Systematic Review and Meta-Analysis of the Occurrence of ESKAPE Bacteria Group in Dogs, and the Related Zoonotic Risk in Animal-Assisted Therapy, and in Animal-Assisted Activity in the Health Context

Animal-assisted interventions are widely implemented in different contexts worldwide. Particularly, animal-assisted therapies and animal-assisted activities are often implemented in hospitals, rehabilitation centers, and other health facilities. These interventions bring several benefits to patients but can also expose them to the risk of infection with potentially zoonotic agents. The dog is the main animal species involved used in these interventions. Therefore, we aimed at collecting data regarding the occurrence of the pathogens ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp.) in dogs, in order to draft guidelines concerning the possible monitoring of dogs involved in animal-assisted therapies and animal-assisted activities in healthcare facilities. We performed a literature search using the PRISMA guidelines to examine three databases: PubMed, Web of Science, and Scopus. Out of 2604 records found, 52 papers were identified as eligible for inclusion in the review/meta-analysis. Sixteen papers reported data on E. faecium; 16 on S. aureus; nine on K. pneumoniae; four on A. baumannii; eight on P. aeruginosa; and six on Enterobacter spp. This work will contribute to increased awareness to the potential zoonotic risks posed by the involvement of dogs in animal-assisted therapies, and animal-assisted activities in healthcare facilities

RICERCA DI Escherichia coli O157:H7 IN GALLINE OVAIOLE E IN ALTRI SERBATOI NON CONVENZIONALI

Il monitoraggio dei serbatoi d’infezione alternativi per E. coli O157:H7 e per altri E. coli patogeni (isolati casualmente nel corso del presente lavoro), ha fornito dei dati molto interessanti che arricchiscono ulteriormente la letteratura scientifica internazionale e pongono l’accento sull’eventualità del rischio zoonosico proveniente dal contatto con queste specie animali, dal consumo delle loro carni e dei loro prodotti (uova). Infatti, più nello specifico, sono stati isolati trentadue ceppi di E. coli O157 da tamponi cloacali di galline ovaiole (26), di colombi urbani (4) e dalle uova di gallina (2); 3 ceppi di E. coli O20 da campioni ambientali dell’allevamento avicolo; 16 ceppi di E. coli O139 da campioni fecali di Daino(13), da tampone rettale di Pecora (1), da campioni ambientali dell’allevamento avicolo (2); 3 ceppi di E. coli O128 da campioni ambientali dell’allevamento avicolo; 5 ceppi di E. coli O141 da tamponi rettali di coniglio (2) e da campioni ambientali dell’allevamento avicolo; 1 ceppo di E. coli O64 e 2 ceppi di E. coli O73 da tamponi rettali di coniglio. È opportuno ricordare, inoltre, che le infezioni sostenute da questi microrganismi possono causare manifestazioni cliniche molto gravi (in particolar modo nell’infezione da E. coli O157 responsabile della Colite Emorragica e della Sindrome Emolitico Uremica) e che la dose infettante è particolarmente bassa. Il controllo di queste infezioni richiederebbe interventi a diversi livelli della filiera alimentare. A livello di allevamento, molte sperimentazioni sono state condotte nell’allevamento bovino, per tentare di contrastare la colonizzazione intestinale da E. coli O157 utilizzando probiotici e batteriofagi o agendo sulle caratteristiche della dieta, ma i risultati sono stati variabili e queste strategie si sono rivelate di scarsa applicabilità. L’eradicazione del microrganismo tramite individuazione ed eliminazione di animali escretori appare un obiettivo non realistico, tenendo conto che numerosi studi hanno dimostrato che un allevamento può risultare negativo a ripetuti campionamenti sia per la bassa prevalenza, sia per l’escrezione transitoria ed intermittente da parte degli animali positivi. È però possibile contrastare il mantenimento del microrganismo in allevamento e la sua diffusione adottando buone pratiche di igiene e management, incluse la pulizia dei sistemi di abbeveraggio e la riduzione dell’eventuale contaminazione fecale degli alimenti. Un altro aspetto importante, a livello di allevamento, è lo smaltimento delle deiezioni, che deve avvenire rispettando i tempi di stoccaggio e maturazione per evitare la contaminazione di ambiente, vegetali a uso alimentare umano e animale e le acque

The Presence of Toxocara Eggs on Dog’s Fur as Potential Zoonotic Risk in Animal-Assisted Interventions: A Systematic Review

