associated with Erysipelothrix rhusiopathiae, the Netherlands, 2021.
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IJsseldijk LL, Begeman L, Duim B, Gröne A, Kik MJL, Klijnstra MD, Lakemeyer J, Leopold MF, Munnink BBO, Ten Doeschate M, van Schalkwijk L, Zomer A, der Graaf-van Bloois LV, and Broens EM
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- Animals, Netherlands epidemiology, Phocoena, Erysipelothrix
- Abstract
In August 2021, a large-scale mortality event affected harbor porpoises (Phocoena phocoena) in the Netherlands. Pathology and ancillary testing of 22 animals indicated that the most likely cause of death was Erysipelothrix rhusiopathiae infection. This zoonotic agent poses a health hazard for cetaceans and possibly for persons handling cetacean carcasses.
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- 2023
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15. Molecular Characterization and Clinical Relevance of Taxonomic Reassignment of Staphylococcus schleiferi Subspecies into Two Separate Species, Staphylococcus schleiferi and Staphylococcus coagulans .
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Naing SY, Duim B, Broens EM, Schweitzer V, Zomer A, van der Graaf-van Bloois L, van der Meer C, Stellingwerff L, Fluit AC, and Wagenaar JA
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Staphylococcus schleiferi is an opportunistic pathogen in humans and dogs. Recent taxonomic reassignment of its subspecies ( S. schleiferi subsp. schleiferi and S. schleiferi subsp. coagulans ) into two separate species ( S. schleiferi and S. coagulans ) lacks supporting data for diagnostic implications and clinical relevance. We aimed to confirm the reclassification of S. schleiferi by using genomic and matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) data for a large set of isolates from humans and animals to investigate their molecular epidemiology and clinical relevance. Routine MALDI-TOF analysis and Illumina sequencing were performed on 165 S. schleiferi isolates from the Netherlands. With 33 publicly available genomes, the study included 198 genomes from 149 dogs, 34 humans, and 15 other sources. The Type Strain Genome Server was used to identify species in the genomes, and the MALDI-TOF MS database was extended to improve species differentiation. MALDI-TOF did not discriminate between S. schleiferi and S. coagulans. Genome phylogeny distinguished the two species in two monophyletic clusters. S. schleiferi isolates originated from humans, while S. coagulans isolates were found in animals and three human isolates clustering with the animal isolates. The sialidase B gene ( nanB ) was a unique marker gene for S. schleiferi , whereas the chrA gene was exclusive for S. coagulans . The mecA gene was exclusively detected in S. coagulans , as were the lnu (A), blaZ , erm (B/C), tet (O/M), and aac (6')- aph (2'') genes. The MALDI-TOF database extension did not improve differentiation between the two species. Even though our whole-genome sequencing-based approach showed clear differentiation between these two species, it remains critical to identify S. schleiferi and S. coagulans correctly in routine diagnostics. IMPORTANCE This study clearly shows that S. schleiferi is a concern in human hospital settings, whereas S. coagulans predominantly causes infections in animals. S. coagulans is more resistant to antibiotics and can sometimes transmit to humans via exposure to infected dogs. Even though genome-based methods can clearly differentiate the two species, current diagnostic methods used routinely in clinical microbiology laboratories cannot distinguish the two bacterial species.
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- 2023
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16. Evidence of cat-to-human transmission of Staphylococcus felis .
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Sips GJ, van Dijk MAM, van Westreenen M, van der Graaf-van Bloois L, Duim B, and Broens EM
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- Humans, Female, Cats, Animals, Middle Aged, Coagulase, Staphylococcus, Virulence Factors genetics, Felis, Staphylococcal Infections veterinary, Staphylococcal Infections microbiology, Cat Diseases
- Abstract
Introduction. Staphylococcus felis is a coagulase-negative staphylococcal species that is commonly isolated from healthy cats. Like other commensal staphylococci, S. felis can cause opportunistic infections, e.g. otitis externa, skin and urinary tract infections, in cats. Gap Statement. Several studies have reported within-household transmission between humans and pets and human infections caused by coagulase-positive staphylococci. However, human infections with coagulase-negative staphylococci of zoonotic origin are relatively rare. Methodology. Culture of a surgical site infection in a 58-year-old woman who underwent a laminectomy revealed dominant growth of S. felis . The three cats owned by the patient were sampled to investigate potential within-household transmission. S. felis isolates were sequenced to investigate the relatedness of the isolates and to look for virulence factors and host specific genes. Results. All cats were colonized with S. felis . Comparative genomics of the isolates showed that each cat was colonized with a distinct genotype. The patient's isolate clustered with isolates of one of the cats. Sequence analysis of the studied isolates together with 29 publicly available S. felis genomes detected putative virulence factors that can be crucial in potential interspecies transmission. Conclusion. The current case is the first reported human infection caused by S. felis and highlights the zoonotic potential of this bacterial species. Evidence of cat-to-human transmission was shown by comparative genomics of isolates from the patient with isolates of her cats.
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- 2023
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17. Cellular and humoral immune responsiveness to inactivated Leptospira interrogans in dogs vaccinated with a tetravalent Leptospira vaccine.
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Novak A, Hindriks E, Hoek A, Veraart C, Broens EM, Ludwig I, Rutten V, Sloots A, and Broere F
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- Dogs, Animals, Vaccines, Combined, CD8-Positive T-Lymphocytes, Leukocytes, Mononuclear, Bacterial Vaccines, Vaccination veterinary, Immunoglobulin G, Leptospira interrogans, Leptospira, Dog Diseases prevention & control, Leptospirosis prevention & control, Leptospirosis veterinary
- Abstract
Vaccination is commonly used to protect dogs against leptospirosis, however, memory immune responses induced by canine Leptospira vaccines have not been studied. In the present study, antibody and T cell mediated responses were assessed in dogs before and 2 weeks after annual revaccination with a commercial tetravalent Leptospira vaccine containing serogroups Canicola and Australis. Vaccination significantly increased average log
2 IgG titers from 6.50 to 8.41 in year 1, from 5.99 to 7.32 in year 2, from 5.32 to 8.32 in year 3 and from 5.32 to 7.82 in year 4. The CXCL-10 levels, induced by in vitro stimulation of PBMC with Canicola and Australis, respectively, significantly increased from 1039.05 pg/ml and 1037.38 pg/ml before vaccination to 2547.73 pg/ml and 2730.38 pg/ml after vaccination. IFN-γ levels increased from 85.60 pg/ml and 178.13 pg/ml before vaccination to 538.62 pg/ml and 210.97 pg/ml after vaccination. The percentage of proliferating CD4+ T cells in response to respective Leptospira strains significantly increased from 1.43 % and 1.25 % before vaccination to 24.11 % and 14.64 % after vaccination. Similar responses were also found in the CD8+ T cell subset. Vaccination also significantly enhanced the percentages of central memory CD4+ T cells from 12 % to 26.97 % and 27.65 %, central memory CD8+ T cells from 3 % to 9.47 % and 7.55 %, and effector CD8+ T cells from 3 % to 7.6 % and 6.42 %, as defined by the expression of CD45RA and CD62L, following stimulation with Canicola and Australis, respectively. Lastly, enhanced expression of the activation marker CD25 on T cells after vaccination was found. Together, our results show that next to IgG responses, also T cell responses are induced in dogs upon annual revaccination with a tetravalent Leptospira vaccine, potentially contributing to protection., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)- Published
- 2023
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18. First Case of Human Brucella canis Infection in the Netherlands.
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Kolwijck E, Lutgens SPM, Visser VXN, van Apeldoorn MJ, Graham H, Koets AP, Schrauwen MMWP, Reubsaet FAG, Broens EM, and Kortbeek LM
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- Animals, Dogs, Female, Humans, Europe, Netherlands, Brucella canis, Brucellosis diagnosis, Brucellosis veterinary, Dog Diseases diagnosis
- Abstract
A patient was diagnosed with Brucella canis following exposure to infected dogs in her breeding facility. Transboundary spread of B. canis through (illegal) import of infected dogs to non-endemic countries in Europe suggest that B. canis infection should be considered in European patients with occupational exposure to dogs., Competing Interests: Potential conflicts of interest. All authors: No reported conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
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- 2022
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19. SARS-CoV-2 infection in dogs and cats is associated with contact to COVID-19-positive household members.
