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Strachan NA, Hales EN, Fischer JR. Prevalence of positive urine culture in the presence of inactive urine sediment in 1049 urine samples from dogs. J Vet Intern Med 2022; 36:629-633. [PMID: 35108434 PMCID: PMC8965268 DOI: 10.1111/jvim.16378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 11/29/2022] Open
Abstract
Background Urinalysis (UA) is often used to screen for bacterial cystitis, regardless of sediment results, and followed up by quantitative urine culture (UC) for definitive diagnosis. Objectives Determine prevalence of positive UCs in dogs with inactive urine sediments on routine UA. Animals A total of 1049 urine samples with inactive urine sediments and UCs collected from dogs presented to a veterinary specialty hospital between January 2018 and February 2020. Methods Retrospective study of dogs with an inactive urine sediment on routine UA and follow‐up UCs. Signalment, UA findings, proteinuria, and UC results were recorded. Associations among these findings were assessed using multivariate logistic regression carried out using a backward stepwise method. Results Overall prevalence of positive UC was 3.4% (95% confidence interval [CI], 2.4‐4.8). Escherichia coli was the most commonly isolated bacteria. Only naturally voided samples were associated with increased prevalence of positive culture when compared to collection by cystocentesis or a non‐specified method. No statistically significant association with culture positivity was found for urine protein‐to‐creatinine ratio, urine specific gravity, urine pH, breed, age, or sex. Conclusions and Clinical Importance Based on the low prevalence (3.4%) of positive culture in urine samples from dogs with inactive sediment on routine UA and the relatively high cost of UC and sensitivity, cost‐benefit analysis including clinical suspicion of lower urinary tract disease should inform testing decisions, rather than routinely performing cultures on urine samples without active sediments.
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Affiliation(s)
- Nicole A Strachan
- Internal Medicine, Veterinary Specialty Hospital of San Diego, San Diego, California, USA
| | - Erin N Hales
- Scientific Programs, Morris Animal Foundation, Denver, Colorado, USA
| | - Julie R Fischer
- Internal Medicine, Veterinary Specialty Hospital of San Diego, San Diego, California, USA
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102
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Taylor DD, Martin JN, Scallan Walter EJ. Survey of companion animal veterinarians' antimicrobial drug prescription practices and awareness of antimicrobial drug use guidelines in the United States. Zoonoses Public Health 2022; 69:277-285. [DOI: 10.1111/zph.12915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 10/13/2021] [Accepted: 11/17/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Daniel D. Taylor
- Colorado School of Public Health Colorado Integrated Food Safety Center of Excellence Aurora Colorado USA
| | - Jennifer N. Martin
- College of Agricultural Sciences Department of Animal Sciences Colorado State University Fort Collins Colorado USA
| | - Elaine J. Scallan Walter
- Colorado School of Public Health Colorado Integrated Food Safety Center of Excellence Aurora Colorado USA
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103
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Torre M, Furrow E, Foster JD. Effect of urine-specific gravity on performance of bacteriuria in predicting urine culture results. J Small Anim Pract 2021; 63:286-292. [PMID: 34897695 DOI: 10.1111/jsap.13456] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 10/04/2021] [Accepted: 10/31/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine the effect of urine-specific gravity (USG) on using microscopic evaluation of bacteriuria to predict urine culture results in dogs and cats. MATERIALS AND METHODS We performed a retrospective medical record review of canine and feline patients that had a urinalysis and urine culture performed simultaneously. The sensitivity, specificity, positive predictive value and negative predictive value of microscopic bacteriuria for predicting urine culture results were calculated, stratified by USG. Multivariable regression was performed to test the effect of USG, pyuria, haematuria and species on the agreement between microscopic bacteriuria and culture results. RESULTS A total of 481 dogs and 291 cats with paired urinalysis and urine culture results were included in the study. Microscopic bacteriuria had moderate sensitivity (76% in dogs, 64% in cats) and high specificity (97% in dogs, 96% in cats) for predicting urine culture bacterial growth. Samples with rod bacteria were more likely to have bacterial growth than those with cocci (OR=Infinity, 95% CI 4.8 - Infinity). As compared to isosthenuric+hyposthenuric samples (USG ≤1.012), agreement was lower in moderately concentrated (OR=0.44, 95% CI 0.19 to 0.91) samples. Absence of bacteriuria, pyuria and haematuria had a high negative predictive value for no bacterial growth (96%). CLINICAL SIGNIFICANCE Microscopic bacteriuria has a high specificity in predicting urine culture results, regardless of USG. The finding that microscopic bacteriuria has better agreement with urine culture results in isosthenuric+hyposthenuric urine argues against reflex culture in these samples, especially if pyuria and haematuria are also absent. Urine microscopy can aid clinicians in determining the likelihood of urine culture growth.
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Affiliation(s)
- M Torre
- Friendship Hospital for Animals, 4105 Brandywine St NW, Washington, DC, 20016, USA
| | - E Furrow
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, USA
| | - J D Foster
- Friendship Hospital for Animals, 4105 Brandywine St NW, Washington, DC, 20016, USA
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104
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The effect of urine storage temperature and boric acid preservation on quantitative bacterial culture for diagnosing canine urinary tract infection. BMC Vet Res 2021; 17:379. [PMID: 34879836 PMCID: PMC8653607 DOI: 10.1186/s12917-021-03083-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 11/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Quantitative bacterial culture (QBC) is the gold standard for diagnosing canine urinary tract infection. Current guidelines recommend QBC within 24 h of urine collection and that unpreserved urine is refrigerated until culture. However, temperature-controlled transport is rarely feasible, indicating a need for alternative storage during transport of urine from primary veterinary practices to the microbiology laboratory. The objective was to investigate the effect of storage temperature and boric acid sponge-preservation on quantitative bacterial culture of canine urine. RESULTS Significant bacteriuria was detected in 72 out of 179 samples (40%) collected from 141 dogs. Overall accuracy was 94-98% for both storage conditions and time points. Non-inferiority (15% margin) to reference quantitative bacterial culture was evident for sensitivity, specificity and predictive values for both storage methods and time points, except for the negative predictive value for 48 h boric acid preservation (NPV: 89, 95% CI [79;95]). There was no significant difference between the sensitivity and specificity for either of the time-points (p-value = 0.07-1). CONCLUSIONS Boric acid sponge-preservation using Uriswab™ is a useful alternative to refrigeration of urine samples during transport. Reliable quantitative bacterial culture results can be obtained from canine urine up to 48 h after collection if urine is refrigerated, and for at least 24 h if urine is stored using a boric acid-containing urine transport system.
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105
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Allerton F, Nuttall T. Antimicrobial use: importance of bacterial culture and susceptibility testing. IN PRACTICE 2021. [DOI: 10.1002/inpr.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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106
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Hsieh ES, Bollig ER, Beaudoin AL, Morrow A, Granick JL. Serial point-prevalence surveys to estimate antibiotic use in a small animal veterinary teaching hospital, November 2018 to October 2019. J Vet Intern Med 2021; 36:244-252. [PMID: 34773289 PMCID: PMC8783336 DOI: 10.1111/jvim.16314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 11/02/2021] [Accepted: 11/03/2021] [Indexed: 11/27/2022] Open
Abstract
Background There is no standardized methodology to measure antibiotic drug use (AU) in small animal veterinary hospitals. Objectives To estimate AU prevalence in a small animal veterinary teaching hospital and characterize usage by indication and evidence of infection. To establish an AU measurement methodology for veterinary settings. Animals Electronic medical records of cats and dogs seen by primary care, urgent care, emergency and critical care, internal medicine, and surgery services during November 2018 to October 2019. Methods On 1 day each month, data (signalment, visit reason, diagnostics, and antibiotic details, including indication) were collected for all animals seen on study services. Results Of 168 inpatient dogs and 452 outpatient dogs, 98 (58.3%) and 107 (23.7%,) were receiving at least 1 antibiotic on the day of data collection, respectively. For cats 15/49 (30.6%) inpatients and 29/187 (15.5%) outpatients were receiving at least 1 antibiotic. Common drug classes prescribed for dogs were potentiated penicillins (28.7%), first‐generation cephalosporins (22.1%), and nitroimidazoles (14.7%), and for cats, common drug classes administered were potentiated penicillins (26.9%), fluoroquinolones (13.5%), and penicillins (11.5%). Common indications for antibiotics included skin, respiratory, gastrointestinal, perioperative, aural, and urinary conditions. Conclusions and Clinical Importance Serial point‐prevalence surveys (PPS) can estimate AU in a large specialty hospital setting and identify targets for antimicrobial stewardship. The methodology developed during this study can be adapted for use in private practice, including large animal practice. Mirroring methods used in human healthcare, the data collection tool can also be used to describe AU nationally through completion of national PPS.
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Affiliation(s)
- Emmelyn S Hsieh
- Davis School of Veterinary Medicine, University of California, Davis, California, USA
| | - Emma R Bollig
- College of Veterinary Medicine, University of Minnesota, Saint Paul, Minnesota, USA
| | | | - Anna Morrow
- College of Veterinary Medicine, University of Minnesota, Saint Paul, Minnesota, USA
| | - Jennifer L Granick
- College of Veterinary Medicine, University of Minnesota, Saint Paul, Minnesota, USA
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Multiple and High-Risk Clones of Extended-Spectrum Cephalosporin-Resistant and blaNDM-5-Harbouring Uropathogenic Escherichia coli from Cats and Dogs in Thailand. Antibiotics (Basel) 2021; 10:antibiotics10111374. [PMID: 34827312 PMCID: PMC8614778 DOI: 10.3390/antibiotics10111374] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/30/2021] [Accepted: 11/05/2021] [Indexed: 11/16/2022] Open
Abstract
Resistance to extended-spectrum cephalosporins (ESC) and carbapenems in Escherichia coli (E. coli), increasingly identified in small animals, indicates a crisis of an antimicrobial resistance situation in veterinary medicine and public health. This study aimed to characterise the genetic features of ESC-resistant E. coli isolated from cats and dogs with urinary tract infections in Thailand. Of 72 ESC-resistant E. coli isolated from diagnostic samples (2016–2018), blaCTX-M including group 1 (CTX-M-55, -15 and -173) and group 9 (CTX-M-14, -27, -65 and -90) variants were detected in 47 isolates (65.28%) using PCR and DNA sequencing. Additional antimicrobial resistance genes, including plasmid-mediated AmpC (CIT and DHA), blaNDM-5, mcr-3, mph(A) and aac(6′)-Ib-cr, were detected in these isolates. Using a broth microdilution assay, all the strains exhibited multidrug-resistant phenotypes. The phylogroups were F (36.11%), A (20.83%), B1 (19.44%), B2 (19.44%) and D (4.17%), with several virulence genes, plasmid replicons and an integrase gene. The DNA fingerprinting using a repetitive extragenic palindromic sequence-PCR presented clonal relationships within phylogroups. Multiple human-associated, high-risk ExPEC clones associated with multidrug resistance, including sequence type (ST) 38, ST131, ST224, ST167, ST354, ST410, ST617 and ST648, were identified, suggesting clonal dissemination. Dogs and cats are a potential reservoir of ESC-resistant E. coli and significant antimicrobial resistance genes.
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108
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Kobayashi Y, Nakamura T, Yonezawa T, Kobayashi K, Murata T. The profile of urinary lipid metabolites in cats with bacterial cystitis. J Vet Med Sci 2021; 83:1977-1981. [PMID: 34744098 PMCID: PMC8762420 DOI: 10.1292/jvms.21-0433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Bacterial cystitis is one of the feline lower urinary tract diseases (FLUTDs). Polyunsaturated fatty acids, such as arachidonic acid (ARA), docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA), are oxidized into various lipid mediators that modulate inflammation. Since the profile of lipid metabolites excreted in urine is useful for assessing inflammatory body conditions, we analyzed 126 types of urinary lipid metabolites in cats with bacterial cystitis. Using LC-MS/MS, we found that the levels of 11 metabolites were higher in the urine of cystitis cats than in the urine of healthy cats. In detail, the urinary levels of ARA, EPA, and DHA and eight of their metabolites were increased in cystitis cats. Focusing on the lipid oxidation pathway, the urinary levels of four cyclooxygenase-, three lipoxygenase-, and one cytochrome p450-dependent oxidated metabolites were increased in bacterial cystitis. These urinary lipid profiles can provide some insight into the pathology and future diagnosis of bacterial cystitis.
