Development of antimicrobial drug resistance in rectal Escherichia coli isolates from dogs hospitalized in an intensive care unit

Abstract
Objective—To determine whether duration of hospitalization in the intensive care unit (ICU) of a veterinary teaching hospital was associated with prevalence of antimicrobial resistance among rectal Escherichia coli isolates from dogs, whether antimicrobial treatment was associated with prevalence of antimicrobial resistance, and whether there were associations among antimicrobial drugs to which isolates were resistant. Design—Prospective observational study. Animals—116 dogs hospitalized in an ICU for ≥ 3 days. Procedures—Rectal swab specimens were obtained every 3 days and submitted for bacterial culture for E coli. Isolates were tested for susceptibility to 12 antimicrobial agents by means of disk diffusion. Results—For each additional day that a dog was hospitalized in the ICU, the odds of being colonized with an E coli isolate resistant to 1 or more of the 12 antimicrobials tested increased by a factor of 1.5, independent of antimicrobial treatment. Dogs that were treated with enrofloxacin were 25.6 times as likely to be colonized by a quinolone-resistant E coli strain as were dogs that did not receive any antimicrobials. Significant correlations were found for resistance to agents in the extended-spectrum cephalosporin group and the quinolone group. Conclusions and Clinical Relevance—Results suggested that the proportion of rectal E coli isolates obtained from dogs housed for ≥ 3 days in a veterinary teaching hospital ICU that were resistant to antimicrobial agents increased as the duration of hospitalization in the ICU increased. Thus, ICU hospitalization time should be as short as possible to prevent development of antimicrobial resistance among rectal E coli isolates.