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Vet Comp Orthop Traumatol 2008; 21(01): 1-7
DOI: 10.3415/VCOT-07-11-0106
Review Article
Schattauer GmbH

A review of multidrug resistant surgical site infections

J. S. Weese
1   Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
› Author Affiliations
Further Information

Publication History

Received 28 November 2007

Accepted 06 January 2007

Publication Date:
17 December 2017 (online)

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Summary

Surgical site infections caused by bacteria that are resistant to multiple classes of antimicrobials are an important and increasing problem in veterinary medicine. Organisms such as methicillin-resistant staphylococci, extended spectrum beta-lactamase Enterobacteriaceae and multi-drug resistant Enterococcus, Acinetobacter and Pseudomonas spp. are among the current concerns; however, the emergence and dissemination of other multi-drug resistant organisms will likely follow. Despite the negative connotations that are associated with multi-drug resistant infections, most infections are potentially treatable if basic principles of infection treatment and infection control are followed.

Keywords

Nosocomial - antimicrobial resistance - surgical site infection
 

  • References

  • 1 Garrett L. Betrayal of trust: the collapse of global public health. NewYork: Hyperion; 2000
    Google Scholar
  • 2 Perez F, Hujer A, Hujer K. et al. Global challenge of multidrug-resistant Acinetobacter baumannii. Antimicrob Agents Chemother 2007; 51: 3471-3484.
    CrossrefPubMedGoogle Scholar
  • 3 Newton G. Antibiotic resistance: an unwinnable war?. 2005 July 1 [cited2007 Nov 5] http://www.wellcome.ac.uk/doc_WTX026155.html.
    PubMedGoogle Scholar
  • 4 Klevens RM, Morrison MA, Nadle J. et al. Invasive methicillin-resistant Staphylococcus aureus infections in the United States. JAMA 2007; 298: 1763-1771.
    CrossrefPubMedGoogle Scholar
  • 5 Guyot Guyot, Layer G. MRSA - 'bug-bear' of a surgical practice: reducing the incidence of MRSA surgical site infections. Ann R Coll Surg Engl 2006; 88: 222-223.
    PubMedGoogle Scholar
  • 6 Anderson DJ, Sexton DJ, Kanafani ZA. et al. Severe surgical site infection in community hospitals: epidemiology, key procedures, and the changing prevalence of methicillin-resistant Staphylococcus aureus. Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America 2007; 28: 1047-1053.
    CrossrefPubMedGoogle Scholar
  • 7 Tomlin J, Pead M, Lloyd D. et al. Methicillin-resis- tant Staphylococcus aureus infections in 11 dogs. VetRec 1999; 144: 60-64.
    PubMedGoogle Scholar
  • 8 Baptiste K, Williams K, Willams N. et al. Methicil- lin-resistant staphylococci in companion animals. Emerging InfectDis 2005; 11: 1942-1944.
    PubMedGoogle Scholar
  • 9 O'Mahony R, Abbott Y, Leonard F. et al. Methicil- lin-resistant Staphylococcus aureus (MRSA) isolated from animals and veterinary personnel in Ireland. Vet Microbiol 2005; 109: 285-296.
    CrossrefPubMedGoogle Scholar
  • 10 Rankin S, Roberts S, O'Shea K. et al. Panton valentine leukocidin (PVL) toxin positive MRSA strains isolated from companion animals. Vet Microbiol 2005; 108: 145-148.
    CrossrefPubMedGoogle Scholar
  • 11 Weese JS, Archambault M, Willey BM. et al. Methicillin-resistant Staphylococcus aureus in horses and horse personnel, 2000-2002. Emerging Infect Dis 2005; 11: 430-435.
    CrossrefPubMedGoogle Scholar
