title: First report of multiresistant, mecA-positive Staphylococcus intermedius in Europe: 12 cases from a veterinary dermatology referral clinic in Germany.
abstract: Resistance to cephalosporins and/or fluoroquinolones by Staphylococcus intermedius has remained low in Europe, with effective drugs generally available for systemic therapy in pets. However, multiresistant, mecA-positive S. intermedius isolated from dogs and cats is now emerging in Europe. Twelve S. intermedius isolates, highly resistant to at least five antimicrobial classes, were isolated from skin and ear infections in 11 dogs and a cat. The 12 isolates represented 23% of all S. intermedius submissions from one veterinary dermatology referral clinic in northern Germany to veterinary diagnostic laboratories during an 18-month period and resistance included cefalexin, methicillin and enrofloxacin. The animals had been referred to the clinic with recurrent superficial pyoderma, deep pyoderma, pododermatitis or chronic otitis, all unresponsive to systemic beta-lactam-antibiotics or fluoroquinolones. Infection resolved in 10 dogs and the cat on a combination of antimicrobial treatment and correction of underlying causes. Four dogs and a cat required systemic and topical therapy; in six dogs topical antimicrobial therapy alone was successful. Phenotypic and genotypic characteristics of the S. intermedius isolates were determined; species identification was confirmed by polymerase chain detection of thermonuclease genes (nuc) and the presence and expression of the gene conferring resistance to all beta-lactam antibiotics (mecA) were demonstrated in all; based on pulsed-field gel electrophoresis, six were indistinguishable, the others closely or possibly related. The emergence of multiresistant, mecA-positive S. intermedius in Europe is alarming. Zoonotic implications, awareness among veterinary laboratories and strategies for the use of antimicrobials in small animal practice need to be considered.
authors.affiliation: Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK. aloeffler@rvc.ac.uk
authors.forename: Anette
authors.initials: A
authors.lastname: Loeffler
authors.forename: Monika
authors.initials: M
authors.lastname: Linek
authors.forename: Arshnee
authors.initials: A
authors.lastname: Moodley
authors.forename: Luca
authors.initials: L
authors.lastname: Guardabassi
authors.forename: Julia M L
authors.initials: JM
authors.lastname: Sung
authors.forename: Margit
authors.initials: M
authors.lastname: Winkler
authors.forename: Reinhard
authors.initials: R
authors.lastname: Weiss
authors.forename: David H
authors.initials: DH
authors.lastname: Lloyd
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D001426:Bacterial Proteins / Q000235:genetics*; D002371:Cat Diseases / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D002415:Cats; D004269:DNA, Bacterial / Q000032:analysis; D003880:Dermatology; D004283:Dog Diseases / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D004285:Dogs; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D005858:Germany / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D046915:Penicillin-Binding Proteins; D016133:Polymerase Chain Reaction / Q000662:veterinary; D012017:Referral and Consultation; D013207:Staphylococcal Skin Infections / Q000382:microbiology / Q000662:veterinary*; D013210:Staphylococcus / Q000187:drug effects / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D004269:DNA, Bacterial; D046915:Penicillin-Binding Proteins; C487789:mecA protein, Staphylococcus aureus