Dr. Ibrahim Elsohaby (DVM, MVSc, GradCert One Health, PhD)
Assistant Professor of Public Health and Epidemiology
Department of Infectious Diseases and Public Health
City University of Hong Kong
Email: ielsohab@cityu.edu.hk
September 12, 2023

OUTLINE

Background5%

AMR in pets
90%

AMR in pet birds
30%

AMR in household cats30%

AMR in dogs, cats, exotic pets
30%

Conclusions
5%

http://www.onehealth glob al.n et /meetings /meetings-2 013/2nd- grf-one- health -su mmit- 2013 /att ach ment/o ne-h ealth- lo go/One Health'One Health' is the collaborative efforts ofmultiple disciplines working locally,nationally and globally to attain optimal
health for humans, animals and ourenvironment.
-American Veterinary Medical Association

Antimicrobial Resistance▪

Antimicrobial Resistance (AMR) is globallyrising public health threat.

▪

Lack of information on the trends and distribution ofresistant pathogens especially in developing countries.
▪

South-East Asia and Middle East identified as two of thethree major regions with the largest gaps in reporting (WHOGlobal Report on Surveillance, 2014).

Antimicrobial Resistance
Inappropriate Use of
Antibiotics inHuman Medicine› Most commonly prescribed
medications› 80% of hospitalized patients
receiving antibiotics› Obtained without a physician
prescription› Lack of water, sanitation, andhygiene (WASH) infrastructure

Lake of hygiene and infection
prevention and control
strategies

Inappropriate Use ofAntibiotics in
Veterinary Medicine› Antibiotics misuse in livestockand fish
› Therapeutic and prophylactic(growth promoter)

AMR Drivers› Refugee and travelers

Political conflicts andhuman mobility

AntimicrobialResistance1

Number of sites recruited
to compile the data(WHO, 2017).

2Sites have access tohuman data only

3

AMR data from animaland environment arelimitedLimitations

4

Focus on farm animals

One Health Approachis needed to address
AMR

AMR in Pet Animals
Saudi Arabia• Household catsEgypt• Pet birds• Pet shop worker

Hong Kong• Dogs• Cats• Exotic pets ( including turtles,snakes, frogs, lizards, pigeons,Chinchilla, guinea pigs, rabbits,pet fish)I - AMR in Pet Birds▪ Are birds bred for ornamental use▪ Zoonotic bacteria▪ In Egypt, the practices of keeping birds as petBudgerigar

increased significantlyObjectives:▪ Prevalence of AMR zoonotic bacteria in petbirds and their human contacts.
▪ Genetic relatedness between isolates frombirds and human sources.

Rosy-faced
lovebird

Red-rumped
parrot

Methodology:▪ 125 cloacal and tracheal swabs▪ 70 hand swabs▪

25 pet shops▪ Bacterial isolation: Seven bacterial species▪ Molecular

identification,

Virulotyping and Genotyping

AMRtesting,Main findings:▪ Pet birds (38%) and human contacts (40%) were positive for at least one bacterium.
▪ Campylobacter and Chlamydia spp. were not identified in both birds and humans.
▪ S. typhimurium (4%) and P. multocida (0.8%) were detected only in birds.
Number and species of bacteria (%)

No.
examined

Staph

E. coli

Klebsiella

Salmonella

Pasteurella

Birds

125

19 (15.2)

22 (17.6)

22 (17.6)

5 (4.0)1 (0.8)48 (38.4)

Workers70

17 (24.3)

10 (14.3)

9 (12.9)

0 (0.0)0 (0.0)28 (40.0)

Total

E. coli

S. aureus▪

18% of birds and 14% humans▪ 15% birds and 24% humans▪

Virulence genes (stx1, stx2, eaeA, hlyA): 60% and 27%▪ Virulence genes (PVL, sea, sed): 42% birds and 47% of humans.

of E. coli isolates recovered from birds and humans.

▪ MRSA: 32% birds and 18% humans

MDR: 81% birds and 70% humans.

▪ MDR: 61% of all isolates including MRSA.

▪

Non-metric multidimensional scaling (nMDS) plotII - AMR in Household Cats
▪ Share common environment with the owners▪ Treatedwith

antimicrobial

agentscommonlyprescribed to humans▪ Potential reservoirs for AMR zoonotic bacteria.

Data:▪ 2000 swabs▪ 400 cats (209 Healthy and 191 Diseased)▪ 5 swabs each cat (skin, anus, ear canal, conjunctival

sac and nares).

Objectives:▪ Investigate the diversity in Staphylococcus spp. recoveredfrom different anatomical locations in healthy and diseasedcats▪ Determine the occurrence of MDR and MRS spp. as well as
possible risk factors associated with colonization in thesecats.

▪ Questionnaire(demographics,healthmanagement, and antimicrobial usage)

status,Main findings:
Staphylococcus spp.
isolated from healthyand diseased cats

Main findings:
Distribution of Staphylococcus spp.

Antimicrobial Susceptibility of Staph. spp.

Risk factors associated with MDR and MRSIII- AMR in Petanimals in Hong Kong

Retrospective
study1➢ The number of pet animals kept in households
is growing.

✓ Electronic laboratory records✓ Dogs, cats, and exotic petsclinical samples✓ Microbiology and AST✓ CityU Veterinary Diagnostic
Laboratory

Objective✓ Identify the most prevalent
bacterial infections andAMR profiles among dogs,cats, exotic pets clinicalsamples in Hong Kong

➢ In Hong Kong, the exact size of the exotic pet
population is unknown.

Prospectivestudy➢ Between 2015 and 2019, at least 4 million
exotic pets were imported from 84 countries.
➢ In 2016, exotic pets accounted for 25.1% of
all pets in Hong Kong.

2✓ Samples from owned dogs
and cats / Stray dogs andcats✓ Samples from exotic pets(reptiles)✓ Data collection (Riskfactors)

Objectives✓ To determine the prevalence ofAMR-zoonotic bacteria✓ Characterize the isolated
phenotypically andgenotypically✓ Identify the potential riskfactors

Dogs

Main findings of dogs and cat's
retrospective analysis:
Data from 2018 to 2022
Dogs

Cats

Number of clinical samples

520

728

Number of veterinary clinics

7755

Bacterial growth

369

290

Total number of bacterial isolates

589

405

AST results

554

394

Cats

Proportion of most isolated bacterial species:Multiple antibiotic resistance (MAR) index:
Dogs

Cats

Initial findings of exotic pets:
No. of clinical samples submitted between 2018and 2022

Hamster

524

Rabbits

301

Turtles and Tortoises

263

Pet birds

263

Guinea pigs

240

Chinchilla

182

Lizards49

Frog18

Pigeon8

Snakes3

Conclusions• High levels of AMR and MDR resistance zoonotic bacteria wereisolated from pet animals.

• Isolated bacteria were resistance to antimicrobials commonlyprescribed in human medicine.

• Antimicrobial stewardship is need to address the potential
threats of AMR in pet animals.

Contributors✓ Prof. Vanessa BARRS (CityU)✓ Dr. Omid NEKOUEI✓ Dr. Fraser I. Hill (CityU VDL)
✓ Chen Xin (Student)✓ Prof. Greg Keefe (UPEI)✓ Prof. J. McClure (UPEI)✓ Elizah McFarland (Student)✓ Cynthia Mitchell (Lab.)✓ Natasha Robinson (Lab.)✓ Dr. Heba Ahmed (Zagazig University)✓ Dr. Rasha Abou Elez (Zagazig University)✓ Dr. Wael M. El-Deeb (KFU)✓ Dr. Mahmoud Fayze (MAWE)

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