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

> **NIH FDA U18** · UNIVERSITY OF PENNSYLVANIA · 2021 · $74,510

## 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 organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Stephen Douglas Cole
- **Activity code:** U18 (R01, R21, SBIR, etc.)
- **Funding institute:** FDA
- **Fiscal year:** 2021
- **Award amount:** $74,510
- **Award type:** 1
- **Project period:** 2021-09-06 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10448662

## Citation

> US National Institutes of Health, RePORTER application 10448662, CREATE a PATH: Prevalence at Teaching Hospitals of CRE in Veterinary Patients through Passive Surveillance (1U18FD007506-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10448662. Licensed CC0.

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