Correspondence

Methicillin-Resistant Staphylococcus aureus in a Family and Its Pet Cat

N Engl J Med 2008; 358:1200-1201March 13, 2008

Article

To the Editor:

Many isolates of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) produce Panton–Valentine leukocidin (PVL), increasing the virulence of the bacteria, which can cause disseminated deep abscesses and necrotizing pneumonia.1 We report the transmission of PVL-positive MRSA between a symptomatic woman and both her asymptomatic family and their healthy pet cat.

An otherwise healthy woman presented with recurrent multiple deep abscesses. Swabs from several abscesses and nasal cultures grew MRSA that was resistant to both beta-lactam and fusidic acid antibiotics. Polymerase-chain-reaction assays for the PVL genes lukS-PV and lukF-PV were positive. The genotype of the staphylococcal chromosomal cassette was SCCmec type IV. Nasal, axillary, and inguinal cultures from her husband and their two children yielded MRSA on several occasions. Mupirocin nasal ointment and antiseptic washes were recommended for all family members. Although the patient's husband and children became MRSA-negative, the patient remained MRSA-positive. Therefore, her three apparently healthy cats were screened. Pharyngeal culture from one cat grew MRSA with the same antimicrobial resistance pattern as that of the human isolates. The clonal identity of the isolates from the family and the cats was found by typing of the spa gene repeat region and multilocus sequence typing,2,3 which showed spa-type t131 and ST80 in all isolates. This sequence combination does not correspond with that of clone USA300 (http://spa.ridom.de).2

A veterinarian recommended topical decolonization of the MRSA-positive cat with ciprofloxacin and rifampin. Four weeks after the cat's treatment, screening tests of the family were negative for MRSA. Moreover, the patient's deep abscesses completely resolved. Further MRSA screening of the asymptomatic cat was declined by the family.

There is evidence that companion animals, mainly dogs, harbor MRSA,4 and interspecies MRSA transmission has been shown in the members of a family and their dog.5 This case illustrates that MRSA transmission also occurs between humans and cats. The abscesses in our patient cleared only after antibiotic treatment of the cat. It remains unclear whether the cat was the source of the patient's infection or vice versa, although spa-type t131 is extremely rare in humans.2 We conclude that pets should be considered as possible household reservoirs of MRSA that can cause infection or reinfection in humans.

Andreas Sing, M.D.
Christian Tuschak, Ph.D.
Stefan Hörmansdorfer, Vet.D.
Bavarian Food and Health Safety Authority, 85764 Oberschleißheim, Germany

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Citing Articles (17)

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   J. B. Bender, K. C. Waters, J. Nerby, K. E. Olsen, S. Jawahir. (2012) Methicillin-Resistant Staphylococcus aureus (MRSA) Isolated From Pets Living in Households With MRSA-Infected Children. Clinical Infectious Diseases 54:3, 449-450
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   Marcy J. Souza, John C. New. 2012. Feline Zoonotic Diseases and Prevention of Transmission. , 1090-1096.
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   Tatsuo Yamamoto, Tomomi Takano, Shizuka Yabe, Wataru Higuchi, Yasuhisa Iwao, Hirokazu Isobe, Kyoko Ozaki, Misao Takano, Ivan Reva, Akihito Nishiyama. (2011) Super-sticky familial infections caused by Panton–Valentine leukocidin-positive ST22 community-acquired methicillin-resistant Staphylococcus aureus in Japan. Journal of Infection and Chemotherapy
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   Issmat I. Kassem. (2011) Chinks in the armor: The role of the nonclinical environment in the transmission of Staphylococcus bacteria. American Journal of Infection Control 39:7, 539-541
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   Manuel Bramble, Daniel Morris, Pam Tolomeo, Ebbing Lautenbach. (2011) Potential Role of Pet Animals in Household Transmission of Methicillin-Resistant Staphylococcus aureus: A Narrative Review. Vector-Borne and Zoonotic Diseases 11:6, 617-620
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    M. Morgan. (2008) Methicillin-resistant Staphylococcus aureus and animals: zoonosis or humanosis?. Journal of Antimicrobial Chemotherapy 62:6, 1181-1187
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