Tracking spread of carbapenemase-producing Enterobacterales between humans and companion animals: successes and challenges

Carbapenemase-producing Enterobacterales (CPE) pose a critical public health threat. Recent reports highlight that CPE emergence in companion animals mirrors that found in humans, underscoring the need for a One Health approach to investigating transmission routes. This Perspective article outlines an interdisciplinary model developed as part of the Centers for Disease Control and Prevention-funded Pathogen Genomics Center of Excellence at the Minnesota Department of Health (MDH) to investigate CPE transmission across human and animal populations. This represents one of the first operational One Health models linking companion animal and human CPE via whole genome sequencing (WGS) at a state-level public health laboratory. Using WGS, 94 companion animal isolates were characterized and revealed diverse genetic lineages from December 2022 through December 2024 in the USA. Genetically linked clusters were identified, including CPE isolates from companion animals and humans. One notable cluster linked human infections with CPE detected in a veterinary hospital. Despite the success of this approach to detect clusters, there were significant challenges, including investigation delays related to sequencing and epidemiology priorities and capacity, resource constraints, and human participant hesitancy. Our findings demonstrate the importance of integrating genomic data with clinical and epidemiological insights, fostering communication between veterinary and public health sectors, and expanding veterinary WGS infrastructure. Ultimately, we advocate for broader public health engagement in veterinary settings to mitigate antimicrobial resistance and improve surveillance of zoonotic transmission pathways.