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Pet husbandry as a risk factor for colonization or infection with MDR organisms: a systematic meta-analysis
Carolin Hackmann1, Petra Gastmeier1, Stefan Schwarz2
1Charité - Universitätsmedizin Berlin, corporate member of Freie Unitversität Berlin and Humboldt-Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany.
Background:
MDR organisms (MDROs) pose a relevant risk for patients in modern healthcare. Although ownership of pet animals is common and owners and pets commonly live in close contact, it is still unclear whether pet ownership may be considered as a risk factor for MDRO acquisition prior to hospitalization.
Methods:
We performed three separate meta-analyses in accordance with the PRISMA guidelines, assessing contact to pets as a risk factor for acquisition of MRSA, VRE and MDR Gram-negatives [namely third-generation cephalosporin-resistant Enterobacterales (3GCRE) and carbapenem-resistant Enterobacterales (CRE)].
Results:
We calculated an increased risk of MRSA carriage for dog owners [risk ratio (RR) 2.28, 95% CI 1.47-3.56]. Meta-analysis did not show a significantly higher risk for 3GCRE colonization among owners of different pet species compared with non-pet owners (RR 1.18, 95% CI 0.83-1.68 for pet owners in general, RR 0.88, 95% CI 0.56-1.40 for dog owners, RR 1.16, 95% CI 0.58-2.34 for cat owners, RR 1.34, 95% CI 0.43-4.18 for rodent owners, RR 0.91, 95% CI 0.38-2.18 for bird owners, and RR 2.34, 95% CI 0.33-16.63 for lizard/frog owners). For VRE, there were insufficient data to perform a meta-analysis.
Conclusions:
Our analyses suggest contact to pet animals is a risk factor for MRSA, but not for 3GCRE/CRE acquisition. Evaluation of the underlying literature suggested a possible role of pet animals as: (i) vectors for the transmission of MDROs between livestock and humans; as well as (ii) a reservoir for MDROs. Pets, therefore, may promote transmission and reinfection of humans.
Insights
Pet ownership is a risk factor for acquiring methicillin-resistant Staphylococcus aureus (MRSA) before hospitalization. However, contact with pets does not appear to increase the risk of acquiring multidrug-resistant Gram-negative bacteria.
Area of Science:
- Veterinary Medicine
- Infectious Diseases
- Public Health
Background:
- Multidrug-resistant organisms (MDROs) present a significant threat in healthcare settings.
- The role of pet ownership in the acquisition of MDROs before hospitalization remains unclear.
Purpose of the Study:
- To investigate whether pet ownership is a risk factor for acquiring specific MDROs prior to hospitalization.
- To assess the association between contact with pets and the acquisition of MRSA, VRE, and MDR Gram-negatives.
Main Methods:
- Three separate meta-analyses were conducted following PRISMA guidelines.
- Contact with pets was assessed as a risk factor for MRSA, VRE, and MDR Gram-negative acquisition.
- Specific MDR Gram-negatives analyzed included third-generation cephalosporin-resistant Enterobacterales (3GCRE) and carbapenem-resistant Enterobacterales (CRE).
Main Results:
- A significantly increased risk of MRSA carriage was found for dog owners (RR 2.28).
- No significantly higher risk for 3GCRE colonization was observed among owners of various pet species compared to non-pet owners.
- Insufficient data precluded a meta-analysis for vancomycin-resistant Enterococci (VRE).
Conclusions:
- Pet animal contact is identified as a risk factor for MRSA acquisition.
- Pet animals may act as vectors or reservoirs for MDRO transmission between livestock and humans.
- Pets could potentially facilitate human transmission and reinfection with MDROs.
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