Evaluation of clinical characteristics and bacterial isolates in dogs with bacterial keratitis: 97 cases (1993-2003)

Staphylococcus pseudintermedius induces pyroptosis of canine corneal epithelial cells by activating the ROS-NLRP3 signalling pathway

Staphylococcus pseudintermedius (S. pseudintermedius) is a common pathogen that causes canine corneal ulcers. However, the pathogenesis remained unclear. In this study, it has been demonstrated that S. pseudintermedius invaded canine corneal epithelial cells (CCECs) intracellularly, mediating oxidative damage and pyroptosis by promoting the accumulation of intracellular reactive oxygen species (ROS) and activating the NLRP3 inflammasome. The canine corneal stroma was infected with S. pseudintermedius to establish the canine corneal ulcer model in vivo. The intracellular infectious model in CCECs was established in vitro to explore the mechanism of the ROS - NLRP3 signalling pathway during the S. pseudintermedius infection by adding NAC or MCC950. Results showed that the expression of NLRP3 and gasdermin D (GSDMD) proteins increased significantly in the infected corneas (p < 0.01). The intracellular infection of S. pseudintermedius was confirmed by transmission electron microscopy and immunofluorescent 3D imaging. Flow cytometry analysis revealed that ROS and pyroptosis rates increased in the experimental group in contrast to the control group (p < 0.01). Furthermore, NAC or MCC950 inhibited activation of the ROS - NLRP3 signalling pathway and pyroptosis rate significantly, by suppressing pro-IL-1β, cleaved-IL-1β, pro-caspase-1, cleaved-caspase-1, NLRP3, GSDMD, GSDMD-N, and HMGB1 proteins. Thus, the research confirmed that oxidative damage and pyroptosis were involved in the process of CCECs infected with S. pseudintermedius intracellularly by the ROS - NLRP3 signalling pathway. The results enrich the understanding of the mechanisms of canine corneal ulcers and facilitate the development of new medicines and prevention measures.

An assessment of bacterial contamination of indirect ophthalmoscopes and condensing lenses used in clinical practice: A multi-center study

PURPOSE

To investigate bacterial contamination of indirect ophthalmoscopes and condensing lenses used in three UK veterinary referral centers, and the impact of an implemented cleaning protocol.

METHODS

Bacteriology samples from 10 indirect ophthalmoscopes and 10 condensing lenses were taken at each center (n = 30 T0), before initiating one of three cleaning frequencies (every 2 weeks/once weekly/daily) for 28 days. The most contaminated indirect ophthalmoscope and condensing lens from each center were re-sampled 30 min prior to (T1; n = 9) and 30 min after (T2; n = 9) the final clean. Sensitivity testing was completed using MIC.

RESULTS

Seventy-three isolates representing 15 different bacterial populations (genus/species) were cultured from 36 of 48 (75%) swabs tested. The most frequently cultured isolates were Staphylococcus spp. 30%, Micrococcus 22%, and Bacillus 14%. Pseudomonas aeruginosa, Pantoea, and Staphylococcus pseudintermedius demonstrated resistance to >50% of antibiotics against which they were tested. Eighty-three percent of T0 samples (54 isolates across 11 species, median 2 isolates/swab), all T1 samples (15 isolates across 8 species, median 2 isolates/swab), and 22% of T2 samples (4 isolates across 4 species, median 0 isolates/swab) were contaminated. Head contact points were most contaminated irrespective of time point. A T1 sample was 57 times more likely (95% CI: 2.4-1376) to have a positive culture than a T2 sample (p = .01).

CONCLUSIONS

Baseline contamination was high, representing a potential source of nosocomial infection in ophthalmic patients and handlers of diagnostic equipment. No center implemented a cleaning protocol prior to this study. Routine cleaning reduces bacterial contamination.

Progressive ulcerative keratitis in dogs in the United Kingdom: Microbial isolates, antimicrobial sensitivity, and resistance patterns

OBJECTIVES

The objective of the study was to identify bacterial pathogens and their antimicrobial sensitivity profile associated with cases of canine progressive ulcerative keratitis.

MATERIALS AND METHODS

Analysis of microbial culture and sensitivity results from dogs with progressive ulcerative keratitis presenting to a UK referral practice between December 2018 and August 2020.

RESULTS

Positive bacterial cultures were obtained from 80/148 (54%) of the canine ulcers sampled with 99 bacterial isolates cultured. Streptococcus canis (n = 29), Pseudomonas aeruginosa (n = 19), and Staphylococcus pseudintermedius (n = 16) were the most common isolates. Pseudomonas aeruginosa was more likely to be isolated whether the ulcer was clinically malacic at the time of sampling (OR = 10.1, p < .001). Ulcers treated prior to culture with fusidic acid were 7.6 times more likely to be positive than those treated with any other antimicrobial(s). Bacterial isolates demonstrated resistance against neomycin (85%), fusidic acid (78%), and tetracycline (68%). Conversely, isolates were most likely to be sensitive to gentamicin (88%), ofloxacin (77%), ciprofloxacin (73%), and chloramphenicol (64%). Antimicrobial combinations of chloramphenicol or gentamicin with a fluoroquinolone (ofloxacin or ciprofloxacin) or chloramphenicol combined with gentamicin were the most effective on in vitro analysis (over 90% susceptibility of all isolates).

CONCLUSION

The most common bacterial species associated with canine progressive ulcerative keratitis in a UK referral population were S. canis, P. aeruginosa, and S. pseudintermedius. Combination antimicrobial therapy is recommended pending culture and sensitivity results given the varied antimicrobial susceptibility profiles and significant bacterial in vitro resistance to antimicrobial monotherapy.

Prevalence and antibiotic resistance in bacterial isolates of dogs with ulcerative keratitis in São Paulo State, Brazil

OBJECTIVE

Identify microorganisms present in canine eyes affected by ulcerative keratitis and assess its resistance profile to available antimicrobial drugs.

