Robert-von-Ostertag-Str. 7-13
14163 Berlin
+49 30 838 51843 / 66949
mikrobiologie@vetmed.fu-berlin.de
Introduction:
Panton-Valentine leukocidin (PVL)-producing Staphylococcus aureus (PVL-SA) is a frequent cause of skin abscesses in humans. Besides antibi-
otics and surgical treatment, topical decolonization is a preventive measure for reducing the risk of PVL-SA recurrence and transmission. Here, we re-
port on an affected family of four that was treated but continued to suffer from repeated PVL-SA positive skin infections even after three courses of
appropriate decolonization and whose two cats were identified to be colonized by S. aureus (SA). Although dogs and cats can be potential carriers of
PVL-SA and hence a source of reinfection for humans, validated protocols for decolonization of animals are not available. Thus, a protocol for outpatient
decolonization using systemic antibiotic treatment of cats was developed.
Methods:
For bacteriological examination, samples from both cats were obtained from the nose, oral cavity, rectum, inguinal and perianal region. SA isolates were
tested for the presence of lukF-lukS by PCR and subjected to susceptibility testing (AST) according to CLSI. Comparative analysis of human and feline
isolates was performed by whole genome sequencing. Results of susceptibility testing were used to develop a decolonization protocol based on systemic
therapy with amoxicillin-clavulanic acid for 10 d and 20 d, respectively.
Results:
Methicillin-susceptible SA was isolated from the oral cavity and nose of both cats. While one cat was a carrier of PVL-SA, a PVL-negative SA strain
was isolated from the second cat. Comparative whole genome analysis revealed close clonal relationships of both the PVL-SA assigned to sequence
type (ST 8) and a further SA (ST45) isolated from human and feline samples. In the course of oral decolonization therapy, a significant reduction of
SA was accomplished. Although the samples of the SA-carrying cat were negative after 10 days, the PVL-SA-positive cat required a second course
of antibiotics (amoxicillin for 18 days). Control examinations of the cats after 3 and 7 weeks were negative for SA.
Discussion:
In the case presented, successful decolonization of cats colonized with PVL-positive or -negative S. aureus was achieved by a combination of
systemic antibiotic therapy and hygiene measures. The close relationship of human and feline isolates suggests transmission between humans and
animals in the household and underscores the importance of potentially colonized pets for the success of decolonization measures.