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Affiliation(s)
- Yui Kobayashi
- Department of Animal Radiology, Graduate School of Agricultural and Life Sciences, The University of Tokyo
| | - Tatsuro Nakamura
- Department of Animal Radiology, Graduate School of Agricultural and Life Sciences, The University of Tokyo
| | - Tomohiro Yonezawa
- Department of Veterinary Clinical Pathobiology, Graduate School of Agricultural and Life Sciences, The University of Tokyo
| | - Koji Kobayashi
- Department of Animal Radiology, Graduate School of Agricultural and Life Sciences, The University of Tokyo
| | - Takahisa Murata
- Department of Animal Radiology, Graduate School of Agricultural and Life Sciences, The University of Tokyo
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109
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Blondeau JM, Fitch SD. In Vitro Killing of Canine Urinary Tract Infection Pathogens by Ampicillin, Cephalexin, Marbofloxacin, Pradofloxacin, and Trimethoprim/Sulfamethoxazole. Microorganisms 2021; 9:2279. [PMID: 34835405 PMCID: PMC8619264 DOI: 10.3390/microorganisms9112279] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 12/24/2022] Open
Abstract
Urinary tract infections are common in dogs, necessitating antimicrobial therapy. We determined the speed and extent of in vitro killing of canine urinary tract infection pathogens by five antimicrobial agents (ampicillin, cephalexin, marbofloxacin, pradofloxacin, and trimethoprim/sulfamethoxazole) following the first 3 h of drug exposure. Minimum inhibitory and mutant prevention drug concentrations were determined for each strain. In vitro killing was determined by exposing bacteria to clinically relevant drug concentrations and recording the log10 reduction and percent kill in viable cells at timed intervals. Marbofloxacin and pradofloxacin killed more bacterial cells, and faster than other agents, depending on the time of sampling and drug concentration. Significant differences were seen between drugs for killing Escherichia coli, Proteus mirabilis, Enterococcus faecalis, and Staphylococcus pseudintermedius strains. At the maximum urine drug concentrations, significantly more E. coli cells were killed by marbofloxacin than by ampicillin (p < 0.0001), cephalexin (p < 0.0001), and TMP/SMX (p < 0.0001) and by pradofloxacin than by cephalexin (p < 0.0001) and TMP/SMX (p < 0.0001), following 5 min of drug exposure. Rapid killing of bacteria should inform thinking on drug selection for short course therapy for uncomplicated UTIs, without compromising patient care, and is consistent with appropriate antimicrobial use and stewardship principles.
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Affiliation(s)
- Joseph M. Blondeau
- Departments of Microbiology and Immunology, Pathology and Laboratory Medicine and Ophthalmology, University of Saskatchewan, Saskatoon, SK S7N 0W8, Canada
- Department of Clinical Microbiology, Royal University Hospital and Saskatchewan Health Authority, Saskatoon, SK S7N 0W8, Canada;
| | - Shantelle D. Fitch
- Department of Clinical Microbiology, Royal University Hospital and Saskatchewan Health Authority, Saskatoon, SK S7N 0W8, Canada;
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110
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Weese JS, Stull JW, Evason M, Webb J, Ballance D, McKee T, Bergman PJ. A multicenter study of antimicrobial prescriptions for cats diagnosed with bacterial urinary tract disease. J Feline Med Surg 2021; 24:806-814. [PMID: 34709080 PMCID: PMC9315180 DOI: 10.1177/1098612x211054815] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Objectives The aim of this study was to evaluate initial antimicrobial therapy in cats
diagnosed with upper or lower bacterial urinary tract infections at
veterinary practices in the USA and Canada. Methods Electronic medical records from a veterinary practice corporation with
clinics in the USA and Canada were queried between 2 January 2016 and 3
December 2018. Feline patient visits with a diagnosis field entry of urinary
tract infection, cystitis and pyelonephritis, as well as variation of those
names and more colloquial diagnoses such as kidney and bladder infection,
and where an antimicrobial was prescribed, were retrieved. Results Prescription data for 5724 visits were identified. Sporadic cystitis was the
most common diagnosis (n = 5051 [88%]), with 491 (8.6%) cats diagnosed with
pyelonephritis and 182 (3.2%) with chronic or recurrent cystitis. Cefovecin
was the most commonly prescribed antimicrobial for all conditions, followed
by amoxicillin–clavulanic acid. Significant differences in antimicrobial
drug class prescribing were noted between practice types and countries, and
over the 3-year study period. For sporadic cystitis, prescription of
amoxicillin–clavulanic acid increased significantly and cefovecin decreased
between 2016 and 2018, and 2017 and 2018, while fluoroquinolone use
increased between 2017 and 2018. Conclusions and relevance The results indicate targets for intervention and some encouraging trends.
Understanding how antimicrobials are used is a key component of
antimicrobial stewardship and is required to establish benchmarks, identify
areas for improvement, aid in the development of interventions and evaluate
the impact of interventions or other changes.
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Affiliation(s)
- J Scott Weese
- Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Jason W Stull
- Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Michelle Evason
- Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Jinelle Webb
- Mississauga-Oakville Veterinary Emergency and Specialty Hospital, Oakville, ON, Canada
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111
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Palerme JS, Zellner E, Leonard S, Viall AK, Berger DJ. Characterization of recessed vulvas in dogs. J Am Vet Med Assoc 2021; 259:744-748. [PMID: 34516259 DOI: 10.2460/javma.259.7.744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the prevalence of vulvar recession in a large population of dogs and to compare the reproductive and physical differences between dogs with and without recessed vulvas. ANIMALS 250 female dogs presenting to a tertiary referral institution. PROCEDURES Female dogs > 6 months of age presenting to a tertiary referral institution were enrolled. At enrollment, a full medical history was obtained with particular emphasis on the presence of lower urinary tract (LUT) disease in the 3 months prior to presentation. All dogs underwent a full physical examination including perivulvar cytologic examination and scoring of the degree of perivulvar skin coverage on the basis of an 8-point scale. Dogs with scores of ≥ 7 were classified as having recessed vulvas. When available, urinalysis data were also included. RESULTS Recessed vulvas were identified in 36 of 250 (14%) dogs. Dogs with recessed vulvas had significantly higher body condition scores and body weights than unaffected dogs. In addition, recessed vulvas were more common in spayed than sexually intact dogs. Dogs spayed at ≤ 1 year of age were almost 3 times as likely to have vulvar recession, compared with dogs spayed at > 1 year of age. No significant difference was identified between affected and unaffected dogs with respect to the prevalence of LUT signs, urinary tract infections, or perivulvar dermatitis. CONCLUSIONS AND CLINICAL RELEVANCE Although recessed vulvas were relatively common in dogs, they did not appear to be associated with an increased risk of LUT disease or perivulvar dermatitis.
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112
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How Accurate Are Veterinary Clinicians Employing Flexicult Vet for Identification and Antimicrobial Susceptibility Testing of Urinary Bacteria? Antibiotics (Basel) 2021; 10:antibiotics10101160. [PMID: 34680741 PMCID: PMC8532927 DOI: 10.3390/antibiotics10101160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/16/2021] [Accepted: 09/22/2021] [Indexed: 12/01/2022] Open
Abstract
Antibiotics are frequently used for treating urinary tract infections (UTI) in dogs and cats. UTI often requires time-consuming and expensive antimicrobial susceptibility testing (AST). Alternatively, clinicians can employ Flexicult Vet, an affordable chromogenic agar with added antibiotics for in-clinic AST. We investigated how well veterinary microbiologists and clinicians, without any prior experience, employ Flexicult Vet for the identification and AST of the most common canine and feline urinary pathogenic bacteria. We prepared 47 monoculture plates containing 10 bacterial species. The test’s mean accuracy was 75.1% for bacteria identification (84.6% and 68.7% for microbiologists and clinicians, respectively) and 79.2% for AST (80.7% and 78.2%). All evaluators employed Flexicult Vet with the accuracies over 90% for the distinctively colored bacteria like Escherichia coli (red), Enterococcus faecalis (turquoise), and Proteus spp. (pale brown). However, the evaluators’ experience proved important in recognizing lightly colored bacteria like Staphylococcus pseudintermedius (accuracies of 82.6% and 40.3%). Misidentifications of E. faecium additionally worsened AST performance since bacterial intrinsic resistance could not be considered. Finally, only 33.3% (3/9) of methicillin-resistant S. pseudintermedius (MRSP) were correctly detected. To conclude, Flexicult Vet proved reliable for certain urinary pathogens. In contrast, light-colored bacteria (e.g., Staphylococcus), often misidentified, require a standard AST.
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113
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Allerton F, Pouwels KB, Bazelle J, Caddy S, Cauvin A, De Risio L, Swann J, Warland J, Kent A. Prospective trial of different antimicrobial treatment durations for presumptive canine urinary tract infections. BMC Vet Res 2021; 17:299. [PMID: 34488771 PMCID: PMC8422737 DOI: 10.1186/s12917-021-02974-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 07/20/2021] [Indexed: 12/03/2022] Open
Abstract
Background Avoidance of unnecessary antimicrobial administration is a key tenet of antimicrobial stewardship; knowing the optimal duration of therapy obviates over-treatment. However, little research has been performed to establish course lengths for common canine infections. In clinical practice, antimicrobial therapy is frequently prescribed in dogs presenting lower urinary tract signs (haematuria, pollakiuria and dysuria/stranguria). The proposed length of treatment in International Consensus guidelines has decreased with each iteration, but these recommendations remain arbitrary and largely extrapolated from experience in people. Methods The objective of this prospective, multi-centre study is to find the shortest course duration that is non-inferior to the standard duration of 7 days of amoxicillin/clavulanate in terms of clinical outcomes for female dogs with lower urinary tract signs consistent with a urinary tract infection. An electronic data capture platform will be used by participating veterinarians working in clinical practice in the United Kingdom. Eligible dogs must be female, aged between 6 months and 10 years and have lower urinary tract signs of up to seven days’ duration. Enrolment will be offered in cases where the case clinician intends to prescribe antimicrobial therapy. Automatic pseudo-randomisation to treatment group will be based on the day of presentation (Monday-Friday); all antimicrobial courses will be completed on the Sunday after presentation generating different treatment durations. Follow-up data will be collected 1, 8 and 22–26 days after completion of the antimicrobial course to ensure effective safety netting, and to monitor short-term outcome and recurrence rates. Informed owner consent will be obtained in all cases. The study is approved by the Ethical Review Board of the University of Nottingham and has an Animal Test Certificate from the Veterinary Medicine’s Directorate. Discussion This study has been designed to mirror current standards of clinical management; conclusions should therefore, be widely applicable and guide practising veterinarians in their antimicrobial decision-making process. A duration-response curve will be created allowing determination of the optimal treatment duration for the management of female dogs with lower urinary tract signs. It is hoped that these results will contribute valuable information to improve future antimicrobial stewardship as part of a wider one-health perspective. Supplementary Information The online version contains supplementary material available at 10.1186/s12917-021-02974-y.
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Affiliation(s)
- Fergus Allerton
- Willows Veterinary Centre and Referral Service; part of Linnaeus Veterinary Limited, Highlands Road, Shirley, Solihull, UK.
| | - Koen B Pouwels
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.,NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial, Oxford, UK.,Resistance at University of Oxford in partnership with Public Health England, Oxford, UK
| | - Julien Bazelle
- Davies Veterinary Specialists; part of Linnaeus Veterinary Limited, Manor Farm Business Park, Higham Gobion, Hitchin, UK
| | - Sarah Caddy
- Cambridge Institute for Therapeutic Immunology and Infectious Disease, Jeffery Cheah Biomedical Centre, Puddicomb Way, Cambridge Biomedical Campus, Cambridge, UK
| | | | - Luisa De Risio
- Linnaeus Veterinary Limited, Friars gate, Shirley, Solihull, UK
| | - James Swann
- Columbia Stem Cell Initiative, Columbia University, 650 West 168th Street, NY, 10032, New York, USA
| | - James Warland
- Wellcome-MRC Cambridge Stem Cell Institute, Jeffrey Cheah Biomedical Centre, University of Cambridge, Puddicombe Way, Cambridge, UK
| | - Andrew Kent
- Willows Veterinary Centre and Referral Service; part of Linnaeus Veterinary Limited, Highlands Road, Shirley, Solihull, UK
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114
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Wingert AM, Murray OA, Lulich JP, Hoelmer AM, Merkel LK, Furrow E. Efficacy of medical dissolution for suspected struvite cystoliths in dogs. J Vet Intern Med 2021; 35:2287-2295. [PMID: 34469023 PMCID: PMC8478031 DOI: 10.1111/jvim.16252] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 08/11/2021] [Accepted: 08/11/2021] [Indexed: 11/28/2022] Open
Abstract
Background Medical dissolution of struvite uroliths in dogs is commonly recommended, but data on success rates and complications are limited. Objectives To evaluate the efficacy of medical dissolution for suspected struvite cystoliths in dogs. Animals Fifty client‐owned dogs fed a therapeutic dissolution diet, with or without administration of antimicrobials, for treatment of suspected struvite cystoliths. Methods Single institution, retrospective case series. Medical records were reviewed for dogs with at least 1 follow‐up visit. Dissolution success, complications, and possible predictors of success were evaluated. Results Full dissolution of cystoliths was achieved in 58% (29/50) of dogs within a median of 35 days (range, 13‐167). Of 21 dogs without success, 7 each had partial dissolution, no dissolution, or undetermined outcome. Uroliths containing >10% nonstruvite mineral were common in the nonsuccess group (11/16 analyzed). Maximum urolith diameter, number of uroliths, and baseline urine pH did not differ significantly between dogs with and without success. Dissolution was more likely in dogs receiving antimicrobial therapy (OR = 16.3, 95% confidence interval 1.9‐787.4, P = .002). Adverse events occurred in 9 dogs (18%); urethral obstructions were the most common, but 3 of 4 dogs with this complication were obstructed on presentation, before trial initiation. Conclusions and Clinical Importance Results support a medical dissolution trial for dogs with suspected struvite cystoliths. If no reduction in urolith size or number occurs by 1 month, a nonstruvite composition is likely, and alternative interventions should be considered. Dogs presenting with urethral obstructions should not be considered candidates for medical dissolution.
