Occurrence of Multidrug-Resistant Bacteria Resulting from the Selective Pressure of Antibiotics: A Comprehensive Analysis of ESBL K. pneumoniae and MRSP Isolated in a Dog with Rhinorrhea

SIMPLE SUMMARY: Antimicrobial resistance (AMR) poses a major threat to human and animal health. One of the causes underlying the emergence of increasingly resistant strains is antibiotic selective pressure. This study aimed to evaluate the impact of treatment with amikacin on an extended spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae isolated in a dog with rhinorrhea. In the middle of the treatment, methicillin-resistant Staphylococcus pseudintermedius (MRSP) was isolated from the left nasal cavity of the dog. At the end of the treatment, K. pneumoniae was not recovered from nasal swab samples, while MRSP displayed phenotypical and genotypical changes. Six weeks after the end of the treatment, only commensal flora was observed in both nasal cavities. These results warn of the effects of antibiotic pressure, which can lead to the emergence of multidrug-resistant strains either by directly promoting the enrichment of bacteria with resistance to multiple antimicrobial agents or via the subsequent acquisition of resistance genes. Therefore, adapting clinical practice to this new reality is crucial to limit the selection and spread of multi-resistant bacteria among pets, humans and the environment. ABSTRACT: Because of public health concerns, much greater scrutiny is now placed on antibiotic use in pets, especially for antimicrobial agents that have human analogs. Therefore, this study aimed to characterize the phenotypic and genotypic profiles of multidrug-resistant bacteria isolated from nasal swabs samples taken from a one-year-old male Serra da Estrela dog with rhinorrhea that was treated with amikacin. An extended-spectrum β-lactamases (ESBL) Klebsiella pneumoniae was isolated in the first sample taken from the left nasal cavity of the dog. Seven days later, methicillin-resistant (MRSP) Staphylococcus pseudintermedius was also isolated. Nevertheless, no alterations to the therapeutic protocol were performed. Once the inhibitory action of the antibiotic disappeared, the competitive advantage of the amikacin-resistant MRSP was lost, and only commensal flora was observed on both nasal cavities. The genotypic profile of extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae revealed the same characteristics and close relation to other strains, mainly from Estonia, Slovakia and Romania. Regarding MRSP isolates, although resistance to aminoglycosides was present in the first MRSP, the second isolate carried aac(6′)-aph(2″), which enhanced its resistance to amikacin. However, the veterinary action was focused on the treatment of the primary agent (ESBL K. pneumoniae), and the antibiotic applied was according to its phenotypic profile, which may have led to the resolution of the infectious process. Therefore, this study highlights the importance of targeted therapy, proper clinical practice and laboratory-hospital communication to safeguard animal, human and environmental health.