Lumbry Park Veterinary Specialists, Axiom Veterinary Laboratories and Finn Pathologists have published a study which reveals the prevalent strains of bacteria in feline urine, and their sensitivity profiles.

For the study, urinalysis results from 2,712 UK feline urine samples submitted and analysed by Axiom and Finn over a period of 14 months² were reviewed.

Urine samples had to have been obtained by cystocentesis and signalment information recorded by their submitting vet³.

These samples did not have to come from cats presenting with FLUTD signs and the researchers therefore say that consideration should be given to a different (potentially even more increased) prevalence in cats presenting with LUT signs.

Bacterial urinary tract infections in cats with FLUTD are estimated to be present in around 8 – 19% of cases⁴.

However, FLUTD is one of the most common reasons for the use of antimicrobial drugs in veterinary medicine and is therefore an important condition to consider to minimise antimicrobial use and development of antimicrobial resistance⁵.

The study found that 15.7% of the samples had a positive culture, with E. coli (43.7%), other Enterobacterales (26.4%) and Enterococcus spp (14.9%) being the most common isolates identified.

Antimicrobial susceptibilities and resistance were also tested.

Notably, Enterococcus species were frequently found to be resistant to multiple antibiotics, and several other isolates demonstrated resistance to frequently used antibiotics.

The data showed Enterococcus spp. were much less susceptible to trimethoprim and sulfamethoxazole (TMPS) than have been previously documented (with 94% of isolates resistant).

Additionally, other Enterobacterales had resistance against cephalosporins and penicillins.

The authors say that data surrounding cephalosporin resistance is particularly notable and problematic; recent data has indeed shown that the cephalosporin cefovecin is a commonly prescribed antibiotic³ for cats presenting with lower urinary tract disease.

The authors also say that data in this study adds to the existing evidence that the use of cephalosporins such as cefovecin may be ineffective in many cases (intrinsic resistance of Enterococcus spp) and therefore should be avoided unless cystocentesis and signalment results support their use.

The inappropriate use of antibiotics for bacterial cystitis could not only be ineffective to manage bacterial cystitis in cats but promote further antimicrobial resistance.

Clarisse D’Août, lead author of the research and Internal Medicine Specialist at Lumbry Park Veterinary Specialists, said: “Even though feline lower urinary tract disease is one of the most common reasons for vets to prescribe antibiotics, the prevalence of bacterial strains in the urine of cats with this condition, and their resistance to commonly used antibiotics, had not been widely studied in the UK to date.

"So we hope that this study can add to the current evidence to making well-justified and practical recommendations in practices about which antibiotics to choose and those to avoid.

"We see this ongoing susceptibility testing as clinically important to avoid the development of further resistant bacteria.”

References

1. D’Août, C.; Taylor, S.S.; Gelendi, S.; Atkinson, C.; Defauw, P. Bacteriuria in Cystocentesis Samples from Cats in the United Kingdom: Prevalence, Bacterial Isolates, and Antimicrobial Susceptibilities. Animals 2022, 12, 3384. https://doi.org/10.3390/ani12233384 
2. Weese, J.S.; Stull, J.W.; Evason, M.; Webb, J.; Ballance, D.; McKee, T.; Bergman, P.J. A multicenter study of antimicrobial prescriptions for cats diagnosed with bacterial urinary tract disease. J. Feline Med. Surg. 2021, 24, 806–814.
   Burke, S.; Black, V.; Sánchez-Vizcaíno, F.; Radford, A.; Hibbert, A.; Tasker, S. Use of cefovecin in a UK population of cats attending first-opinion practices as recoarded in electronic health records. J. Feline Med. Surg. 2016, 19, 687–692.
3. January 2018 – February 2019.
4. Gerber, B.; Boretti, F.S.; Kley, S.; Laluha, P.; Müller, C.; Sieber, N.; Unterer, S.; Wenger, M.; Flückiger, M.; Glaus, T.; et al. Evaluation of clinical signs and causes of lower urinary tract disease in European cats. J. Small Anim. Pract. 2005, 46, 571–577. https://doi.org/10.1111/j.1748-5827.2005.tb00288.x.
   Sævik, B.K.; Trangerud, C.; Ottesen, N.; Sørum, H.; Eggertsdóttir, A.V. Causes of lower urinary tract disease in Norwegian cats. J. Feline Med. Surg. 2011, 13, 410–417. https://doi.org/10.1016/j.jfms.2010.12.012.
   Teichmann-Knorrn, S.; Dorsch, R. Signifikante Bakteriurie der Katze: Bakterielle Harnwegsinfektion und subklinische Bakteriurie. Tierarztl. Prax Ausg. K Kleintiere Heimtiere 2018, 46, 247–259. https://doi.org/10.15654/TPK-180521.
5. Murphy, C.P.; Reid-Smith, R.J.; Boerlin, P.; Weese, J.S.; Prescott, J.F.; Janecko, N.; McEwen, S.A. Out-patient antimicrobial drug use in dogs and cats for new disease events from community companion animal practices in Ontario. Can. Vet. J. 2012, 53, 291–298. PMID: 22942447, PMCID: PMC3280785.
   Schmitt, K.; Lehner, C.; Schuller, S.; Schüpbach-Regula, G.; Mevissen, M.; Peter, R.; Müntener, C.R.; Naegeli, H.; Willi, B. Antimicrobial use for selected diseases in cats in Switzerland. BMC Vet. Res. 2019, 15, 94. https://doi.org/10.1186/s12917-019-1821-0.
6. Breed, age, sex and neutering status.

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