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Affiliation(s)
- Allie M Wingert
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota, USA
| | - Olivia A Murray
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota, USA
| | - Jody P Lulich
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota, USA
| | - Alexis M Hoelmer
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota, USA
| | - Lindsay K Merkel
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota, USA
| | - Eva Furrow
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota, USA
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115
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Fonseca JD, Mavrides DE, Graham PA, McHugh TD. Results of urinary bacterial cultures and antibiotic susceptibility testing of dogs and cats in the UK. J Small Anim Pract 2021; 62:1085-1091. [PMID: 34463359 PMCID: PMC9292356 DOI: 10.1111/jsap.13406] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 07/02/2021] [Accepted: 07/15/2021] [Indexed: 11/28/2022]
Abstract
Objectives Bacterial urinary tract infections are a common diagnosis in small animal practice and antibiotics are often administered empirically. The aim of this study was to investigate the aetiology and antibiotic resistance of uropathogens in dogs and cats in the UK. Materials and Methods Retrospective study of uroculture and antibiotic susceptibility testing results (n=808) by disk diffusion processed at a veterinary pathology laboratory between 2011 and 2012. Results Significant bacteriuria was detected in 18.4% of samples from dogs and 10.0% from cats, most of which (>90%) yielded a single organism. Escherichia coli was the most prevalent bacterial species (54.7% and 55.6% of feline and canine isolates, respectively) followed by Proteus mirabilis in dog samples (22.7%) and Enterococcus spp. in cat samples (23.2%). Approximately a third of E. coli isolates were resistant to ampicillin but resistance was much lower among Enterococcus spp. and P. mirabilis. Resistance to amoxicillin‐clavulanic acid also seemed to be emerging, particularly in E. coli (almost 20% resistant). In contrast, resistance to trimethoprim‐sulfamethoxazole for uropathogens remained <13% except for P. mirabilis (19.4%). Overall, fluoroquinolones showed the best in vitro activity (resistance mostly below 10% for enrofloxacin and marbofloxacin). Clinical Significance Our results provide evidence of the emergence of resistance to antibiotics commonly used to treat bacterial urinary tract infections. Continued monitoring of the patterns of antibiotic resistance in uropathogens is needed to assess the adequacy of recommendations on the empiric therapy of these infections.
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Affiliation(s)
- J D Fonseca
- Centre for Clinical Microbiology, University College London, Royal Free Campus, London, NW3 2QG, UK
| | - D E Mavrides
- Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge, CB3 0ES, UK
| | - P A Graham
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, LE12 5RD, UK
| | - T D McHugh
- Centre for Clinical Microbiology, University College London, Royal Free Campus, London, NW3 2QG, UK
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116
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Weese JS, Webb J, Ballance D, McKee T, Stull JW, Bergman PJ. Evaluation of antimicrobial prescriptions in dogs with suspected bacterial urinary tract disease. J Vet Intern Med 2021; 35:2277-2286. [PMID: 34397135 PMCID: PMC8478060 DOI: 10.1111/jvim.16246] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 07/26/2021] [Accepted: 07/28/2021] [Indexed: 11/27/2022] Open
Abstract
Background Antimicrobials are commonly used to treat urinary tract disease in dogs. Understanding antimicrobial use is a critical component of antimicrobial stewardship efforts. Hypothesis/Objectives To evaluate antimicrobial prescriptions for dogs diagnosed with acute cystitis, recurrent cystitis, and pyelonephritis. Animals Dogs prescribed antimicrobials for urinary tract disease at veterinary practices in the United States and Canada. Materials and Methods A retrospective review of antimicrobial prescriptions was performed. Results The main clinical concerns were sporadic bacterial cystitis (n = 6582), recurrent cystitis (n = 428), and pyelonephritis (n = 326). Amoxicillin/clavulanic acid (2702, 41%), cefpodoxime (1024, 16%), and amoxicillin (874, 13%) were most commonly prescribed for sporadic bacterial cystitis. The median prescribed duration was 12 days (range, 3‐60 days; interquartile range [IQR], 4 days). Shorter durations were used in 2018 (median, 10 days; IQR, 4 days) compared to both 2016 and 2017 (both median, 14 days; IQR, 4 days; P ≤ .0002). Amoxicillin/clavulanic acid (146, 33%), marbofloxacin (95, 21%), and cefpodoxime (65, 14%) were most commonly used for recurrent cystitis; median duration of 14 days (range, 3‐77 days; IQR, 10.5 days). Amoxicillin/clavulanic acid (86, 26%), marbofloxacin (56, 17%), and enrofloxacin (36, 11%) were most commonly prescribed for pyelonephritis; however, 93 (29%) dogs received drug combinations. The median duration of treatment was 14 days (range, 3‐77 days; IQR, 11 days). Conclusions and Clinical Importance Decreases in duration and increased use of recommended first‐line antimicrobials were encouraging. Common drug choices and durations should still be targets for antimicrobial stewardship programs that aim to optimize antimicrobial use, concurrently maximizing patient benefits while minimizing antimicrobial use and use of higher tier antimicrobials.
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Affiliation(s)
| | - Jinelle Webb
- Mississauga-Oakville Veterinary Emergency and Specialty Hospital, Oakville, Ontario, Canada
| | | | - Talon McKee
- VCA Clinical Studies, Los Angeles, California, USA
| | - Jason W Stull
- Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
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117
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Phongphaew W, Kongtia M, Kim K, Sirinarumitr K, Sirinarumitr T. Association of bacterial isolates and antimicrobial susceptibility between prostatic fluid and urine samples in canine prostatitis with concurrent cystitis. Theriogenology 2021; 173:202-210. [PMID: 34399384 DOI: 10.1016/j.theriogenology.2021.07.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 07/26/2021] [Accepted: 07/31/2021] [Indexed: 10/20/2022]
Abstract
Most old, intact male dogs usually have prostate disorders, especially benign prostatic hypertrophy and prostatitis with or without abscesses, and concurrent cystitis. The successful treatment of dogs with prostatitis concurrent with cystitis has relied on choosing an appropriate antimicrobial drug based on a bacterial culture and drug sensitivity testing. The objective of the study was to compare the prevalence of bacterial species and results of drug susceptibility testing of bacteria that were isolated from the prostatic fluids and urine samples that were collected from dogs with both prostatitis and cystitis. One hundred and sixty intact male dogs, who presented with both diseases, were recruited for the study. The disease diagnoses were based on clinical history notes, physical examinations, abdominal ultrasonography, prostatic fluid cytology, urinalysis and bacterial cultures from both prostatic fluid and urine samples. The bacterial culture results demonstrated that the major species that were detected in either the prostatic fluid or urine samples were Staphylococcus spp., Escherichia coli, Pseudomonas spp., Streptococcus spp., Proteus mirabilis and Klebsiella pneumoniae. Staphylococcus spp. (26.5 %, 43/162) and Escherichia coli (26.1 %, 12/46) were the most prevalent species from the prostatic fluid and urine samples, respectively. Statistical tests revealed that there were no significantly different prevalence levels among the isolated bacteria between the prostatic fluid and urine samples. Imipenem and gentamicin were the most potent antimicrobial drugs tested against the bacterial isolates in the present study. However, the administration of imipenem to treat prostatitis and cystitis in dogs was of concern. Interestingly, there were no significant differences in the antimicrobial drug susceptibility trends between the prostatic fluid and urine samples. Based on these results, a urine sample might be considered as an optional sample for bacterial cultures and antimicrobial drug susceptibility testing when it is not possible to collect a prostatic fluid sample.
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Affiliation(s)
- Wallaya Phongphaew
- Department of Pathology, Faculty of Veterinary Medicine, Kasetsart University, Bangkok, 10900, Thailand
| | - Mintraporn Kongtia
- Department of Companion Animal Clinical Sciences, Faculty of Veterinary Medicine, Kasetsart University and Center for Theriogenology Unit at Kasetsart University Veterinary Teaching Hospital, Bangkok, 10900, Thailand
| | - Kiyeon Kim
- Division of Bioinformatics, Research Center for Zoonosis Control, Hokkaido University, Hokkaido, 001-0020, Japan
| | - Kaitkanoke Sirinarumitr
- Department of Companion Animal Clinical Sciences, Faculty of Veterinary Medicine, Kasetsart University and Center for Theriogenology Unit at Kasetsart University Veterinary Teaching Hospital, Bangkok, 10900, Thailand
| | - Theerapol Sirinarumitr
- Department of Pathology, Faculty of Veterinary Medicine, Kasetsart University, Bangkok, 10900, Thailand.
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118
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Methylprednisolone Induces Extracellular Trap Formation and Enhances Bactericidal Effect of Canine Neutrophils. Int J Mol Sci 2021; 22:ijms22147734. [PMID: 34299355 PMCID: PMC8304006 DOI: 10.3390/ijms22147734] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/11/2021] [Accepted: 07/13/2021] [Indexed: 12/15/2022] Open
Abstract
Methylprednisolone is a glucocorticoid and can negatively influence immune defense mechanisms. During bacterial infections in the dog, neutrophils infiltrate infected tissue and mediate antimicrobial effects with different mechanisms such as phagocytosis and neutrophil extracellular trap (NET) formation. Here, we investigated the influence of methylprednisolone on canine NET formation and neutrophil killing efficiency of Gram positive and Gram negative bacteria. Therefore, canine blood derived neutrophils were treated with different concentrations of methylprednisolone over time. The survival factor of Staphylococcus pseudintermedius, Streptococcus canis or Escherichia coli was determined in presence of stimulated neutrophils. Additionally, free DNA and nucleosomes as NET marker were analyzed in supernatants and neutrophils were assessed for NET formation by immunofluorescence microscopy. Methylprednisolone concentrations of 62.5 and 625 µg/mL enhanced the neutrophil killing of Gram positive bacteria, whereas no significant influence was detected for the Gram negative Escherichia coli. Interestingly, higher amounts of free DNA were detected under methylprednisolone stimulation in a concentration dependency and in the presence of Streptococcus canis and Escherichia coli. The nucleosome release by neutrophils is induced by bacterial infection and differs depending on the concentration of methylprednisolone. Furthermore, immunofluorescence microscopy analysis identified methylprednisolone at a concentration of 62.5 µg/mL as a NET inducer. In summary, methylprednisolone enhances NET-formation and time-dependent and concentration-dependent the bactericidal effect of canine neutrophils on Gram positive bacteria.
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119
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Cole SD, Elliott ER, Rankin SC. SODAPOP: A Metacognitive Mnemonic Framework to Teach Antimicrobial Selection. JOURNAL OF VETERINARY MEDICAL EDUCATION 2021; 48:263-266. [PMID: 32412374 DOI: 10.3138/jvme.2019-0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Mnemonics are used widely throughout medical education to help manage large amounts of information and to promote a systematic approach to complex problems. SODAPOP is a metacognitive mnemonic that offers learners a framework for veterinary clinical decision making to support optimal antimicrobial selection. SODAPOP has students consider the source and organism before they decide to treat; then they consider the antimicrobials to which the organism is susceptible with regard to contraindications in the patient; and, ultimately, the options are weighed and a plan is formulated. A preliminary study showed that students' perception of SODAPOP was favorable and that exposure to SODAPOP improved student confidence levels. Further research is needed to determine whether SODAPOP improves students' optimal antimicrobial selection. SODAPOP could be a potentially helpful teaching tool because it can be mapped to the Association of American Veterinary Medical Colleges competency-based veterinary education framework under subcompetencies 1.3 and 4.2. A mnemonic such as SODAPOP could be integrated throughout the veterinary curriculum both in basic science courses (microbiology) and with real cases during clinical rotations.
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120
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Nielsen SS, Bicout DJ, Calistri P, Canali E, Drewe JA, Garin‐Bastuji B, Gonzales Rojas JL, Gortazar Schmidt C, Herskin M, Michel V, Miranda Chueca MA, Padalino B, Pasquali P, Roberts HC, Sihvonen LH, Spoolder H, Stahl K, Velarde A, Viltrop A, Winckler C, Guardabassi L, Hilbert F, Mader R, Aznar I, Baldinelli F, Alvarez J. Assessment of animal diseases caused by bacteria resistant to antimicrobials: Dogs and cats. EFSA J 2021; 19:e06680. [PMID: 34194578 PMCID: PMC8237238 DOI: 10.2903/j.efsa.2021.6680] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
In this opinion the antimicrobial-resistant bacteria responsible for transmissible diseases that constitute a threat to dog and cat health have been assessed. The assessment has been performed following a methodology based on information collected via an extensive literature review and expert judgement. Details of the methodology used for this assessment are explained in a separate opinion. A global state of play of antimicrobial resistant Staphylococcus pseudintermedius, Staphylococcus aureus, Staphylococcus schleiferi, Escherichia coli, Proteus mirabilis, Klebsiella spp., Enterobacter spp., Pseudomonas aeruginosa, Clostridium perfringens, Clostridioides difficile, Enterococcus faecalis and Enterococcus faecium has been provided. Among those bacteria, EFSA identified S. pseudintermedius, E. coli and P. aeruginosa with > 90% certainty as the most relevant antimicrobial resistant bacteria in the EU based on the available evidence. The animal health impact of these most relevant bacteria, as well as their eligibility for being listed and categorised within the animal health law framework will be assessed in separate scientific opinions.