  • 12 Cuny C, Kuemmerle J, Stanek C. et al. Emergenceof MRSA infections in horses in a veterinary hospital: strain characterisation and comparison with MRSA from humans. Euro Surveill 2006; 11: 44-47.
    CrossrefPubMedGoogle Scholar
  • 13 Moodley A, Stegger M, Bagcigil A. et al. spa typing ofmethicillin-resistant Staphylococcus aureus isolated from domestic animals and veterinary staff in the UK and Ireland. J Antimicrob Chemother 2006; 58: 1118-1123.
    CrossrefPubMedGoogle Scholar
  • 14 Rich Rich, Roberts L. MRSA in companion animals. VetRec 2006; 159: 535-536.
    PubMedGoogle Scholar
  • 15 Weese J, Dick H, Willey B. et al. Suspected transmission of methicillin-resistant Staphylococcus aureus between domestic pets and humans in veterinary clinics and in the household. Vet Microbiol 2006; 115: 148-155.
    CrossrefPubMedGoogle Scholar
  • 16 Leonard F, Abbott Y, Rossney A. et al. Methicillin-resistant Staphylococcus aureus isolated from a veterinary surgeon and five dogs in one practice. Vet Rec 2006; 158: 155-159.
    CrossrefPubMedGoogle Scholar
  • 17 Weese J, Rousseau J, Willey B. et al. Methicillin- resistant Staphylococcus aureus in horses at avet- erinary teaching hospital: frequency, characterization, and association with clinical disease. J Vet Intern Med 2006; 20: 182-186.
    CrossrefPubMedGoogle Scholar
  • 18 Weese Weese, Lefebvre SL. Risk factors formethicil- lin-resistant Staphylococcus aureus colonization in horses admitted to a veterinary teaching hospital. Can Vet J 2007; 48: 921-926.
    PubMedGoogle Scholar
  • 19 Gorwitz RJ, Jernigan D, Powers J. et al. Participants in the CDC-Convened experts' meeting on management of MRSA in the community. Strategies for clinical management of MRSA in the community: summary of an experts' meeting convened by the Centers for Disease Control and Prevention. 2006 [cited 2006 Mar 1] http://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca.html
    PubMedGoogle Scholar
  • 20 Sabol K, Echevarria K, Lewis J. Community-as- sociatedmethicillin-resistant Staphylococcus aureus: new bug, old drugs. Ann Pharmacother 2006; 40: 1125-1133.
    CrossrefPubMedGoogle Scholar
  • 21 Weese J, Archambault M, Willey B. et al. Methi- cillin-resistant Staphylococcus aureus in horses and horse personnel, 2000-2002. Emerging Infect Dis 2005; 11: 430-5.
    CrossrefPubMedGoogle Scholar
  • 22 Cuny C, Kuemmerle J, Stanek C. et al. Emergence of MRSA infections in horses in a veterinary hospital: strain characterisation and comparison with MRSA from humans. Euro Surveill 2006; 11: 44-47.
    CrossrefPubMedGoogle Scholar
  • 23 Loeffler A, Boag A, Sung J. et al. Prevalence of methicillin-resistant Staphylococcus aureus among staff and pets in a small animal referral hospital in the UK. J Antimicrob Chemother 2005; 56: 692-697.
    CrossrefPubMedGoogle Scholar
  • 24 Hanselman B, Kruth S, Rousseau J. et al. Methicil- lin-resistant Staphylococcus aureus colonization in veterinary personnel. Emerging Infect Dis 2006; 12: 1933-1938.
    CrossrefPubMedGoogle Scholar
  • 25 Wulf M, van Nes A, Eikelenboom-Boskamp A. et al. Methicillin-resistant Staphylococcus aureus in veterinary doctors and students, the Netherlands. Emerging Infect Dis 2006; 12: 1939-1941.
    CrossrefPubMedGoogle Scholar
  • 26 Wulf MW, Sørum M, van Nes A. et al. Prevalence of methicillin-resistant Staphylococcus aureus among veterinarians: an international study. Clin Microbiol Infect. 2007 Nov 7 [Epub ahead of print].
    PubMedGoogle Scholar
