Claire R Burbick1, Trevor L Alexander1, Rebecca Wolking1, Tamara Gull1, Olgica Ceric1, Renate Reimschuessel1. 1. Washington Animal Disease Diagnostic Laboratory, Washington State University, 1940 SE Olympia Ave, Pullman, Washington 99164, USA (Burbick, Alexander, Wolking); Department of Veterinary Microbiology and Pathology, Washington State University, PO Box 647040, Pullman, Washington 99164, USA (Burbick); Veterinary Medical Diagnostic Laboratory, University of Missouri, PO Box 6023, Columbia, Missouri 65205, USA (Gull); Veterinary Laboratory Investigation and Response Network, Center for Veterinary Medicine, United States Food and Drug Administration, 8491 Muirkirk Road, Laurel, Maryland 20708, USA (Ceric, Reimschuessel).
Abstract
Objective: Carbapenems are broad-spectrum β-lactams with excellent activity against multidrug-resistant (MDR) Enterobacterales. Unfortunately, resistance to carbapenems within this bacterial family, known as carbapenem-resistant Enterobacterales (CRE), occurs and challenges the ability to treat difficult MDR infections. Although the impact of carbapenem-resistance has been greatest in human medicine, reports in the veterinary literature are increasing especially as national veterinary antimicrobial resistance surveillance programs are now in place. In this brief communication, we report the isolation of a non-carbapenemase-producing, carbapenem-resistant Klebsiella pneumoniae from the urine of a dog, discuss the likely mechanism of resistance, and wider implications. Animal: Canine. Procedure: Whole genome sequencing and phenotypic antimicrobial susceptibility testing was performed on a K. pneumoniae isolated from the urine of a dog. Results: Antimicrobial susceptibility testing identified phenotypic resistance to imipenem and meropenem. Phenotypic detection of carbapenemase production was negative. Whole genome sequencing identified efflux pump genes associated with carbapenem resistance and point mutations in membrane porin genes. No carbapenemase gene was identified. Conclusion: Phenotypic antimicrobial susceptibility testing identified the K. pneumoniae as a non-carbapenemase producing carbapenem-resistant organism with the proposed genotypic mechanism including alteration of efflux pumps and membrane porin activity and/or expression. Clinical significance: Currently, there is limited use of carbapenem antimicrobial drugs in veterinary medicine, and practitioners may be unfamiliar or unaware of this type of resistance, its significance on routine antimicrobial susceptibility test reports, and implications for antimicrobial therapy and public health. Carbapenem-resistant Enterobacterales are infrequently isolated from companion animals; however, due to increasing adoption of advanced medical and surgical interventions, they may become more prevalent. Copyright and/or publishing rights held by the Canadian Veterinary Medical Association.
Objective: Carbapenems are broad-spectrum β-lactams with excellent activity against multidrug-resistant (MDR) Enterobacterales. Unfortunately, resistance to carbapenems within this bacterial family, known as carbapenem-resistant Enterobacterales (CRE), occurs and challenges the ability to treat difficult MDR infections. Although the impact of carbapenem-resistance has been greatest in human medicine, reports in the veterinary literature are increasing especially as national veterinary antimicrobial resistance surveillance programs are now in place. In this brief communication, we report the isolation of a non-carbapenemase-producing, carbapenem-resistant Klebsiella pneumoniae from the urine of a dog, discuss the likely mechanism of resistance, and wider implications. Animal: Canine. Procedure: Whole genome sequencing and phenotypic antimicrobial susceptibility testing was performed on a K. pneumoniae isolated from the urine of a dog. Results: Antimicrobial susceptibility testing identified phenotypic resistance to imipenem and meropenem. Phenotypic detection of carbapenemase production was negative. Whole genome sequencing identified efflux pump genes associated with carbapenem resistance and point mutations in membrane porin genes. No carbapenemase gene was identified. Conclusion: Phenotypic antimicrobial susceptibility testing identified the K. pneumoniae as a non-carbapenemase producing carbapenem-resistant organism with the proposed genotypic mechanism including alteration of efflux pumps and membrane porin activity and/or expression. Clinical significance: Currently, there is limited use of carbapenem antimicrobial drugs in veterinary medicine, and practitioners may be unfamiliar or unaware of this type of resistance, its significance on routine antimicrobial susceptibility test reports, and implications for antimicrobial therapy and public health. Carbapenem-resistant Enterobacterales are infrequently isolated from companion animals; however, due to increasing adoption of advanced medical and surgical interventions, they may become more prevalent. Copyright and/or publishing rights held by the Canadian Veterinary Medical Association.
Authors: Kathryn E Holt; Heiman Wertheim; Ruth N Zadoks; Stephen Baker; Chris A Whitehouse; David Dance; Adam Jenney; Thomas R Connor; Li Yang Hsu; Juliëtte Severin; Sylvain Brisse; Hanwei Cao; Jonathan Wilksch; Claire Gorrie; Mark B Schultz; David J Edwards; Kinh Van Nguyen; Trung Vu Nguyen; Trinh Tuyet Dao; Martijn Mensink; Vien Le Minh; Nguyen Thi Khanh Nhu; Constance Schultsz; Kuntaman Kuntaman; Paul N Newton; Catrin E Moore; Richard A Strugnell; Nicholas R Thomson Journal: Proc Natl Acad Sci U S A Date: 2015-06-22 Impact factor: 11.205
Authors: Ea Zankari; Henrik Hasman; Salvatore Cosentino; Martin Vestergaard; Simon Rasmussen; Ole Lund; Frank M Aarestrup; Mette Voldby Larsen Journal: J Antimicrob Chemother Date: 2012-07-10 Impact factor: 5.790
Authors: Stephen D Cole; Laura Peak; Gregory H Tyson; Renate Reimschuessel; Olgica Ceric; Shelley C Rankin Journal: Emerg Infect Dis Date: 2020-02 Impact factor: 6.883