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121
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Evaluation of a Biocide Used in the Biological Isolation and Containment Unit of a Veterinary Teaching Hospital. Antibiotics (Basel) 2021; 10:antibiotics10060639. [PMID: 34071748 PMCID: PMC8229411 DOI: 10.3390/antibiotics10060639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 11/17/2022] Open
Abstract
Hospital-acquired infections (HAIs) are a rising problem worldwide, and the best way of coping with them is through infection tracking and surveillance systems, combined with prevention strategies, namely efficient disinfection protocols, that employ various biocides. However, increasing reports about reductions in biocide susceptibility and the development of cross-resistance to antimicrobials emphasize the need for identifying the factors influencing biocide efficiency. In this study, 29 bacterial isolates (n = 3 E. coli, n = 2 Pseudomonas spp., n = 23 Enterococcus spp., and n = 1 Staphylococcus pseudintermedius), obtained from environmental samples collected from the Biological Isolation and Containment Unit (BICU), of the Veterinary Teaching Hospital of the Faculty of Veterinary Medicine, University of Lisbon, were tested in order to determine their antimicrobial susceptibility to various antibiotics. Thirteen of these isolates were further selected in order to determine their antimicrobial susceptibility to Virkon™ S, with and without the presence of organic matter. Afterward, seven of these isolates were incubated in the presence of sub-lethal concentrations of this formulation and, subsequently, new susceptibility profiles were determined. Fourteen of the 29 isolates (48.3%) were classified as multidrug resistant, all previously identified as enterococci. Concerning Virkon™ S's susceptibility, the Minimal Bactericidal Concentration (MBC) of this biocide regarding all isolates was at least eight times lower than the concentration regularly used, when no organic matter was present. However, when organic matter was added, MBC values rose up to 23 times. After exposure to sub-lethal concentrations of Virkon™ S, four enterococci presented a phenotypical change regarding antimicrobial susceptibility towards gentamicin. Virkon™ S also resulted in higher MBC values, up to 1.5 times, in the presence of low concentrations of organic matter, but no rise in these values was observed in assays without interfering substance. Virkon™ S seemed to be an efficient formulation in eliminating all bacteria isolates isolated from the BICU. However, organic matter could represent a hindrance to this ability, which emphasizes the importance of sanitization before disinfection procedures. The changes seen in antimicrobial susceptibility could be explained by a general stress-induced response promoted by the sub-lethal levels of Virkon™ S. Additionally, when no organic matter was present, a decrease in susceptibility to this biocide seemed to be non-existent.
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122
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Deprey J, Baldinger A, Livet V, Blondel M, Taroni M, Lefebvre C, Goy-Thollot I, Moissonnier P, Viguier É, Pouzot-Nevoret C, Carozzo C, Cachon T. Risk factors and clinical relevance of positive urine cultures in cats with subcutaneous ureteral bypass. BMC Vet Res 2021; 17:199. [PMID: 34044828 PMCID: PMC8157650 DOI: 10.1186/s12917-021-02898-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 05/06/2021] [Indexed: 11/10/2022] Open
Abstract
Background The objective of the study was to report the incidence and risk factors associated with positive urine bacterial cultures as well as long-term outcome in cats with subcutaneous ureteral bypass (SUB) devices. Results Medical records of cats that underwent SUB device placement were retrospectively reviewed. Signalment of the cat, laterality of the ureteral obstruction, surgery, anesthesia and hospitalization duration, bacterial culture results and follow-up data were retrieved. Thirty-two cats met the inclusion criteria. Four cats (12.5%) had a positive intraoperative culture, with two of them being treated successfully. Ten cats out of 28 (35.7%) were documented with a positive urine culture during follow-up period, with a median time between discharge and identification of the first positive urine culture of 159 days (range 8–703 days). Bacteriuria resolved in 60% of cats (6/10). Escherichia coli was the most common organism, isolated in 4 out of 10 postoperative urine cultures. Overall, subclinical bacteriura was documented for 6 of 32 (18.8%) cats and 5 of 32 (15.6%) cats displayed clinicals signs suggestive of persistent UTI. One cat had subclinical bacteriuria. Three cats died during the follow-up period. There was a significant difference between negative and positive urine bacterial culture groups in median hospitalization duration (5 days versus 6 days, P = 0.022) and in median body condition score (5/9 versus 4/9, P = 0.03). Cats with a longer hospital stay and with a lower body condition score were more likely to have a positive urine culture during follow-up period. Conclusions SUB device placement surgery is associated with complications such as chronic bacteriuria. Bacteriuria in our study resolved with appropriate antibiotic treatment in more than half of cats. Risk factors identified for positive urine culture were a longer hospitalization duration and a decreased body condition score.
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Affiliation(s)
- Julie Deprey
- Department of Small Animal Surgery, Vetagro Sup, Campus Vétérinaire de Lyon, Marcy l'Etoile, France. .,Research Unit ICE, UPSP 2011.03.101, Université de Lyon, Veterinary Campus of VetAgro Sup, Marcy l'Etoile, France.
| | - Arnaud Baldinger
- Department of Small Animal Surgery, Vetagro Sup, Campus Vétérinaire de Lyon, Marcy l'Etoile, France.,Research Unit ICE, UPSP 2011.03.101, Université de Lyon, Veterinary Campus of VetAgro Sup, Marcy l'Etoile, France
| | - Véronique Livet
- Department of Small Animal Surgery, Vetagro Sup, Campus Vétérinaire de Lyon, Marcy l'Etoile, France.,Research Unit ICE, UPSP 2011.03.101, Université de Lyon, Veterinary Campus of VetAgro Sup, Marcy l'Etoile, France
| | - Margaux Blondel
- Department of Small Animal Surgery, Vetagro Sup, Campus Vétérinaire de Lyon, Marcy l'Etoile, France.,Research Unit ICE, UPSP 2011.03.101, Université de Lyon, Veterinary Campus of VetAgro Sup, Marcy l'Etoile, France
| | - Mathieu Taroni
- Department of Small Animal Surgery, Vetagro Sup, Campus Vétérinaire de Lyon, Marcy l'Etoile, France.,Research Unit ICE, UPSP 2011.03.101, Université de Lyon, Veterinary Campus of VetAgro Sup, Marcy l'Etoile, France
| | - Cynthia Lefebvre
- Department of Small Animal Surgery, Vetagro Sup, Campus Vétérinaire de Lyon, Marcy l'Etoile, France
| | - Isabelle Goy-Thollot
- Intensive Care Unit (SIAMU), Université de Lyon, Veterinary Campus of VetAgro Sup, Marcy l'Etoile, France.,Université de Lyon, Veterinary Campus of VetAgro Sup, APCSe, F-69280, Marcy l'Etoile, France
| | - Pierre Moissonnier
- Department of Small Animal Surgery, Vetagro Sup, Campus Vétérinaire de Lyon, Marcy l'Etoile, France.,Research Unit ICE, UPSP 2011.03.101, Université de Lyon, Veterinary Campus of VetAgro Sup, Marcy l'Etoile, France
| | - Éric Viguier
- Department of Small Animal Surgery, Vetagro Sup, Campus Vétérinaire de Lyon, Marcy l'Etoile, France.,Research Unit ICE, UPSP 2011.03.101, Université de Lyon, Veterinary Campus of VetAgro Sup, Marcy l'Etoile, France
| | - Céline Pouzot-Nevoret
- Intensive Care Unit (SIAMU), Université de Lyon, Veterinary Campus of VetAgro Sup, Marcy l'Etoile, France.,Université de Lyon, Veterinary Campus of VetAgro Sup, APCSe, F-69280, Marcy l'Etoile, France
| | - Claude Carozzo
- Department of Small Animal Surgery, Vetagro Sup, Campus Vétérinaire de Lyon, Marcy l'Etoile, France.,Research Unit ICE, UPSP 2011.03.101, Université de Lyon, Veterinary Campus of VetAgro Sup, Marcy l'Etoile, France
| | - Thibaut Cachon
- Department of Small Animal Surgery, Vetagro Sup, Campus Vétérinaire de Lyon, Marcy l'Etoile, France.,Research Unit ICE, UPSP 2011.03.101, Université de Lyon, Veterinary Campus of VetAgro Sup, Marcy l'Etoile, France
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Hopman NEM, Wagenaar JA, van Geijlswijk IM, Broens EM. Development and Pilot of an Interactive Online Course on Antimicrobial Stewardship in Companion Animals. Antibiotics (Basel) 2021; 10:antibiotics10050610. [PMID: 34065607 PMCID: PMC8161360 DOI: 10.3390/antibiotics10050610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/06/2021] [Accepted: 05/17/2021] [Indexed: 11/28/2022] Open
Abstract
A holistic approach to antimicrobial use (AMU) and prescribing is needed to combat the problem of antimicrobial resistance (AMR). Previously, an antimicrobial stewardship programme (ASP) was developed, introduced, and evaluated in 44 Dutch companion animal clinics, which resulted in an optimization of AMU. As a follow-up to this, an online course was developed to promote awareness of AMU, AMR, and responsible antimicrobial prescribing. The aim of this paper is to describe the development and pilot, including evaluation, of this course, which will be disseminated more widely among Dutch companion animal veterinarians. The interactive programme consists of a major e-learning component and two online, face-to-face meetings. The course comprises five different parts corresponding with five consecutive weeks. Theory on several topics is offered, for example on AMU and AMR in general, Dutch regulations and guidelines on veterinary AMU, behavioural change, and possible methods to quantify AMU. Additionally, several assignments are offered, for example to reflect upon one’s own current antimicrobial prescribing behaviour. Interactive discussion and peer-to-peer learning are promoted. Since September 2020, the course has been offered in a pilot phase, and the feedback is promising. Evaluation of the pilot phase will result in recommendations for further optimization and dissemination.
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Affiliation(s)
- Nonke E. M. Hopman
- Department Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Yalelaan 1, 3584 CL Utrecht, The Netherlands; (J.A.W.); (E.M.B.)
- Correspondence:
| | - Jaap A. Wagenaar
- Department Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Yalelaan 1, 3584 CL Utrecht, The Netherlands; (J.A.W.); (E.M.B.)
- Wageningen Bioveterinary Research, Houtribweg 39, 8221 RA Lelystad, The Netherlands
| | - Ingeborg M. van Geijlswijk
- IRAS Veterinary Pharmacology and Therapeutics Group, Department Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 106, 3584 CM Utrecht, The Netherlands;
| | - Els M. Broens
- Department Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Yalelaan 1, 3584 CL Utrecht, The Netherlands; (J.A.W.); (E.M.B.)
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Woolley CSC, Handel IG, Bronsvoort BM, Schoenebeck JJ, Clements DN. Surveillance of a vomiting outbreak in dogs in the UK using owner-derived and internet search data. Vet Rec 2021; 189:e308. [PMID: 34008199 DOI: 10.1002/vetr.308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/09/2021] [Accepted: 03/07/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND In early 2020, the Small Animal Veterinary Surveillance Network reported evidence of an outbreak of acute prolific vomiting in dogs in the UK. The aims of this study were to investigate whether there was evidence for a vomiting outbreak in Dogslife and Google Trends data and to describe its characteristics. METHODS Incidence of Dogslife vomiting reports and the Google search index for 'dog vomiting' and 'puppy vomiting' between December 2019 and March 2020 was compared to the respective data from the same months in previous years. Risks for dogs vomiting and factors influencing veterinary attendance in Dogslife were identified using multivariable logistic regression. RESULTS This study confirmed a vomiting outbreak was evident in UK dogs between December 2019 and March 2020 using data from Dogslife and Google Trends. The odds of a vomiting incident being reported to Dogslife was 1.51 (95% CI: 1.24-1.84) in comparison to previous years. Dogslife data identified differences in owner-decision making when seeking veterinary attention and identified factors associated with dogs at higher odds of experiencing a vomiting episode. CONCLUSION Owner-derived data including questionnaires and internet search queries should be considered a valid, valuable source of information for veterinary population health surveillance.
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Affiliation(s)
- Charlotte S C Woolley
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush Campus, Midlothian, UK
| | - Ian G Handel
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush Campus, Midlothian, UK
| | - Barend M Bronsvoort
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush Campus, Midlothian, UK
| | - Jeffrey J Schoenebeck
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush Campus, Midlothian, UK
| | - Dylan N Clements
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush Campus, Midlothian, UK
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Antibiotic Stewardship for Canine and Feline Acute Urinary Tract Infection: An Observational Study in a Small Animal Hospital in Northwest Italy. Antibiotics (Basel) 2021; 10:antibiotics10050562. [PMID: 34064943 PMCID: PMC8150826 DOI: 10.3390/antibiotics10050562] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 04/30/2021] [Accepted: 05/07/2021] [Indexed: 02/06/2023] Open
Abstract
Antimicrobial stewardship programs (ASPs) have been suggested to reduce antimicrobial resistance phenomena in veterinary medicine, as antibiotics are commonly used without microbiological confirmation. The aim of the present study is to design a specific working flow for a tailored antimicrobial treatment in the case of canine and feline urinary tract infections (UTIs). Urine samples were collected by cystocentesis from 16 dogs and 12 cats presenting acute signs of UTI. The therapy was decided according to the minimal inhibitory concentration, and it was possible to monitor 14 dogs and 11 cats. Rescue therapy (amoxicillin and clavulanic acid) was included in emergency cases. Escherichia coli, Proteus mirabilis, and Streptococcus canis were isolated in dogs, and Escherichia coli, Staphylococcus pseudintermedius, and Staphylococcus aureus were isolated in cats. No multidrug-resistant strains were detected, but all Staphylococci were methicillin resistant. Only one cat received rescue therapy, and only one dog was recruited. Dogs were treated with tetracycline (1/14), fluoroquinolones (6/14), beta-lactams (6/14), and gentamicin (1/14), while cats received fluoroquinolones (3/11), nitrofurans (1/11), clindamycin (1/11), and beta-lactams (6/11). The success rate was very high. Our findings are interesting because this is the first ASP in Italy, and it may be used as a model to develop ASPs for other pathologies.
