Haemolytic–uraemic syndrome caused by a non-O157 : H7 Escherichia coli strain in experimentally inoculated dogs

Antimicrobial Susceptibility Profiles of Escherichia Coli Isolates from Diarrheic Dogs in Maiduguri, Borno State, Nigeria

Diarrhea caused by multidrug-resistant Escherichia coli (E. coli) is an important and common problem in companion animals, especially dogs. Moreover, these dogs may serve as a reservoir of pathogenic strains of E. coli that may cause enteric and extra-intestinal infections in humans and other animals. This study was conducted to investigate the antibiotic susceptibility pattern of E. coli isolates from diarrheic dogs in Maiduguri Metropolis, Borno State, Nigeria. In fecal samples of 200 dogs with diarrhea, 147 E. coli strains (73.5%) were isolated and characterized by the standard bacteriological techniques (culture, biochemical tests, and antimicrobial susceptibility testing). Out of the 147 positive isolates, 45, 50, and 52 were from Elkanemi Park, Magaram, and Sabon gari wards respectively. The isolates show 100% resistance to chloramphenicol, cefuroxime, and ceftriaxone, 96.6% to amoxicillin, and 95.9% to gentamicin, while all (100%) were susceptible to ciprofloxacin. All the isolates showed multiple antimicrobial resistance. The result of the current study showed that dogs in Maiduguri are important reservoirs of multidrug-resistant E. coli. Therefore, it is important to adopt and apply guidelines for the correct use of antimicrobials in small animal practice to reduce the emergence of multidrug resistance among E. coli in companion animals.

Investigation of an outbreak of bloody diarrhea complicated with hemolytic uremic syndrome

In July-August 2009, eight patients with bloody diarrhea complicated by hemolytic uremic syndrome (HUS) were admitted to hospitals in Tbilisi, Georgia. We started active surveillance in two regions for bloody diarrhea and post-diarrheal HUS. Of 25 case-patients who developed HUS, including the initial 8 cases, half were ⩾15 years old, 67% were female and seven (28%) died. No common exposures were identified. Among 20 HUS case-patients tested, Shiga toxin was detected in the stools of 2 patients (one with elevated serum IgG titers to several Escherichia coli serogroups, including O111 and O104). Among 56 persons with only bloody diarrhea, we isolated Shiga toxin-producing E. coli (STEC) O104:H4 from 2 and Shigella from 10; 2 had serologic evidence of E. coli O26 infection. These cases may indicate a previously unrecognized burden of HUS in Georgia. We recommend national reporting of HUS and improving STEC detection capacity.

Lyme nephritis

OBJECTIVE

To review what is known and highlight knowledge gaps regarding Lyme nephritis (LN).

DATA SOURCES

Publications identified via PubMed using the keywords "Borrelia burgdorferi," "Borreliosis," "glomerulonephritis," "protein-losing nephropathy," "autoimmunity," and "retriever," and as generated by investigators working in the fields of Borreliosis and immune-mediated glomerulonephritis.

HUMAN DATA SYNTHESIS

Postborrelial immune-mediated glomerulonephritis was described recently in 6 people; 3 responded to antimicrobials/steroids, 1 to antimicrobials/angiotensin-converting enzyme inhibitor/warfarin, 1 required hemodialysis but became hemodialysis independent after 5 months and treatment with antimicrobials, steroids, plasmapheresis, immunoglobulin, and 1 did not respond to steroids and angiotensin-converting enzyme inhibitor and still requires hemodialysis.

VETERINARY DATA SYNTHESIS

Lyme nephritis is seen in <1-2% of Lyme seropositive dogs, with an average onset at 5-6 years. Labrador and Golden Retrievers are predisposed to this condition. Prior or concurrent lameness is described in 9-28% cases. Historical presentations include acute progressive protein-losing nephropathy with membranoproliferative glomerulonephritis, tubular necrosis/regeneration, and interstitial nephritis, but possibly milder forms exist. Complications include thromboembolic events, hypertension, effusive disease, and oliguric/anuric renal failure. Diagnostic tests help stage disease and rule out other causes. Renal biopsy is advocated early, when intervention may help, and to prove if immune-complex disease exists. Treatment includes standard therapy for protein-losing nephropathy, long-term antimicrobials, and perhaps immunosuppressive therapy.

CONCLUSIONS

There is no experimental model of LN to study predisposing factors, pathogenesis, onset, progression, treatment, or prevention. There are no predictive tests to identify the few individuals at highest risk, therefore all seropositive dogs should be screened and monitored for proteinuria. Lyme nephritis mimics other forms of protein-losing nephropathy and sometimes Leptospirosis. Renal biopsy helps show if immune-complex disease exists, but may not prove LN specifically. More studies are warranted on dogs with Lyme-specific immune-complex deposition to evaluate risk factors, understand pathogenesis, variability of expression, and to validate treatment and prevention protocols.