CREATE a PATH: Prevalence at Teaching Hospitals of CRE in Veterinary Patients through Passive Surveillance

NIH RePORTER · FDA · U18 · $74,510 · view on reporter.nih.gov ↗

Abstract

The rise of human infections caused by carbapenem-resistant Enterobacterales (CRE) is considered one of the most urgent threats to modern healthcare by the Centers for Disease Control and Prevention. Until recently CRE were associated with healthcare-associated infections (HCAIs) but reports of infections acquired in the community are now a concern. In parallel, there is growing concern in veterinary medicine over reports of the isolation of CRE from companion animals. Companion animals could potentially play a role in CRE transmission in communities; however, it is currently unknown what the prevalence of CRE carriage among animals is in the USA. The aims of this study are to (1) estimate the prevalence of carbapenem-resistant Enterobacterales (CRE) among dogs and cats presenting to veterinary teaching hospitals in the USA and (2) characterize isolates of CRE from companion animals by whole genome sequencing (WGS). For the first aim of this project, the existing Vet-LIRN infrastructure will be leveraged to complete a short-term, proof-of-concept, passive surveillance project for CRE in companion animals. A total of five laboratories associated with veterinary teaching hospitals will participate in this initial study. All laboratories will use chromogenic agar to screen between 30-50 fecal specimens monthly for CRE over 10 months. Presumptive positive isolates will be sent to the University of Pennsylvania’s laboratory for identification, antimicrobial susceptibility testing (AST) and phenotypic characterization of carbapenemase enzyme production. The estimated prevalence will be calculated as the proportion of the positive specimens out of the total number of specimens tested. Under the second aim, confirmed CRE will be sent to the Louisiana Animal Disease Diagnostic Laboratory (LADDL) at the Louisiana State University for whole genome sequencing. Raw sequencing data will be uploaded and processed through the NCBI Pathogen Detection pipeline to detect antimicrobial resistance genes and to characterize isolates by multilocus sequence typing along with supplementary analyses. Based on previous studies, we estimate a prevalence of about 1% among dogs and cats that will have genetically distinct background and harbor a variety of different mechanisms for carbapenem resistance. This study will serve as a basis for wider surveillance strategies for CRE in companion animals and will build capacity within the Vet-LIRN program to identify and characterize CRE.

Key facts

NIH application ID
10448662
Project number
1U18FD007506-01
Recipient
UNIVERSITY OF PENNSYLVANIA
Principal Investigator
Stephen Douglas Cole
Activity code
U18
Funding institute
FDA
Fiscal year
2021
Award amount
$74,510
Award type
1
Project period
2021-09-06 → 2023-08-31