METHODS

Samples were collected from 88 canine eyes that exhibited ulcerative keratitis. They were identified using MALDI-TOF and subjected to antimicrobial susceptibility testing by disk diffusion.

RESULTS

Among the assessed subjects, brachycephalic dogs accounted for 74.48% (50/83) of the evaluated canines. Among the 88 evaluated eyes, 90.9% (80/88) showed positive cultures, with 11.33% (10/88) of the samples isolating more than one species of bacteria. Of all bacterial isolates identified (90), Gram-positive bacteria accounted for 63.33% (57/90), while Gram-negative bacteria constituted 36.66% (33/90), with predominance of Staphylococcus spp. at 35.55% (32/90) being, Staphylococcus pseudintermedius at 68.75% (22/32), and Pseudomonas aeruginosa at 15.55% (14/90), respectively. Staphylococcus spp. exhibited resistance to penicillin (89.29%), sulfadiazine and trimethoprim (60.71%), and tetracycline (67.86%), while doxycycline (88.89%), cefotaxime (85.71%), chloramphenicol (82.14%), gentamicin, and moxifloxacin (78.57%) showed the highest sensitivity rates. Pseudomonas aeruginosa displayed sensitivity (100%) to gentamicin and imipenem, and resistance (8.33%) to norfloxacin, ciprofloxacin, and cefepime. Similarly, the Enterobacteriaceae family showed higher sensitivity to amikacin and gentamicin (88.89%), imipenem (88.24%), and levofloxacin (87.5%), with pronounced resistance to amoxicillin-clavulanate (50%) and cefazolin (47.06%). This highlights multiresistance in 23.33% (21/90) of the isolates.

CONCLUSIONS

The most isolated species in canine ulcerative keratitis are S. pseudintermedius and P. aeruginosa. However, other species were also isolated, demonstrating diversity in ocular microbiota infection. There is a high-rate multidrug resistance associated with canine ulcerative keratitis. Nevertheless, these strains exhibited sensitivity to antimicrobials commonly used in veterinary ophthalmology.

Argon cold atmospheric plasma eradicates pathogens in vitro that are commonly associated with canine bacterial keratitis

Purpose

To investigate the antimicrobial effect of cold atmospheric plasma (CAP) on pathogens associated with canine bacterial keratitis.

Materials and methods

Pseudomonas aeruginosa, Staphylococcus pseudintermedius, and Streptococcus canis strains, which were obtained from dogs with infectious keratitis, were subjected to testing. For each species, four isolates and a reference strain were cultivated on Columbia sheep blood agar and treated with the kiNPen Vet® plasma pen from Neoplas GmbH, Greifswald, Germany. Various continuous treatment durations (0.5, 2, and 5 min) were applied, along with a 0.5-min treatment repeated four times at short intervals. These treatments were conducted at distances of 3 and 18 mm between the agar surface and the pen.

Results

CAP treatment reduced bacterial growth in all three species. The most effective treatment duration was 5 min at 3 mm distance, resulting in inhibition zones ranging from 19 to 22 mm for P. aeruginosa, 26-45 mm for S. pseudintermedius and an overall reduction of bacterial growth for Str. canis. Inhibition zones were smaller with decreasing treatment duration and larger distance. Treatment times of 30 s repeated four times and 2 min showed comparable results. Treatment with argon alone did not lead to visible reduction of bacterial growth.

Conclusion

Argon cold atmospheric plasma demonstrated a potent in vitro antimicrobial effect on P. aeruginosa, S. pseudintermedius and Str. canis strains with the latter showing the highest sensitivity.

Corneal stromal ulcerations in a referral population of dogs and cats in the Netherlands (2012-2019): Bacterial isolates and antibiotic resistance

OBJECTIVE

To evaluate bacterial isolates from corneal stromal ulcerations in dogs and cats in the Netherlands, review their antibiotic susceptibility, determine whether recent topical treatment affected bacterial culture results, and investigate whether (multi-drug) resistance patterns changed over time.

ANIMALS STUDIED

Client-owned dogs and cats were diagnosed with corneal stromal ulceration at the Utrecht University Clinic for Companion Animals between 2012 and 2019.

PROCEDURES

Retrospective analysis.

RESULTS

In total, 163 samples were collected from 122 dogs (130 samples) and 33 cats. Positive cultures were obtained from 76 canine and 13 feline samples (59% and 39%, respectively) and included Staphylococcus (42 in dogs, 8 in cats), Streptococcus (22 in dogs, 2 in cats), and Pseudomonas (9 in dogs, 1 in cats) species. Significantly fewer positive cultures were found in dogs and cats previously treated with topical antibiotics (χ2  = 6.52, p = .011 and χ2  = 4.27, p = .039, respectively). Bacterial resistance to chloramphenicol was more common in dogs previously treated with chloramphenicol (χ2  = 5.24, p = .022). The incidence of acquired antibiotic resistance did not increase significantly over time. In dogs, the incidence of multi-drug-resistant isolates increased significantly between 2012-2015 and 2016-2019 (9.4% vs. 38.6%, p = .0032).

CONCLUSIONS

Staphylococcus, Streptococcus, and Pseudomonas species were the most common bacteria associated with canine and feline corneal stromal ulcerations. Previous treatment with antibiotics affected bacterial culture results and antibiotic sensitivity. Although the overall incidence of acquired antibiotic resistance did not change over time, the incidence of multi-drug-resistant isolates in dogs increased over an 8-year period.

