Multilaboratory Survey To Evaluate Salmonella Prevalence in Diarrheic and Nondiarrheic Dogs and Cats in the United States between 2012 and 2014

Eleven laboratories collaborated to determine the periodic prevalence of Salmonella in a population of dogs and cats in the United States visiting veterinary clinics. Fecal samples (2,965) solicited from 11 geographically dispersed veterinary testing laboratories were collected in 36 states between January 2012 and April 2014 and tested using a harmonized method. The overall study prevalence of Salmonella in cats (3 of 542) was <1%. The prevalence in dogs (60 of 2,422) was 2.5%. Diarrhea was present in only 55% of positive dogs; however, 3.8% of the all diarrheic dogs were positive, compared with 1.8% of the nondiarrheic dogs. Salmonella-positive dogs were significantly more likely to have consumed raw food (P = 0.01), to have consumed probiotics (P = 0.002), or to have been given antibiotics (P = 0.01). Rural dogs were also more likely to be Salmonella positive than urban (P = 0.002) or suburban (P = 0.001) dogs. In the 67 isolates, 27 unique serovars were identified, with three dogs having two serovars present. Antimicrobial susceptibility testing of 66 isolates revealed that only four of the isolates were resistant to one or more antibiotics. Additional characterization of the 66 isolates was done using pulsed-field gel electrophoresis and whole-genome sequencing (WGS). Sequence data compared well to resistance phenotypic data and were submitted to the National Center for Biotechnology Information (NCBI). This study suggests an overall decline in prevalence of Salmonella-positive dogs and cats over the last decades and identifies consumption of raw food as a major risk factor for Salmonella infection. Of note is that almost half of the Salmonella-positive animals were clinically nondiarrheic

Campylobacter pinnipediorum subsp. caledonicus and C. pinnipediorum subsp. pinnipediorum recovered from abscesses in pinnipeds

Campylobacter pinnipediorum was described recently for isolates recovered from pinnipeds. The novel species was further split into 2 subspecies based on host and geography, with C. pinnipediorum subsp. pinnipediorum recovered from otariid seals in California (USA) and C. pinnipediorum subsp. caledonicus recovered from phocid seals in Scotland. We report details of the infections of 7 pinnipeds from which C. pinnipediorum was isolated: C. pinnipediorum subsp. caledonicus was isolated from 2 harbour seals Phoca vitulina and a single grey seal Halichoerus grypus, and C. pinnipediorum subsp. pinnipediorum was isolated from California sea lions Zalophus californianus. Six of the isolates were recovered from samples collected at post-mortem investigation. In 2 of the Scottish seals and in 3 of the California seals, C. pinnipediorum was the sole bacterial isolate recovered from abscesses present and suggests they may have resulted from conspecific or intraspecific bite wounds

Phenotypic and Genotypic Characterization of Animal-Source Salmonella Heidelberg Isolates.

Salmonella enterica serotype Heidelberg (S. Heidelberg) is frequently implicated in human foodborne Salmonella infections and often produces more severe clinical disease than other serotypes. Livestock and poultry products represent a potential risk for transmission to humans. The purpose of this study was to evaluate 49 S. Heidelberg veterinary isolates for exponential growth rate (EGR), PFGE pattern, and antimicrobial resistance to evaluate these parameters as mechanisms by which S. Heidelberg emerged as a virulent foodborne pathogen. Isolates were categorized by species of origin; clinical or environmental sources; and time frame of recovery. Growth rates were determined in nutrient media using serial dilutions and colony counts; PFGE was performed according to the CDC PulseNet protocol. Minimum inhibitory concentration and susceptibility determinations were performed against antimicrobials important in human medicine. Eighteen unique PFGE patterns were detected in the isolates tested. Antimicrobial resistance was significantly greater (P < 0.05) for ten of 15 drugs in clinical over environmental isolates; for four drugs between the time frames; and for ten drugs between species of origin. The large genetic diversity present in isolates of this serotype may convey competitive advantages to this organism, while the presence of antimicrobial resistance represents a potential zoonotic risk via animal-source food products

Phenotypic and Genotypic Characterization of Animal-Source Salmonella Heidelberg Isolates.

