Surveillance affecting infection control in a veterinary teaching hospital
Date
2017
Authors
Ouyang, Ben, author
Morley, Paul, advisor
Schissler, Jennifer, advisor
Anderson, Brooke, committee member
Burgess, Brandy, committee member
Weese, Scott, committee member
Journal Title
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Volume Title
Abstract
Healthcare-associated infections (HCAI) are poorly understood in veterinary medicine. Methicillin-resistant Staphylococcus pseudintermedius (MRSP) is an increasingly reported pathogen of dogs. Consequently, there are increasing concerns regarding treatment difficulties and propagation of antibiotic resistance. The first study seeks to estimate the burden of MRSP carriage among dogs presenting to the Colorado State University Veterinary Teaching Hospital (CSU-VTH). This study enrolled 243 canine patients across 3 different hospital services upon admission to the VTH and 155 canine patients across 3 different hospital services that received paired samples at two different time points. The 3 hospital services were Community Practice (healthy patients), Dermatology (patients with skin disease) and Surgical Oncology (patients with a higher risk of acquiring an infection during visit). The estimated prevalence of MRSP carriage at enrollment and follow-up was 4%. For enrollment samples, no patients enrolled through Community Practice carried MRSP, while 8% of Dermatology patients and 3% of Surgical Oncology patients were MRSP carriers. For paired samples, carriage persistence was only seen for patients enrolled through Dermatology. Results of this study showed that the prevalence of MRSP carriers among dogs presenting to the CSU-VTH falls within ranges previously published. MRSP colonization was seen most commonly among dogs with skin disease and least commonly among healthy dogs. The second study focuses on surveillance for HCAIs via patient temperatures stored in the electronic medical record (EMR) system of a VTH. Little work has been done in veterinary medicine on surveillance of HCAIs in a VTH. The EMR system contains patient temperature data for each visit. This study explores the association between fevers after admission and known risk factors for HCAIs (e.g. duration of stay in the hospital, critical care involvement). This study included all medical records corresponding to canine visits from the period of January 1, 2012 to June 30, 2015. After selecting for visits of ≥ 1 night and removing missing data, 6,254 unique canine visits remained. Visits were classified into type of case (Medicine, Surgery, Oncology, Other) and whether critical care (ECC) was involved). Length of stay was determined based on admission and discharge date. A visit that produced a fever after admission was a visit where the animal had a normal rectal temperature (≤102.5°F) upon admission and subsequently produced a fever (>102.5°F) after admission. The cumulative incidence of fevers after admission was calculated. Odds ratios (OR) between fevers after admission and case type and ECC involvement and duration of stay in the hospital were calculated via multivariable logistic regression. The estimated cumulative incidence of fevers after admission was 9%. Results of multivariable regression showed that a negative association existed between Medicine-type cases, Oncology-type cases and long duration of hospitalization (>2 days). This study shows that fevers after admission are associated with known risk factors for HCAIs and may be useful in a syndromic approach to HCAI surveillance. This study did not explore the association between HCAI and fevers after admission.
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Subject
MRSP
veterinary teaching hospital
syndromic surveillance
healthcare-associated infections