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Kannekens-Jager MM, de Rooij MMT, de Groot Y, Biesbroeck E, de Jong MK, Pijnacker T, Smit LAM, Schuurman N, Broekhuizen-Stins MJ, Zhao S, Duim B, Langelaar MFM, Stegeman A, Kooistra HS, Radstake C, Egberink HF, Wagenaar JA, and Broens EM
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- Humans, Animals, Cats, Dogs, SARS-CoV-2, Animals, Wild, COVID-19 epidemiology, COVID-19 veterinary, Cat Diseases epidemiology, Dog Diseases epidemiology
- Abstract
Several domestic and wild animal species are susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Reported (sero)prevalence in dogs and cats vary largely depending on the target population, test characteristics, geographical location and time period. This research assessed the prevalence of SARS-CoV-2-positive cats and dogs (PCR- and/or antibody positive) in two different populations. Dogs and cats living in a household with at least one confirmed COVID-19-positive person (household (HH) study; 156 dogs and 152 cats) and dogs and cats visiting a veterinary clinic (VC) (VC study; 183 dogs and 140 cats) were sampled and tested for presence of virus (PCR) and antibodies. Potential risk factors were evaluated and follow-up of PCR-positive animals was performed to determine the duration of virus shedding and to detect potential transmission between pets in the same HH. In the HH study, 18.8% (27 dogs, 31 cats) tested SARS-CoV-2 positive (PCR- and/or antibody positive), whereas in the VC study, SARS-CoV-2 prevalence was much lower (4.6%; six dogs, nine cats). SARS-CoV-2 prevalence amongst dogs and cats was significantly higher in the multi-person HHs with two or more COVID-19-positive persons compared with multi-person HHs with only one COVID-19-positive person. In both study populations, no associations could be identified between SARS-CoV-2 status of the animal and health status, age or sex. During follow-up of PCR-positive animals, no transmission to other pets in the HH was observed despite long-lasting virus shedding in cats (up to 35 days). SARS-CoV-2 infection in dogs and cats appeared to be clearly associated with reported COVID-19-positive status of the HH. Our study supports previous findings and suggests a very low risk of pet-to-human transmission within HHs, no severe clinical signs in pets and a negligible pet-to-pet transmission between HHs., (© 2022 The Authors. Transboundary and Emerging Diseases published by Wiley-VCH GmbH.)
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- 2022
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20. Virulence plasmids in clinical isolates of Rhodococcus equi from sick foals in the Netherlands.
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Takai S, Ohashi M, Suzuki Y, Sasaki Y, Kakuda T, Broens EM, Wagenaar JA, and van Duijkeren E
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- Animals, Bacterial Proteins genetics, Female, Horses genetics, Netherlands, Plasmids genetics, Soil Microbiology, Virulence genetics, Virulence Factors genetics, Actinomycetales Infections epidemiology, Actinomycetales Infections microbiology, Actinomycetales Infections veterinary, Horse Diseases epidemiology, Rhodococcus equi genetics
- Abstract
Clinical samples from 123 foals with suspected rhodococcosis submitted to the Veterinary Microbiological Diagnostic Centre of the Faculty of Veterinary Medicine between 1993 and 2006 were tested for the presence of the virulence gene vapA. Of the 123 samples, 120 were vapA-positive and 3 vapA-negative Rhodococcus equi were isolated. The 120 vapA-positive R. equi were isolated from 70 tracheal wash, 19 lung tissues, 7 lymph nodes, 6 synovial fluids, 13 abscesses or pus and single isolates from the uterus, gut, cerebrospinal fluid, abdomen fluid and faeces. Of the 120 isolates, 46 were from Dutch warmblood horses, 23 from Friesian horses, 14 from Trotters, 4 from Holsteiners, 3 from Arab breed, 2 from ponies, 1 from a Welsh pony and 27 from undefined breed horses. Using plasmid profile analysis of the 120 isolates, 117 isolates contained the 85-kb type I plasmid, 2 contained the 87-kb type I plasmid and 1 contained the novel 52-kb non-mobilizable virulence plasmid reported recently. These results showed that the virulent R. equi strains harbouring a virulence plasmid of 85-kb type I or 87-kb type I, which have been detected in clinical isolates from five European countries, are widespread in the Netherlands. This is the first report of plasmid types of clinical R. equi isolates in the Netherlands., (© 2022 Society for Applied Microbiology.)
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- 2022
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21. SARS-CoV-2 infection in cats and dogs in infected mink farms.
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van Aart AE, Velkers FC, Fischer EAJ, Broens EM, Egberink H, Zhao S, Engelsma M, Hakze-van der Honing RW, Harders F, de Rooij MMT, Radstake C, Meijer PA, Oude Munnink BB, de Rond J, Sikkema RS, van der Spek AN, Spierenburg M, Wolters WJ, Molenaar RJ, Koopmans MPG, van der Poel WHM, Stegeman A, and Smit LAM
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- Animals, Animals, Wild, Cats, Dogs, Farms, Humans, Mink, SARS-CoV-2, COVID-19 epidemiology, COVID-19 veterinary, Cat Diseases epidemiology, Dog Diseases epidemiology
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Animals like mink, cats and dogs are susceptible to SARS-CoV-2 infection. In the Netherlands, 69 out of 127 mink farms were infected with SARS-CoV-2 between April and November 2020 and all mink on infected farms were culled after SARS-CoV-2 infection to prevent further spread of the virus. On some farms, (feral) cats and dogs were present. This study provides insight into the prevalence of SARS-CoV-2-positive cats and dogs in 10 infected mink farms and their possible role in transmission of the virus. Throat and rectal swabs of 101 cats (12 domestic and 89 feral cats) and 13 dogs of 10 farms were tested for SARS-CoV-2 using PCR. Serological assays were performed on serum samples from 62 adult cats and all 13 dogs. Whole Genome Sequencing was performed on one cat sample. Cat-to-mink transmission parameters were estimated using data from all 10 farms. This study shows evidence of SARS-CoV-2 infection in 12 feral cats and 2 dogs. Eleven cats (18%) and two dogs (15%) tested serologically positive. Three feral cats (3%) and one dog (8%) tested PCR-positive. The sequence generated from the cat throat swab clustered with mink sequences from the same farm. The calculated rate of mink-to-cat transmission showed that cats on average had a chance of 12% (95%CI 10%-18%) of becoming infected by mink, assuming no cat-to-cat transmission. As only feral cats were infected it is most likely that infections in cats were initiated by mink, not by humans. Whether both dogs were infected by mink or humans remains inconclusive. This study presents one of the first reports of interspecies transmission of SARS-CoV-2 that does not involve humans, namely mink-to-cat transmission, which should also be considered as a potential risk for spread of SARS-CoV-2., (© 2021 The Authors. Transboundary and Emerging Diseases published by Wiley-VCH GmbH.)
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- 2022
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22. Within-Household Transmission and Bacterial Diversity of Staphylococcus pseudintermedius .
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Wegener A, Duim B, van der Graaf-van Bloois L, Zomer AL, Visser CE, Spaninks M, Timmerman AJ, Wagenaar JA, and Broens EM
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Staphylococcus pseudintermedius can be transmitted between dogs and their owners and can cause opportunistic infections in humans. Whole genome sequencing was applied to identify the relatedness between isolates from human infections and isolates from dogs in the same households. Genome SNP diversity and distribution of plasmids and antimicrobial resistance genes identified related and unrelated isolates in both households. Our study shows that within-host bacterial diversity is present in S. pseudintermedius , demonstrating that multiple isolates from each host should preferably be sequenced to study transmission dynamics., Competing Interests: The authors declare no conflict of interest.
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- 2022
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23. Monitoring of ticks and their pathogens from companion animals obtained by the "tekenscanner" application in The Netherlands.
