Background: Carbapenem-resistant Enterobacterales (CRE) increasingly cause veterinary outbreaks, yet little is known about feline CRE colonization.
Objective: We conducted a CRE colonization matched case-control study of hospitalized cats.
Animals: During March–August 2025, we screened 628 client-owned cats hospitalized at a New York City referral veterinary facility.
Methods: Admission and discharge rectal swabs were cultured on CRE-selective media. Cases were CRE negative at admission and positive at discharge. Controls were up to 3 randomly selected cats hospitalized the same week and were CRE negative at admission and discharge. Data were from electronic medical records and veterinary surveys. Separate conditional logistic regression models estimated matched odds ratios (mOR) and 95% confidence intervals (CI).
Results: Among screened cats, 301 had admission and discharge swabs collected. Twenty-four cases were matched with 63 controls. Median age was 8.7 years for cases, 6.9 years for controls. Most cases (86%) and controls (76%) had emergency service admissions. Cases had longer median hospital duration (4 days, interquartile range (IQR) 2–5 versus 2 days, IQR 1–3). Cases with >3 comorbidities (mOR 4.4, CI 0.7–27.9), antibiotic administration (mOR 3.3, CI 0.9–11.9), ventilation (mOR 2.4, CI 0.1–39.7), intubation (mOR 0.7, CI 0.3–2.1), or surgery (mOR 0.5, CI 0.1–1.5) had no greater CRE odds than controls.
Conclusions and Clinical Importance: Feline CRE colonization occurred in 8% of hospitalizations. CRE should be considered during veterinary infection control. Further study to identify pathways to reduce CRE exposure in veterinary settings is needed, particularly for longer hospitalizations.
