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Panton-Valentine leukocidin (PVL)-producing S. aureus (SA) cause recurrent skin abscesses in humans. In addition to antibiotic and surgical treatment, decolonization of patients is necessary to prevent reinfection and further transmission. Here, we report on an affected family (two adults and two children) whose two cats were identified as SA colonized after all family members had been previously decolonized three times and continued to suffer reinfections. Since validated strategies for decolonization of animals do not yet exist, we aimed to develop a protocol for outpatient decolonization using systemic antibiotic treatment of cats.
SA isolates of the cats were tested for pvl by PCR and subjected to susceptibility testing (AST) according to CLSI. Comparative analysis of human and feline isolates was performed by whole genome sequencing. The decolonization protocol included oral therapy with amoxicillin-clavulanic acid based on the results of susceptibility testing.
SA was isolated from the oral cavity and nose of both cats. While one cat was a carrier of a pvl-positive isolate, only a pvl-negative SA strain was isolated from the second cat. Comparative whole genome analysis revealed close clonal relationship of both the pvl-positive isolates assigned to ST 8 and the pvl-negative SA (ST45) from humans and cats. After a total of 20 days of oral therapy, SA could not be isolated in any animal. Control examinations after 3 and 7 weeks also showed negative results.
Decolonizing the pets led to successful elimination of the bacteria from the household. Clinicians should consider pets as possible reinfection sources.