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Kopecny L, Palm CA, Segev G, Westropp JL. Urolithiasis in dogs: Evaluation of trends in urolith composition and risk factors (2006-2018). J Vet Intern Med 2021; 35:1406-1415. [PMID: 33960543 PMCID: PMC8162591 DOI: 10.1111/jvim.16114] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 03/18/2021] [Accepted: 03/21/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Urolithiasis is a common and often recurrent problem in dogs. OBJECTIVE To evaluate trends in urolith composition in dogs and to assess risk factors for urolithiasis, including age, breed, sex, neuter status, urolith location, and bacterial urolith cultures. SAMPLE POPULATION A total of 10 444 uroliths and the dogs from which they were obtained. METHODS The laboratory database at the UC Davis Gerald V. Ling Urinary Stone Analysis Laboratory was searched for all urolith submissions from dogs between January 2006 and December 2018. Mineral type, age, breed, sex, neuter status, urolith location, and urolith culture were recorded. Trends were evaluated and variables compared to evaluate risk factors. RESULTS Calcium oxalate (CaOx) and struvite-containing uroliths comprised the majority of all submissions from dogs, representing 47.0% and 43.6%, respectively. The proportion of CaOx-containing uroliths significantly decreased from 49.5% in 2006 to 41.8% in 2018 (P = .006), with no change in the proportion of struvite-containing urolith submissions. Cystine-containing uroliths comprised 2.7% of all submissions between 2006 and 2018 and a significant nonlinear increase in this mineral type occurred over time (1.4% of all submissions in 2006 to 8.7% in 2018; P < .001). Of all cystine-containing uroliths, 70.3% were from intact male dogs. Age, breed, and sex predispositions for uroliths were similar to those previously identified. CONCLUSIONS AND CLINICAL IMPORTANCE Although calcium oxalate- and struvite-containing uroliths continue to be the most common uroliths submitted from dogs, a decrease in the proportion of CaOx-containing uroliths and an increase in the proportion of cystine-containing uroliths occurred during the time period evaluated.
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Affiliation(s)
- Lucy Kopecny
- Department of Veterinary Medicine and Epidemiology, University of California Davis, Davis, California, USA
| | - Carrie A Palm
- Department of Veterinary Medicine and Epidemiology, University of California Davis, Davis, California, USA
| | - Gilad Segev
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, Hebrew University of Jerusalem, Rehovot, Israel
| | - Jodi L Westropp
- Department of Veterinary Medicine and Epidemiology, University of California Davis, Davis, California, USA
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Kopecny L, Palm CA, Segev G, Larsen JA, Westropp JL. Urolithiasis in cats: Evaluation of trends in urolith composition and risk factors (2005-2018). J Vet Intern Med 2021; 35:1397-1405. [PMID: 33955071 PMCID: PMC8162610 DOI: 10.1111/jvim.16121] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 03/24/2021] [Accepted: 03/25/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Urolithiasis is an important upper and lower urinary tract disease in cats that results in morbidity and mortality. OBJECTIVE To describe trends in composition of uroliths in cats and evaluate risk factors related to age, breed, sex, urolith location, and bacterial urolith cultures. SAMPLE POPULATION A total of 3940 uroliths and the cats from which they were obtained. METHODS The database of the UC Davis Gerald V. Ling Urinary Stone Analysis Laboratory was searched for all urolith submissions from cats between January 2005 and December 2018. Mineral type, age, breed, sex, and urolith location and culture results were recorded. Trends were evaluated and variables compared to evaluate risk factors. RESULTS A significant decrease in the proportion of calcium oxalate (CaOx)-containing uroliths occurred over time (P = .02), from 50.1% (204/407) of all submissions in 2005 to 37.7% (58/154) in 2018. In contrast, the proportion of struvite-containing uroliths increased significantly (P = .002), from 41.8% (170/407) in 2005 to 54.5% (84/154) in 2018. The proportion of CaOx-containing uroliths in the upper urinary tract was significantly higher compared to the proportion of other urolith types in the upper urinary tract. Urate-containing uroliths were the third most common type (361/3940, 9.2%). Overall, sex and age predispositions were similar to those reported previously. CONCLUSIONS AND CLINICAL IMPORTANCE The decrease in the proportion of CaOx-containing uroliths and increase in the proportion of struvite-containing uroliths warrants investigation. Further education regarding the efficacy of medical dissolution of struvite-containing uroliths is recommended.
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Affiliation(s)
- Lucy Kopecny
- Department of Veterinary Medicine and Epidemiology, University of California Davis, Davis, California, USA
| | - Carrie A Palm
- Department of Veterinary Medicine and Epidemiology, University of California Davis, Davis, California, USA
| | - Gilad Segev
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, Hebrew University of Jerusalem, Rehovot, Israel
| | - Jennifer A Larsen
- Department of Molecular Biosciences, University of California Davis, Davis, California, USA
| | - Jodi L Westropp
- Department of Veterinary Medicine and Epidemiology, University of California Davis, Davis, California, USA
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128
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Goggs R, Menard JM, Altier C, Cummings KJ, Jacob ME, Lalonde-Paul DF, Papich MG, Norman KN, Fajt VR, Scott HM, Lawhon SD. Patterns of antimicrobial drug use in veterinary primary care and specialty practice: A 6-year multi-institution study. J Vet Intern Med 2021; 35:1496-1508. [PMID: 33942943 PMCID: PMC8163138 DOI: 10.1111/jvim.16136] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 04/14/2021] [Accepted: 04/16/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Combatting antimicrobial resistance requires a One Health approach to antimicrobial stewardship including antimicrobial drug (AMD) use evaluation. Current veterinary AMD prescribing data are limited. OBJECTIVES To quantify companion animal AMD prescribing in primary care and specialty practice across 3 academic veterinary hospitals with particular focus on third-generation cephalosporins, fluoroquinolones, and carbapenems. ANIMALS Dogs and cats presented to 3 academic veterinary hospitals from 2012 to 2017. METHODS In this retrospective study, AMD prescribing data from 2012 to 2017 were extracted from electronic medical records at each hospital and prescriptions classified by service type: primary care, specialty practice or Emergency/Critical Care (ECC). Hospital-level AMD prescribing data were summarized by species, service type, AMD class, and drug. Multivariable logistic full-factorial regression models were used to estimate hospital, year, species, and service-type effects on AMD prescribing. Estimated marginal means and confidence intervals were plotted over time. RESULTS The probability of systemic AMD prescribing for any indication ranged between 0.15 and 0.28 and was higher for dogs than cats (P < .05) apart from 2017 at hospital 1. Animals presented to primary care were least likely to receive AMDs (dogs 0.03-0.15, cats 0.03-0.18). The most commonly prescribed AMD classes were aminopenicillins/β-lactamase inhibitors (0.02-0.15), first-generation cephalosporins (0.00-0.09), fluoroquinolones (0.00-0.04), nitroimidazoles (0.01-0.06), and tetracyclines (0.00-0.03). Among the highest priority classes, fluoroquinolones (dogs 0.00-0.09, cats 0.00-0.08) and third-generation cephalosporins (dogs 0.00-0.04, cats 0.00-0.05) were most frequently prescribed. CONCLUSIONS AND CLINICAL IMPORTANCE Antimicrobial drug prescribing frequencies were comparable to previous studies. Additional stewardship efforts might focus on fluoroquinolones and third-generation cephalosporins.
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Affiliation(s)
- Robert Goggs
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Julie M Menard
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Craig Altier
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Kevin J Cummings
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Megan E Jacob
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Denise F Lalonde-Paul
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Mark G Papich
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Keri N Norman
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine, Texas A&M University, College Station, Texas, USA
| | - Virginia R Fajt
- Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine, Texas A&M University, College Station, Texas, USA
| | - H Morgan Scott
- Department of Veterinary Pathobiology, College of Veterinary Medicine, Texas A&M University, College Station, Texas, USA
| | - Sara D Lawhon
- Department of Veterinary Pathobiology, College of Veterinary Medicine, Texas A&M University, College Station, Texas, USA
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Courtice R, Sniatynski M, Rubin JE. Characterization of antimicrobial-resistant Escherichia coli causing urinary tract infections in dogs: Passive surveillance in Saskatchewan, Canada 2014 to 2018. J Vet Intern Med 2021; 35:1389-1396. [PMID: 33751667 PMCID: PMC8162607 DOI: 10.1111/jvim.16103] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 02/25/2021] [Accepted: 02/25/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Urinary tract infections (UTIs) are common in dogs and can be caused by multidrug-resistant Escherichia coli (E coli). OBJECTIVE To describe the frequency and mechanisms of antimicrobial resistance (AMR) among E coli causing UTIs in dogs in Western Canada during a 4-year surveillance period. ANIMALS Urine from 516 dogs. METHODS From November 2014 to 2018, 516 nonduplicate E coli isolates from the urine of dogs were collected from a diagnostic laboratory. Susceptibility testing was determined for a panel of 14 antimicrobials belonging to 7 drug classes. Resistant isolates were screened for the presence of extended-spectrum beta-lactamases (ESBLs), AmpC β-lactamases, and plasmid-mediated quinolone resistance (PMQR) genes. Epidemiological relationships were assessed by MLST. RESULTS 80.2% (414/516) of isolates were susceptible to all antimicrobials tested. There was no significant increase in the proportion of isolates resistant to any of the tested antimicrobials during the study period. Resistance to ampicillin was the most common (14.9%, 77/516). Overall, 12 isolates had blaCMY-2 -type AmpC β-lactamases, and 7 produced CTX-M-type ESBLs. A single isolate had the aac(6')-Ib-cr PMQR gene. The qnr and qepA determinants were not detected. A single isolate belonging to the pandemic lineage ST131 was identified. CONCLUSION Escherichia coli isolated from the urine of dogs in our region remain susceptible to first-line therapies, though resistance, particularly to the aminopenicillins, warrants monitoring. This is the first description of E coli ST131 from a companion animal in Canada.
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Affiliation(s)
- Rachel Courtice
- Department of Veterinary Microbiology, Western College of Veterinary MedicineUniversity of SaskatchewanSaskatoonSaskatchewanCanada
- Canadian Food Inspection AgencySaskatoonSaskatchewanCanada
| | - Michelle Sniatynski
- Department of Veterinary Microbiology, Western College of Veterinary MedicineUniversity of SaskatchewanSaskatoonSaskatchewanCanada
| | - Joseph E. Rubin
- Department of Veterinary Microbiology, Western College of Veterinary MedicineUniversity of SaskatchewanSaskatoonSaskatchewanCanada
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Sitovs A, Sartini I, Giorgi M. Levofloxacin in veterinary medicine: a literature review. Res Vet Sci 2021; 137:111-126. [PMID: 33964616 DOI: 10.1016/j.rvsc.2021.04.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/26/2021] [Accepted: 04/27/2021] [Indexed: 01/10/2023]
Abstract
A potent third-generation antimicrobial fluoroquinolone drug, levofloxacin was introduced into human clinical practice in 1993. Levofloxacin is also used in veterinary medicine, however its use is limited: it is completely banned for veterinary use in the EU, and used extralabel in only companion animals in the USA. Since its introduction to clinical practice, many studies have been published on levofloxacin in animal species, including pharmacokinetic studies, tissue drug depletion, efficacy, and animal microbial isolate susceptibility to levofloxacin. This literature overview highlights the most clinically relevant and scientifically important levofloxacin studies linked to the field of veterinary medicine.
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Affiliation(s)
- Andrejs Sitovs
- Department of Pharmacology, Rīga Stradiņš University, Riga, Latvia.
| | - Irene Sartini
- Department of Veterinary Medicine, University of Sassari, Sassari, Italy
| | - Mario Giorgi
- Department of Veterinary Sciences, University of Pisa, San Piero a Grado, Pisa, Italy
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131
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Antimicrobial Prescribing Practices in Dogs and Cats by Colombian Veterinarians in the City of Medellin. Vet Sci 2021; 8:vetsci8050073. [PMID: 33925855 PMCID: PMC8145059 DOI: 10.3390/vetsci8050073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/19/2021] [Accepted: 04/24/2021] [Indexed: 11/17/2022] Open
Abstract
This study surveyed the prescribing behavior of Colombian companion animal veterinarians and compared the responses to the current guidelines of the International Society for Companion Animals on Infectious Diseases (ISCAID). A convenience sample of 100 primary-care veterinary practitioners was selected from the city of Medellin. A questionnaire was designed to present hypothetical clinical scenarios regarding prescription choices for systemic antimicrobials. The numbers of veterinarians empirically prescribing a course of systemic antimicrobials for each scenario were-perioperative elective surgeries (86%), superficial pyoderma (90%), lower urinary tract disease (52%), acute hemorrhagic diarrhea (50%), and kennel cough (46%). For urinary tract disease, cultures and susceptibility testing were only performed by half of the respondents, suggesting lower diagnostic standards. In superficial pyoderma cases, cytology was performed in the following percent of cases-0% (24), 20% (30), 40% (17), 60% (11), 80% (8), and 100% (10). Antimicrobials were over-prescribed relative to emerging standard for elective surgeries (86%), kennel cough (46%), and acute hemorrhagic diarrhea (50%). Critically important antimicrobials, such as fluoroquinolones, were applied commonly for superficial pyoderma (18%), kennel cough (12%), and lower urinary tract disease in dogs (20%) and cats (26%). In conclusion, antimicrobial prescribing behavior was inconsistent with current guidelines, and antimicrobial use could be improved by appropriate diagnostic steps allowing choice of an optimal antimicrobial drug. Overall, we documented the widespread use of antimicrobials for the treatment of these four common disease conditions.