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Kooyman FNJ, Zweerus H, Nijsse ER, Jongejan F, Wagenaar JA, and Broens EM
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- Animals, Dogs, Netherlands, Pets, Babesia genetics, Borrelia, Dog Diseases microbiology, Ixodes microbiology, Rickettsia genetics, Tick Infestations veterinary, Tick-Borne Diseases epidemiology, Tick-Borne Diseases microbiology, Tick-Borne Diseases veterinary
- Abstract
Ticks are vectors for many pathogens of veterinary and medical interest. In order to monitor ticks and tick-borne pathogens, the "Tekenscanner" (Dutch for Tick scanner), a citizen science project, was launched in The Netherlands. It is a smartphone application for pet-owners to get ticks from their dog or cat, identified and checked for pathogens for free. At the same time, information about the pet and the geographic location of tick infestation becomes available for research. The application was launched in 2018, and the results of the first 6 months after launch of the app were reported. Ticks were identified based on morphology, and DNA was extracted and amplified by a panel of tick-borne pathogen-specific primers. Next, the amplicons were subjected to reverse line blot with specific probes for important pathogens to determine their presence or absence. The present paper describes the results of 2019 and 2020. There were 2260 ticks collected from 871 dogs and 255 cats (26 ticks were from an unknown host) and all pet owners were informed about the results. Four species of ticks were collected: Ixodes ricinus (90.0%), Ixodes hexagonus (7.3%), Dermacentor reticulatus (2.8%) and Rhipicephalus sanguineus (0.1%). Ixodes ricinus was the tick with the most divergent pathogens: Anaplasma sp. (1.3%), Babesia sp. (0.8%), Borrelia spp. (4.8%), Neoehrlichia sp. (3.7%) and Rickettsia helvetica (12.6%). In I. hexagonus, R. helvetica (1.8%) and Babesia sp. (0.6%) were detected and Rickettsia raoultii in D. reticulatus (16.2%). One of the two nymphs of R. sanguineus was co-infected with Borrelia and R. helvetica and the other one was uninfected. The high numbers of different pathogens found in this study suggest that companion animals, by definition synanthropic animals, and their ticks can serve as sentinels for emerging tick-borne pathogens., (© 2022. The Author(s).)
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- 2022
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24. Review and Analysis of National Monitoring Systems for Antimicrobial Resistance in Animal Bacterial Pathogens in Europe: A Basis for the Development of the European Antimicrobial Resistance Surveillance Network in Veterinary Medicine (EARS-Vet).
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Mader R, Muñoz Madero C, Aasmäe B, Bourély C, Broens EM, Busani L, Callens B, Collineau L, Crespo-Robledo P, Damborg P, Filippitzi ME, Fitzgerald W, Heuvelink A, van Hout J, Kaspar H, Norström M, Pedersen K, Pohjanvirta T, Pokludova L, Dal Pozzo F, Slowey R, Teixeira Justo C, Urdahl AM, Vatopoulos A, Zafeiridis C, Madec JY, and Amat JP
- Abstract
The monitoring of antimicrobial resistance (AMR) in bacterial pathogens of animals is not currently coordinated at European level. To fill this gap, experts of the European Union Joint Action on Antimicrobial Resistance and Healthcare Associated Infections (EU-JAMRAI) recommended building the European Antimicrobial Resistance Surveillance network in Veterinary medicine (EARS-Vet). In this study, we (i) identified national monitoring systems for AMR in bacterial pathogens of animals (both companion and food-producing) among 27 countries affiliated to EU-JAMRAI, (ii) described their structures and operations, and (iii) analyzed their respective strengths, weaknesses, opportunities and threats (SWOT). Twelve countries reported having at least one national monitoring system in place, representing an opportunity to launch EARS-Vet, but highlighting important gaps in AMR data generation in Europe. In total, 15 national monitoring systems from 11 countries were described and analyzed. They displayed diverse structures and operations, but most of them shared common weaknesses (e.g., data management and representativeness) and common threats (e.g., economic vulnerability and data access), which could be addressed collectively under EARS-Vet. This work generated useful information to countries planning to build or improve their system, by learning from others' experience. It also enabled to advance on a pragmatic harmonization strategy: EARS-Vet shall follow the European Committee on Antimicrobial Susceptibility Testing (EUCAST) standards, collect quantitative data and interpret AMR data using epidemiological cut-off values., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Mader, Muñoz Madero, Aasmäe, Bourély, Broens, Busani, Callens, Collineau, Crespo-Robledo, Damborg, Filippitzi, Fitzgerald, Heuvelink, van Hout, Kaspar, Norström, Pedersen, Pohjanvirta, Pokludova, Dal Pozzo, Slowey, Teixeira Justo, Urdahl, Vatopoulos, Zafeiridis, Madec and Amat.)
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- 2022
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25. Defining the scope of the European Antimicrobial Resistance Surveillance network in Veterinary medicine (EARS-Vet): a bottom-up and One Health approach.
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Mader R, Bourély C, Amat JP, Broens EM, Busani L, Callens B, Crespo-Robledo P, Damborg P, Filippitzi ME, Fitzgerald W, Grönthal T, Haenni M, Heuvelink A, van Hout J, Kaspar H, Muñoz Madero C, Norström M, Pedersen K, Pokludova L, Dal Pozzo F, Slowey R, Urdahl AM, Vatopoulos A, Zafeiridis C, and Madec JY
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- Animals, Anti-Bacterial Agents pharmacology, Bacteria, Cats, Cattle, Chickens, Dogs, Drug Resistance, Bacterial, Female, Swine, One Health
- Abstract
Background: Building the European Antimicrobial Resistance Surveillance network in Veterinary medicine (EARS-Vet) was proposed to strengthen the European One Health antimicrobial resistance (AMR) surveillance approach., Objectives: To define the combinations of animal species/production types/age categories/bacterial species/specimens/antimicrobials to be monitored in EARS-Vet., Methods: The EARS-Vet scope was defined by consensus between 26 European experts. Decisions were guided by a survey of the combinations that are relevant and feasible to monitor in diseased animals in 13 European countries (bottom-up approach). Experts also considered the One Health approach and the need for EARS-Vet to complement existing European AMR monitoring systems coordinated by the ECDC and the European Food Safety Authority (EFSA)., Results: EARS-Vet plans to monitor AMR in six animal species [cattle, swine, chickens (broilers and laying hens), turkeys, cats and dogs], for 11 bacterial species (Escherichia coli, Klebsiella pneumoniae, Mannheimia haemolytica, Pasteurella multocida, Actinobacillus pleuropneumoniae, Staphylococcus aureus, Staphylococcus pseudintermedius, Staphylococcus hyicus, Streptococcus uberis, Streptococcus dysgalactiae and Streptococcus suis). Relevant antimicrobials for their treatment were selected (e.g. tetracyclines) and complemented with antimicrobials of more specific public health interest (e.g. carbapenems). Molecular data detecting the presence of ESBLs, AmpC cephalosporinases and methicillin resistance shall be collected too., Conclusions: A preliminary EARS-Vet scope was defined, with the potential to fill important AMR monitoring gaps in the animal sector in Europe. It should be reviewed and expanded as the epidemiology of AMR changes, more countries participate and national monitoring capacities improve., (© The Author(s) 2022. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.)
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- 2022
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26. Canine Staphylococcus argenteus : Case Report from The Netherlands.
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Meijer EFJ, van Renssen A, Maat I, van der Graaf-van Bloois L, Duim B, and Broens EM
- Abstract
Staphylococcus argenteus has been reported worldwide in humans, while reported non-human cases are sparse. Its complete epidemiology, alongside its infectivity and pathogenicity in humans and non-humans, remain to be clarified. Here, we describe the first reported canine Staphylococcus argenteus , causing a deep wound infection in a Labrador retriever after orthopedic surgery. The closed genome is reported, with phylogenic and genetic analyses, as well as extensive phenotypic antimicrobial susceptibility testing for human and veterinary antibiotics. No genetic explanation could be found for its interaction with a canine host, underscoring the intrinsic multispecies pathogenicity and potential (anthropo-)zoonotic spread of Staphylococcus argenteus .
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- 2022
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27. Genomic Investigation of Two Acinetobacter baumannii Outbreaks in a Veterinary Intensive Care Unit in The Netherlands.
