A clinical approach to multidrug-resistant urinary tract infection and subclinical bacteriuria in dogs and cats

ABSTRACT

Multidrug-resistant bacteria are increasingly isolated from the urinary tract of pets, particularly those that suffer from concurrent conditions, have been hospitalised, or were treated with antimicrobials in the recent past. Many of the multidrug-resistant bacteria encountered are resistant to all commonly used oral antibiotics. This poses both a therapeutic dilemma in the individual pet and a threat to public health. This article begins with an overview of multidrug resistance in organisms that are commonly isolated from the urinary tract of pets. This is followed by a proposed clinical approach to managing multidrug-resistant urinary bacteria, which summarises current knowledge regarding appropriate sampling and analysis, reviews the current guidelines regarding appropriate antimicrobial use and discusses treatment options that might be considered. The article highlights several shortcomings of the current knowledge to be considered when planning future clinical research and developing policies.

KEYWORDS:

• Urinary tract infection
• bacteriuria
• multidrug resistance
• dogs
• cats
• antimicrobial stewardship

Acknowledgements

Part of this material was first presented at the Australian and New Zealand College of Veterinary Scientists Science Week 2018. Dr Lauren Lacorcia is gratefully acknowledged for her input on the manuscript. Publication of this state of the art review was generously supported by the Companion Animal Veterinarians Branch of the New Zealand Veterinary Association.

ORCID

T Johnstone http://orcid.org/0000-0001-6643-9153