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132
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Amphaiphan C, Yano T, Som-In M, Kungwong P, Wongsawan K, Pusoonthornthum R, Salman MD, Tangtrongsup S. Antimicrobial drug resistance profile of isolated bacteria in dogs and cats with urologic problems at Chiang Mai University Veterinary Teaching Hospital, Thailand (2012-2016). Zoonoses Public Health 2021; 68:452-463. [PMID: 33844465 DOI: 10.1111/zph.12832] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/08/2021] [Accepted: 03/29/2021] [Indexed: 11/27/2022]
Abstract
The present study aimed to estimate the proportion of bacterial urinary tract infection (UTI) in dogs and cats, assess risks associated with bacterial UTI, and to determine bacterial isolates' antimicrobial susceptibility and resistance pattern from the urinary tract of dogs and cats with urologic problems. The medical records from animals visiting Chiang Mai University Small Animal Veterinary Teaching Hospital between January 2012 and December 2016 were reviewed. In total, 203 dogs and 49 cats with urinary tract diseases that had samples submitted for bacterial culture were identified;198 and 24 bacterial isolates were recovered from dogs' and cats' submitted samples, respectively. At least one episode of bacterial UTI was detected in 75.4% (95% CI: 69.4-81.3) of dogs and in 40.8% (95% CI: 26.6-55.1) of cats with UTI and submitted urine cultures. Of 242 submitted urinary samples from dogs and 60 urinary samples from cats, bacteria were identified in 74.0% (95% CI: 68.4-79.5) and 38.3% (95% CI: 26.0-50.6), respectively. The most common pathogen of bacteria positive cultured from dogs was Staphylococcus spp. (30.3%), followed by Escherichia coli (16.7%), and Proteus spp. (13.6%). For cats, the most common pathogen was Pseudomonas spp. (25.0%), followed by E. coli (20.8%) and Proteus spp. (16.7%). Staphylococcus spp. isolates from dogs and Proteus spp. isolates from cats were highly susceptible to Amoxicillin/clavulanic acid (AMC) at 88% and 75%, respectively. Of all isolated bacteria, 67.1% of the bacteria from dogs and 83.3% from cats were multidrug-resistant (MDR). The proportion of MDR-bacterial urinary tract infections in dogs and cats with urologic problems in this study was high. This observation raises concerns regarding the potential of zoonotic transmission of MDR-bacteria from these companion animals. The results suggested that AMC remains a good empirical drug for treating UTIs in dogs in this region.
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Affiliation(s)
| | - Terdsak Yano
- Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Manita Som-In
- Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Phunnapha Kungwong
- Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | | | - Mo D Salman
- Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand.,Animal Population Health Institute, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Sahatchai Tangtrongsup
- Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand.,Research Center of Producing and Development of Products and Innovations for Animal Health and Production, Chiang Mai University, Chiang Mai, Thailand
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Allerton F, Prior C, Bagcigil AF, Broens E, Callens B, Damborg P, Dewulf J, Filippitzi ME, Carmo LP, Gómez-Raja J, Harpaz E, Mateus A, Nolff M, Phythian CJ, Timofte D, Zendri F, Jessen LR. Overview and Evaluation of Existing Guidelines for Rational Antimicrobial Use in Small-Animal Veterinary Practice in Europe. Antibiotics (Basel) 2021; 10:antibiotics10040409. [PMID: 33918617 PMCID: PMC8069046 DOI: 10.3390/antibiotics10040409] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 11/16/2022] Open
Abstract
Antimicrobial stewardship guidelines (ASGs) represent an important tool to help veterinarians optimize their antimicrobial use with the objective of decreasing antimicrobial resistance. The aim of this study was to map and qualitatively assess the ASGs for antimicrobial use in cats and dogs in Europe. Country representatives of the European Network for Optimization of Veterinary Antimicrobial Treatment (ENOVAT) were asked to identify ASGs published in their countries. All collated ASGs updated since January 2010 containing recommendations on antimicrobial therapy for at least three conditions affecting different organ systems in cats and dogs underwent detailed review including AGREE II analysis. Out of forty countries investigated, fifteen ASGs from eleven countries met the inclusion criteria. Several critical principles of antimicrobial use were identified, providing a framework that should assist development of stewardship guidance. The AGREE II analysis highlighted several methodological limitations of the currently available ASGs. This study sheds light on the lack of national ASGs for dogs and cats in multiple European countries and should encourage national bodies to prioritize guideline development in small animals. A greater awareness of the need to use a structured approach to guideline development could improve the quality of ASGs in the future.
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Affiliation(s)
- Fergus Allerton
- Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull B90 4NH, UK
- Correspondence:
| | - Cameron Prior
- Veterinary Specialists Scotland, 1 Deer Park Road Livingston, Scotland EH54 8AG, UK;
| | - Arzu Funda Bagcigil
- Department of Microbiology, Faculty of Veterinary Medicine, Istanbul University-Cerrahpaşa, 34320 Avcılar, Istanbul, Turkey;
| | - Els Broens
- Faculty of Veterinary Medicine, Department of Biomolecular Health Sciences, Utrecht University, Yalelaan 1, 3584 CL Utrecht, The Netherlands;
| | - Bénédicte Callens
- Centre of Knowledge on Antimicrobial Use and Resistance, Galileelaan 5/02, 1210 Brussels, Belgium;
| | - Peter Damborg
- Department of Veterinary and Animal Sciences, University of Copenhagen, Stigbøjlen 4, 1870 Frederiksberg, Denmark;
| | - Jeroen Dewulf
- Veterinary Epidemiology Unit, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium;
| | | | - Luís Pedro Carmo
- Veterinary Public Health Institute, Vetsuisse Faculty, University of Bern, Schwarzenburgstrasse 161, 3097 Liebefeld, Bern, Switzerland;
| | | | - Erez Harpaz
- Faculty of Veterinary Medicine, Institute for Production Animal Clinical Science, Norwegian University of Life Sciences, Small Ruminant Research and Herd Health, Høyland, 4325 Sandnes, Norway; (E.H.); (C.J.P.)
| | - Ana Mateus
- Hawkshead Campus, Royal Veterinary College, University of London, Hawkshead Lane, Hatfield AL9 7TA, Hertfordshire, UK;
| | - Mirja Nolff
- Clinic for Small Animal Surgery Tierspital Zürich, Vetsuisse Faculty, University of Zürich, Winterthurerstrasse 260, 8057 Zürich, Switzerland;
| | - Clare J. Phythian
- Faculty of Veterinary Medicine, Institute for Production Animal Clinical Science, Norwegian University of Life Sciences, Small Ruminant Research and Herd Health, Høyland, 4325 Sandnes, Norway; (E.H.); (C.J.P.)
| | - Dorina Timofte
- Department of Veterinary Anatomy, Leahurst Campus, Institute of Infection, Veterinary and Ecological Sciences, Physiology and Pathology, University of Liverpool, Neston CH64 7TE, UK; (D.T.); (F.Z.)
| | - Flavia Zendri
- Department of Veterinary Anatomy, Leahurst Campus, Institute of Infection, Veterinary and Ecological Sciences, Physiology and Pathology, University of Liverpool, Neston CH64 7TE, UK; (D.T.); (F.Z.)
| | - Lisbeth Rem Jessen
- Department of Veterinary Clinical Sciences, Faculty of Health Sciences, University of Copenhagen, Dyrlægevej 16, 1870 Frederiksberg C, Denmark;
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134
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Infections of the Urinary Tract of Bacterial Origin in Dogs and Cats. FOLIA VETERINARIA 2021. [DOI: 10.2478/fv-2021-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
The diseases of the urinary tract in small animal medicine, especially in dogs and cats, occur frequently with different etiologies. The most common cause of urinary tract infections (UTIs) are bacteria which enter upwards through the urethral opening. UTIs occur in hosts with compromised defence mechanisms in which the virulent microbes can adhere, multiply and persist in the urinary tract. In addition to bacteria, also viruses or fungi may infect the urinary tracts. Bacterial infection can develop in the upper (kidneys and ureters) or lower (bladder, urethra) urinary tract and are manifested by various clinical signs such as: frequent or difficult and painful urination, presence of blood in the urine, or its foul odour. The symptoms in sick animals are often accompanied by fever, discomfort, and loss of appetite. The UTIs in dogs and cats are caused by both Gram-negative (e. g. Escherichia coli, Pseudomonas aeruginosa, Klebsiella spp., Proteus spp.) and Gram-positive (e. g. Staphylococcus spp., Streptococcus spp., and Enterococcus spp.) bacteria. The properly performed aseptic sampling of the urine is one of the most important steps in bacteriological diagnostics. In this study, 105 urine samples were collected from dogs and cats. The cultivation, microscopy and biochemical examinations were used for species identification. Finally, the bacteriological examination included also determining the susceptibility of pathogens against antibiotics by the disc-diffusion method. The results were processed and expressed as a percentage according to identified pathogens, animal species, sex, breed and age. The uropathogens were diagnosed mainly in males aged 7—10 years. The most commonly identified pathogens were Escherichia coli, Streptococcus spp. and Staphylococcus spp. Tests of bacterial susceptibility to antibiotics showed that enrofloxacin, cefotaxime, and cephazolin were the most effective against uropathogens.
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135
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Frey E, Jacob M. Development of a method for creating antibiograms for use in companion animal private practices. J Am Vet Med Assoc 2021; 257:950-960. [PMID: 33064617 DOI: 10.2460/javma.257.9.950] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To identify a method for developing antibiograms for use in companion animal private practices (PPs). SAMPLES Reports (n = 532) of aerobic bacterial culture and antimicrobial susceptibility testing performed between January 1, 2018, and December 31, 2018, at 11 PPs and 1 academic primary care practice (APCP). PROCEDURES Data extracted from reports included patient identification number, laboratory accession number, patient signalment, collection method, body site, and results of bacterial culture and antimicrobial susceptibility testing. A custom antibiogram was then constructed with the help of commonly available software by adapting methods used by human hospitals. Susceptibility patterns of bacteria isolated by PPs and the APCP were compared to identify challenges associated with collating data from multiple laboratories. RESULTS 4 bacterial species (Escherichia coli, Proteus mirabilis, Pseudomonas aeruginosa, and Staphylococcus pseudintermedius) and 3 bacterial groups (Enterobacteriaceae, Enterococcus spp, and coagulase-positive Staphylococcus spp) met the minimum requirement of ≥ 15 isolates for construction of an antibiogram. For urine samples, 3 bacterial species and 2 bacterial groups met the minimum requirement of ≥ 10 isolates. For samples from skin, 2 bacterial species and 2 bacterial groups met the minimum requirement of ≥ 10 isolates. Patient signalment, sample source, and distribution of bacterial isolates were similar between PP and APCP patients. CONCLUSIONS AND CLINICAL RELEVANCE Results demonstrated that it was feasible to adapt existing guidelines for developing antibiograms in human medicine to the veterinary outpatient setting. Use of antibiograms could aid in empirical antimicrobial drug selection in a manner that supports antimicrobial stewardship principles.
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136
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Frey E, Jacob M. Commentary: Using antibiograms to promote antimicrobial stewardship during treatment of bacterial cystitis and superficial bacterial folliculitis in companion animal practice. J Am Vet Med Assoc 2021; 257:900-903. [PMID: 33064614 DOI: 10.2460/javma.257.9.900] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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137
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Jones E, Alawneh J, Thompson M, Allavena R. Association between case signalment and disease diagnosis in urinary bladder disease in Australian cats and dogs. J Vet Diagn Invest 2021; 33:498-505. [PMID: 33797303 DOI: 10.1177/10406387211004008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Urinary bladder diseases are common in dogs and cats; however, there is little published work on urinary bladder disease in Australian pets. We identified pathology records of Australian dogs and cats with urinary bladder tissue submitted to the University of Queensland Veterinary Laboratory Service during 1994-2016 (n = 320). We described the proportion of bladder diseases in dogs and cats, and applied the less-commonly used logistic regression procedure to quantify associations between signalment variables and disease diagnosis that were evident using descriptive statistics alone. After preliminary analysis, both species were combined because of similar results. Spayed/castrated animals were 74% less likely to be diagnosed with cystitis compared with intact animals. Animals 4-11 y old were also at lower risk of being diagnosed with cystitis compared with younger or older animals. Male animals were at increased risk of neoplasia compared to females, which contrasts with reports from North America and Europe. There was increased risk for developing neoplasia with progressive age, with up to 20 times higher odds in the > 11-y age group. Logistic regression modeling provided unique insight into proportionate morbidity of urinary bladder diseases in Australian dogs and cats.