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Naing SY, Hordijk J, Duim B, Broens EM, van der Graaf-van Bloois L, Rossen JW, Robben JH, Leendertse M, Wagenaar JA, and Zomer AL
- Abstract
Acinetobacter baumannii is a nosocomial pathogen that frequently causes healthcare-acquired infections. The global spread of multidrug-resistant (MDR) strains with its ability to survive in the environment for extended periods imposes a pressing public health threat. Two MDR A. baumannii outbreaks occurred in 2012 and 2014 in a companion animal intensive care unit (caICU) in the Netherlands. Whole-genome sequencing (WGS) was performed on dog clinical isolates ( n = 6), environmental isolates ( n = 5), and human reference strains ( n = 3) to investigate if the isolates of the two outbreaks were related. All clinical isolates shared identical resistance phenotypes displaying multidrug resistance. Multi-locus Sequence Typing (MLST) revealed that all clinical isolates belonged to sequence type ST2. The core genome MLST (cgMLST) results confirmed that the isolates of the two outbreaks were not related. Comparative genome analysis showed that the outbreak isolates contained different gene contents, including mobile genetic elements associated with antimicrobial resistance genes (ARGs). The time-measured phylogenetic reconstruction revealed that the outbreak isolates diverged approximately 30 years before 2014. Our study shows the importance of WGS analyses combined with molecular clock investigations to reduce transmission of MDR A. baumannii infections in companion animal clinics.
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- 2022
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28. Periocular tinea caused by zoonotic Trichophyton benhamiae.
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Sips GJ, Lekkerkerk WSN, Boddé E, Broens EM, Vonk AG, and Thio HB
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- Animals, Bacterial Zoonoses, Female, Humans, Middle Aged, Tinea etiology, Antifungal Agents therapeutic use, Arthrodermataceae isolation & purification, Terbinafine therapeutic use, Tinea microbiology
- Abstract
Competing Interests: Declaration of interests We declare no competing interests.
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- 2021
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29. Serological Screening for Antibodies against SARS-CoV-2 in Dutch Shelter Cats.
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van der Leij WJR, Broens EM, Hesselink JW, Schuurman N, Vernooij JCM, and Egberink HF
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- Animals, COVID-19 epidemiology, COVID-19 immunology, COVID-19 Nucleic Acid Testing veterinary, COVID-19 Serological Testing veterinary, Cat Diseases immunology, Cats, Cross-Sectional Studies, Female, Housing, Animal, Humans, Male, Netherlands epidemiology, SARS-CoV-2 physiology, Seroepidemiologic Studies, Virus Shedding, Antibodies, Neutralizing blood, Antibodies, Viral blood, COVID-19 veterinary, Cat Diseases epidemiology, SARS-CoV-2 immunology
- Abstract
The COVID-19 pandemic raised concerns that companion animals might be infected with, and could become a reservoir of, SARS-CoV-2. As cats are popular pets and susceptible to Coronavirus, we investigated the seroprevalence of SARS-CoV-2 antibodies in shelter cats housed in Dutch animal shelters during the COVID-19 pandemic. In this large-scale cross-sectional study, serum samples of shelter cats were collected during the second wave of human COVID-19 infections in The Netherlands. Seroprevalence was determined by using an indirect protein-based ELISA validated for cats, and a Virus Neutralization Test (VNT) as confirmation. To screen for feline SARS-CoV-2 shedding, oropharyngeal and rectal swabs of cats positive for ELISA and/or VNT were analyzed using PCR tests. In 28 Dutch animal shelters, 240 shelter cats were convenience sampled. Two of these cats (0.8%; CI 95%: 0.1-3.0%) were seropositive, as evidenced by the presence of SARS-CoV-2 neutralizing antibodies. The seropositive animals tested PCR negative for SARS-CoV-2. Based on the results of this study, it is unlikely that shelter cats could be a reservoir of SARS-CoV-2 or pose a (significant) risk to public health.
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- 2021
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30. Absence of Host-Specific Genes in Canine and Human Staphylococcus pseudintermedius as Inferred from Comparative Genomics.
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Wegener A, Broens EM, van der Graaf-van Bloois L, Zomer AL, Visser CE, van Zeijl J, van der Meer C, Kusters JG, Friedrich AW, Kampinga GA, Sips GJ, Smeets L, van Kerckhoven MEJ, Timmerman AJ, Wagenaar JA, and Duim B
- Abstract
Staphylococcus pseudintermedius is an important pathogen in dogs that occasionally causes infections in humans as an opportunistic pathogen of elderly and immunocompromised people. This study compared the genomic relatedness and antimicrobial resistance genes using genome-wide association study (GWAS) to examine host association of canine and human S. pseudintermedius isolates. Canine ( n = 25) and human ( n = 32) methicillin-susceptible S. pseudintermedius (MSSP) isolates showed a high level of genetic diversity with an overrepresentation of clonal complex CC241 in human isolates. This clonal complex was associated with carriage of a plasmid containing a bacteriocin with cytotoxic properties, a CRISPR-cas domain and a pRE25-like mobile element containing five antimicrobial resistance genes. Multi-drug resistance (MDR) was predicted in 13 (41%) of human isolates and 14 (56%) of canine isolates. CC241 represented 54% of predicted MDR isolates from humans and 21% of predicted MDR canine isolates. While it had previously been suggested that certain host-specific genes were present the current GWAS analysis did not identify any genes that were significantly associated with human or canine isolates. In conclusion, this is the first genomic study showing that MSSP is genetically diverse in both hosts and that multidrug resistance is important in dog and human-associated S. pseudintermedius isolates.
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- 2021
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31. Transboundary Spread of Brucella canis through Import of Infected Dogs, the Netherlands, November 2016-December 2018.
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van Dijk MAM, Engelsma MY, Visser VXN, Keur I, Holtslag ME, Willems N, Meij BP, Willemsen PTJ, Wagenaar JA, Roest HIJ, and Broens EM
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- Animals, Dogs, Europe, Eastern, Netherlands, Romania, Brucella canis, Brucellosis, Dog Diseases
- Abstract
Brucella canis had not been isolated in the Netherlands until November 2016, when it was isolated from a dog imported from Romania. Including this case, 16 suspected cases were notified to the authorities during the following 25 months. Of these 16 dogs, 10 were seropositive; tracking investigations found another 8 seropositive littermates. All seropositive animals were rescue dogs imported from Eastern Europe. B. canis was cultured from urine, blood, and other specimens collected from the dogs. Genotyping of isolates revealed clustering by litter and country. Isolating B. canis in urine indicates that shedding should be considered when assessing the risk for zoonotic transmission. This case series proves introduction of B. canis into a country to which it is not endemic through import of infected dogs from B. canis-endemic areas, posing a threat to the naive autochthonous dog population and humans.
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- 2021
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32. Development and Pilot of an Interactive Online Course on Antimicrobial Stewardship in Companion Animals.
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Hopman NEM, Wagenaar JA, van Geijlswijk IM, and Broens EM
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A holistic approach to antimicrobial use (AMU) and prescribing is needed to combat the problem of antimicrobial resistance (AMR). Previously, an antimicrobial stewardship programme (ASP) was developed, introduced, and evaluated in 44 Dutch companion animal clinics, which resulted in an optimization of AMU. As a follow-up to this, an online course was developed to promote awareness of AMU, AMR, and responsible antimicrobial prescribing. The aim of this paper is to describe the development and pilot, including evaluation, of this course, which will be disseminated more widely among Dutch companion animal veterinarians. The interactive programme consists of a major e-learning component and two online, face-to-face meetings. The course comprises five different parts corresponding with five consecutive weeks. Theory on several topics is offered, for example on AMU and AMR in general, Dutch regulations and guidelines on veterinary AMU, behavioural change, and possible methods to quantify AMU. Additionally, several assignments are offered, for example to reflect upon one's own current antimicrobial prescribing behaviour. Interactive discussion and peer-to-peer learning are promoted. Since September 2020, the course has been offered in a pilot phase, and the feedback is promising. Evaluation of the pilot phase will result in recommendations for further optimization and dissemination.
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- 2021
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33. Driving Laboratory Standardization of Bacterial Culture and Antimicrobial Susceptibility Testing in Veterinary Clinical Microbiology in Europe and Beyond.