N-Acetylcysteine and Its Immunomodulatory Properties in Humans and Domesticated Animals

N-acetylcysteine (NAC), an acetylated derivative of the amino acid L-cysteine, has been widely used as a mucolytic agent and antidote for acetaminophen overdose since the 1960s and the 1980s, respectively. NAC possesses antioxidant, cytoprotective, anti-inflammatory, antimicrobial, and mucolytic properties, making it a promising therapeutic agent for a wide range of diseases in both humans and domesticated animals. Oxidative stress and inflammation play a major role in the onset and progression of all these diseases. NAC's primary role is to replenish glutathione (GSH) stores, the master antioxidant in all tissues; however, it can also reduce levels of pro-inflammatory tumor necrosis factor-alpha (TNF-∝) and interleukins (IL-6 and IL-1β), inhibit the formation of microbial biofilms and destroy biofilms, and break down disulfide bonds between mucin molecules. Many experimental studies have been conducted on the use of NAC to address a wide range of pathological conditions; however, its effectiveness in clinical trials remains limited and studies often have conflicting results. The purpose of this review is to provide a concise overview of promising NAC usages for the treatment of different human and domestic animal disorders.

Streptococcus canis prevalence on the normal and abnormal ocular surface of dogs referred for ophthalmic disease in Canada

Streptococcus canis is a beta-haemolytic, Gram-positive cocci commonly identified on the canine ocular surface under both healthy and diseased conditions. The objective of the study was to determine the prevalence of S. canis on the normal and abnormal ocular surface of a canine ophthalmology referral population in Canada, and to investigate potential clinical aspects that may be associated with its presence. Included were 59 dogs (118 eyes) with unilateral or bilateral ocular disease diagnosed at the time of conjunctival sampling. A real-time PCR specific for S. canis was standardized for use with conjunctival swabs. Total DNA was extracted from 118 samples and used as template for the diagnostic assay. Samples were considered positive if amplification was detected and dissociation temperature matched a positive control. Signalment and other clinical data were also collected at the time of sampling. Of the 118 eyes sampled, 8 tested positive for S. canis (6.8%). No association between the detection of S. canis and breed, cephalic conformation, sex, age, use of ophthalmic antibiotics or other topical medications, ophthalmic diagnosis, use of systemic antibiotics or other systemic medications, or systemic diagnosis was identified. In conclusion, S. canis may be present on the ocular surface of dogs at a higher rate than previously reported. It is suggested that this may be linked to the use of PCR for pathogen detection instead of culture.

Multidirectional corneoconjunctival transposition in the treatment of large keratomalacia in 7 dogs and 5 cats

OBJECTIVE

To describe the use of multidirectional corneoconjunctival transposition (CCT) as a surgical treatment for large keratomalacia.

METHOD

A prospective study including dogs and cats initially presenting with keratomalacia larger than 6 × 6 mm and affecting more than half of the corneal thickness. Signalment, concurrent eye diseases, ulcer size, bacterial culture and susceptibility testing results, follow-up, and outcome were recorded. The surgery consisted of harvesting of two or three opposite corneoconjunctival grafts, after removal of the malacic tissue using a square-edge keratectomy. The medical treatment consisted of administration of topical and systemic antibiotics, topical atropine, and N-acetylcysteine. Follow-up examinations were performed at D7, D14, D21, and D28, and then at various time points. The corneal clarity score (CCS) was recorded upon completion of the follow-up period.

RESULTS

Seven dogs and five cats were included. Brachycephalic dogs were overrepresented, with no breed predisposition in cats. Concurrent eye diseases were corneal pigmentation in three dogs, hypopyon in two dogs, nictitating membrane wound in one dog, and corneal perforation in one cat. The size of the keratomalacia ranged from 6 × 6 to 9.5 × 11.5 mm. The short-term complications were suture dehiscence (two of 12) and progression of the keratomalacia (one of 12). The long-term complications were corneal pigmentation (10 of 12), corneal epithelial inclusion cyst (two of 12), and marginal synechiae (one of 12). All animals were sighted at the last follow-up. The median CCS was G3 (range G2-G4).

CONCLUSION

Multidirectional CCT is an effective surgical treatment for large keratomalacia in dogs and cats.

In Vitro Antimicrobial Activity of N-Acetylcysteine against Pathogens Most Commonly Associated with Infectious Keratitis in Dogs and Cats

To determine the in vitro antimicrobial activity of N-acetylcysteine (NAC) against common pathogens associated with infectious keratitis in dogs and cats, clinical isolates of Staphylococcus (S.) pseudintermedius (n = 20), Streptococcus (St.) canis (n = 10) and Pseudomonas (P.) aeruginosa (n = 7) of canine and feline infectious ulcerative keratitis and a quality control strain (P. aeruginosa DSM 19880) were tested. The minimal inhibitory concentration (MIC) of NAC concentrations was determined using microdilution methodology. For S. pseudintermedius and P. aeruginosa, NAC concentrations in the range of 1.56 mg/mL (0.156%) to 100 mg/mL (10%), and for St. canis, concentrations ranging from 0.195 mg/mL (0.0195%) to 6.25 mg/mL (0.625%) were tested. For S. pseudintermedius, the MIC was 3.12 mg/mL (0.312%) for all tested isolates. For P. aeruginosa isolates and the quality control strain, the MIC ranged from 3.12 mg/mL (0.312%) to 6.25 mg/mL (0.625%). For St. canis, the MIC ranged from 1.56 mg/mL (0.156%) to 3.12 mg/mL (0.312%). NAC has an in vitro antimicrobial activity against three bacterial species commonly found in infectious keratitis in dogs and cats and therefore may be a promising alternative or adjuvant to topical antibiotics. The results warrant a clinical pilot study to assess the potential of NAC to reduce or replace the use of topical antibiotics in line with the One Health approach.

An Update on the Ocular Surface Bacterial Microbiota in Small Animals

High-throughput sequencing (HTS) techniques have revolutionized the way we understand microbial communities in both research and clinical settings and are bringing new insights into what constitutes a healthy ocular surface (and a diseased one). As more diagnostic laboratories incorporate HTS into their technique repertoire, practitioners can expect this technology to become increasingly accessible for clinical practice, potentially becoming the new standard. However, particularly regarding ophthalmic microbiota, considerable research remains to render HTS accessible and applicable.