  • 27 Seguin JC, Walker RD, Caron JP. et al. Methicillin- resistant Staphylococcus aureus outbreak in avet- erinary teaching hospital: potential human-to-animal transmission. J Clin Microbiol 1999; 37: 1459-1463.
    PubMedGoogle Scholar
  • 28 Kania S, Williamson N, Frank L. et al. Methicillin resistance of staphylococci isolated from the skin of dogs with pyoderma. Am J Vet Res 2004; 65: 1265-1268.
    CrossrefPubMedGoogle Scholar
  • 29 Morris D, Rook K, Shofer F. et al. Screening of Staphylococcus aureus, Staphylococcus inter- medius, and Staphylococcus schleiferi isolates obtained from small companion animals for antimicrobial resistance: a retrospective review of749 isolates (2003-04). Vet Dermatol 2006; 17: 332-337.
    CrossrefPubMedGoogle Scholar
  • 30 Zubeir I, Kanbar T, Alber J. et al. Phenotypic and genotypic characteristics ofmethicillin/oxacillin- resistant Staphylococcus intermedius isolated from clinical specimens during routine veterinary microbiological examinations. Vet Microbiol 2007; 121: 170-176.
    CrossrefPubMedGoogle Scholar
  • 31 Sasaki T, Kikuchi K, Tanaka Y. et al. Reclassifi- cation of phenotypically-identified Staphylococ- cus intermedius strains. J Clin Microbiol 2007; 45: 2770-2778.
    CrossrefPubMedGoogle Scholar
  • 32 Sasaki T, Kikuchi K, Tanaka Y. et al. Methicillin- resistant Staphylococcus pseudintermedius in a veterinary teaching hospital. J Clin Microbiol 2007; 45: 1118-1125.
    CrossrefPubMedGoogle Scholar
  • 33 Frank L, Kania S, Hnilica K. et al. Isolation of Staphylococcus schleiferi from dogs with pyoderma. J Am Vet Med Assoc 2003; 222: 451-454.
    CrossrefPubMedGoogle Scholar
  • 34 Lilenbaum W, Esteves AL, Souza GN. Prevalence and antimicrobial susceptibility of staphylococci isolated from saliva of clinically normal cats. Lett Appl Microbiol 1999; 28: 448-452.
    CrossrefPubMedGoogle Scholar
  • 35 Yasuda R, Kawano J, Onda H. et al. Methicillin-re- sistant coagulase-negative staphylococci isolated from healthy horses in Japan. Am J Vet Res 2000; 61: 1451-1455.
    CrossrefPubMedGoogle Scholar
  • 36 Busscher J, van Duijkeren E, Sloet van Oldruiten-borgh-Oosterbaan M. The prevalence ofmethicillin-resistant staphylococci in healthy horses in the Netherlands. VetMicrobiol 2006; 113: 131-136.
    PubMedGoogle Scholar
  • 37 Vengust M, Anderson M, Rousseau J. et al. Methi- cillin-resistant staphylococcal colonization in clinically normal dogs and horses in the community. Lett Appl Microbiol 2006; 43: 602-606.
    CrossrefPubMedGoogle Scholar
  • 38 Mascini Mascini, Bonten M. Vancomycin-resistant enterococci: consequences for therapy and infection control. Clin Microbiol Infect 2005; 11 (Suppl. 04) 43-56.
    CrossrefPubMedGoogle Scholar
  • 39 Seguin MA, Vaden SL, Altier C. et al. Persistent urinary tract infections and reinfections in 100 dogs (1989-1999). J Vet Intern Med 2003; 17: 622-631.
    PubMedGoogle Scholar
  • 40 Devriese L, Ieven M, Goossens H. et al. Presence of vancomycin-resistant enterococci in farm and pet animals. Antimicrob Agents Chemother 1996; 40: 2285-2287.
    CrossrefPubMedGoogle Scholar
  • 41 de Niederhüusern S, Sabia C, Messi P. et al. VanA- type vancomycin-resistant enterococci in equine and swine rectal swabs and in human clinical samples. Curr Microbiol 2007; 55: 240-246.
    CrossrefPubMedGoogle Scholar
  • 42 Amyes S. Enterococci and streptococci. Int JAnti- microb Agents 2007; 29 (Suppl. 03) S43-52.
    PubMedGoogle Scholar
  • 43 Saphir Saphir, Carter GR. Gingival flora of the dog with special reference to bacteria associated with bites. J Clin Microbiol 1976; 3: 344-349.