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Timofte D, Broens EM, Guardabassi L, Pomba C, Allerton F, Ikonomopoulos J, Overesch G, and Damborg P
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- Animals, Bacteria, Europe, Humans, Microbial Sensitivity Tests, Reference Standards, Anti-Infective Agents pharmacology, Laboratories
- Abstract
Globally, antimicrobial resistance is one of the most important public health challenges in which the clinical microbiology laboratory plays a critical role by providing guidance for antimicrobial treatment. Despite the recognition of its importance, there is still a real need for the standardized training of clinical microbiologists and harmonization of diagnostic procedures. This is particularly true for veterinary clinical microbiology, where additional challenges exist when microbiologists are trying to fulfill a professional role very similar to that of their colleagues working in human microbiology laboratories. The specific points that need addressing to improve the outputs of veterinary microbiology laboratories discussed here include (i) harmonization of methodologies used by veterinary laboratories for antimicrobial susceptibility testing (AST); (ii) specific guidelines for interpretation and reporting of AST results for animal pathogens; (iii) guidelines for detection of antimicrobial resistance mechanisms in animal isolates; (iv) standardization of diagnostic procedures for animal clinical specimens; and (v) the need to train more veterinary clinical microbiology specialists. However, there is now a plan to address these issues, led by the European Network for Optimization of Veterinary Antimicrobial Treatment (ENOVAT), which is bringing together experts in veterinary microbiology, pharmacology, epidemiology, and antimicrobial stewardship from Europe and wider afield. ENOVAT is aiming to work with project partners toward standardization and harmonization of laboratory methodologies and optimization of veterinary antimicrobial treatment. Ultimately, the project may provide a mechanism for standardization and harmonization of veterinary clinical microbiology methodologies that could then be used as a template for implementation at a wider international level., (Copyright © 2021 Timofte et al.)
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- 2021
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34. Serologic Screening of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Cats and Dogs during First Coronavirus Disease Wave, the Netherlands.
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Zhao S, Schuurman N, Li W, Wang C, Smit LAM, Broens EM, Wagenaar JA, van Kuppeveld FJM, Bosch BJ, and Egberink H
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- Animals, Cats, Dogs, Humans, Mink, Netherlands epidemiology, Seroepidemiologic Studies, COVID-19, SARS-CoV-2
- Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can infect many animal species, including minks, cats, and dogs. To gain insights into SARS-CoV-2 infections in cats and dogs, we developed and validated a set of serologic assays, including ELISA and virus neutralization. Evaluation of samples from animals before they acquired coronavirus disease and samples from cats roaming SARS-CoV-2-positive mink farms confirmed the suitability of these assays for specific antibody detection. Furthermore, our findings exclude SARS-CoV-2 nucleocapsid protein as an antigen for serologic screening of cat and dog samples. We analyzed 500 serum samples from domestic cats and dogs in the Netherlands during April-May 2020. We showed 0.4% of cats and 0.2% of dogs were seropositive. Although seroprevalence in cats and dogs that had unknown SARS-CoV-2 exposure was low during the first coronavirus disease wave, our data stress the need for development of continuous serosurveillance for SARS-CoV-2 in these 2 animal species.
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- 2021
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35. Seal finger following a photography incident.
- Author
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Sips GJ, Bakashvili N, Broens EM, and Schurink CAM
- Published
- 2021
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36. Building the European Antimicrobial Resistance Surveillance network in veterinary medicine (EARS-Vet).
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Mader R, Damborg P, Amat JP, Bengtsson B, Bourély C, Broens EM, Busani L, Crespo-Robledo P, Filippitzi ME, Fitzgerald W, Kaspar H, Madero CM, Norström M, Nykäsenoja S, Pedersen K, Pokludova L, Urdahl AM, Vatopoulos A, Zafeiridis C, and Madec JY
- Subjects
- Animals, Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents therapeutic use, Bacteria, Drug Resistance, Bacterial, Antimicrobial Stewardship, One Health
- Abstract
Antimicrobial resistance (AMR) should be tackled through a One Health approach, as stated in the World Health Organization Global Action Plan on AMR. We describe the landscape of AMR surveillance in the European Union/European Economic Area (EU/EEA) and underline a gap regarding veterinary medicine. Current AMR surveillance efforts are of limited help to veterinary practitioners and policymakers seeking to improve antimicrobial stewardship in animal health. We propose to establish the European Antimicrobial Resistance Surveillance network in Veterinary medicine (EARS-Vet) to report on the AMR situation, follow AMR trends and detect emerging AMR in selected bacterial pathogens of animals. This information could be useful to advise policymakers, explore efficacy of interventions, support antimicrobial stewardship initiatives, (re-)evaluate marketing authorisations of antimicrobials, generate epidemiological cut-off values, assess risk of zoonotic AMR transmission and evaluate the burden of AMR in animal health. EARS-Vet could be integrated with other AMR monitoring systems in the animal and medical sectors to ensure a One Health approach. Herein, we present a strategy to establish EARS-Vet as a network of national surveillance systems and highlight challenges of data harmonisation and bias. Strong political commitment at national and EU/EEA levels is required for the success of EARS-Vet.
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- 2021
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37. Clindamycin resistance of skin derived Staphylococcus pseudintermedius is higher in dogs with a history of antimicrobial therapy.
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van Damme CMM, Broens EM, Auxilia ST, and Schlotter YM
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- Animals, Anti-Bacterial Agents administration & dosage, Clindamycin administration & dosage, Dog Diseases drug therapy, Dogs, Female, Male, Netherlands epidemiology, Prevalence, Retrospective Studies, Staphylococcal Infections drug therapy, Staphylococcal Infections epidemiology, Anti-Bacterial Agents pharmacology, Clindamycin pharmacology, Drug Resistance, Multiple, Bacterial, Skin microbiology, Staphylococcal Infections veterinary, Staphylococcus drug effects
- Abstract
Background: In the Netherlands there is a lack of data regarding resistance of Staphylococcus pseudintermedius to the systemic antimicrobial drugs used for the treatment of superficial pyoderma., Objectives: To assess antimicrobial resistance, with emphasis on resistance to clindamycin and meticillin, in clinical isolates of S. pseudintermedius isolated from dogs with superficial pyoderma. Results were compared between dogs with and without a history of systemic antimicrobial therapy during the previous year., Animals: A retrospective study of 237 referral cases presented to an academic teaching hospital between 2014 and 2019, with the clinical and microbiological diagnosis of superficial pyoderma., Methods and Materials: All clinical isolates were identified primarily by MALDI-TOF mass spectrometry. Antimicrobial susceptibility was tested either by an agar diffusion method (2014-2016) or by broth microdilution. Antimicrobial history in the preceding year was obtained from medical records., Results: Meticillin-resistant S. pseudintermedius (MRSP) was isolated from 8% of superficial pyoderma cases. Within the meticillin-susceptible S. pseudintermedius (MSSP) population, clindamycin resistance was significantly more common in isolates derived from dogs with histories of antimicrobial treatment (37.7%) compared to dogs with no histories of exposure (21.7%; P = 0.03)., Conclusions: Given the high prevalence of clindamycin resistance in MSSP isolated from dogs with prior antimicrobial exposure, it is recommended that bacterial culture and susceptibility testing be pursued before prescribing systemic antimicrobials. Clindamycin should be regarded as the preferred treatment option if susceptibility is confirmed, due to its narrow spectrum and reduced selective pressure for MRSP., (© 2020 The Authors. Veterinary Dermatology published by John Wiley & Sons Ltd on behalf of the European Society of Veterinary Dermatology and the American College of Veterinary.)
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- 2020
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38. Leptospira infection and shedding in dogs in Thailand.
