Frequently Asked Questions about Carbapenem-Resistant Enterobacterales (CRE) for Pet Owners
Antibiotic-resistant germs have developed the ability to resist the effects of antibiotics designed to kill them. If your pet has an antibiotic-resistant infection, your veterinarian might ask to do additional tests to be sure they choose the correct drug to treat the infection. Antibiotic-resistant infections may take longer to treat and can be more expensive to treat. 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.
CRE is a type of antibiotic-resistant germ and is an urgent public health threat. CRE stands for carbapenem-resistant Enterobacterales. Enterobacterales are a group of bacteria (a type of germ) commonly found in the digestive systems of people and animals. Both people and animals can carry CRE in their gut without getting sick. But if these germs get into other parts of the body, they can cause serious infections of the lungs, blood, urinary tract, and brain.
Carbapenems are antibiotics used to treat serious multidrug-resistant bacterial infections. Carbapenem-resistant Enterobacterales (CRE) can survive carbapenem antibiotic treatment, making the infections they cause very difficult to treat. Antibiotics used to treat CRE can have more side effects and be less effective than treatments for less antibiotic-resistant germs.
No. Both humans and animals can be colonized with CRE, meaning they can carry the bacteria in their gut without it causing infection. People and animals colonized with CRE may still shed the germ into their environment and can still spread the germ to others.
Animals can get CRE from many potential sources, including contaminated food or contact with people or animals who are infected with or carriers of the germ. Because people and animals can carry CRE in their gut without any symptoms, it might be hard to know exactly where your pet got CRE.
Pets and people can share germs, including CRE. We don’t know how often this happens with CRE. There are only a few reports describing exchange of CRE between animals and people, but it is difficult to find the direction of spread (from person to animal or from animal to person).
Scientists are working to better understand the risk to owners of developing a CRE infection from exposure to a pet, but generally the risk is thought to be low. Healthy people rarely get CRE infections. The people who are most at risk of getting this germ are those who have weakened immune systems, have recently taken antibiotics, or who need medical devices like ventilators (breathing machines) or urinary catheters.
A few simple precautions can reduce the risk of getting CRE and other germs after contact with animals:
Clean Your Hands
Whether you are playing with, feeding, or cleaning up after your pet, it is important to clean your hands to help reduce the risk of getting sick from the germs pets can carry. If you or a family member are concerned about illness, talk to a doctor and mention the animals you’ve had contact with recently.
Always clean 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
You can use either an alcohol-based hand sanitizer or soap and running water to clean your hands. If hands are visibly soiled, then soap and water should be used. Adults should help young children with hand washing.
Practice Good Pet Hygiene
In addition to hand washing, practicing good pet hygiene can help prevent the spread of germs between pets and people. Keep pets and their supplies out of the kitchen and disinfect pet crates/carriers and supplies outside the house when possible. Whenever possible, avoid cleaning pet supplies in the kitchen sink, food preparation areas, or the bathroom sink. Pets can contaminate surfaces in your home with germs—you don’t have touch pets to get sick from their germs.
Always remove your dog’s feces (poop) from your yard and public places using a bag, dispose of it in proper areas, and clean your hands after. Dog and cat poop can contain germs and parasites that can be harmful to people. Keep children away from areas that might contain dog or cat poop.
If your pet is sick, call your veterinarian. Cats or dogs that have diarrhea should be seen by a veterinarian. If your pet has a history of CRE, tell the veterinary clinic/hospital staff when you book an appointment and at the time of arrival about your pet’s history of this germ.
You can find more information about reducing the risk of spreading germs from pets to you and your family at Healthy Pets Healthy People.
CRE can spread between animals, so owners of a pet with CRE should discuss the risk to their other animals with their veterinarian. To avoid the spread of the germ between animals in the household:
- Practice good personal hygiene, especially hand washing after handling pets/pet food or cleaning litter boxes/cleaning up poop.
- Keep litter boxes, pet dishes, pet beds, and toys clean. Litter boxes should be cleaned at least daily.
- Keep pets away from wildlife.
No, it is not necessary to give up a pet with CRE. You should take steps to reduce your risk of getting CRE from your pet, like cleaning your hands often and practicing good pet hygiene.
If you have a higher risk of infection (for example, you have a weakened immune system, you take antibiotics frequently, or you use medical devices like urinary catheters), then you should also follow these helpful tips to reduce your risk of getting CRE from your shared environment:
- 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.
- Keep outdoor sandboxes covered.
- Wear gloves when gardening and during contact with soil or sand because it might be contaminated with animal feces (poop). Wash hands with soap and water after gardening or contact with soil or sand.
If you’re concerned about your risk of CRE infection, talk to your healthcare provider.
Not much is known about how long companion animals may carry CRE. One report from Switzerlandexternal icon found that most dogs with CRE tested negative within 3 months of CRE first being identified, although a few dogs carried the germ for more than 4 months. Your pet might carry CRE longer if they are continually exposed over time or if they need antibiotic treatment. If your pet has a CRE infection, they may continue to carry the germ even after they have been treated and their symptoms disappear.
If your pet has CRE, they could spread it to other animals at the dog park. So, it is recommended that dogs do not visit the dog park if they are currently sick, have an active infection, or are taking antibiotics. Since animals may carry CRE for several months, even if they don’t have symptoms of infection, talk to your veterinarian about when your dog can go back to the dog park or be around other animals. Always remove your dog’s feces (poop) from your yard and public places using a bag, dispose of it in proper areas, and clean your hands.