title: Case-control risk factor study of methicillin-resistant Staphylococcus pseudintermedius (MRSP) infection in dogs and cats in Germany.
abstract: Methicillin-resistant Staphylococcus pseudintermedius (MRSP) has emerged as a highly drug-resistant small animal veterinary pathogen. Although often isolated from outpatients in veterinary clinics, there is concern that MRSP follows a veterinary-hospital-associated epidemiology. This study's objective was to identify risk factors for MRSP infections in dogs and cats in Germany. Clinical isolates of MRSP cases (n=150) and methicillin-susceptible S. pseudintermedius (MSSP) controls (n=133) and their corresponding host signalment and medical data covering the six months prior to staphylococcal isolation were analysed by multivariable logistic regression. The identity of all MRSP isolates was confirmed through demonstration of S. intermedius-group specific nuc and mecA. In the final model, cats (compared to dogs, OR 18.5, 95% CI 1.8-188.0, P=0.01), animals that had been hospitalised (OR 104.4, 95% CI 21.3-511.6, P<0.001), or visited veterinary clinics more frequently (>10 visits OR 7.3, 95% CI 1.0-52.6, P=0.049) and those that had received topical ear medication (OR 5.1, 95% CI 1.8-14.9, P=0.003) or glucocorticoids (OR 22.5, 95% CI 7.0-72.6, P<0.001) were at higher risk of MRSP infection, whereas S. pseudintermedius isolates from ears were more likely to belong to the MSSP-group (OR 0.09, 95% CI 0.03-0.34, P<0.001). These results indicate an association of MRSP infection with veterinary clinic/hospital settings and possibly with chronic skin disease. There was an unexpected lack of association between MRSP and antimicrobial therapy; this requires further investigation but may indicate that MRSP is well adapted to canine skin with little need for selective pressure.
authors.affiliation: Tierärztliche Spezialisten Hamburg, Rodigallee 85, 22043 Hamburg, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Lehner
authors.affiliation: Tierärztliche Spezialisten Hamburg, Rodigallee 85, 22043 Hamburg, Germany.
authors.forename: Monika
authors.initials: M
authors.lastname: Linek
authors.affiliation: Department of Clinical Sciences and Services, The Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, United Kingdom.
authors.forename: Ross
authors.initials: R
authors.lastname: Bond
authors.affiliation: Department of Clinical Sciences and Services, The Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, United Kingdom.
authors.forename: David H
authors.initials: DH
authors.lastname: Lloyd
authors.affiliation: Institut für Hygiene und Infektionskrankheiten der Tiere, Justus-Liebig-University Giessen, Frankfurter Strasse 85-89, 35392 Giessen, Germany.
authors.forename: Ellen
authors.initials: E
authors.lastname: Prenger-Berninghoff
authors.affiliation: Small Animal Teaching Hospital, Dermatology Unit, Justus-Liebig-University Giessen, Frankfurter Strasse 85-89, 35392 Giessen, Germany.
authors.forename: Nina
authors.initials: N
authors.lastname: Thom
authors.affiliation: SynlabVet, Labor Hamburg, Schillerstrasse 29, 21502 Geesthacht, Germany.
authors.forename: Iris
authors.initials: I
authors.lastname: Straube
authors.affiliation: Department of Production and Population Medicine, The Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, United Kingdom.
authors.forename: Kristien
authors.initials: K
authors.lastname: Verheyen
authors.affiliation: Department of Clinical Sciences and Services, The Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, United Kingdom. Electronic address: aloeffler@rvc.ac.uk.
authors.forename: Anette
authors.initials: A
authors.lastname: Loeffler
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001426:Bacterial Proteins / Q000235:genetics; D016022:Case-Control Studies; D002371:Cat Diseases / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D002415:Cats; D004283:Dog Diseases / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D004285:Dogs; D005260:Female; D005858:Germany / Q000453:epidemiology; D006762:Hospitals, Animal / Q000706:statistics & numerical data; D008297:Male; D016106:Methicillin Resistance / Q000235:genetics; D008836:Micrococcal Nuclease / Q000235:genetics; D008954:Models, Biological; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000662:veterinary*; D013210:Staphylococcus / Q000187:drug effects / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; C548250:MecA protein, Staphylococcus pseudintermedius; C074002:nuc protein, staphylococcus; D008836:Micrococcal Nuclease
keywords: Antimicrobial resistance; Infection control; MRSP; Otitis; Pyoderma; Veterinary