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Altheimer K, Jongwattanapisan P, Luengyosluechakul S, Pusoonthornthum R, Prapasarakul N, Kurilung A, Broens EM, Wagenaar JA, Goris MGA, Ahmed AA, Pantchev N, Reese S, and Hartmann K
- Subjects
- Animals, Antibodies, Bacterial, Dog Diseases epidemiology, Dogs, Humans, Leptospira genetics, Leptospirosis epidemiology, Leptospirosis microbiology, Leptospirosis urine, Phylogeny, Risk Factors, Thailand epidemiology, Zoonoses, Bacterial Shedding, Dog Diseases microbiology, Leptospira physiology, Leptospirosis veterinary
- Abstract
Background: Leptospirosis is a widespread zoonosis and has been recognized as a re-emerging infectious disease in humans and dogs, but prevalence of Leptospira shedding in dogs in Thailand is unknown. The aim of this study was to determine urinary shedding of Leptospira in dogs in Thailand, to evaluate antibody prevalence by microscopic agglutination test (MAT) and enzyme-linked immunosorbent assay (ELISA), and to assess risk factors for Leptospira infection. In Northern, Northeastern, and Central Thailand, 273 stray (n = 119) or client-owned (n = 154) dogs from rural (n = 139) or urban (n = 134) areas were randomly included. Dogs that had received antibiotics within 4 weeks prior to sampling were excluded. No dog had received vaccination against Leptospira. Urine was evaluated by real-time polymerase chain reaction (PCR) specific for lipL32 gene of pathogenic Leptospira. Additionally, urine was cultured for 6 months in Ellinghausen-McCullough-Johnson-Harris (EMJH) medium. Antibodies were measured by ELISA and MAT against 24 serovars belonging to 15 serogroups and 1 undesignated serogroup. Risk factor analysis was performed with backwards stepwise selection based on Wald., Results: Twelve of 273 (4.4%; 95% confidence interval (CI): 2.0-6.8%) urine samples were PCR-positive. In 1/273 dogs (0.4%; 95% CI: 0.01-1.1%) Leptospira could be cultured from urine. MAT detected antibodies in 33/273 dogs (12.1%; 95% CI: 8.2-16.0%) against 19 different serovars (Anhoa, Australis, Ballum, Bataviae, Bratislava, Broomi, Canicola, Copenhageni, Coxi, Grippotyphosa, Haemolytica, Icterohaemorrhagiae, Khorat, Paidjan, Patoc, Pyrogenes, Rachmati, Saxkoebing, Sejroe). In 111/252 dogs (44.0%; 95% CI: 37.9-50.2%) immunoglobulin M (IgM) and/or immunoglobulin G (IgG) antibodies were found by ELISA. Female dogs had a significantly higher risk for Leptospira infection (p = 0.023)., Conclusions: Leptospira shedding occurs in randomly sampled dogs in Thailand, with infection rates comparable to those of Europe and the USA. Therefore, the potential zoonotic risk should not be underestimated and use of Leptospira vaccines are recommended.
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- 2020
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39. Specific staphylococcal cassette chromosome mec (SCCmec) types and clonal complexes are associated with low-level amoxicillin/clavulanic acid and cefalotin resistance in methicillin-resistant Staphylococcus pseudintermedius.
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Wegener A, Damborg P, Guardabassi L, Moodley A, Mughini-Gras L, Duim B, Wagenaar JA, and Broens EM
- Subjects
- Amoxicillin-Potassium Clavulanate Combination, Animals, Anti-Bacterial Agents pharmacology, Cephalothin, Chromosomes, Dogs, Methicillin Resistance, Microbial Sensitivity Tests, Multilocus Sequence Typing, Netherlands, Staphylococcus, Dog Diseases, Methicillin-Resistant Staphylococcus aureus, Staphylococcal Infections epidemiology, Staphylococcal Infections veterinary
- Abstract
Background: Staphylococcus pseudintermedius is a common pathogen in dogs and methicillin resistance has emerged over recent decades. According to the current guidelines, S. pseudintermedius displaying oxacillin resistance should be reported as resistant to all β-lactams., Objectives: To identify possible associations between β-lactam resistance levels and clonal complexes (CCs) and/or staphylococcal cassette chromosome mec (SCCmec) types in methicillin-resistant S. pseudintermedius (MRSP)., Methods: MICs of oxacillin, penicillin, ampicillin, amoxicillin/clavulanic acid and cefalotin were determined by broth microdilution for 86 clinical canine MRSP isolates from Denmark and the Netherlands. PCR and sequencing were used for SCCmec typing and MLST., Results: Isolates belonged to CC71 (n = 36), CC258 (n = 33), CC45 (n = 11), CC68 (n = 1) and five singleton STs. SCCmecII-III was exclusively found in CC71 and SCCmecIV was significantly associated with CC258. SCCmecV and non-typeable SCCmec types occurred in 4 and 14 isolates, respectively. SCCmecIV was associated with lower MICs of oxacillin (<2 mg/L), ampicillin (<8 mg/L) and amoxicillin/clavulanic acid (<4 mg/L) and with susceptibility to cefalotin (<4 mg/L). All isolates harbouring SCCmecV were susceptible to cefalotin as well., Conclusions: SCCmec types were associated with different CCs and with either high- or low-level resistance to different β-lactams. The finding of amoxicillin/clavulanic acid (20%) and cefalotin (70%) in vitro susceptibility across all CCs might have clinical implications, since amoxicillin/clavulanic acid and first-generation cephalosporins are first-choice antibiotics for treatment of S. pseudintermedius infections. Pharmacokinetic/pharmacodynamic and clinical outcome studies are warranted to evaluate the in vivo efficacy of these β-lactams for treatment of MRSP infections., (© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2020
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40. Implementation and evaluation of an antimicrobial stewardship programme in companion animal clinics: A stepped-wedge design intervention study.
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Hopman NEM, Portengen L, Hulscher MEJL, Heederik DJJ, Verheij TJM, Wagenaar JA, Prins JM, Bosje T, Schipper L, van Geijlswijk IM, and Broens EM
- Subjects
- Animals, Drug Resistance, Microbial, Humans, Netherlands epidemiology, Prospective Studies, Anti-Infective Agents administration & dosage, Antimicrobial Stewardship, Hospitals, Animal
- Abstract
Background: To curb increasing resistance rates, responsible antimicrobial use (AMU) is needed, both in human and veterinary medicine. In human healthcare, antimicrobial stewardship programmes (ASPs) have been implemented worldwide to improve appropriate AMU. No ASPs have been developed for and implemented in companion animal clinics yet., Objectives: The objective of the present study was to implement and evaluate the effectiveness of an ASP in 44 Dutch companion animal clinics. The objectives of the ASP were to increase awareness on AMU, to decrease total AMU whenever possible and to shift AMU towards 1st choice antimicrobials, according to Dutch guidelines on veterinary AMU., Methods: The study was designed as a prospective, stepped-wedge, intervention study, which was performed from March 2016 until March 2018. The multifaceted intervention was developed using previous qualitative and quantitative research on current prescribing behaviour in Dutch companion animal clinics. The number of Defined Daily Doses for Animal (DDDAs) per clinic (total, 1st, 2nd and 3rd choice AMU) was used to quantify systemic AMU. Monthly AMU data were described using a mixed effect time series model with auto-regression. The effect of the ASP was modelled using a step function and a change in the (linear) time trend., Results: A statistically significant decrease of 15% (7%-22%) in total AMU, 15% (5%-24%) in 1st choice AMU and 26% (17%-34%) in 2nd choice AMU was attributed to participation in the ASP, on top of the already ongoing time trends. Use of 3rd choice AMs did not significantly decrease by participation in the ASP. The change in total AMU became more prominent over time, with a 16% (4%-26%) decrease in (linear) time trend per year., Conclusions: This study shows that, although AMU in Dutch companion animal clinics was already decreasing and changing, AMU could be further optimised by participation in an antimicrobial stewardship programme., Competing Interests: The authors have declared that no competing interests exist.
- Published
- 2019
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41. Attitudes and perceptions of Dutch companion animal veterinarians towards antimicrobial use and antimicrobial resistance.