Animal-assisted interventions (AAIs) usually contribute to the well-being and health of users/patients, but it is essential that the animals involved in these activities do not represent a source of zoonoses. This systematic review focused on the evaluation of the potential risk of the transmission of Toxocara by dogs’ fur, considering their involvement as the main animal species in AAIs. Three databases were considered: MEDLINE/PubMed, Scopus, and Web of Science, and the PRISMA guidelines were used. Out of 162 articles found, 14 papers were identified as eligible for inclusion in the review. Although the findings were very heterogeneous, they showed that regular parasitological surveillance to plan effective control programs is strongly needed to guarantee the health of pets and consequently the public health, according to the concept of One Health. Since AAIs involve patients and/or users potentially susceptible, it is very important to appropriately treat dogs enrolled in these interventions after an accurate diagnosis of parasitic zoonoses

Parasitic infections in dogs involved in animal-assisted interventions

Animal Assisted Interventions (AAIs) programmes have been considered useful in different settings, such as hospital, therapeutic, educational and assisted living environments. In these contexts, all animals, and particularly dogs, should be subjected to appropriate health controls to prevent a potential risk of transmission of zoonotic agents. Domestic dogs are reservoirs of many zoonotic pathogens including several gastrointestinal parasites (protozoa and helminths). Therefore, the aim of the present study was to investigate the presence of the protozoan Giardia duodenalis and zoonotic gastrointestinal nematodes (geohelminths) in dogs hosted in a dog educational centre in the city of Naples (southern Italy) where the animals were trained to AAI. Between April and June 2016, 74 dog faecal samples were analysed using the FLOTAC dual technique to detect G. duodenalis cysts and other parasitic elements. Out of the 74 faecal samples examined, 18 (24.3%; 95% CI = 15.4–35.9) were positive for parasitic elements. Specifically, 8 were positive for G. duodenalis (44.4%; 95% CI = 22.4–68.7). In addition, some co-infections were also found: one sample (5.6%; 95% CI = 0.3–29.4) resulted positive to both Toxocara canis and Trichuris vulpis and two samples (11.1%; 95% CI = 1.9–36.1) were positive to both G. duodenalis and Ancylostomidae. Given that children, young adults and immunocompromised individuals are among the main users of the AAIs, specific guidelines targeting G. duodenalis and other gastrointestinal zoonotic parasites should be formulated in order to develop effective control and prevention strategies and reduce the zoonotic risk favoured by the human-dog interaction

Prevalence and Phenotypic Antimicrobial Resistance among ESKAPE Bacteria and Enterobacterales Strains in Wild Birds

Antimicrobial resistance (AMR) is a current public health issue globally. To counter this phenomenon and prioritize AMR in the health sector, the World Health Organization (WHO) published a list of bacterial pathogens against which the development of new antimicrobial agents is urgently needed, designating the ESKAPE pathogens (i.e., Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) with a 'priority status'. Moreover, the One Health High Level Expert Panel (OHHLEP) states that human health is closely linked to animal and environmental health, thus promoting a holistic One Health approach in order to be prepared to address possible emerging health threats from the human-animal-environment interface. Wild birds may host and spread pathogens, integrating the epidemiology of infectious diseases. The aim of this study was to examine the role of wild birds as a source of ESKAPE bacteria and other antibiotic-resistant enterobacterales. A total of fifty strains within the ESKAPE group were detected in 40/163 cloacal samples of examined birds (24.5%). Additionally, different strains of enterobacterales were detected in 88/163 cloacal samples (53.9%). Isolated strains exhibited antimicrobial resistance, including towards critically important antibiotics (e.g., third, fourth, fifth generation cephalosporins, fluoroquinolones) for human medicine. Our results confirm that wild birds are potential reservoirs of several pathogens and antimicrobial-resistant bacteria and that they could be involved in the dissemination of those bacteria across different environments, with resulting public health concerns

An Animal-Assisted Education Intervention with Dogs to Promote Emotion Comprehension in Primary School Children—The Federico II Model of Healthcare Zooanthropology

Emotion comprehension (EC) is a crucial competence for children, as it determines the quality of peer interactions. This study assessed the efficacy of an animal-assisted education (AAE) intervention with dogs based on the Federico II Model of Healthcare Zooanthropology (FMHZ) to promote EC in a group of primary school children. One hundred and four children (48 females) aged 6–7 years took part in the study, of whom 63 participated in the AAE intervention (i.e., experimental group) and 41 did not (i.e., control group). The intervention was deployed in a school setting through a group format and consisted of five bimonthly sessions. EC was assessed pre- and post-intervention, and at a 3-month follow-up. Student’s t-test and mixed-model ANOVA were performed to analyze the effect of the intervention on EC. EC significantly improved in children of the experimental group compared to the control group. Significant time effects from pre- to post-intervention, post-intervention to follow-up, and pre-intervention to follow-up assessment were found in the experimental group only. AAE based on FMHZ was effective in improving EC in children

