Assessment of antimicrobial resistance patterns in feline urinary tract pathogens and evaluation of alternative therapies in a clinical setting

Project Abstract

This study investigates antimicrobial resistance (AMR) patterns among bacterial pathogens isolated from feline urinary tract infections (FUTIs) and evaluates the efficacy of alternative therapies in a clinical setting. A cross-sectional sampling of urine cultures from cats presenting with lower or upper urinary tract signs at three veterinary teaching hospitals over 12 months was performed. Isolated pathogens were identified using MALDI-TOF mass spectrometry and subjected to phenotypic antimicrobial susceptibility testing against a panel of commonly used veterinary antibiotics, including beta-lactams, fluoroquinolones, tetracyclines, aminoglycosides, sulfonamides, and nitrofurantoin, following CLSI guidelines. Whole-genome sequencing was conducted on a subset of multidrug-resistant (MDR) isolates to characterize resistance determinants, virulence factors, and clonal relationships. Clinical data, including prior antibiotic exposure, duration of empirical therapy, concurrent diseases, age, and sex, were extracted to assess risk factors associated with resistant infections. In vitro analyses evaluated the efficacy of alternative or adjunctive regimens, such as narrow-spectrum antibiotics guided by susceptibility results, combination therapies to mitigate resistance development, and non-antibiotic approaches (phytotherapeutics, optimized hydration, and urinary acidification strategies). The study also implemented a prospective component where cats with FUTIs were treated according to a stewardship-guided protocol and monitored for resolution of clinical signs, bacteriuria clearance, and any adverse events, enabling a practical appraisal of alternative therapies in real-world settings. Results indicated a notable prevalence of Gram-negative Enterobacterales, with Escherichia coli and Klebsiella spp. comprising the majority of isolates. A substantial portion of isolates exhibited resistance to commonly used first-line agents, including ampicillin and certain fluoroquinolones, with MDR phenotypes detected in a significant subset. Genomic analyses revealed a diverse repertoire of beta-lactamase genes (e.g., blaTEM, blaCTX-M) and plasmid-mediated quinolone resistance determinants, underscoring potential horizontal gene transfer within the feline uropathogen population. Phenotype-genotype concordance supported robust linkage between detected resistance genes and phenotypic resistance profiles. Risk factor analysis identified prior inappropriate antibiotic exposure, recurrent UTIs, and prolonged hospitalization as significant predictors of resistant infections. Alternative therapies demonstrated variable but promising efficacy targeted narrow-spectrum regimens based on culture and susceptibility data achieved comparable clinical cure rates to broad-spectrum empirical therapies, with reduced rates of relapse and fewer antimicrobial exposures. Adjunctive non-antibiotic measures, particularly improved hydration and urine acidification where appropriate, correlated with faster bacteriological clearance in selected cases. The stewardship-guided treatment protocol reduced overall antibiotic usage without compromising outcomes, illustrating the feasibility and benefits of integrating AMR surveillance with therapeutic decision-making in feline practice. This work provides actionable insights into AMR patterns in FUTIs, highlights important resistance determinants relevant to veterinary medicine, and offers evidence on the viability of alternative therapies to enhance antimicrobial stewardship, animal welfare, and clinical outcomes.

Project Overview

What This Project Is About

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A plain-language overview of the topic and what the project investigates.

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The Problem It Addresses

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What problem or gap this project tackles and why it matters to the field or society.

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Objectives of the Project

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1. Identify the common bacterial pathogens that cause urinary tract infections in cats.
2. Determine current antimicrobial resistance patterns in these pathogens.
3. Evaluate alternative, non-traditional therapies and their potential effectiveness.
4. Assess how resistance trends could guide empirical treatment choices.
5. Provide practical recommendations for veterinarians on antibiotic use and stewardship.

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What You Will Do Step by Step

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1. Review existing literature on feline urinary tract infections and resistance.
2. Collect urine samples from clinical cases with owner consent.
3. Isolate bacterial pathogens and perform susceptibility testing against common antibiotics.
4. Test alternative therapies (e.g., phytotherapy, probiotics, or supportive care) in vitro and, where possible, in vivo.
5. Analyze resistance data to identify patterns and risk factors.
6. Compare outcomes of conventional vs. alternative approaches.
7. Summarize findings and discuss implications for practice and policy.

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Expected Outcome

Anticipated results include a map of resistance patterns, an assessment of viable alternative treatments, and clear guidance for clinicians on selecting effective therapies while reducing unnecessary antibiotic use.