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Hopman NEM, Mughini-Gras L, Speksnijder DC, Wagenaar JA, van Geijlswijk IM, and Broens EM
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- Animals, Netherlands, Pets, Veterinarians statistics & numerical data, Anti-Infective Agents therapeutic use, Attitude, Clinical Competence statistics & numerical data, Drug Resistance, Microbial, Perception, Veterinarians psychology
- Abstract
Antimicrobial use (AMU) in humans and animals facilitates the emergence of antimicrobial resistance (AMR). With increasing AMR being recognised as a major global threat for public health, responsible AMU is strongly advocated in both human and veterinary medicine. Knowledge on factors influencing antimicrobial prescribing behaviour of companion animal veterinarians is needed to promote responsible AMU in companion animals and to improve compliance with current legislation and guidelines. The present study aimed to quantitively investigate attitudes and perceptions of companion animal veterinarians towards AMU and AMR and to identify associations with demographic characteristics as possible explanatory variables. A self-administered questionnaire was developed based upon an earlier qualitative interview study, and 1608 potential participants (i.e. practising companion animal veterinarians) were invited. The questionnaire included questions addressing general descriptives of the respondents and questions with 6-point Likert scale statements, to assess attitudes towards AMU, AMR, factors influencing antimicrobial prescribing, and possible options to support responsible AMU. The response rate was 32% (22% when complete questionnaires considered). Categorical Principal Component Analysis (CATPCA) was conducted on 76 Likert scale questions. This resulted in a final model with 37 questions explaining 38.7% of the variance of the question scores, with three underlying dimensions ("attitudinal profiles"). Additionally, general descriptives were added to the CATPCA as possible explanatory variables. The first dimension, related to "social responsibility" was positively associated with veterinarians working in clinics dedicated to companion animals, with veterinarians working in a referral clinic, and with more experienced veterinarians. The second dimension was related to "scepticism", which was positively associated with being a male veterinarian and with more experienced veterinarians. The third dimension was related to "risk avoidance", especially regarding surgical procedures, and was negatively associated with veterinarians working in clinics in urban areas and with veterinarians working part-time. Antimicrobial prescribing behaviour was self-reported to be well considered, and respondents did not see economic drivers as important influencing factors. The unwillingness of owners and financial constraints were perceived as important barriers for performing further diagnostics. To improve AMU, a multifaceted approach, taking differences between companion animal veterinarians (e.g., in experience and gender) and differences in work situation (e.g., full-time versus part-time) into account, should be directed at companion animal veterinarians and owners. Moreover, a joint and comprehensive effort of several stakeholders, like veterinary nurses, guideline developers, pharmaceutical industry, and providers of diagnostics, is needed to optimise AMU in companion animals., (Copyright © 2019 Elsevier B.V. All rights reserved.)
- Published
- 2019
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42. Time trends, seasonal differences and determinants of systemic antimicrobial use in companion animal clinics (2012-2015).
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Hopman NEM, Portengen L, Heederik DJJ, Wagenaar JA, Van Geijlswijk IM, and Broens EM
- Subjects
- Administration, Intravenous, Animals, Cats, Dogs, Female, Male, Rabbits, Retrospective Studies, Surveys and Questionnaires, Anti-Infective Agents therapeutic use, Hospitals, Animal statistics & numerical data, Hospitals, Animal trends, Pets, Seasons
- Abstract
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., (Copyright © 2019 Elsevier B.V. All rights reserved.)
- Published
- 2019
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43. Quantifying Antimicrobial Use in Dutch Companion Animals.
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Hopman NEM, van Dijk MAM, Broens EM, Wagenaar JA, Heederik DJJ, and van Geijlswijk IM
- Abstract
Antimicrobial resistance (AMR) is an increasing threat, both in human and in veterinary medicine. To reduce the selection and spread of AMR, antimicrobial use (AMU) should be optimized, also in companion animals. To be able to optimize AMU, a feasible method to quantify AMU and information on current AMU are needed. Therefore, a method to quantify AMU was developed, using the number of Defined Daily Doses Animal (DDDA). This method was used to explore applied antimicrobial classes and to identify differences in prescribing patterns in time and between veterinary clinics. Antimicrobial procurement data of the years 2012-2014 were collected retrospectively from 100 Dutch veterinary clinics providing care for companion animals. The mean number of DDDAs per clinic per year decreased significantly from 2012 to 2014. A shift in used classes of antimicrobials (AMs) was seen as well, with a significant decrease in use of third choice AMs (i.e., fluoroquinolones and third generation cephalosporins). Large differences in total AMU were seen between clinics ranging from 64-fold in 2012 to 20-fold in 2014. Despite the relative low and decreasing AMU in Dutch companion animal clinics during the study, the substantial differences in antimicrobial prescribing practices between clinics suggest that there is still room for quantitative and qualitative optimization of AMU.
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- 2019
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44. The bacterial and fungal microbiome of the skin of healthy dogs and dogs with atopic dermatitis and the impact of topical antimicrobial therapy, an exploratory study.
- Author
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Chermprapai S, Ederveen THA, Broere F, Broens EM, Schlotter YM, van Schalkwijk S, Boekhorst J, van Hijum SAFT, and Rutten VPMG
- Subjects
- Administration, Topical, Animals, Case-Control Studies, DNA, Bacterial genetics, DNA, Ribosomal Spacer genetics, Dermatitis, Atopic microbiology, Dogs, Female, Male, RNA, Bacterial genetics, RNA, Ribosomal, 16S genetics, Anti-Bacterial Agents therapeutic use, Dermatitis, Atopic veterinary, Dog Diseases microbiology, Skin microbiology
- Abstract
Canine atopic dermatitis is a genetically predisposed inflammatory and pruritic allergic skin disease that is often complicated by (secondary) bacterial and fungal (yeast) infections. High-throughput DNA sequencing was used to characterize the composition of the microbiome (bacteria and fungi) inhabiting specific sites of skin in healthy dogs and dogs with atopic dermatitis (AD) before and after topical antimicrobial treatment. Skin microbiome samples were collected from six healthy control dogs and three dogs spontaneously affected by AD by swabbing at (non-) predilection sites before, during and after treatment. Bacteria and fungi were profiled by Illumina sequencing of the 16S ribosomal RNA gene of bacteria (16S) and the internally transcribed spacer of the ribosomal gene cassette in fungi (ITS). The total cohort of dogs showed a high diversity of microbes on skin with a strong individual variability of both 16S and ITS profiles. The genera of Staphylococcus and Porphyromonas were dominantly present both on atopic and healthy skin and across all skin sites studied. In addition, bacterial and fungal alpha diversity were similar at the different skin sites. The topical antimicrobial treatment increased the diversity of bacterial and fungal compositions in course of time on both AD and healthy skin., (Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.)
- Published
- 2019
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45. Comparative genomics of phenotypic antimicrobial resistances in methicillin-resistant Staphylococcus pseudintermedius of canine origin.
- Author
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Wegener A, Broens EM, Zomer A, Spaninks M, Wagenaar JA, and Duim B
- Subjects
- Animals, Anti-Bacterial Agents pharmacology, Dog Diseases epidemiology, Dog Diseases microbiology, Dogs microbiology, Genome, Bacterial, Genotype, Microbial Sensitivity Tests, Multilocus Sequence Typing, Netherlands epidemiology, Phylogeny, Point Mutation, Staphylococcal Infections epidemiology, Staphylococcal Infections microbiology, Staphylococcus drug effects, Staphylococcus isolation & purification, Whole Genome Sequencing, Drug Resistance, Multiple, Bacterial genetics, Genomics, Methicillin Resistance genetics, Phenotype, Staphylococcal Infections veterinary, Staphylococcus genetics
- Abstract
Staphylococcus pseudintermedius is an important pathogen in dogs. Since 2004, methicillin- resistant S. pseudintermedius (MRSP) isolates, often multidrug resistant, have been observed in dogs in the Netherlands. This study aims to link the observed resistance phenotypes in canine MRSP to genotypic antimicrobial resistance markers, and to study the phylogeny of MRSP by genomic comparisons. The genomes of fifty clinical isolates of MRSP from dogs from the Netherlands were sequenced. The resistance genes were identified, and for twenty one different antimicrobials their presence and sequence were associated with the resistance phenotypes. In case of observed discrepancies, the genes were aligned with reference genes. Of the phenotypic resistances, 98.3% could be explained by the presence of an associated resistance gene or point mutation. Discrepancies were mainly resistance genes present in susceptible isolates; 43.8% (7/16) were explained by an insertion, deletion or mutation in the gene. In relation with the resistance gene presence or absence, a single-nucleotide polymorphism (SNP) based phylogeny was constructed to define the population dynamics. The resistance gene content differed according to clonal complex, from very conserved (CC45), to partly conserved (CC71) to highly diverse (CC258) resistance gene patterns. In conclusion, this study shows that the antimicrobial genotype from whole genome sequencing is highly predictive of the resistance phenotype in MRSP. Interestingly, the observed clonal complexes of MRSP isolates were linked with resistance gene patterns., (Copyright © 2018 Elsevier B.V. All rights reserved.)
