Vetrec-c100091.indd

Short Communications
solution every other day. Initially, the seal ate well and the wound appeared to be healing. Two weeks into treatment, the seal showed a decreased appetite and increased lethargy, and the wound devel- Staphylococcus aureus in oped a purulent exudate. The exudate was cultured on sheep blood agar and incubated at 37°C in air with 5 per cent carbon dioxide for five days at the University of California at Davis Veterinary Medical Teaching Hospital. The culture yielded an isolate that was identified as MRSA. Pulsed-field gel electrophoresis was performed by the Centers for Disease Control and Prevention (CDC), and the strain was identi-fied as USA300, a typical community-associated MRSA in the USA (Johnson and others 2007). Antibiotic sensitivity testing of the isolate was determined using the broth microdilution method, and antimi- V. Fravel, W. Van Bonn, C. Rios, F. Gulland crobial susceptibility was read as minimal inhibitory concentrations. This method revealed sensitivities to doxycycline, amikacin, chlo-ramphenicol and gentamicin. Treatment was changed to doxycycline METICILLIN-resistant Staphylococcus aureus (MRSA) is an important (Vibramycin; West-Ward Pharmaceuticals) at 10 mg/kg orally twice zoonosis that has increased in prevalence over the past decade, with daily. The animal improved within three days and the doxycycline was up to 2 per cent of human beings acting as carriers, posing a risk to in- discontinued after 18 days. One week following the cessation of antibi- contact animals (Tattevin and others 2009, Loeffler and Lloyd 2010, otic treatment, the seal’s body condition had improved and the wound Couto and others 2011). Pulsed-field gel electrophoresis has been used had almost completely healed; therefore, the seal was released.
to separate MRSA strains into community-associated strains, which Upon receipt of the wound culture results, the seal’s nares, the are sensitive to many non-β-lactam antibiotics, and hospital- associated nares of a seal sharing the pen, the pool walls and water in the pool, strains, which are usually multidrug-resistant (Johnson and others and the floor of the enclosure the animals were housed in were 2007, Tattevin and others 2009). The two major strains of communi- swabbed, transported on Amies media and cultured within 48 hours ty-associated MRSA in the USA are USA300 and USA400 (Bootsma as described above. MRSA was isolated from all the swabs of the enclosure and the wounded seal’s nares, but not from the pool water MRSA has been isolated from most domestic animal species. or from the in-contact seal’s nares. The seals were moved to a sepa- Strains isolated from dogs and cats are usually human-associated rate pool, and the original pool was drained and cleaned with dilute strains (Loeffler and Lloyd 2010), whereas MRSA isolates from horses sodium hypochlorite solution; no MRSA was isolated from follow-up vary genetically from common human isolates. Food animals are often swabs of the pen and pool walls one week later. Subsequent cultures infected with a unique MRSA lineage that has evolved independent- of randomly chosen pools and pens throughout the facility was per- ly from common human S aureus clones (Loeffler and Lloyd 2010). formed as well and revealed no isolation of MRSA.
Strains have also been isolated from wild and captive marine mam- The source of the MRSA isolate in this case could not be deter- mals (Faires and others 2009, Schaefer and others 2009). Following mined, as the wound was not cultured until after the lack of response the isolation of MRSA from the blowhole of a bottlenose dolphin to initial treatment. The seal was potentially exposed to over 100 (Tursiops truncatus) that was suspected to have died of pneumonia, sur- human caregivers over the course of its rehabilitation, and had a period veillance of other marine mammals in the facility revealed MRSA of improvement before declining; therefore, it is possible that the infec- in nasal secretions from several bottlenose dolphins and walruses tion was acquired at TMMC. It is also possible that the animal was (Odobenus rosmarus). No efforts were made to actively decolonise these colonised with MRSA at initial presentation to TMMC.
animals. Eight months later, repeated cultures from previously MRSA- In conclusion, this report describes not only the potential for colonised animals were negative. The death of a harbour seal (Phoca marine mammals in coastal waters to acquire a typically human-asso- vitulina) associated with MRSA occurred at a seal sanctuary in Ireland, ciated bacterial infection, but also the potential for human caregivers and MRSA was cultured from the animal’s spleen and a lymph node to transmit disease to the animals in their care. MRSA infections in marine mammals can be controlled with easily accessible antibiotics This short communication documents the isolation of MRSA and can be eradicated from their environment with simple hygiene from a non-healing wound in a weanling 20.5 kg female harbour seal measures, as has been highlighted in this case. This report also demon- that stranded in California, USA, and was brought to The Marine strates the need for further research into sources of antibiotic-resistant Mammal Center (TMMC), Sausalito, for treatment.
bacteria in marine mammals that share coastal waters with human On admission, the seal was lethargic, in poor body condition and had a large open wound, typical of a shark bite, across the hip area. Radiographs revealed no evidence of bone involvement. Initial treat- Acknowledgements
ment consisted of amoxicillin (Aurobindo Pharma) at a dose of 22 mg/ The authors thank Robyn A. Stoddard, Brandi Limbago and Gregory kg orally twice daily, enrofloxacin (Baytril; Bayer) at 5 mg/kg orally E. Fosheim at CDC for facilitating and performing the pulsed- once daily and carprofen (Rimadyl; Pfizer) at 4 mg/kg orally once daily. field gel electrophoresis. In addition, they thank Spencer Jang and The wound was debrided and flushed with dilute povidone-iodine all the staff at the University of California at Davis Microbiology Laboratory for isolating the MRSA and facilitating the transfer of the isolate to CDC. Finally, the authors thank all the staff, volunteers and veterinary externs who participated in the treatment and care of the affected seal.
V. Fravel, DVM,
W. Van Bonn, DVM,
References
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Short Communications
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Staphylococcus aureus
Meticillin-resistant
in a harbour seal (
Phoca vitulina
V. Fravel, W. Van Bonn, C. Rios, et al.
Veterinary Recorddoi: 10.1136/vr.d4199 Updated information and services can be found at: References
Published online July 8, 2011 in advance of the print journal.
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Source: http://www.marinemammalcenter.org/assets/pdfs/vetsci-stranding/scientific-contributions/2011/fravel-2011-mrsa-in-a-hs.pdf