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Affiliation(s)
- Emily Jones
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
| | - John Alawneh
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia.,Good Clinical Practice Research Group, The University of Queensland, Gatton, Queensland, Australia
| | - Mary Thompson
- School of Veterinary Medicine, Murdoch University, Murdoch, Western Australia, Australia
| | - Rachel Allavena
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
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138
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Towards a Better and Harmonized Education in Antimicrobial Stewardship in European Veterinary Curricula. Antibiotics (Basel) 2021; 10:antibiotics10040364. [PMID: 33808353 PMCID: PMC8067070 DOI: 10.3390/antibiotics10040364] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/24/2021] [Accepted: 03/24/2021] [Indexed: 11/16/2022] Open
Abstract
Education in antimicrobial stewardship (AMS) in veterinary medicine is essential to foster responsible antimicrobial use and control of antimicrobial resistance (AMR) in animals. AMS is listed by the EU and international organizations among the basic 'Day One Competences' required of veterinary students upon graduation. Our aim was to evaluate the quality of education of European veterinary students in AMS. We distributed a 27-item survey addressing the perceptions of preparedness and acquired skills on key topics related to AMS to final-year veterinary students in Europe. We collected 3423 complete answers from 89 veterinary schools in 30 countries. Selection of treatment strategies and awareness of emerging AMR problems were markedly different between countries. Overall, only one in four students was familiar with guidelines for antimicrobial use. The students perceived a medium-high impact of veterinary antimicrobial use on AMR in humans. Notably, 75% of the students felt the need for improved teaching on AMS, half of which also demanded more teaching on general antimicrobial therapy. Our results highlight several possible strategies to improve the quality of education, ranging from a better link between clinical rotations and the theory taught in pre-clinical modules, to a more effective introduction into best practices for antimicrobial use.
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139
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Melgarejo T, Oakley BB, Krumbeck JA, Tang S, Krantz A, Linde A. Assessment of bacterial and fungal populations in urine from clinically healthy dogs using next-generation sequencing. J Vet Intern Med 2021; 35:1416-1426. [PMID: 33739491 PMCID: PMC8162589 DOI: 10.1111/jvim.16104] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 02/28/2021] [Accepted: 03/03/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Urine from clinically healthy dogs is not sterile. Characterizing microbial diversity and abundance within this population of dogs is important to define normal reference ranges for healthy urine. OBJECTIVES To establish composition and relative representation of bacterial and fungal microbiomes in urine of clinically healthy dogs. ANIMALS Fifty clinically healthy dogs. METHODS Analytic study. Urine sampling via cystocentesis. Comprehensive evaluation of urine including standard urinalysis, culture and sensitivity, next-generation sequencing (NGS), and bioinformatics to define bacterial and fungal microbiome. RESULTS Culture did not yield positive results in any samples. Next-generation sequencing of urine established low presence of bacteria, fungi, or both in all samples. Diversity and abundance of bacterial and fungal communities varied between urine samples from different dogs. Struvite crystals were associated with bacterial community structure (P = .07) and there was a positive correlation between struvite crystals and pH. CONCLUSIONS AND CLINICAL IMPORTANCE The microbiome in urine of clinically healthy dogs has diverse bacterial and fungal species These findings highlight limitations of conventional culture testing and the need for culture-independent molecular diagnostics to detect microorganisms in urine.
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Affiliation(s)
- Tonatiuh Melgarejo
- Western University of Health Sciences (WesternU), College of Veterinary Medicine, Pomona, California, USA
| | - Brian B Oakley
- Western University of Health Sciences (WesternU), College of Veterinary Medicine, Pomona, California, USA
| | | | | | - Adam Krantz
- Western University of Health Sciences (WesternU), College of Veterinary Medicine, Pomona, California, USA
| | - Annika Linde
- Western University of Health Sciences (WesternU), College of Veterinary Medicine, Pomona, California, USA
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140
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Blondeau JM, Rankin SC. Diagnostic clinical microbiology. J Vet Pharmacol Ther 2021; 44:250-269. [PMID: 33686661 DOI: 10.1111/jvp.12962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/27/2021] [Accepted: 02/09/2021] [Indexed: 01/07/2023]
Abstract
Technological advancements have changed the way clinical microbiology laboratories are detecting and identifying bacterial, viral, parasitic, and yeast/fungal pathogens. Such advancements have improved sensitivity and specificity and reduce turnaround time to reporting of clinically important results. This article discusses and reviews some traditional methodologies along with some of the technological innovations introduced into diagnostic microbiology laboratories. Some insight to what might be available in the coming years is also discussed.
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Affiliation(s)
- Joseph M Blondeau
- Division of Clinical Microbiology, Royal University Hospital and Saskatchewan Health Authority, Saskatoon, SK, Canada.,Department of Microbiology and Immunology, University of Saskatchewan, Saskatoon, SK, Canada.,Department of Pathology and Laboratory Medicine, University of Saskatchewan, Saskatoon, SK, Canada.,Department of Ophthalmology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Shelley C Rankin
- Department of Pathobiology, University of Pennsylvania, School of Veterinary Medicine, Philadelphia, PA, USA
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141
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Humphreys WJE, Barton J, Batchelor D, Mortier JR. Extension of gas into the abdominal wall secondary to recurrent coliform emphysematous cystitis in a diabetic dog. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- William James Edward Humphreys
- Department of Small Animal Clinical Science: Diagnostic Imaging Institute of Veterinary Science, University of Liverpool Neston UK
| | - James Barton
- Department of Small Animal Clinical Science: Internal Medicine Institute of Veterinary Science, University of Liverpool Neston UK
| | - Daniel Batchelor
- Department of Small Animal Clinical Science: Internal Medicine Institute of Veterinary Science, University of Liverpool Neston UK
| | - Jeremy R. Mortier
- Department of Small Animal Clinical Science: Diagnostic Imaging Institute of Veterinary Science, University of Liverpool Neston UK
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142
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Lees P, Pelligand L, Giraud E, Toutain PL. A history of antimicrobial drugs in animals: Evolution and revolution. J Vet Pharmacol Ther 2021; 44:137-171. [PMID: 32725687 DOI: 10.1111/jvp.12895] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 06/08/2020] [Accepted: 07/06/2020] [Indexed: 12/17/2022]
Abstract
The evolutionary process of antimicrobial drug (AMD) uses in animals over a mere eight decades (1940-2020) has led to a revolutionary outcome, and both evolution and revolution are ongoing, with reports on a range of uses, misuses and abuses escalating logarithmically. As well as veterinary therapeutic perspectives (efficacy, safety, host toxicity, residues, selection of drug, determination of dose and measurement of outcome in treating animal diseases), there are also broader, nontherapeutic uses, some of which have been abandoned, whilst others hopefully will soon be discontinued, at least in more developed countries. Although AMD uses for treatment of animal diseases will continue, it must: (a) be sustainable within the One Health paradigm; and (b) devolve into more prudent, rationally based therapeutic uses. As this review on AMDs is published in a Journal of Pharmacology and Therapeutics, its scope has been made broader than most recent reviews in this field. Many reviews have focused on negative aspects of AMD actions and uses, especially on the question of antimicrobial resistance. This review recognizes these concerns but also emphasizes the many positive aspects deriving from the use of AMDs, including the major research-based advances underlying both the prudent and rational use of AMDs. It is structured in seven sections: (1) Introduction; (2) Sulfonamide history; (3) Nontherapeutic and empirical uses of AMDs (roles of agronomists and veterinarians); (4) Rational uses of AMDs (roles of pharmacologists, clinicians, industry and regulatory controls); (5) Prudent use (residue monitoring, antimicrobial resistance); (6) International and inter-disciplinary actions; and (7) Conclusions.
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Affiliation(s)
- Peter Lees
- The Royal Veterinary College, University of London, London, UK
| | | | - Etienne Giraud
- INTHERES, INRA, ENVT, Université de Toulouse, Toulouse, France
| | - Pierre-Louis Toutain
- The Royal Veterinary College, University of London, London, UK
- INTHERES, INRA, ENVT, Université de Toulouse, Toulouse, France
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143
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Machado L, de Oliveira MC, Barbieri CR, Riboldi CI, Leotti VB, González FHD, Valle SDF, Siqueira FM, Pöppl ÁG. Clinical and microbiological characterization of subclinical bacteriuria and sporadic bacterial cystitis in dogs with spontaneous hypercortisolism. Comp Immunol Microbiol Infect Dis 2021; 75:101624. [PMID: 33609989 DOI: 10.1016/j.cimid.2021.101624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 01/27/2021] [Accepted: 02/05/2021] [Indexed: 12/25/2022]
Abstract
Study's aims were to characterize subclinical bacteriuria (SB) and sporadic bacterial cystitis (SBC) in dogs with spontaneous hypercortisolism (HC). Prospective cross-sectional design divided patients as newly diagnosed (n = 27), poorly controlled (n = 21), well controlled (n = 34), and controls (n = 19). Urine culture positive results were identified by MALDI-TOF and submitted to antibiogram. Escherichia coli was the most common microorganism (36%). The majority of positive cultures in HC were SB (12.2%). All 4.1% SBC cases were in well controlled HC cases. Bacteriuria correlated with low urine specific gravity and low lymphocyte count. HC degree of control correlated with leukocyturia. SB/SBC cases were treated based in antimicrobial susceptibility leading to microbiological cure in 75% of HC cases. Persistent infections occurred only in SB cases, all by E. coli which became more resistant. SB/SBC prevalence in canine HC is actually lower. Further evidence for current ISCAID guideline contraindication for SB treatment due to HC were provided.
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Affiliation(s)
- Letícia Machado
- Veterinary Sciences Post-Graduation Program, Federal University of Rio Grande do Sul, Av. Bento Gonçalves 9090, Porto Alegre, Rio Grande do Sul, CEP 91540-000, Brazil
| | - Milena Cleff de Oliveira
- Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Av. Bento Gonçalves 9090, Porto Alegre, Rio Grande do Sul, CEP 91540-000, Brazil
| | - Cláudia Ruga Barbieri
- Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Av. Bento Gonçalves 9090, Porto Alegre, Rio Grande do Sul, CEP 91540-000, Brazil
| | - Camila Impérico Riboldi
- Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Av. Bento Gonçalves 9090, Porto Alegre, Rio Grande do Sul, CEP 91540-000, Brazil
| | - Vanessa Bielefeldt Leotti
- Department of Statistics, Mathematics and Statistics Institute, Federal University of Rio Grande do Sul, Av. Bento Gonçalves 9500, Porto Alegre, Rio Grande do Sul, CEP 91540-000, Brazil
| | - Félix Hilário Díaz González
- Veterinary Sciences Post-Graduation Program, Federal University of Rio Grande do Sul, Av. Bento Gonçalves 9090, Porto Alegre, Rio Grande do Sul, CEP 91540-000, Brazil; Department of Veterinary Clinical Pathology, School of Veterinary Medicine, Federal University of Rio Grande do Sul, Av. Bento Gonçalves 9090, Porto Alegre, Rio Grande do Sul, CEP 91540-000, Brazil
| | - Stella de Faria Valle
- Veterinary Sciences Post-Graduation Program, Federal University of Rio Grande do Sul, Av. Bento Gonçalves 9090, Porto Alegre, Rio Grande do Sul, CEP 91540-000, Brazil; Department of Veterinary Clinical Pathology, School of Veterinary Medicine, Federal University of Rio Grande do Sul, Av. Bento Gonçalves 9090, Porto Alegre, Rio Grande do Sul, CEP 91540-000, Brazil
| | - Franciele Maboni Siqueira
- Veterinary Sciences Post-Graduation Program, Federal University of Rio Grande do Sul, Av. Bento Gonçalves 9090, Porto Alegre, Rio Grande do Sul, CEP 91540-000, Brazil; Department of Veterinary Clinical Pathology, School of Veterinary Medicine, Federal University of Rio Grande do Sul, Av. Bento Gonçalves 9090, Porto Alegre, Rio Grande do Sul, CEP 91540-000, Brazil
| | - Álan Gomes Pöppl
- Veterinary Sciences Post-Graduation Program, Federal University of Rio Grande do Sul, Av. Bento Gonçalves 9090, Porto Alegre, Rio Grande do Sul, CEP 91540-000, Brazil; Department of Animal Medicine, School of Veterinary Medicine, Federal University of Rio Grande do Sul, Av. Bento Gonçalves 9090, Porto Alegre, Rio Grande do Sul, CEP 91540-000, Brazil.
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144
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Grant DC, Nappier MT, Corrigan VK. Diagnostic accuracy of a point-of-care test using voided urine samples for detection of bacteriuria in dogs with signs of lower urinary tract disease. J Vet Intern Med 2021; 35:993-996. [PMID: 33527463 PMCID: PMC7995359 DOI: 10.1111/jvim.16040] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 01/12/2021] [Accepted: 01/15/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Bacterial urine culture is recommended in dogs suspected of having urinary tract infection (UTI), but there is expense and delay in obtaining such results. HYPOTHESIS/OBJECTIVE To determine the diagnostic performance of a rapid immunoassay (RIA) dipstick for detection of bacteriuria using voided urine from dogs with clinical signs of lower UTI. ANIMALS Twenty-four client-owned dogs. METHODS Voided urine was collected and the RIA performed within 30 minutes. Urine collected by cystocentesis was submitted for aerobic urine culture. McNemar's test and kappa coefficient were calculated to determine agreement between the 2 tests. RESULTS Nine of 21 dogs (43%) had UTI verified by aerobic urine culture. There was 1 false-negative and no false-positive RIA results. Sensitivity, specificity, positive predictive value, and negative predictive value of the RIA were 89%, 100%, 100%, and 92%, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE This RIA is promising for correctly identifying whether or not voided urine samples from dogs with lower urinary tract clinical signs have true bacteriuria in a rapid, inexpensive manner. Additional patients should be enrolled in a similar study to determine if diagnostic performance is robust in a large population.
