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Zoonotic colonisation and infection
AMR bacteria and/genes can be transferred between humans and animals in both directions. This varies – MRSP is fairly animal specific but MRSA seem to move between species more readily, and gene transfer is
more frequent among Gram-negative bacteria. The risk of infection is very low as these are mostly commensal opportunists. Nevertheless, owners of animals with AMR colonisation or infections should be asked about risk factors for infections and be given appropriate hygiene advice. Whether animals belonging to owners with recent hospital contact are at greater risk of AMR carriage is less clear, but it would be prudent to check.
Raw food diets
These diets are more often contaminated with potential pathogens (e.g. Salmonella, Campylobacter or Listeria) or AMR bacteria compared to dry foods. Raw meat is a risk factor for carriage of AMR bacteria (e.g. ESBL producing E.coli) and shedding of pathogens.
Environmental exposure
Early studies have suggested that contamination of the environment by antibiotic treated dogs and farm animals may facilitate dissemination of AMR in communities. Other sources of environmental contamination include sewage and effluent from farms, hospitals and veterinary premises.
Conclusions
We have clear responsibilities in reducing antimicrobial use and infection control. We must encourage owners to expect less antibiotic treatment and to treat effectively. Finally, we can work with policy makers to develop effective guidelines and regulation.
Further resources
British Veterinary Association - www.bva.co.uk/public/documents/bva_ antimicrobials_poster.pdf
British Small Animal Veterinary Association - www.bsava.com/Advice/ PracticePack/PROTECTPoster/tabid/1500/Default.aspx
www.bsava.com/Resources/MRSA.aspx
British Equine Veterinary Association - www.beva.org.uk/useful-info/Vets/ Guidance/AMR
Responsible Use of Medicines in Agriculture (RUMA) - www.ruma.org.uk
Federation of European Companion Animal Veterinary Associations (FECAVA) - www.fecava.com
International Society for Companion Animal Infectious Diseases (ISCAID) – www.iscaid.org
Bella Moss Foundation - www.bellamossfoundation.com
Antibiotic Action and Guardian campaigns - http://antibiotic-action.com/ & http://antibioticguardian.com/
An Urban Experience
 Key steps in effective infection control
      Hand hygiene
 Clean and disinfect hands before and after touching animals or material Wash hands if visibly soiled Avoid watches, jewellery and nails that interfere with cleaning Wear gloves if necessary, but these are not a substitute for hand hygiene
 Protective clothing
  Wear clean appropriate protective clothing Change out of protective clothing when leaving the premises
 Barrier nursing
  Use extra protection for high risk cases; change between patients
 Surgery
   Use a high standard of preparation, cleanliness and surgical skill Protect wounds from licking and trauma
   Cleaning
 Use effective products Follow clear guidelines Don’t rely on visual assessments of cleanliness Launder regularly, separating clean and soiled items
 Surveillance
  Clinical audit and review of infections and resistance patterns Discuss results with your microbiology laboratory Join passive surveillance programmes
 Training
   Train and encourage all staff Adopt written protocols Appoint an infection control champion (or team)
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