Topical Ocular Therapeutics in Small Animals

This article reviews the administration of common topical ophthalmic medications, in relation to factors influencing absorption including composition of topical ophthalmic preparations, and potential systemic effects. Commonly prescribed, commercially available topical ophthalmic medications are discussed with respect to pharmacology, their indications for use, and adverse effects. Knowledge of topical ocular pharmacokinetics is essential for the management of veterinary ophthalmic disease.

Antibiotic Recommendations for Treatment of Canine Stromal Corneal Ulcers

The aim of the study was to identify the aerobic bacterial isolates and determine corresponding antibiotic susceptibility profiles in vitro in canine clinical specimens with stromal corneal ulcers, with the goal of providing recommendations for first-line treatment with antibiotics. A total of 198 canine corneal stromal ulcer samples were studied between 2018 and 2021. A corneal swab was collected and cultured under aerobic conditions. Bacterial organisms were identified at the species level by MALDI-TOF mass spectrometry. Antibiotic susceptibility testing for commonly used topical and systemic antibiotics was performed by disk diffusion. Bacterial growth was obtained from 80% of samples. A variety of bacterial species were identified wherein the most common specimens were represented by Staphylococcus pseudintermedius (22%), Staphylococcus epidermidis (12%), Staphylococcus capitis (11%), and Pseudomonas aeruginosa (10%). Based on the overall antibiotic susceptibility data, neopolybac alone (96%) or a combination of neopolybac with either ofloxacin or amikacin (each 99%) showed the best coverage for commonly isolated bacterial organisms from canine corneal stromal ulcers. Results of this study support the use of the combined antibiotics as the first-line response for the treatment of canine corneal stromal ulcers. A statically significant increase in acquired bacterial resistance was detected during the longitudinal data observation.

Evaluation of conjunctival graft procedures and factors that lead to graft complications in canine cases

PURPOSE

To describe the complications of conjunctival graft surgery occurring in cases at a referral ophthalmic service and evaluate factors that lead to occurrence of complications in canine cases.

METHODS

A retrospective case-control study was completed using data from the Veterinary Medical Center at the Western College of Veterinary Medicine, Saskatoon, Canada, between May 2015 and March 2020. Case records from dogs that underwent conjunctival pedicle graft surgery and subsequently either did or did not develop a conjunctival graft complication were reviewed.

RESULTS

One hundred and six dogs undergoing conjunctival graft surgeries were identified. Sixteen conjunctival graft complications occurred, of which, eight led to negative outcomes. Univariable analysis comparing canine eyes that developed complications to control eyes revealed potential (p ≤ .05) differences between the groups in post-operative fluoroquinolone use, Streptococcus canis isolation, intraoperative intravenous cefazolin use, corneal stromal white cell infiltrate, and mean ulcer diameter. The use of intraoperative cefazolin could not be effectively evaluated with available data; however, no dogs (n = 22) receiving intraoperative cefazolin developed complications. Multivariable analysis revealed that dogs that were treated with a second-generation fluoroquinolone and that had S. canis isolated had higher odds of experiencing complications than dogs that were not treated with a second-generation fluoroquinolone and that were S. canis negative (Odds ratio = 64.7 [95% CI 6.3-669], p < .0001).

CONCLUSIONS

Streptococcus species played a role in conjunctival graft complications in our study. Empiric selection of second-generation fluoroquinolone monotherapy may need reconsideration given the frequent isolation of Streptococcus spp. from canine ulcers. The use of intraoperative cefazolin may be associated with a lower complication rate.

Impact of multi-drug resistance on clinical outcomes of dogs with corneal ulcers infected with Staphylococcus pseudintermedius

Objective

Compare characteristics and clinical outcomes of dogs with infectious keratitis from Staphylococcus pseudintermedius considered to be multidrug-resistant (MDR) or not.

Procedures

Staphylococcus pseudintermedius isolated as the primary pathogen from canine patients with ulcerative keratitis were considered MDR if resistant to at least one agent in three or more classes of antibiotics. Medical records were reviewed for history, patients' characteristics, clinical appearance, therapeutic interventions, and clinical outcomes.

Results

Twenty-eight dogs (28 eyes) were included. Compared to non-MDR cases, MDR diagnosis was significantly more common in dogs with recent (≤30 days) anesthesia (7/15 vs. 1/13, P = 0.038) and more common in non-brachycephalic dogs (8/15 vs. 2/13, P = 0.055). Clinical appearance (ulcer size/depth, anterior chamber reaction, etc.) did not differ significantly between groups (P ≥ 0.055). Median (range) time to re-epithelialization was longer in MDR vs. non-MDR eyes [29 (10-47) vs. 22 (7-42) days] but the difference was not significant (P = 0.301). Follow-up time was significantly longer in dogs with MDR keratitis [47 (29-590) vs. 29 (13-148) days, P = 0.009]. No other significant differences were noted between MDR and non-MDR eyes in regard to time for ulcer stabilization [4 (1-17) days vs. 4 (1-12), P = 0.699], number of eyes requiring surgical stabilization (7/15 vs. 7/13, P = 0.246) or enucleation (1/15 vs. 2/13, P = 1.000), success in maintaining globe (14/15 vs. 11/13, P = 0.583) or success in maintaining vision (12/15 vs. 10/13, P = 1.000).

Conclusions

MDR infections may prolong corneal healing time but did not appear to affect overall clinical outcomes in dogs with bacterial keratitis. Further research is warranted in a larger canine population and other bacterial species.