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Affiliation(s)
- David C Grant
- Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia, USA
| | - Michael T Nappier
- Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia, USA
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145
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Keebaugh AE, DeMonaco SM, Grant DC, Panciera DL. Prevalence of, and factors associated with, positive urine cultures in hyperthyroid cats presenting for radioiodine therapy. J Feline Med Surg 2021; 23:74-78. [PMID: 32478636 PMCID: PMC10741353 DOI: 10.1177/1098612x20926090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Urinary tract infections (UTIs) are reported to be relatively common in hyperthyroid cats, with prevalence rates ranging from 12% to 22%. Factors that are associated with UTIs include age, decreasing body weight and active urine sediments. The purpose of this study was to investigate the prevalence of positive urine cultures (PUCs) in hyperthyroid cats and associated risk factors for PUC. METHODS In total, 197 hyperthyroid cats presenting for radioiodine therapy had urine cultures prospectively performed on cystocentesis samples. Data pertaining to clinical signs, drug history, age, weight, blood urea nitrogen, creatinine, serum thyroxine and urinalysis were also evaluated. RESULTS The prevalence of PUCs in this population of hyperthyroid cats was 5.1% and all cats were subclinical. Microscopic bacteriuria was significantly associated with a PUC (60%) compared with a negative urine culture (1.6%) status. Age, weight, urine specific gravity <1.020, urine pH, hematuria, pyuria, thyroxine concentration, breed and sex were not associated with PUC status. CONCLUSIONS AND RELEVANCE The prevalence of PUCs in this population of cats was lower than previous reports of cats with hyperthyroidism. Cats with a PUC were subclinical at the time of culture, regardless of urine sediment abnormalities. Further studies are necessary to determine the clinical significance of subclinical bacteriuria in hyperthyroid cats.
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Affiliation(s)
- Audrey E Keebaugh
- Department of Small Animal Clinical Sciences,
Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, USA
| | - Stefanie M DeMonaco
- Department of Small Animal Clinical Sciences,
Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, USA
| | - David C Grant
- Department of Small Animal Clinical Sciences,
Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, USA
| | - David L Panciera
- Department of Small Animal Clinical Sciences,
Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, USA
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146
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Darwich L, Seminati C, Burballa A, Nieto A, Durán I, Tarradas N, Molina-López RA. Antimicrobial susceptibility of bacterial isolates from urinary tract infections in companion animals in Spain. Vet Rec 2021; 188:e60. [PMID: 33960452 DOI: 10.1002/vetr.60] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 11/02/2020] [Accepted: 12/11/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND The increasing emergence of multidrug-resistant bacteria, causing urinary tract infections (UTI) in dogs and cats, represents a great therapeutic challenge and a public health concern. METHODS Laboratory records of 4943 urinary microbiological diagnosis results and antimicrobial resistance profiles of suspected UTI cases in dogs and cats were analysed from 2016 to 2018 in Spain. RESULTS This study showed a higher percentage of positive microbiological diagnoses in dogs (42%, 1368/3270) than in cats (27%, 457/1673). Although Escherichia coli was the most frequently isolated bacterium, the frequency of antimicrobial susceptibility of E. coli isolates was lower compared to other bacterial species like Enterococcus spp., Staphylococcus spp., Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterobacter (E. cloacae), and Proteus mirabilis. The antimicrobial susceptibility testing of Gram-positive cocci showed higher levels of resistance in cats to common beta-lactams used for the treatment of complicated UTIs, as well as to fluoroquinolones, aminoglycosides, and carbapenems. Moreover, enterobacteria (E. coli, K. pneumoniae, and P. mirabilis) from cats presented high resistance frequencies to beta-lactams, including third- and fourth-generation cephalosporins and fluoroquinolones. CONCLUSION This study updates data on the current antimicrobial resistance in UTI bacteria from companion animals in Spain, which may help to guide clinicians for the appropriate use of antimicrobials.
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Affiliation(s)
- Laila Darwich
- Departament de Sanitat i Anatomia Animal, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Spain.,UAB, Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Campus de la Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Chiara Seminati
- Departament de Sanitat i Anatomia Animal, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Spain
| | | | - Alba Nieto
- Departament de Sanitat i Anatomia Animal, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Spain
| | - Inma Durán
- Departamento Veterinaria de Laboratorio Echevarne, S.A., Barcelona, Spain
| | - Núria Tarradas
- Departamento Veterinaria de Laboratorio Echevarne, S.A., Barcelona, Spain
| | - Rafael A Molina-López
- Catalan Wildlife Service, Centre de Fauna Salvatge de Torreferrussa, Barcelona, Spain
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147
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Tinoco-Najera A, Steiner JM, Suchodolski JS, Lidbury JA. Risk factors for urinary bacterial growth in dogs with congenital portosystemic shunts: 66 cases (1997-2019). J Small Anim Pract 2021; 62:359-364. [PMID: 33491792 DOI: 10.1111/jsap.13294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To identify risk factors for urinary bacterial growth in dogs with confirmed congenital portosystemic shunts on which a quantitative urine culture was performed. MATERIALS AND METHODS Sixty-six dogs were included in this retrospective cross-sectional study. Medical records were reviewed from 1997 through 2019. Variables of interest included age, sex and sexual status, clinical signs for a urinary tract infection, blood urea concentration, urinalysis abnormalities, ultrasound abnormalities of the urinary tract, and previous treatment. Univariable and multivariable analyses were performed. RESULTS The median age of the dogs was one year (range: 0.2-11.0 years). Urinary tract ultrasound abnormalities (cystic calculi and cystic debris) were reported in 50 dogs (75.7%). Abnormalities on urinalysis included pyuria in nine dogs (13.6%), bacteriuria in 13 dogs (19.7%), and haematuria in 26 dogs (39.4%). The median urine specific gravity was 1.021 (range: 1.004-1.052). Sixteen dogs (24.2%) had a positive quantitative urine culture. Based on multivariable analysis, bacteriuria (Odds ratio, 116; 95% CI, 9.6-1393; P = < 0.001) was the only variable significantly associated with a significantly increased odds for a positive quantitative urine culture. CLINICAL SIGNIFICANCE Clinical and subclinical bacteriuria can occur in dogs with congenital portosystemic shunts. In this group of dogs, bacteriuria was a risk factor for urinary bacterial growth.
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Affiliation(s)
- A Tinoco-Najera
- Gastrointestinal Laboratory, Texas A&M University, College Station, Texas, 77843-4474, USA
| | - J M Steiner
- Gastrointestinal Laboratory, Texas A&M University, College Station, Texas, 77843-4474, USA
| | - J S Suchodolski
- Gastrointestinal Laboratory, Texas A&M University, College Station, Texas, 77843-4474, USA
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148
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Li Y, Fernández R, Durán I, Molina-López RA, Darwich L. Antimicrobial Resistance in Bacteria Isolated From Cats and Dogs From the Iberian Peninsula. Front Microbiol 2021; 11:621597. [PMID: 33584590 PMCID: PMC7874003 DOI: 10.3389/fmicb.2020.621597] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 12/30/2020] [Indexed: 12/16/2022] Open
Abstract
Pet animals are assumed to be potential reservoirs in transferring antimicrobial resistance (AMR) to humans due to the extensively applied broad-spectrum antimicrobial agents and their close contact with humans. In this study, microbiological data and antimicrobial susceptibility results of dog (n = 5,086) and cat (n = 789) clinical samples from a private Laboratory of Diagnosis in Barcelona were analyzed. Samples came from different counties of the Iberian Peninsula during 2016–2018. In dogs, clinical samples were most commonly from otitis, and in cats from wounds, respiratory tract infections and conjunctivitis. In both pet groups, Staphylococcus spp. (31% in dogs vs 30% in cats), Streptococcus spp. (19% vs 17%), Pseudomonas spp. (16% vs 10%), Escherichia coli (8% vs 5.6%), and Enterococcus spp. (5.5% vs 6.8%) were shown as the most predominant bacteria. However, higher frequencies of P. aeruginosa, P. canis, and S. pseudintermedius were found in dogs, while S. aureus and P. multocida were more prevalent in cats. The antimicrobial susceptibility testing demonstrated that Enterococcus spp. and Pseudomonas spp. presented the highest levels of AMR in both dogs and cats. Within the Enterobacteriaceae, E. coli showed low levels of AMR compared to Klebsiella, Proteus, or Enterobacter spp. Respiratory tract infections caused by K. pneumoniae presented higher AMR in cats. By contrast, Pasteurella isolates from the respiratory tract were highly sensitive to all the antimicrobials in cats and dogs. Data from this study could be used to guide empirical antimicrobial selection in companion animal veterinary practices in the Iberian Peninsula.
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Affiliation(s)
- Yanli Li
- Departament de Sanitat i Anatomia Animal, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rubén Fernández
- Departament de Sanitat i Anatomia Animal, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Inma Durán
- Departamento Veterinaria de Laboratorios Echevarne, Barcelona, Spain
| | - Rafael A Molina-López
- Catalan Wildlife Service, Centre de Fauna Salvatge de Torreferrussa, Barcelona, Spain
| | - Laila Darwich
- Departament de Sanitat i Anatomia Animal, Universitat Autònoma de Barcelona, Barcelona, Spain
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149
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Guzmán Ramos PJ, Shiel RE, Fernández Pérez C, Ríos Boeta AM, Perlado Chamizo MR, Ballester Aguado JI, Ruiz Duro N, Ortiz-Díez G. Antimicrobial resistance increased over an 8-year period in Enterobacteriaceae cultured from canine urine samples. J Small Anim Pract 2021; 62:279-285. [PMID: 33460135 DOI: 10.1111/jsap.13291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 10/06/2020] [Accepted: 11/26/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aims of the present study were to describe the prevalence of positive urinary bacterial culture in dogs, to identify the most commonly isolated microorganisms and to analyse changes in antimicrobial susceptibility patterns over time. MATERIAL AND METHODS A retrospective case series was performed using culture and susceptibility results from canine urine samples collected between January 2010 and December 2017. The presence or absence of infection, identity of the bacterium with heaviest growth, and susceptibility profile were recorded for each sample. Trends in the frequency of positive culture and antimicrobial resistance were assessed by Poisson regression modelling. Prevalence rate ratio and 95% confidence interval were reported for resistance to each antimicrobial. RESULTS A positive urine culture was documented in 771 (22.5%) of 3420 samples. Escherichia coli was the most commonly isolated microorganism. There was no significant increase in the frequency of positive bacterial culture over the study period (prevalence rate ratio 0.98; 95% confidence interval: 0.92 to 1.0). Overall, there was an increase in antimicrobial resistance within Enterobacteriaceae from 5.2 to 35.6%. The prevalence of multidrug-resistant bacteria varied from year to year throughout the study period. However, the Poisson regression model identified a significant increase in the frequency of multidrug-resistant Enterobacteriaceae over this period, averaging approximately 22% per year (prevalence rate ratio 1.22, 95% confidence interval: 1.06 to 1.42). CLINICAL SIGNIFICANCE The significant increase in antimicrobial resistance observed in this study is concerning and may have implications for veterinary and public health. Appropriate measures, such as antibiotic stewardship programmes, should be implemented to address increasing antimicrobial resistance.
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Affiliation(s)
- P J Guzmán Ramos
- School of Veterinary Medicine, College of Health and Agricultural Sciences, University College Dublin, Dublin, Belfield, Dublin 4, Ireland
| | - R E Shiel
- School of Veterinary Medicine, College of Health and Agricultural Sciences, University College Dublin, Dublin, Belfield, Dublin 4, Ireland
| | - C Fernández Pérez
- Servicio de Medicina Preventiva, Instituto de Investigación Sanitaria (IsDSSS), Hospital Clínico San CarlosCalle del Prof. Martín Lagos, Madrid, 28040, Spain
| | - A M Ríos Boeta
- Hospital Veterinario PucholCalle Sauceda 8, Madrid, 28050, Spain
| | - M R Perlado Chamizo
- Hospital Clínico Veterinario, Universidad Alfonso X el SabioAvenida de la Universidad, 1, Madrid, 28691, Spain
| | - J I Ballester Aguado
- Hospital Clínico Veterinario, Universidad Alfonso X el SabioAvenida de la Universidad, 1, Madrid, 28691, Spain
| | - N Ruiz Duro
- Hospital Clínico Veterinario, Universidad Alfonso X el SabioAvenida de la Universidad, 1, Madrid, 28691, Spain
| | - G Ortiz-Díez
- Hospital Clínico Veterinario, Universidad Alfonso X el SabioAvenida de la Universidad, 1, Madrid, 28691, Spain
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150
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Letters to the Editor. J Am Vet Med Assoc 2021; 258:130-132. [PMID: 33405983 DOI: 10.2460/javma.258.2.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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