    PubMedGoogle Scholar
  • 44 Johnson Johnson, Fales WH. Clinical and microbi- ologic findings in dogs with bronchoscopically diagnosed tracheal collapse: 37 cases (1990-1995). J Am Vet Med Assoc 2001; 219: 1247-1250.
    CrossrefPubMedGoogle Scholar
  • 45 Newton J, Wood J, Chanter N. A case control study of factors and infections associated with clinically apparent respiratory disease in UK Thoroughbred racehorses. PrevVet Med 2003; 60: 107-132.
    PubMedGoogle Scholar
  • 46 Francey T, Gaschen F, Nicolet J. et al. The role of Acinetobacter baumannii as a nosocomial pathogen for dogs and cats in an intensive care unit. J Vet Intern Med 2000; 14: 177-183.
    CrossrefPubMedGoogle Scholar
  • 47 Boerlin P, Eugster S, Gaschen F. et al. Transmission of opportunistic pathogens in a veterinary teaching hospital. Vet Microbiol 2001; 82: 347-359.
    CrossrefPubMedGoogle Scholar
  • 48 Krcmery V, Kalavsky E. Multidrug-resistant Acinetobacter baumannii. Emerging Infect Dis 2007; 13: 943-944.
    CrossrefPubMedGoogle Scholar
  • 49 Naas T, Kernbaum S, Allali S. et al. Multidrug-re- sistant Acinetobacter baumannii, Russia. Emerging InfectDis 2007; 13: 669-671.
    PubMedGoogle Scholar
  • 50 Fournier P, Vallenet D, Barbe V. et al. Comparative genomics of multidrug resistance in Acinetob- acter baumannii. PLoS Genet. 2006 2. e7.
    PubMedGoogle Scholar
  • 51 Reid G, Grim S, Aldeza C. et al. Rapid development of Acinetobacter baumannii resistance to tigecycline. Pharmacotherapy 2007; 27: 1198-1201.
    CrossrefPubMedGoogle Scholar
  • 52 Deplano A, Denis O, Poirel L. et al. Molecular characterization of an epidemic clone of pananti- biotic-resistant Pseudomonas aeruginosa. J Clin Microbiol 2005; 43: 1198-1204.
    CrossrefPubMedGoogle Scholar
  • 53 Bonomo R, Szabo D. Mechanisms of multidrug resistance in Acinetobacter species and Pseudo- monas aeruginosa. Clin Infect Dis 2006; 43 (Suppl. 02) S49-56.
    CrossrefPubMedGoogle Scholar
  • 54 Navon-Venezia S, Ben-Ami R, Carmeli Y. Update on Pseudomonas aeruginosa and Acinetobacter baumannii infections in the healthcare setting. Curr Opin Infect Dis 2005; 18: 306-313.
    CrossrefPubMedGoogle Scholar
  • 55 Agodi A, Barchitta M, Cipresso R. et al. Pseudo- monas aeruginosa carriage, colonization, and infection in ICU patients. Intensive Care Med 2007; 33: 1155-1161.
    CrossrefPubMedGoogle Scholar
  • 56 Sauer P, Andrew S, Lassaline M. et al. Changes in antibiotic resistance in equine bacterial ulcerative keratitis (1991-2000): 65 horses. Vet Ophthalmol 2003; 6: 309-313.
    CrossrefPubMedGoogle Scholar
  • 57 Keller Keller, Hendrix D. Bacterial isolates and antimicrobial susceptibilities in equine bacterial ulcerative keratitis (1993--2004). Equine Vet J 2005; 37: 207-211.
    PubMedGoogle Scholar
  • 58 Teresa Tejedor M., Martin JL, Navia M. et al. Mechanisms of fluoroquinolone resistance in Pseudomonas aeruginosa isolates from canine infections. Vet Microbiol 2003; 94: 295-301.
    CrossrefPubMedGoogle Scholar
  • 59 Palmeiro BS, Morris DO, Wiemelt SP. et al. Evaluation of outcome of otitis media after lavage of the tympanic bulla and long-term antimicrobial drug treatment in dogs: 44 cases (1998-2002). J AmVet Med Assoc 2004; 225: 548-553.
    PubMedGoogle Scholar
  • 60 Gatoria IS, Saini NS, Rai TS. et al. Comparison of three techniques for the diagnosis of urinary tract infections in dogs with urolithiasis. J Small Anim Pract 2006; 47: 727-732.
    CrossrefPubMedGoogle Scholar