Bacterial Prevalence in Skin, Urine, Diarrheal Stool, and Respiratory Samples from Dogs

The emergence of bacterial infections in companion animals is a growing concern as humans can also be infected through the transmission of pathogenic bacteria. Because there have been few studies conducted on companion animals, the extent and significance of prevalence in veterinary practices remain unknown. This is the first nationwide surveillance report aimed at elucidating the prevalence pattern and associated infections of isolated bacteria from dogs in Korea. Bacterial isolates were collected from seven different laboratories participating in the Korean Veterinary Antimicrobial Resistance Monitoring System from 2018 to 2019. The samples were obtained from the diarrheal stool, skin/ear, urine, and respiratory samples of veterinary hospital-visited dogs. Isolation and identification of bacterial species was carried out using a bacterial culture approach and then confirmed with matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF) and polymerase chain reaction (PCR). Out of 3135 isolates in dogs, 1085, 1761, 171, and 118 were extracted from diarrheal stool, skin/ear, urine, and respiratory samples, respectively. The overall prevalence of bacteria was higher among two age groups (1-5 and 6-10 years) with a 66.5 percent prevalence. This study showed that Escherichia coli was the most prevalent species among isolated bacterial species of diarrheal and urine origin, whereas Staphylococcus pseudintermedius was the most prevalent among skin and respiratory sample isolates. The data on the prevalence of bacteria for each dog specimen could provide basic information to estimate the extent of bacterial infection and antimicrobial resistance development and to guide veterinarians in therapeutic decisions in clinical practices throughout Korea.

Antibiotic resistance, biofilm formation, and virulence factors of isolates of staphylococcus pseudintermedius from healthy dogs and dogs with keratitis

Canine bacterial keratitis is a common infection that can potentially threaten vision. Staphylococcus pseudintermedius (S. pseudintermedius) is an opportunistic pathogen that has been isolated from the canine conjunctival sac but there are only a few reports on the role of this bacterium in canine keratitis. This study focused on the distribution rate of S. pseudintermedius in the canine conjunctival sac, and the antibiotic resistance, biofilm-producing ability, and dissemination of virulence factors in strains of S. pseudintermedius isolated from healthy dogs and dogs with keratitis. The study included 35 healthy dogs and 40 dogs with keratitis. Bacterial species were confirmed by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI–TOF MS). Strains of S. pseudintermedius were screened for resistance against nine different antibiotics by the Kirby–Bauer assay. The ability to produce biofilm was investigated by microtiter plate assay (MtP) and amplification of icaA and icaD genes. Virulence factors in the strains were also evaluated. A total of 132 aerobic bacteria were isolated from the 119 samples in the study. Among them, 67 bacterial strains were isolated from 70 eyes of healthy dogs, and 65 bacterial strains were isolated from 49 eyes of dogs with keratitis. The prevalence of S. pseudintermedius, which was the most frequent bacterial isolate in both the groups, was 20.9% in the healthy group and 23.08% in the keratitis group. Most of the isolates of S. pseudintermedius were sensitive to rifampin (96.6%), oxacillin (100%), and neomycin (96.6%), and resistant to tetracycline (96.6%). Virulence factors such as lip (96.6%), hlgB (96.6%), and hlgA (96.6%) were found in most of the isolates, and 89.66% of isolates were classed as biofilm producers. In conclusion, S. pseudintermedius was the common bacterium in the conjunctivital sac of the healthy dogs and dogs with keratitis in Yangzhou, China, and the presence of virulence factors and biofilm-formation ability were high in the strains isolated from the dogs with keratitis.

Case Report: The First Report on Moraxella canis Isolation From Corneal Ulcer in a Bulldog

A 5-year-old castrated male bulldog was diagnosed with a corneal ulcer accompanied by edema and conjunctival hyperemia. Ophthalmic examination and microbiological analysis were performed, and the bacteria were found to be gram-negative and globular. The isolated clone was identified as Moraxella canis (MZ579539) via MALDI-TOF MS and 16S rDNA sequencing. Antimicrobial susceptibility testing showed that the bacteria were sensitive to tetracycline and chloramphenicol, but resistant to levofloxacin and ciprofloxacin. After a conjunctival flap was placed, tobramycin ophthalmic solution and 5% sodium hyaluronate were administered. Following surgery, the ulcer was effectively controlled, and after 3 weeks, the cornea healed. This is the first case report of a canine corneal ulcer associated with M. canis, which should be considered when corneal ulceration or keratitis were suspected.

In vitro susceptibility of canine corneal bacterial pathogens to three cross-linking protocols

OBJECTIVE

To assess in vitro antibacterial efficacy of three cross-linking (XL) protocols on bacteria associated with canine ulcerative keratitis.

METHODS

Three XL protocols: UVA 3 mW/cm² for 60 min, UVA 3 mW/cm² for 30 min, and UVA 30 mW/cm² for 3 min with and without application of riboflavin and a riboflavin-only protocol were performed in vitro on the four most common bacterial genera isolated from cases of canine ulcerative keratitis treated at Dick White Referrals, UK. Zones of bacterial growth inhibition (GIZ) associated with treatment were measured and compared.

RESULTS

The four most common isolates were Pseudomonas aeruginosa (PA) (48/140, 34.3%), Streptococcus spp. (32/140, 22.9%), Staphylococcus spp. (24/140, 17.1%) and Escherichia coli (EC) (11/140, 7.9%). PA, EC, Streptococcus canis (SC), and Staphylococcus pseudintermedius (SP), isolated from canine corneas, were selected for testing. EC and SC demonstrated growth inhibition following all UVA/riboflavin protocols. PA and SP only displayed growth inhibition following the 60 min UVA/riboflavin protocol. GIZ areas for 60 min UVA/riboflavin protocols were significantly greater than 30 and 3 min UVA/riboflavin protocols (p < .01) and there was no significant difference between 30 and 3 min UVA/riboflavin protocols. In respect to GIZ areas, EC was significantly more susceptible to XL than SP (p = <.01).

CONCLUSIONS

All UVA/riboflavin XL protocols caused growth inhibition of EC and SC in vitro. PA and SP did not show clear growth inhibition in vitro following exposure to XL protocol settings of UVA 3 mW/cm² for 30 min and UVA 30 mW/cm² for 3 min.

Comparison of corneal culture results obtained using the ESwab™ and Amies charcoal swab in canine and feline patients

OBJECTIVE

The objective of the study was to compare corneal culture results using the ESwab™ and Amies charcoal swab.