Salmonella enterica serotype Heidelberg (S. Heidelberg) is frequently implicated in human foodborne Salmonella infections and often produces more severe clinical disease than other serotypes. Livestock and poultry products represent a potential risk for transmission to humans. The purpose of this study was to evaluate 49 S. Heidelberg veterinary isolates for exponential growth rate (EGR), PFGE pattern, and antimicrobial resistance to evaluate these parameters as mechanisms by which S. Heidelberg emerged as a virulent foodborne pathogen. Isolates were categorized by species of origin; clinical or environmental sources; and time frame of recovery. Growth rates were determined in nutrient media using serial dilutions and colony counts; PFGE was performed according to the CDC PulseNet protocol. Minimum inhibitory concentration and susceptibility determinations were performed against antimicrobials important in human medicine. Eighteen unique PFGE patterns were detected in the isolates tested. Antimicrobial resistance was significantly greater (P < 0.05) for ten of 15 drugs in clinical over environmental isolates; for four drugs between the time frames; and for ten drugs between species of origin. The large genetic diversity present in isolates of this serotype may convey competitive advantages to this organism, while the presence of antimicrobial resistance represents a potential zoonotic risk via animal-source food products

Isolation of Campylobacter fetus subspecies fetus from an abdominal abscess in an adult mare.

A 12-year-old Warmblood mare was referred for evaluation of behavioral changes not explained by general physical examination or lameness evaluation. Transrectal ultrasound examination was performed to determine if the behavioral changes were related to ovarian abnormalities, and a large abscess was found near the base of the cecum. Laparoscopic-guided aspiration and lavage of the abscess cavity followed by injection of benzyl penicillin G was carried out. Culture of the lavage sample yielded Campylobacter fetus subspecies fetus, an organism not previously reported as an etiological agent in abdominal abscesses in horses. The mare was treated after surgery with an extended course of antibiotics (minocycline per os q12h for 10 days followed by enrofloxacin per os q24h for 42 days). The mare resumed work in competitive eventing 10 months after surgery, and the behavioral complaints had resolved according to the owner. Key clinical message: We describe the diagnosis and treatment of a mare with an abdominal abscess from which Campylobacter fetus subspecies fetus was cultured. This organism has not previously been reported as an etiological agent in abdominal abscesses in horses

Comparative effectiveness of opioid tapering or abrupt discontinuation vs no dosage change for opioid overdose or suicide for patients receiving stable long-term opioid.

Importance: Opioid dosage tapering has emerged as a strategy to reduce harms associated with long-term opioid therapy; however, evidence supporting this approach is limited. Question: For patients receiving stable long-term opioid therapy compared with a stable opioid dosage, what is the association of opioid dosage tapering or abrupt discontinuation with opioid overdose or suicide? Findings: In this comparative effectiveness study of 415 123 episodes of stable long-term opioid therapy among 199 836 individuals, opioid tapering was associated with a small absolute increase in opioid overdose or suicide compared with a stable opioid dosage. No significant difference in outcomes between abrupt discontinuation and stable opioid therapy was identified. Meaning: These findings do not support opioid dosage tapering as a strategy to reduce harms for patients receiving stable long-term opioid therapy without evidence of misuse

Pre-Printed Versus Handwritten Post-It Notes’ Impact on Survey Response in Hard to Recruit Survey Recipients: A Randomized Controlled Trial in Veterans with PTSD Disability

Our goal was to see if affixing pre-printed Post-it note messages to a mailed survey would generate response rates similar to when handwritten Post-it notes were used in hard to recruit survey recipients. The study was a nested, randomized controlled trial of 575 individuals from a cohort of 2,100 United States Veterans with PTSD disability. Analysis was intention-to-treat. Survey response rate was 38.5% in the pre-printed Post-it note arm and 44.9% in the handwritten Post-it note arm (p = 0.09). In non-inferiority testing, pre-printed notes’ response rate exceeded the 10% margin of inferiority but was less than the 15% margin when compared to handwritten notes