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Where Do MRSA Infections Come From?

Posted Nov 26 2013 6:00am
Dr. Coates is a veterinarian based in the other “Sunshine State” – that's Colorado to the rest of you – where she lives and plays with a varied range of animals. She shares her professional and personal experiences, Monday through Friday, here on petMD's blog, the Fully Vetted. Log in for your daily dose of her insight and wisdom. < Previous Post Next Post > Nov 26, 2013 Where Do MRSA Infections Come From? by Dr. Jennifer Coates, DVM     Share       Save to mypetMDWith recent news stories about the three Tampa Bay Buccaneer football players who were diagnosed with MRSA, questions regarding these types of infections in pets are likely to arise.
 
MRSA is short for Methicillin-Resistant Staphylococcus aureus. Staph aureus is a type of bacteria found in the nasal passages of up to 30-40 percent of healthy people. It can also be found anywhere on the skin, in soft tissues, or in the ears. It usually doesn’t cause disease, but can lead to infections through breaks in the skin, such as cuts, wounds, or surgical incisions.
 
A small number (0.5%-2%) of these bacteria have acquired a gene (mecA) that codes for a protein making the bacteria resistant to many antibiotics. These bacteria likely have developed resistance because of increased antibiotic use. The infections are no more severe than regular Staph infections, but are much harder to eliminate due to their antibiotic-resistance.
 
There are two types of MRSA infections in people based on where they are acquired: health-care associated (HC-MRSA) or community-associated (CA-MRSA). HC-MRSA infections are usually more serious and can involve the bloodstream and/or internal organs. Fortunately, these infections are on the decline due to better infection-control practices. CA-MRSA infections are found mostly in sports settings, child care facilities, or crowded living situations. The bacteria are acquired during personal contact or through shared items such as towels and equipment.
 
Many people wonder … can my pet give me MRSA? Surprisingly, you are more likely to give the infection to your pet than the other way around. MRSA infections occur infrequently in pets, with the infections being less virulent than in people and usually more easily resolved.
 
The greater concern for our pets is Staphylococcus pseudointermedius. This bacterium is found on most, if not all healthy dogs and less commonly on cats. Transmission is usually through close contact with other pets. The emerging threat is blamed on improperly used antibiotics and failure to practice good infection control. The incidence of resistant strains in these bacteria (referred to as MRSP) varies widely, but it has been reported in up to 30 percent of dogs. Many dogs harbor these bacteria without illness, but MRSP infections are on the rise.
 
MRSP infections look like “regular” skin infections, but do not resolve with appropriate empiric antibiotic therapy. When this occurs, testing should include culture and sensitivity to identify the resistant bacteria and help identify an appropriate antibiotic for treatment.
 
Because it may be difficult to find effective systemic antibiotics, veterinarians should consider topical antimicrobial therapy for superficial infections (flushing wounds, shampoos, conditioners, sprays, ointments, and even the application of honey have all been found to be helpful). It is also important to diagnose and treat secondary invaders (e.g., yeast and non-resistant bacteria) that can complicate infections.
 
Good hygiene is paramount in preventing infections — resistant or otherwise. Gloves and other protective devices should be worn during contact with affected individuals, followed by proper hand-washing. Infections and wounds should be kept covered, potentially-contaminated items disinfected (e.g., bowls, bedding, and collars), and contact between affected and unaffected people/animals should be prevented.
 
There is some concern that these infections can be transferred between people and animals, but the true zoonotic potential is not known. Precautions are necessary to reduce this risk in veterinary clinics and in the home.
 
This post was written by Dr. Jennifer Ratigan, a veterinarian in Waynesboro, VA. I’ve known Jen since before we attended veterinary school together and thought you might like to get her take on the world of veterinary medicine. She’ll be contributing posts to Fully Vetted from time to time.
 

