COCA Now: Multistate Outbreak of Multidrug-Resistant Campylobacter Infections Linked to Contact with Pet Store Puppies (Final Update)

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Multistate Outbreak of Multidrug-Resistant Campylobacter Infections Linked to Contact with Pet Store Puppies (Final Update)


CDC, several states, and the U.S. Department of Agriculture’s Animal and Plant Health Inspection Service (USDA-APHIS) investigated a multistate outbreak of multidrug-resistant Campylobacter infections. Epidemiologic and laboratory evidence indicated that contact with puppies sold through Petland stores were a likely source of this outbreak. This outbreak investigation is over; however, illnesses could continue because people may be unaware of the risk of Campylobacter infections from puppies and dogs. This multi-drug resistant outbreak highlights the need for responsible use of antibiotics in pets.

A total of 113 people with laboratory confirmed infections or symptoms consistent with Campylobacter infection were linked to this outbreak. Illnesses were reported from 17 states. There were 23 hospitalizations and 0 deaths. Campylobacter bacteria isolated from clinical samples from ill people and from puppies in this outbreak were resistant to recommended, first-line antibiotics used to treat severe Campylobacter infections.

Clinicians should consider the following when managing patients who have suspected or confirmed Campylobacter infection related to this outbreak:

  • Supportive care (for example, rehydration, and electrolyte repletion) should be sufficient for most patients.
  • For patients who may require antibiotics (for example, those who are at high risk for serious illness, such as infants and young children, adults aged 65 years and older, pregnant women, and people with compromised immunity):

                - Order stool culture and antimicrobial susceptibility testing.

                - Choose an antibiotic based on the results of the testing.

                - Consider consulting an infectious disease specialist for patient management.

  • When empiric treatment is required, avoid agents to which the outbreak strain is resistant. This includes penicillins, amoxicillin-clavulanic acid, cephalosporins, metronidazole, and trimethoprim-sulfamethoxazole, to which Campylobacter jejuni are inherently resistant.

Veterinarians should thoroughly clean surfaces and equipment that have been in contact with stool from any dog suspected to have a Campylobacter infection.

  • Use water and detergent to remove any organic material. Then disinfect the surface or equipment using an EPA-registered disinfectant. Follow label instructions.
  • Refer here for the National Association of Public Health Veterinarians' (NASPHV) information on proper disinfection procedures.

The full report, which includes more information for healthcare providers and veterinarians, as well as advice to pet owners and pet store workers is available here.