CREATE a PATH: Prevalence at Teaching Hospitals of CRE in Veterinary Patients through Passive Surveillance

创建一条路径：通过被动监测了解教学医院兽医患者中 CRE 的患病率

• 批准号: 10448662
• 负责人: Stephen Douglas Cole
• 金额: $ 7.45万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-06 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10448662
• 关键词: CREATE; PATH; Prevalence; Teaching; Hospitals

The rise of human infections caused by carbapenem-resistant Enterobacterales (CRE) is considered one of the most urgent threats to modern healthcare by the Centers for Disease Control and Prevention. Until recently CRE were associated with healthcare-associated infections (HCAIs) but reports of infections acquired in the community are now a concern. In parallel, there is growing concern in veterinary medicine over reports of the isolation of CRE from companion animals. Companion animals could potentially play a role in CRE transmission in communities; however, it is currently unknown what the prevalence of CRE carriage among animals is in the USA. The aims of this study are to (1) estimate the prevalence of carbapenem-resistant Enterobacterales (CRE) among dogs and cats presenting to veterinary teaching hospitals in the USA and (2) characterize isolates of CRE from companion animals by whole genome sequencing (WGS). For the first aim of this project, the existing Vet-LIRN infrastructure will be leveraged to complete a short-term, proof-of-concept, passive surveillance project for CRE in companion animals. A total of five laboratories associated with veterinary teaching hospitals will participate in this initial study. All laboratories will use chromogenic agar to screen between 30-50 fecal specimens monthly for CRE over 10 months. Presumptive positive isolates will be sent to the University of Pennsylvania’s laboratory for identification, antimicrobial susceptibility testing (AST) and phenotypic characterization of carbapenemase enzyme production. The estimated prevalence will be calculated as the proportion of the positive specimens out of the total number of specimens tested. Under the second aim, confirmed CRE will be sent to the Louisiana Animal Disease Diagnostic Laboratory (LADDL) at the Louisiana State University for whole genome sequencing. Raw sequencing data will be uploaded and processed through the NCBI Pathogen Detection pipeline to detect antimicrobial resistance genes and to characterize isolates by multilocus sequence typing along with supplementary analyses. Based on previous studies, we estimate a prevalence of about 1% among dogs and cats that will have genetically distinct background and harbor a variety of different mechanisms for carbapenem resistance. This study will serve as a basis for wider surveillance strategies for CRE in companion animals and will build capacity within the Vet-LIRN program to identify and characterize CRE.

抗碳青霉烯引起的肠杆菌（CRE）引起的人类感染的兴起被认为是一种 疾病控制与预防中心对现代医疗保健的最紧急威胁。直到最近 CRE与医疗保健相关感染（HCAI）相关，但在 社区现在是一个问题。同时，兽医医学上越来越关注有关 从伴侣动物中隔离CRE。伴侣动物可能在CRE传播中发挥作用 在社区中；但是，目前尚不清楚动物中CRE携带者在 美国。这项研究的目的是（1）估计抗碳青霉烯的患病率（CRE） 在美国兽医教学医院呈现的狗和猫中，（2）是隔离的特征 来自整个基因组测序（WGS）的伴侣动物的Cre。对于该项目的第一个目的，现有 将利用兽医利益基础设施来完成短期概念证明，被动监视项目 用于伴侣动物中的Cre。共有五个与兽医教学医院相关的实验室将 参加这项初步研究。所有实验室将使用成色琼脂在30-50粪便之间进行筛选 每月标本在10个月内为CRE进行标本。推定的阳性分离物将被发送到大学 宾夕法尼亚州的实验室，用于识别，抗菌易感性测试（AST）和表型 碳青霉酶产生的表征。估计的患病率将计算为 阳性样品的比例来自测试的标本总数。在第二个目标下， 确认的CRE将被送往路易斯安那州的路易斯安那动物疾病诊断实验室（LADDL） 州立大学全基因组测序。原始测序数据将上传并通过 NCBI病原体检测管道以检测抗菌耐药基因并表征通过 多焦点序列与补充分析一起键入。根据先前的研究，我们估计 狗和猫的患病率约为1％ 碳青霉烯电阻的不同机制。这项研究将作为更广泛监视的基础 伴侣动物中CRE的策略，并将在兽医LIRN计划中建立能力来识别和 特征CRE。