Intensive medical care in companion animal clinics could pose a risk for the selection and dissemination of multidrug-resistant organisms (MDROs). Infection prevention and control (IPC) concepts are key measures to reduce the spread of MDROs, but data on IPC standards in companion animal clinics is sparse. The study assessed IPC standards in seven companion animal clinics and practices in Switzerland by structured IPC audits and combined results with environmental MDRO contamination and MDRO carriage of the personnel. IPC audits were held between August 2018 and January 2019. The observations in 34 IPC areas were scored based on predefined criteria (not fulfilled/partially fulfilled/fulfilled = score 0/1/2). Environmental swabs and nasal and stool samples from veterinary personnel were tested for methicillin-resistant (MR) staphylococci and macrococci and for colistin-resistant, extended-spectrum β-lactamase- and carbapenemase-producing (CP) Enterobacterales (CPE). Species was identified by MALDI-TOF MS, antimicrobial resistance determined by microdilution and β-lactam resistance gene detection, and genetic relatedness assessed by REP−/ERIC-PCR and multilocus sequence typing. Of a maximum total IPC score of 68, the institutions reached a median (range) score of 33 (19–55). MDROs were detected in median (range) 8.2% (0–33.3%) of the sampling sites. Clinics with low IPC standards showed extensive environmental contamination, i.e. of intensive care units, consultation rooms and utensils. CPE were detected in two clinics; one of them showed extensive contamination with CP Klebsiella pneumoniae (ST11, blaOXA-48) and MR Staphylococcus pseudintermedius (ST551, mecA). Despite low IPC scores, environmental contamination with MDROs was low in primary opinion practices. Three employees were colonized with Escherichia coli ST131 (blaCTX-M-15, blaCTX-M-27, blaCTX-M-14). Two employees carried CP E. coli closely related to environmental (ST410, blaOXA-181) and patient-derived isolates (ST167, blaNDM-5). MR Staphylococcus aureus (ST225, mecA) and MR S. pseudintermedius (ST551, mecA) of the same sequence types and with similar resistance profiles were found in employees and the environment in two clinics. The study indicates that IPC standards in companion animal clinics are variable and that insufficient IPC standards could contribute to the evolution of MDROs which can be transferred between the environment and working personnel. The implementation of IPC concepts in companion animal clinics should urgently be promoted.

中文翻译：

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在瑞士伴侣动物诊所，不良的预防和控制标准与产生碳青霉烯酶的肠杆菌和其他耐多药细菌的环境污染有关。

伴侣动物诊所的重症监护可能会导致选择和传播耐多药生物（MDRO）的风险。感染预防和控制（IPC）概念是减少MDRO传播的关键措施，但伴侣动物诊所中有关IPC标准的数据很少。该研究通过对IPC进行结构化审核，评估了瑞士七个伴侣动物诊所和诊所的IPC标准，并将结果与​​环境MDRO污染和人员MDRO运输相结合。在2018年8月至2019年1月之间进行了IPC审核。根据预先定义的标准对IPC的34个领域的观察结果进行评分（未实现/部分实现/完成=得分0/1/2）。对来自兽医人员的环境拭子以及鼻和粪便样品进行了耐甲氧西林（MR）葡萄球菌和大球菌检测，以及大肠菌素抗性，广谱β-内酰胺酶和碳青霉烯酶生产（CP）肠杆菌（CPE）测试。通过MALDI-TOF MS鉴定物种，通过微稀释和β-内酰胺抗性基因检测确定抗药性，并通过REP- / ERIC-PCR和多位点序列分型评估遗传相关性。IPC最高总得分为68，这些机构的中位（范围）得分为33（19-55）。在采样点的中位数（范围）8.2％（0–33.3％）中检测到MDRO。IPC标准低的诊所显示出广泛的环境污染，例如重症监护室，诊室和用具。在两家诊所中发现了CPE；其中之一显示出广泛感染了肺炎克雷伯氏菌（ST11，blaOXA-48）和MR假单胞菌葡萄球菌（ST551，mecA）。尽管IPC得分较低，但在主要舆论实践中，MDRO对环境的污染仍然较低。三名员工被大肠杆菌ST131（blaCTX-M-15，blaCTX-M-27，blaCTX-M-14）定殖。两名员工携带与环境（ST410，blaOXA-181）和患者分离株（ST167，blaNDM-5）密切相关的CP大肠杆菌。在两家诊所的员工和环境中发现了具有相同序列类型和相似耐药性的金黄色葡萄球菌（ST225，mecA）和假单胞菌（pseudintermedius）（ST551，mecA）。研究表明，伴侣动物诊所的IPC标准是可变的，IPC标准不足可能会导致MDRO的进化，MDRO可以在环境和工作人员之间转移。迫切需要在伴侣动物诊所中实施IPC概念。