- Published
- 2018
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46. Factors influencing antimicrobial prescribing by Dutch companion animal veterinarians: A qualitative study.
- Author
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Hopman NEM, Hulscher MEJL, Graveland H, Speksnijder DC, Wagenaar JA, and Broens EM
- Subjects
- Animals, Drug Prescriptions statistics & numerical data, Netherlands, Anti-Infective Agents therapeutic use, Drug Prescriptions veterinary, Pets, Practice Patterns, Physicians' statistics & numerical data, Veterinarians statistics & numerical data
- Abstract
Use of antimicrobials selects for antimicrobial resistance, and this poses a threat for both human and animal health. Although previous studies show that total antimicrobial use in Dutch companion animal clinics is relatively low and decreasing, the majority of antimicrobials prescribed are categorised as critically important for human medicine by the World Health Organization (WHO). Large differences in use between clinics are also observed. Identification of factors that influence the prescribing behaviour of veterinarians is needed to tailor future interventions aimed at promoting prudent use of antimicrobials in companion animals. The aim of this study was to explore factors influencing the antimicrobial prescribing behaviour of companion animal veterinarians in the Netherlands. Face-to-face, semi-structured interviews were used to interview 18 Dutch companion animal veterinarians. Interviews were held until theoretical data saturation was reached. An interview guide was used to structure the interviews, and ATLAS.ti 7.5 was used to manage and analyse the qualitative data. An iterative approach was applied to develop a conceptual model of factors that influence antimicrobial prescribing behaviour. The conceptual model shows four major categories of factors that influence the antimicrobial prescribing behaviour: veterinarian-related factors, patient-related (i.e. owner- and pet-related) factors, treatment-related factors (i.e. alternative treatment options and antimicrobial-related factors) and contextual factors (i.e. professional interactions, further diagnostics and environmental factors). All four major categories of influencing factors should be addressed to improve awareness on antimicrobial prescribing behaviour and to develop an antimicrobial stewardship programme for companion animal clinics., (Copyright © 2018 Elsevier B.V. All rights reserved.)
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- 2018
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47. Characterization of Staphylococcus aureus isolated from milk samples of dairy cows in small holder farms of North-Western Ethiopia.
- Author
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Mekonnen SA, Lam TJGM, Hoekstra J, Rutten VPMG, Tessema TS, Broens EM, Riesebos AE, Spaninks MP, and Koop G
- Subjects
- Animals, Anti-Bacterial Agents, Bacterial Toxins genetics, Cattle, Dairying, Enterotoxins genetics, Ethiopia epidemiology, Female, Leukocidins, Microbial Sensitivity Tests, Multilocus Sequence Typing, Staphylococcal Infections epidemiology, Staphylococcal Infections microbiology, Superantigens genetics, Virulence Factors genetics, Mastitis, Bovine microbiology, Milk microbiology, Staphylococcal Infections veterinary, Staphylococcus aureus genetics
- Abstract
Background: Staphylococcus aureus is a contagious, opportunistic pathogen that causes clinical or subclinical mastitis in dairy cattle. The genetic background and antimicrobial resistance of isolates from Ethiopian dairy farms has not been studied. Therefore, the aim of this study was to characterize S. aureus from Ethiopian hand milked dairy cows, by spa, MLST and virulence factor typing, and by assessment of antimicrobial susceptibility. A total of 79 S. aureus isolates from intramammary infections was studied. A PCR was used to detect lukM-lukF' and pvl genes encoding the bovine and human associated bi-component leukocidins, and the toxic shock syndrome toxin gene-1 (tst). Antimicrobial susceptibility was determined using the broth microdilution method., Results: Twenty different spa types were identified, most isolates were t042 (58%), and the closely related t15786 (11%). The proportion of isolates positive for lukM-lukF', tst and pvl was low at 0.04, 0.10 and 0.09 respectively, with lukM-lukF' often co-occurring with tst, but not with pvl. Methicillin-resistance was not found, but resistance to penicillin/ampicillin (86%) and tetracycline (54%) was very common., Conclusions: We found a high degree of relatedness among bovine S. aureus isolates in North-Western Ethiopia, suggesting contagious within and between farm transmission of strains that are often resistant to commonly used antimicrobials. This highlights the need for effective preventive measures that aim at limiting transmission of bacteria rather than using antimicrobials to control S. aureus mastitis in Ethiopia.
- Published
- 2018
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48. Response to a Salmonella Enteritidis challenge in old laying hens with different vaccination histories.
- Author
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van de Reep L, Nielen M, Verstappen KMHW, Broens EM, van den Broek J, and Velkers FC
- Subjects
- Animals, Cecum microbiology, Female, Liver microbiology, Salmonella Infections, Animal immunology, Spleen microbiology, Chickens immunology, Poultry Diseases immunology, Salmonella Vaccines immunology, Salmonella enteritidis immunology, Salmonella typhimurium immunology, Vaccination veterinary
- Abstract
Extending the laying period of laying hens is beneficial for economic and sustainability purposes. Because vaccines were designed with a shorter laying period envisaged, it is unclear whether current Salmonella vaccines can provide sufficient levels of protection against infection at an older age. The purpose of this experiment was to determine the efficacy of early rearing vaccination schemes against Salmonella challenge late in the laying period. There were four treatment groups: birds that had not been vaccinated (Group 1), birds vaccinated with live Salmonella Enteritidis (SE) (Group 2), with live and inactivated SE (Group 3), or with live SE and live Salmonella Typhimurium (Group 4). At the end of the laying period, the birds were transported from the laying farm to the research facility where they were orally challenged with 2.06 × 109 colony-forming units SE at around 82 wk of age. Hens were euthanized and bacteriology was performed on cecum, liver, spleen, and follicular fluid samples to determine SE colonization 7 and 14 d after challenge. Clinical and bacteriological findings of hens vaccinated with different vaccination schemes and the non-vaccinated control group were compared. No significant differences in SE colonization were found for vaccinated groups compared to the non-vaccinated control group. This may be a result of waning immunity due to the long time between vaccination and challenge. Also, as vaccination took place in the rearing period in the field, initial levels of immunity may not have been optimal due to shortcomings in the vaccination technique. Furthermore, the results of this study may have been affected by differences in age, breed, and origin between the groups. Therefore, controlled studies from early age onwards are necessary for more accurate comparisons between vaccines.
- Published
- 2018
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49. Brucella suis Infection in Dog Fed Raw Meat, the Netherlands.
- Author
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van Dijk MAM, Engelsma MY, Visser VXN, Spierenburg MAH, Holtslag ME, Willemsen PTJ, Wagenaar JA, Broens EM, and Roest HIJ
- Subjects
- Animals, Dog Diseases transmission, Dogs, Genes, Bacterial, Genotype, Humans, Multilocus Sequence Typing, Netherlands epidemiology, Phylogeny, Animal Feed microbiology, Brucella suis classification, Brucella suis genetics, Brucellosis veterinary, Dog Diseases epidemiology, Dog Diseases microbiology, Meat microbiology
- Abstract
A Brucella suis biovar 1 infection was diagnosed in a dog without typical exposure risks, but the dog had been fed a raw meat-based diet (hare carcasses imported from Argentina). Track and trace investigations revealed that the most likely source of infection was the dog's raw meat diet.
- Published
- 2018
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50. Prudent Use of Antimicrobials in Exotic Animal Medicine.
- Author
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Broens EM and van Geijlswijk IM
- Subjects
- Animals, Animals, Exotic, Anti-Infective Agents administration & dosage, Veterinary Drugs administration & dosage
- Abstract
Reduction of antimicrobial use can result in reduction of resistance in commensal bacteria. In exotic animals, information on use of antimicrobials and resistance in commensals and pathogens is scarce. However, use of antimicrobials listed as critically important antimicrobials for human medicine seems high in exotic animals. Ideally, the selection of a therapy should be based on an accurate diagnosis and antimicrobial susceptibility testing. When prescribing antimicrobials based on empiricism, knowledge of the most common pathogens causing specific infections and the antimicrobial spectrum of antimicrobial agents is indispensable. Implementing antimicrobial stewardship promotes the prudent use of antimicrobials in exotic animals., (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Published
- 2018
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