Zoonotic Risk of Encephalitozoon cuniculi in Animal-Assisted Interventions: Laboratory Strategies for the Diagnosis of Infections in Humans and Animals

The involvement of animals for therapeutic purposes has very ancient roots. To date, it is clear that animal-assisted interventions (AAIs), in addition to ensuring the replacement of missing or deficient affects, improves psychophysiological parameters connected to human health. However, AAI could potentially present risks related to the transmission of infectious agents from animals to humans. Among these microorganisms, E. cuniculi is a microspore which induces pathological effects (fever, headache, nausea, vomiting, diarrhea, breathlessness, respiratory symptoms, and weakness) in both humans and animals. Consequently, an accurate and fast diagnosis of E. cuniculi infection, as well as the identification of new diagnostic approaches, is of fundamental importance. This literature review was carried out to provide an extensive and comprehensive analysis of the most recent diagnostic techniques to prevent and care for E. cuniculi-associated risks in the AAI field

Changes of Oxytocin and Serotonin Values in Dialysis Patients after Animal Assisted Activities (AAAs) with a Dog-A Preliminary Study

Simple Summary This study aimed to improve the moment of dialysis because the emotional management of a person during treatment can help to reduce stress, anxiety and depression. This process positively affects the acceptance and progress of treatment and improves the self-management of the disease, a very important achievement in chronic kidney disease. Serotonin and oxytocin are important neuromodulators of different human behaviours, such as affectivity and socialization, and are involved in the control of stress, anxiety and social cooperation. The relationship between humans and domestic animals provides psychophysical well-being and can facilitate interpersonal bonds by favouring mechanisms involved in social relations. Dogs due to their ethological characteristics, allow the establishment of an active relationship through play, communication and interaction. Animal-assisted activities (AAAs) are structured interventions aimed at improving the psychophysical conditions of people in stressful conditions. Our study was aimed at determining the circulating levels of serotonin and oxytocin in patients who participated in an AAAs program with a dog during dialysis treatment. Our study aimed to measure the levels of serotonin and oxytocin in patients affected by end-stage renal disease (ESRD), undergoing dialysis and participating in a program of animal-assisted activities (AAAs) with a dog. Ten patients with comparable levels of ESRD were enrolled. A blood sample was taken before the start of the study in order to establish basal levels. Eleven meetings were held once a week for 3 months during the last hour of dialysis, and blood samples were collected before and after AAAs. Two more meetings, one month apart from each other, were held two months later without the dog but with the same veterinarian zootherapist. Blood was drawn at the beginning and at the end of each meeting. The samples were then processed for the measurement of serotonin and oxytocin, and data obtained were analysed using analysis of variance with mixed effect models. The results show an increasing level of both serotonin and oxytocin between subsequent meetings with the dog and an increasing trend of inter-intervention levels. Overall, the results suggest that AAAs lead to modifications of serotonin and oxytocin levels, which are also accompanied by behavioural changes of patients

Antimicrobial Resistance of Escherichia coli and Pseudomonas aeruginosa from Companion Birds

Antimicrobial resistance is a public health concern worldwide and it is largely attributed to the horizontal exchange of transferable genetic elements such as plasmids carrying integrons. Several studies have been conducted on livestock showing a correlation between the systemic use of antibiotics and the onset of resistant bacterial strains. In contrast, although companion birds are historically considered as an important reservoir for human health threats, little information on the antimicrobial resistance in these species is available in the literature. Therefore, this study was aimed at evaluating the antimicrobial resistance of Escherichia coli and Pseudomonas aeruginosa isolated from 755 companion birds. Cloacal samples were processed for E. coli and P. aeruginosa isolation and then all isolates were submitted to antimicrobial susceptibility testing. P. aeruginosa was isolated in 59/755 (7.8%) samples, whereas E. coli was isolated in 231/755 (30.7%) samples. Most strains showed multidrug resistance. This study highlights that companion birds may act as substantial reservoirs carrying antimicrobial resistance genes which could transfer directly or indirectly to humans and animals, and from a One Health perspective this risk should not be underestimated