Screening of environmental swabs at a veterinary teaching hospital after isolation of Klebsiella pneumoniae in a cat with Urinary Tract Infection.

Nosocomial infections (NIs) represent an important public health issue of the 21th century, in humans and animals. On May 2022 a case of NI has been documented in a cat presented at the Veterinary Teaching Hospital of University of Parma for lower urinary tract disease (FLUTD). The first urine sample was cultured onto suitable culture solid media and BHI broth, resulting sterile. During the hospitalization the cat underwent catheterization due to urethral obstruction and developed clinical signs suggestive for sepsis. Urine and blood samples were cultured, isolating Klebsiella pneumoniae (KP). Antibiogram (AB) was performed by Kirby-Bauer, testing 20 antibiotics selected for the treatment of systemic diseases of cats, resulting not effective in vitro. A NI was hypothesized and environmental screening was performed. Seventy swab samples were collected in intensive care unit, examination rooms and ultrasound rooms. KP was confirmed in the cage where the patient was hospitalized and on the keyboard in the ultrasound room, together with other bacteria agents of nosocomial infections: E.coli, Staphylococcus aureus, Enterobacter cloacae, Pseudomonas fluorescens, Burkholderia cepacia, Stenotrophomonas maltophilia, Acinetobacter Iwoffii. Each bacterial strain was evaluated by AB, then 13 strains including KP, resistant to at least 14 antimicrobials, were evaluated through MIC assay. According to Magiorakos et al (2012), Sweeney et al (2018), referring to antimicrobials used in companion animals, 11 strains were multidrug-resistant (MDR). These findings highlight the need for active surveillance and improved hygiene standards to decrease the risk of NI transmission in the setting of a veterinary teaching hospital.