CRE in pets: Sharing may not be caring

While reading this article ( the old adage of people resembling their pets crossed my mind. Dog and owner look-alike contests are part of popular folklore and I can remember an episode of the Today show with people bickering about correlations between overweight pets and overweight pet owners.

The resemblance between pets and owners unfortunately seems to extend to their bacterial flora. Apparently, companion animals can contribute to the epidemiology of MRSA ( and healthy dog and cats carry ESBL-producing bugs in their poop ( More recently the emergence of Oxa-48 and NDM-1 carrying carbapenem resistant superbugs in companion animals was reported in the USA (J Antimicrob Chemother 2013; 68: 2802–8 and Antimicrob Agents Chemother 2013; 57: 2902–3).

Needless to say, clinical infections with CRE are of growing public health concern. Considering the close contact between pets and humans, the emergence of CRE in companion animals adds another challenging scenario to controlling the dissemination of these superbugs. Suppose your dearest dog or cat somehow catches a CRE infection, or just becomes a healthy carrier of a multi-drug resistant superbug. Hugging, licking, kissing or allowing your pet to sleep in your bed, may pass these bugs on to you. You, hopefully, will not become infected, but could transfer the bugs to other household members, friends, colleagues or even other pets. If this scenario becomes reality, the impact on transmission of superbugs could be dramatic.

The authors of the aforementioned article therefore propose 4 profound recommendations to control the emergence of multi-drug resistance in companion animals and the potential risk of interspecies transmission. These recommendations include the development of antibiotic stewardship programs in veterinary practices to restrict the use of critically important antibiotics for human medicine. But such ASP’s, similar to the ones developed for human medicine, can only work properly if essential diagnostic tools are available to support such programs. Therefore, we see an important role for medical microbiology labs to facilitate the development and implementation of these recommendations. Surely, we will need diagnostic assays to detect infections with CRE and other multi-drug resistant bugs in pets. We will also need these tools to perform surveillance programs for these MDR organisms in companion animals. Accordingly, bacterial culture and antibiotic susceptibility testing assays should be adapted for use in companion animal veterinary clinics. Only then an evidence based approach to diagnosis and treatment of infections in companion animals can be sustained.

We are convinced that these recommendations are not redundant. On the contrary, we would like to elaborate on a supplementary recommendation. Complementary to measures directed at limiting the development of antimicrobial resistance in pets, strategies to curb interspecies transmission are essential. Thus, infection control strategies should be developed and specifically designed for companion animal veterinary clinics. These strategies are fundamental to control the dissemination of superbugs among companion animals and between animals and humans.
This all may seem too far fetched. But that’s probably only until we consider that dog poop on your sidewalk, potentially loaded with the most dreadful of all resistant superbugs, may impose a whole new public health threat now…

Category : Blog

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