ANIMALS STUDIED

One hundred fourteen canine and fifteen feline eyes.

PROCEDURES

Retrospective analysis of Dick White Referrals bacterial and fungal corneal culture data was conducted. Results were included from canine and feline patients, which presented with suspected infectious keratitis that had samples taken using an Amies charcoal swab followed by an ESwab™ in the same eye. In respect to positive and negative cultures, a McNemar test was conducted comparing instances of disagreement between swab types, and the Kappa coefficient (κ) was calculated to assess the level of agreement between swab types.

RESULTS

The ESwab™ produced more positive corneal cultures (71/129 [55.0%]) than the Amies charcoal swab (41/129 [31.8%]). 2/129 eyes produced positive fungal cultures. Considering 37/129 eyes in which both swab types detected a positive corneal culture, the same bacterial species were cultured from each swab type in 34/37 (91.9%) eyes, and an additional bacterial species was cultured by the ESwab™ in 3/37 (8.1%) eyes. In 34/38 (89.5%), instances of disagreement between swab types, the ESwab™ showed a positive culture, and the Amies charcoal swab showed a negative culture from the same eye, and this difference was significant (p < 0.0001). There was a moderate level of agreement between results from both swab types (κ = 0.432).

CONCLUSIONS

ESwab™ sampling alone may be superior to Amies charcoal swabs for detecting presence of bacteria in suspected infectious keratitis in cats and dogs.

MCC950 attenuates inflammation-mediated damage in canines with Staphylococcus pseudintermedius keratitis by inhibiting the NLRP3 inflammasome

BACKGROUND

Bacterial keratitis is a common eye disease in dogs and can seriously affect vision. This study investigated the anti-inflammatory effect of MCC950 in the cornea of canines infected with Staphylococcus pseudintermedius (S. pseudintermedius).

METHODS

In vitro, canine cornea epithelial cells were pretreated with MCC950 and PDTC and then infected with S. pseudintermedius. The key proteins of the NF-κB pathway and NLRP3 inflammasome were detected by Western blotting, the levels of inflammatory factors were detected by qPCR, and the levels of MDA and LDH were detected by assay kit. In vivo, the canine keratitis model was established by injecting S. pseudintermedius into the corneal stroma layer. After treatment with MCC950, slit-lamp examinations were performed. Cornea tissue protein and RNA were extracted, and Western blotting was used to detect key proteins of the NF-κB pathway and NLRP3 inflammasome. qPCR was used to detect the inflammatory factors. Paraffin sections of corneal tissue were prepared for HE staining and immunohistochemical staining.

RESULTS

After MCC950 treatment, the expression levels of key proteins in the NF-κB pathway and NLRP3 inflammasome in canine cornea epithelial cells and corneal tissues were decreased, and the expression levels of IL-1β, IL-6, IL-8, IL-18 and TNF-α were reduced. Cellular MDA and LDH levels were decreased. In vivo, the degree of corneal opacity, edema, neovascularization and corneal injury area decreased after MCC950 treatment. Canine corneal sections showed that MCC950 attenuated neutrophil infiltration.

CONCLUSION

MCC950 alleviates the inflammatory response to canine keratitis caused by S. pseudintermedius by inhibiting the activation of the NLRP3 inflammasome.

French Bulldogs differ to other dogs in the UK in propensity for many common disorders: a VetCompass study

Background

The French Bulldog is a highly popular dog breed but is linked with many serious health issues. A holistic view of breed health in French Bulldogs would assist efforts to appreciate the overall health strengths and weaknesses in the French Bulldog and to take appropriate steps to mitigate these.

Based on random sampling of French Bulldogs and non-French Bulldogs under primary veterinary care during 2016 within the VetCompass Programme, a cohort study design was used to estimate the one-year (2016) period prevalence of the most commonly diagnosed disorders in each group. Risk factor analysis used multivariable logistic regression modelling methods.

Results

The analysis included 2,781 French Bulldogs and 21,850 non-French Bulldogs. French Bulldogs were younger (1.51 years, IQR 0.86 – 2.77 vs. 4.48 years, IQR 1.94 – 8.14) (p < 0.001) and lighter (12.45 kg, IQR 11.00 – 14.03 versus 13.80 kg, IQR 8.10 – 25.12) (p < 0.001) than non-French Bulldogs. Of 43 common specific-level disorders across both groups, French Bulldogs had significantly increased adjusted odds of 20/43 (46.5 %) disorders and significantly reduced adjusted odds of 11/43 (25.6 %) disorders compared to non-French Bulldogs. Highly predisposed disorders in French Bulldogs included stenotic nares (OR 42.14; 95 % CI 18.50 to 95.99; p < 0.001), Brachycephalic Obstructive Airway Syndrome (OR 30.89; 95 % CI 20.91 to 45.64; p < 0.001), aural discharge (OR 14.40; 95 % CI 9.08 to 22.86; p < 0.001), skin fold dermatitis (OR 11.18; 95 % CI 7.19 to 17.40; p < 0.001) and dystocia (OR 9.13; 95 % CI 5.17 to 16.13; p < 0.001). At a grouped-level of diagnostic precision, French Bulldogs had increased adjusted odds of 12/32 (37.5 %) disorders and reduced adjusted odds of 6/32 (18.8 %) disorders compared to non-French Bulldogs.

Conclusions

These results identified ultra-predispositions with worryingly higher odds in French Bulldogs for several disorders, suggesting that the health of French Bulldogs has diverged substantially from, and may be lower than, the health of the wider non-French Bulldog population. Many of these predispositions are closely associated with the conformational extremes that define the French Bulldog breed. Shifting the typical conformation of the French Bulldog population towards a more moderate phenotype is proposed as a logical opportunity to reduce the serious health issues endemic in the French Bulldog breed.

