Today's Veterinary Practice

MAY-JUN 2018

Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.

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77 MAY/JUNE 2018 ‚óŹ TVPJOURNAL.COM CLINICAL INSIGHTS Staphylococcus aureus is a human-host adapted, Gram-positive bacteria commonly found on the skin and in the nasal passages of people. Often considered a commensal organism, it is also an opportunistic pathogen, causing skin and invasive infections. Methicillin-resistant S. aureus (MRSA) was first reported in the early 1960s, shortly after the introduction of methicillin. In the late 1970s, MRSA infection rates increased dramatically, mainly occurring in hospitalized patients. In the 1990s, another significant change occurred when MRSA infections acquired in the community among previously healthy individuals were recognized. 1 These two sources of MRSA are now referred to as HA-MRSA (health care- associated) and CA-MRSA (community-associated). In contrast, S. aureus is not host-adapted to dogs or cats. For this reason, when a pet is colonized with S. aureus, including both methicillin- resistant and methicillin-susceptible strains, the bacteria does not generally persist in the pet for more than a few weeks. 2,3 The most frequent commensal Staphylococcus in dogs and cats is S. pseudintermedius, which can also be methicillin- resistant (MRSP). While S. pseudintermedius or MRSP can transiently colonize people, infections are rare. 4,5 MRSA and MRSP can be thought of as mirror images, host-adapted to people or pets respectively, but with rare occurrences of colonizing or infecting the other group. Though the focus here is MRSA, infection control recommendations apply equally to minimizing transmission of MRSP within a clinic, and to staff and owners. It is important to understand the difference between colonization (carrier) and infection. Both animals and people can be colonized with MRSA, meaning the bacteria is present on skin or in nasal passages, but is not causing infection or disease.6 However, MRSA is also capable of causing infections in people and animals. In people, MRSA most often causes skin and soft tissue infections, sometimes with serious complications1. In dogs and cats, MRSA is most often associated with skin, wound or surgical site infections, otitis, or urinary tract infections. 1,7 MRSA in dogs and cats is generally acquired from people. The strains found in pets closely match those found in people in that geographic region.7 Colonization rates of MRSA in cats and dogs normally range from 0-4%; however, colonization rates in specific populations may be as high as 7-9%.1 Primary risk factors for MRSA colonization in pets are contact with an MRSA-infected person, repeated courses of antimicrobials, visiting a veterinary facility, surgery, or hospitalization for several days. 7,8 MRSA in the Veterinary Clinic: Management of Pets and People Malia Ireland, DVM, MPH, Leslie Kollmann, BS, CVT, AAS, Joni Scheftel, DVM, MPH, DACVPM MANAGEMENT STRATEGIES shutterstock.com/Tatiana Shepeleva

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