ADS 03 - Infection Prevention and a One Health Approach to Mitigate New Delhi Metallo-β-lactamase-producing Escherichia coli Transmission Risks

Wednesday, June 28, 2023

2:56 PM – 3:15 PM

Location: W103 A/B; Orange County Convention Center

CE: .33

CNE Credits: 0.33
CME Credits: 0.33

Presenter(s)

Nikki Mueller, MLS(ASCP)CM, MBA, CIC (she/her/hers)

Regional Infection Preventionist
Wisconsin Department of Health Services
Mosinee, Wisconsin

Disclosure(s): No financial relationships to disclose

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Co-Author(s)

Kiara X. McNamara, DNP, BSN (she/her/hers)

Epidemic Intelligence Service Officer
Centers for Disease Control and Prevention
Atlanta, Georgia
CH

Caroline (Callie) A. Habrun, DVM, MPHTM (she/her/hers)

Epidemic Intelligence Service Officer
Centers for Disease Control and Prevention
Atlanta, Georgia
Leslie Kollmann, BS, CVT

Certified Veterinary Technician
Minnesota Department of Health
St. Paul, Minnesota
AB

Amanda Beaudoin, DVM, PhD

Adjunct Assistant Professor
University of Minnesota College of Veterinary Medicine
Ashlie Dowdell, BA (she/her/hers)

Director Healthcare-Associated Infections Prevention Program
Wisconsin Department of Health Services, Division of Public Health
Madison, Wisconsin

Moderator(s)

Trent MacAllister, MPH, MS, CIC (he/him/his)

Infection Preventionist
Washington State Department of Health, Washington

Disclosure(s): No financial relationships to disclose

Co-Moderator(s)

Christine Zirges, DNP, ACNS-BC, CIC, FAPIC

System Director Infection Prevention
SSM Health
St Louis, Missouri

Disclosure(s): No financial relationships to disclose

Background: Multidrug-resistant organisms (MDROs) are well-known concerns in human healthcare, but less is known about them in animal populations. When a New Delhi Metallo-beta-lactamase producing Escherichia coli (CP-CRE), was identified at an animal rescue facility (ARF), a multidisciplinary team consisting of veterinary, public health, and infection prevention professionals responded to prevent further transmission and strengthen infection prevention and control (IPC).

Methods: After the initial identification, public health authorities collaborated with the ARF and associated veterinary clinics to determine the MDRO transmission risk within the facilities and to the surrounding community based on current practices. Focused IPC observations were completed to evaluate practices and identify possible transmission routes.

Results: Many challenges were identified, including high population density, suboptimal environmental cleaning, limited space for animal isolation, and no separation between human and animal spaces. The ARF had few IPC procedures built into the care of these high-risk animals, some of which had countries of origin where CP-CRE is endemic. Associated veterinary locations were found to incorporate some IPC practices in their daily routines. Public health staff educated facilities’ staff on a variety of IPC topics, including hand hygiene, use of personal protective equipment, and cleaning and disinfection methods, so better IPC practices could be incorporated into the daily routines at the ARF and veterinary facilities.

Conclusions: Findings from this outbreak suggest lack of regular IPC practices may contribute to novel MDRO transmission within animal care settings, across human and animal settings, and to the public in the surrounding communities. Veterinarians should be included in discussions given the One Health implications of antibiotic resistance, including updating standards to jointly keep animals, people, and the environment safe from increasing MDRO concerns. A multidisciplinary team to bridge human and animal health can help reduce MDRO transmission risks by building MDRO foundational knowledge and tailoring IPC practices in affected facilities.

Learning Objectives:

Describe a public health response to an outbreak of NDM E. coli among dogs living at an animal rescue facility.
List examples of challenges that may be encountered in animal care and rescue settings.
Describe infection prevention and control practices that may be incorporated into routines to mitigate transmission risks associated with NDM E. coli.