Carbapenem-resistant Enterobacterales and Animals Basics

Overview

Enterobacterales are a group of bacteria (germs). They are a normal part of the animal gut but can also cause infections. Carbapenem-resistant Enterobacterales (CRE) are germs resistant to one or several antibiotics called carbapenems.

If your pet has CRE, talk to your veterinarian about what to expect and how to prevent the spread of germs to other pets and people in your home.

Signs and symptoms

Pets may experience:

• Bloodstream infections
• Skin and ear infections
• Upper respiratory tract infections
• Urinary tract infections
• Wound infections

How it spreads

It might be hard to know exactly where and when your pet got CRE. Animals can get CRE from many sources, including other animals with CRE infections. Animals can carry CRE in their gut without any symptoms.

Pets and people can share germs, including CRE. We don't know how often this happens with CRE. Scientists are working to understand the risk of developing a CRE infection from exposure to a pet, but currently believe the risk is low.

People or animals can carry the germs on or in their body without infection, known as colonization.

Reducing risk

• Always clean your hands:
  • After touching or playing with your pet.
  • After feeding your pet or handling pet food.
  • After providing medical or nursing care.
  • After handling pet habitats or equipment (crates, cages, toys, food and water dishes, etc.).
  • After cleaning up after pets.
  • Before preparing food or drinks.
  • Before eating and drinking.
  • After removing soiled clothes or shoes.
• Practice good pet hygiene:
  • Keep pets and their supplies out of the kitchen.
  • Keep litter boxes, pet dishes, pet beds, and toys clean.
  • Whenever possible, avoid cleaning pet supplies in the kitchen sink, near food, or the bathroom sink.
  • Always remove your dog's poop from your yard and public places using a bag, dispose of it in proper areas, and clean your hands after.
  • Keep children away from areas that might contain dog or cat poop.
• If your pet is sick, call your veterinarian.
• When you book a veterinary appointment tell the hospital staff if your pet has a history of CRE.
• If you have a weakened immune system, take antibiotics frequently, or use medical devices like urinary catheters, then you should also:
  • Avoid changing cat litter, cleaning up your pet's poop, or bathing your pet, if possible. If no one else can perform the task, then wear disposable gloves and wash your hands with soap and water afterwards.
  • Avoid letting your pet lick/kiss your face and any wounds you have.
  • Cover outdoor sandboxes.
  • Wear gloves when gardening and during contact with soil or sand, as it may contain animal poop. Wash hands with soap and water after gardening or contact with soil or sand.

If you're worried about your risk of CRE infection, talk to your healthcare provider.

Treatment and recovery

You don't need to give up a pet with CRE. If your pet has a CRE infection, your veterinarian might ask to do additional tests to be sure they choose the correct drug to treat the infection. Antimicrobial-resistant infections may take longer to treat and can be more expensive to treat. Pets can carry CRE without signs of infection. In these cases, your veterinarian may not recommend any treatment.

Talk to your veterinarian about what to expect and how to prevent your pet's germs from spreading to other pets and people in your home.

What to expect long-term

If your pet has a CRE infection, they may continue to carry the germ after treatment and their symptoms disappear. Scientists are still working to understand how long cats and dogs carry CRE.1

Protecting others' pets

• Do not visit places like the dog park if your pet is currently sick, has an active infection, or is taking antibiotics. This may put other pets at risk.
• Since animals may carry CRE for several months, even if they don't have symptoms of infection, talk to your veterinarian about when your pet can go back to places like the dog park or be around other animals.