Dr. Jennifer Coates
 
References
Weese, J. S. (2012 May) Management of methicillin-resistant Staphylococcal infections. Paper presented at American College of Veterinary Internal Medicine, New Orleans, Louisiana. Accessed on the Veterinary Information Network 11/20/13.
Centers for Disease Control and Prevention. Methicillin-resistant Staphylococcus aureus (MRSA) infections. Accessed October 15, 2013.
 
Image: Thinkstock
 
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TheOldBroad Zoonotic Infection 11/26/2013 07:12pm "Surprisingly, you are more likely to give the infection to your pet than the other way around."

To be honest, I wasn't aware that infections could be "shared" and certainly didn't think they could be zoonotic. I've learned something today! Reply to this comment Report abuse 1 Jcash My Nightmare 11/26/2013 07:37pm I live in Hawaii where MRSA (and a few other multi-resistant bacterial infections) is the highest in the nation, double the national average. A small hospital on the NE side of Oahu sees 2-3 human MRSA cases in just 1 ER shift.

In November 2011, I took my healthy dog to the Vet (had been taking my animals to this Vet for over 6 years). He was given Rimadyl (even though an earlier blood test showed he could not tolerate) that caused a side effect – skin lesions. (I was not given any info concerning Rimadyl, just told to give it to him) The lesions got infected and spread yet the Vet refused to take a Culture & Sensitivity test and just prescribed different antibiotic, 4 to be exact. He told me that my dog must have a fungal infection but to continue giving him the antibiotics.

To make a long story short, when a test was finally done, it showed he had 5 organisms, MRSA/MRSS, STREP GROUP A, PSEUDOMONAS, ESCHERICHIA COLI, and KLEBSIELLA PNEUMONIAE.

Both the MRS and STREP were found to be RESISTANT to ALL available antibiotics. Because of the non-judicious use of antibiotics and many lost opportunities to properly diagnose the infections, my dog endured horrible pain and discomfort for over 5 months. He was not going to survive so we had to put him down.

Over those 5 months, the Vet/Clinic told us that there was no need to take any extra precautions (NO gloves or gowns needed when treating the dog) and they even had us stay in the waiting room with other humans and animals AFTER he was diagnosed. The Vet actually took a culture while we were in the waiting room!

Despite all 5 bacteria, they insisted he was NOT contagious. (I did try to find another vet but each one I contacted refused to see my dog and said they did not want to get involved...)

A few weeks after my dog was diagnosed with all 5 bacteria, I got sick with STREP A and another one of my dogs got a UTI STAPH infection.

I have contacted every organization (both State & private), even contacted the Dept. of Health, the Hawaii Vet Board, the State Vet and even the Federal Vet and the media. No one wanted to get involved and said it was not in their job description. When I contacted OSHA, they were very concerned but could only do an investigation if an employee filed a complaint, not a customer. It seems no one is really concerned about public health and the companion animal population in this state.

Ironically, when I tried to inform the public concerning MRS and pets, I was threatened with a Lawsuit by the Animal Clinic. I guess if someone wants to sue you for letting people know, it must be an important issue!

My goal, which at this point seems to be impossible, is to not let this happen again. The Clinic and its Vets have stated that the standard of care was met. They told me that even though blood tests indicated my dog could not tolerate Rimadyl, he still could be given it and that Rimadyl had nothing to do with the skin lesions. (I am allergic to aspirin and I wonder if an MD would still consider it OK to give to me!) I did have a test done on my dog for any underlying conditions but nothing showed up.

I honestly believe that what happened to my dog will happen again and again. I filed a complaint with the Hawaii Board of Veterinarians 13 1/2 months ago and I have yet to hear from them. I have been told that the chance of anything changing is slim to nil. Hawaii is one of 4 states that fought the requirement of its Vets to take CE courses. A Bill was finally passed for just 20 hours and will not go into effect until 2016.

Needless to say, I am disappointed that no one connected to veterinary medicine in Hawaii decided to step forward rather than turn a blind eye. In my case, the duty of the veterinarian to inform the client and to practice standard of care medicine did not take place and both animal and human had to suffer.
I did put a website together if you are interested in the whole story.

makaivethawaii.com

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