Multi-drug-resistant Acinetobacter calcoaceticus-Acinetobacter baumannii complex infection outbreak in dogs and cats in a veterinary hospital.

J Small Anim Pract. November 2016;57(11):617-625.

S Kuzi¹, S E Blum², N Kahane³, A Adler⁴, O Hussein⁵, G Segev⁶, I Aroch⁷

¹ Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot 76100, Israel. sharon.kuzi@gmail.com.; ² Department of Bacteriology, Kimron Veterinary Institute, Bet Dagan 5020000, Israel.; ³ Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot 76100, Israel.; ⁴ National Center of Infection Control, Sackler School of Medicine, Tel Aviv University, Tel Hashomer 52621, Israel.; ⁵ National Center of Infection Control, Sackler School of Medicine, Tel Aviv University, Tel Hashomer 52621, Israel.; ⁶ Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot 76100, Israel.; ⁷ Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot 76100, Israel.

Abstract

BACKGROUND:Members of the Acinetobacter calcoaceticus-Acinetobacter baumannii complex cause severe outbreaks in humans, and are increasingly reported in animals.

OBJECTIVE AND METHODS:A retrospective study, describing a severe outbreak in dogs and cats caused by a multidrug resistant member of the Acinetobacter calcoaceticus-Acinetobacter baumannii complex in a veterinary hospital, between July 2010 and November 2012.

RESULTS:The study included 19 dogs and 4 cats. Acinetobacter calcoaceticus-Acinetobacter baumannii complex bacteria were isolated from urine (9 animals), respiratory tract (11), tissues (3) and blood (1). The most common infection-associated findings included fever, purulent discharge from endotracheal tubes, hypotension, and neutropaenia. Infections led to pneumonia, urinary tract infection, cellulitis and sepsis. Infection was transmitted in the intensive care unit, where 22 of 23 animals were initially hospitalised. The mortality rate was 70% (16 of 23 animals), and was higher in cases of respiratory infection compared to other infections. Aggressive environmental cleaning and disinfection, with staff education for personal hygiene and antisepsis, sharply decreased the infection incidence.

CLINICAL SIGNIFICANCE:Health care-associated outbreaks with multidrug resistant Acinetobacter calcoaceticus-Acinetobacter baumannii complex in dogs and cats are potentially highly fatal and difficult to eradicate, warranting monitoring, antiseptic techniques and judicious antibiotic use.

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