title: Treatment of feline giardiasis during an outbreak of diarrhoea in a cattery: potential effects on faecal Escherichia coli resistance patterns.
abstract: An outbreak of diarrhoea involving 16 cats at a cattery in Norway was investigated. Treatment and control of the outbreak were the primary objectives, but the effects of treatment on the antimicrobial resistance profiles of Escherichia coli isolated from faeces were also investigated.
  
  
  
  Faecal samples were investigated for Giardia cysts by immunofluorescence microscopy, and multi-locus genotyping was performed to determine the Giardia genotype. Faecal E coli were assessed, before and after treatment for giardiasis, for antimicrobial resistance.
  
  
  
  The outbreak was probably caused by Giardia duodenalis, Assemblage F. Although infection was eliminated in most cats following treatment with fenbendazole, over 30% of the infected cats required a second treatment round (combined fenbendazole and metronidazole). Investigation of sensitivity to antibacterial drugs of E coli that had been isolated both prior to and following treatment demonstrated that fenbendazole treatment may select for resistant bacteria.
  
  
  
  Controlling Giardia infections in dense cat populations can be challenging, and requires strict hygiene measures. In cases where fenbendazole alone does not result in treatment success, a combination treatment with fenbendazole and metronidazole may be effective. Although this study did not include untreated controls, we suggest that the potential for changes in gut microbiota and antimicrobial resistance development should be considered when choosing antiprotozoal drugs, particularly in cases of treatment failure and where repeat treatment is required.
authors.affiliation: Department of Food Safety and Infection Biology, Norwegian University of Life Sciences, Oslo, Norway.
authors.forename: Kristoffer Relling
authors.initials: KR
authors.lastname: Tysnes
authors.affiliation: Department of Food Safety and Infection Biology, Norwegian University of Life Sciences, Oslo, Norway Current address: Voetbalstraat 25, 2110 Wijnegem, Belgium.
authors.forename: Katrien
authors.initials: K
authors.lastname: Luyckx
authors.affiliation: Department of Food Safety and Infection Biology, Norwegian University of Life Sciences, Oslo, Norway Current address: PrivatVetPraksis Finnmark, Norway.
authors.forename: Leon
authors.initials: L
authors.lastname: Cantas
authors.affiliation: Department of Food Safety and Infection Biology, Norwegian University of Life Sciences, Oslo, Norway lucy.robertson@nmbu.no.
authors.forename: Lucy J
authors.initials: LJ
authors.lastname: Robertson
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000981:Antiprotozoal Agents / Q000627:therapeutic use*; D002371:Cat Diseases / Q000188:drug therapy* / Q000382:microbiology / Q000469:parasitology; D002415:Cats; D003967:Diarrhea / Q000188:drug therapy / Q000382:microbiology / Q000469:parasitology / Q000662:veterinary*; D004196:Disease Outbreaks / Q000662:veterinary; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000187:drug effects*; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000662:veterinary*; D005243:Feces / Q000382:microbiology; D005260:Female; D005273:Fenbendazole / Q000627:therapeutic use; D005873:Giardiasis / Q000188:drug therapy / Q000382:microbiology / Q000662:veterinary*; D008826:Microbial Sensitivity Tests; D064307:Microbiota / Q000187:drug effects
chemical_list: D000900:Anti-Bacterial Agents; D000981:Antiprotozoal Agents; D005273:Fenbendazole