  • 61 Peremans K, De Winter F, Janssens L. et al. An infected hip prosthesis in a dog diagnosed with a 99mTc-ciprofloxacin (infecton) scan. Vet Radiol Ultrasound; 2002; 43: 178-182.
    CrossrefPubMedGoogle Scholar
  • 62 Li XZ, Mehrotra M, Ghimire S. et al. beta-Lactam resistance and beta-lactamases in bacteria of animal origin. VetMicrobiol 2007; 121: 197-214.
    PubMedGoogle Scholar
  • 63 Paterson D. Resistance in gram-negative bacteria: Enterobacteriaceae. Am J Infect Control 2006; 34: S20-8 discussion S64-73.
    CrossrefPubMedGoogle Scholar
  • 64 Vo A, van Duijkeren E, Fluit A. et al. Characteristics of extended-spectrum cephalosporin-resistant Escherichia coli and Klebsiella pneumoniae isolates from horses. Vet Microbiol 2007; 124: 248-255.
    CrossrefPubMedGoogle Scholar
  • 65 Sidjabat HE, Hanson ND, Smith-Moland E. et al. Identification of plasmid-mediated extended- spectrum and AmpC beta-lactamases in Enter- obacter spp. isolated from dogs. J Med Microbiol 2007; 56: 426-434.
    PubMedGoogle Scholar
  • 66 Elder Elder, Paterson C. Sharps injuries in UKhealth care: a review of injury rates, viral transmission and potential efficacy of safety devices. Occupational medicine (Oxford, England) 2006; 56: 566-574.
    CrossrefPubMedGoogle Scholar
  • 67 Ramphal Ramphal, Ambrose P. Extended-spectrum beta- lactamases and clinical outcomes: current data. Clin Infect Dis 2006; 42 (Suppl. 04) S164-172.
    CrossrefPubMedGoogle Scholar
  • 68 Paterson D, Mulazimoglu L, Casellas J. et al. Epidemiology of ciprofloxacin resistance and its relationship to extended-spectrum beta-lactamase production in Klebsiella pneumoniae isolates causing bacteremia. Clin Infect Dis 2000; 30: 473-478.
    CrossrefPubMedGoogle Scholar
  • 69 Larson E. Guideline for use of topical antimicrobial agents. Am J Infect Control 1988; 16: 253-266.
    CrossrefPubMedGoogle Scholar
  • 70 Edwards-Jones V, Buck R, Shawcross SG. et al. The effect of essential oils onmethicillin-resistant Staphylococcus aureus using a dressing model. Burns 2004; 30: 772-777.
    CrossrefPubMedGoogle Scholar
  • 71 Muto C, Jernigan J, Ostrowsky B. et al. SHEA guideline for preventing nosocomial transmission of multidrug-resistant strains of Staphylococcus aureus and enterococcus. Infect Control Hosp Epidemiol 2003; 24: 362-386.
    PubMedGoogle Scholar
  • 72 Weese JS. Barrier precautions, isolation protocols, and personal hygiene in veterinary hospitals. Vet Clin North Am Equine Pract 2004; 20: 543-559.
    CrossrefPubMedGoogle Scholar
  • 73 Barton M, Hawkes M, Moore D. et al. Guidelines for the prevention and management of community-associated methicillin-resistant Staphylococcus aureus: a perspective for Canadian health care practitioners. Can J Infect Dis Med Microbiol 2006; 17 suppl C 4C-24C.
    PubMedGoogle Scholar
  • 74 Dwyer RM. Environmental disinfection to control equine infectious diseases. Vet Clin North Am Equine Pract 2004; 20: 531-542.
    CrossrefPubMedGoogle Scholar
  • 75 Boyce J, Pittet D. Unknown Guideline for Hand Hygiene in Health-Care Settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/ SHEA/APIC/IDSA Hand Hygiene Task Force. Infect Control Hosp Epidemiol 2002; 23: S3-40.
    CrossrefPubMedGoogle Scholar
  • 76 Traub-Dargatz J, Weese J, Rousseau J. et al. Pilot study to evaluate 3 hygiene protocols on the reduction of bacterial load on the hands of veterinary staff performing routine equine physical examinations. Can Vet J 2006; 47: 671-676.
    PubMedGoogle Scholar