The French Bulldog is currently a hugely popular dog breed in the UK. However, the breed is linked with a range of serious health issues. Using veterinary clinical data from the VetCompass Programme at the Royal Veterinary College, this study aimed to compare the frequency of common disorders in French Bulldogs against that of all remaining dogs to identify health strengths and weaknesses in French Bulldogs. This overall view of breed health can assist owners, breeders and veterinarians to take appropriate actions to improve the health of French Bulldogs.

From an overall population of 905,544 dogs, random samples of 2,781 French Bulldogs and 21,850 non-French Bulldogs were included in the analysis. French Bulldogs were younger (1.51 years versus 4.48 years) and lighter (12.45 kg versus 13.80 kg) than non-French Bulldogs. French Bulldogs had increased risk of 20/43 (46.5 %) specific disorders and decreased risk of 11/43 (25.6 %) specific disorders compared to non-French Bulldogs. The disorders with greatest relative risk in French Bulldogs compared to non-French Bulldogs were narrowed nostrils (x 42.14), Brachycephalic Obstructive Airway Syndrome (x 30.89), ear discharge (x 14.40), skin fold dermatitis (x 11.18) and difficulty giving birth [dystocia] (x 9.13). When the disorders were grouped into broad disease categories, French Bulldogs had increased risk of 12/32 (37.5 %) disorder groups and reduced risk of 6/32 (18.8 %) disorder groups compared to non-French Bulldogs.

This study suggests that the health of French Bulldogs is very different, and largely much poorer, that the health of the wider non-French Bulldog population. Many of these differences are closely associated with the extreme body shape that defines the French Bulldog breed. Shifting the body shape of French Bulldogs to become more moderate, and hence less extreme, is proposed as a logical opportunity to reduce the current serious and common health issues in the French Bulldog breed.

Comparison of antimicrobial resistance patterns in dogs with bacterial keratitis presented to a veterinary teaching hospital over two multi-year time periods (1993-2003 and 2013-2019) in the Southeastern United States

OBJECTIVE

To report clinical characteristics of dogs with bacterial keratitis, identify the most common bacterial isolates within this population, characterize the bacterial isolates' antimicrobial resistance patterns, and compare those resistance patterns to previously reported resistance patterns.

ANIMAL STUDIED

Dogs diagnosed with bacterial keratitis between 2013 and 2019.

PROCEDURES

Data pertaining to breed; Schirmer tear test I results; use of cyclosporine, tacrolimus, or corticosteroids at time of ulcer diagnosis; bacterial genus or species isolated; and resistance to selected antimicrobials as measured by Kirby-Bauer disk diffusion were collected. Resistance patterns were compared to those reported by Tolar et al. (2006).

RESULTS

One hundred seventy bacterial isolates were cultured from 138 eyes from 130 dogs. Of these dogs, 45% were brachycephalic, 62% had STT <15 mm/min, and 28% were receiving a corticosteroid at the time of examination. The most common isolates were Staphylococcus pseudintermedius (31%), β-hemolytic Streptococcus spp. (28%), and Pseudomonas aeruginosa (18%). Compared to the 1993-2003 study period, there were significant increases in resistance to cephalothin and polymyxin B among S. pseudintermedius isolates. β-hemolytic Streptococcus spp. and P. aeruginosa isolates had no significant changes in resistance to the tested antimicrobials.

CONCLUSION

Isolates of S. pseudintermedius, β-hemolytic Streptococcus spp., and P. aeruginosa had minimal changes in resistance between the two study periods. In this population, monotherapy with ciprofloxacin or combination therapy of tobramycin and a first-generation cephalosporin continue to be appropriate for use in cases of suspected bacterial keratitis while awaiting results of susceptibility testing.

Prevalence of Antimicrobial Resistant Bacteria from Conjunctival Flora in an Eye Infection Prone Breed (Saint Bernard)

The conjunctival bacterial resident and opportunistic flora of dogs may represent a major source of dissemination of pathogens throughout the environment or to other animals and humans. Nevertheless, contamination with bacteria from external sources is common. In this context, the study of the antimicrobial resistance (AMR) pattern may represent an indicator of multidrug resistant (MDR) strains exchange. The present study was focused on a single predisposed breed-Saint Bernard. The evaluated animals were healthy, but about half had a history of ocular disease/treatment. The swabs collected from conjunctival sacs were evaluated by conventional microbiological cultivation and antimicrobial susceptibility testing (AST). The most prevalent Gram-positive was Staphylococcus spp.; regardless of the history, while Gram-negative was Pseudomonas spp.; exclusively from dogs with a history of ocular disease/treatment. Other identified genera were represented by Bacillus, Streptococcus, Trueperella, Aeromonas and Neisseria. The obtained results suggest a possible association between the presence of mixed flora and a history of ocular disease/treatment. A high AMR was generally observed (90%) in all isolates, especially for kanamycin, doxycycline, chloramphenicol and penicillin. MDR was recorded in Staphylococcus spp. and Pseudomonas spp. This result together with a well-known zoonotic potential may suggest an exchange of these strains within animal human populations and the environment.

Melting corneal ulcers (keratomalacia) in dogs: A 5-year clinical and microbiological study (2014-2018)

OBJECTIVES

To identify bacterial microorganisms associated with canine keratomalacia, review their antimicrobial sensitivity, and evaluate clinical outcomes compared to results of microbial culture.

METHODS

Retrospective analysis of clinical records of dogs diagnosed with a melting corneal ulcer presented to a referral hospital in Hertfordshire, UK between 2014 and 2018.

RESULTS

One hundred and ten melting corneal ulcers were sampled in 106 dogs. The most common pure bacterial isolate was Pseudomonas aeruginosa (n = 26) followed by β-hemolytic Streptococcus (n = 12). Melting corneal ulcers that cultured coagulase-positive Staphylococcus, coliform bacteria, Pasteurella multocida, Enterococcus, and Streptococcus viridans presented in smaller numbers and were analyzed together (n = 16). Multiple cultures were identified in nine cases (n = 9). Forty-seven cultures yielded no bacterial growth (n = 47). The susceptibility to fluoroquinolones remained high with the exception of β-hemolytic Streptococci. There was no significant difference in the ulcer severity at presentation in regard to the cultured bacteria. Overall, 63 eyes (57%) received surgical grafting in addition to medical treatment. In 14 cases (13%), the progression of corneal melting despite medical ± surgical treatment resulted in enucleation. Fifty-seven percent (8/14) of the enucleated eyes cultured pure Pseudomonas aeruginosa isolates. In contrast, all β-hemolytic Streptococcus-associated ulcers healed.

CONCLUSIONS

The most common bacterial species associated with canine keratomalacia were Pseudomonas aeruginosa and β-hemolytic Streptococcus. Because of the variation in antibacterial sensitivity between these two species, bacterial culture and sensitivity testing should be performed in all dogs presenting with keratomalacia. Melting corneal ulcers associated with pure Pseudomonas infection were significantly more likely to result in globe loss than melting corneal ulcers associated with other cultures.

Prevalence and Antibiotic Susceptibility of Bacterial Isolates From Dogs With Ulcerative Keratitis in Midwestern United States

The objective of this study was to describe bacterial culture and antibiotic susceptibility results in 476 dogs presenting with suspected bacterial keratitis in Iowa and surrounding Midwestern states, further detailing trends in patient characteristics, seasonality, and antimicrobial resistance. Corneal swabs yielded 465 bacterial isolates and 220 cultures (46.2%) with no apparent growth (0–5 isolates per culture). The most frequent bacterial genera were Staphylococcus (32.3%), Streptococcus (19.1%), and Pseudomonas (12.5%), while the most common bacterial species were Staphylococcus pseudintermedius (26.7%), Streptococcus canis (12%), and Pseudomonas aeruginosa (7.5%). Compared to mixed-breed dogs, canine breeds most likely to be examined for ulcerative keratitis included Boston terrier, Cavalier King Charles spaniel, miniature pinscher, pug, rat terrier, Saint Bernard, shih tzu, and silky terriers. In summer, the likelihood to yield a negative culture was reduced while the likelihood to culture Pseudomonas species was increased. Bacteria considered multidrug resistant (MDR, resistant to ≥ 3 antibiotic classes) represented 20% of all canine isolates and were most prevalent for Staphylococcus species (33%). An alarming, escalating trend of MDR prevalence was noted between 2016 (5%) and 2020 (34%). Individual ophthalmic preparations (i.e., single antibiotics or commercially available antibiotic combinations) with highest efficacy against all bacterial isolates included chloramphenicol (83%), ceftiofur (79%), amikacin (77%), neomycin-polymyxin B-bacitracin (77%), and gentamicin (74%). Efficacy of systemic antibiotics and combinations of ophthalmic preparations was also evaluated. Based on the present findings, triple antibiotic (Neo-Poly-Bac) is recommended as empirical monotherapy for prophylactic antibiotic therapy in dogs with simple corneal ulcers, while a chloramphenicol-ciprofloxacin combination is empirically recommended for therapeutic management of infected corneal ulcers. Pending culture and susceptibility results, appropriate selection of empiric antibiotic therapy is important to enhance therapeutic outcome and reduce antibacterial resistance in dogs with corneal ulceration.

Using minimum inhibitory concentration values of common topical antibiotics to investigate emerging antibiotic resistance: A retrospective study of 134 dogs and 20 horses with ulcerative keratitis

OBJECTIVES

To identify the minimum inhibitory concentration (MIC) distribution for commonly used topical antibiotics from isolates of dogs and horses with ulcerative bacterial keratitis, and to investigate changes in MIC values over time and following treatment with topical fluoroquinolones.

ANIMALS STUDIED

One hundred thirty-four client-owned dogs and 20 client-owned horses with bacterial ulcerative keratitis.

PROCEDURE

Minimum inhibitory concentration values for 14 topical antibiotics were reported for canine and equine cases of bacterial ulcerative keratitis between 2013 and 2018. Changes in MIC values over time and after treatment with topical fluoroquinolones were reported.

RESULTS

The three most common bacterial genera isolated were Staphylococcus, Streptococcus, and Pseudomonas. Together, these represented 79.4% of canine cases and 77.4% of equine cases. Overall, isolates from horses tended to have lower MIC values, as did Pseudomonas isolates from both dogs and horses, compared to other bacterial genera, especially Staphylococcus spp. The MIC values of erythromycin and trimethoprim sulfa for Staphylococcus spp., and the MIC value of moxifloxacin for Pseudomonas significantly increased over time. Previous topical fluoroquinolone use was associated with a significant increase in the MIC value of ofloxacin in canine and equine Staphylococcus isolates and current topical fluoroquinolone use was associated with significant increases in the MIC values of ciprofloxacin, moxifloxacin, and ofloxacin in canine Staphylococcus isolates.

CONCLUSION

Patients previously or currently treated with topical fluoroquinolones, particularly in Staphylococcus infections, may require alternative antibiotics or additional antibiotic classes other than fluoroquinolones. Bacterial culture with MIC susceptibility testing should be highly recommended when a Staphylococcal infection is suspected.

Tear film concentrations of topically applied 0.5% oxytetracycline ointment in normal canine eyes

OBJECTIVE

To determine the tear film levels of oxytetracycline in normal canine eyes after application of the ophthalmic ointment, Terramycin™ (0.5% oxytetracycline, polymyxin B sulfate), to guide appropriate treatment frequency.

ANIMALS STUDIED

Ten research beagles.

PROCEDURES

Ten research beagles with confirmed normal eyes were administered 0.02 mL of Terramycin™ ophthalmic ointment onto the dorsal bulbar conjunctival surface of the right eye. Tear samples were collected via dye-less Schirmer tear strips at 2, 4, 6, 8, and 12 hours post-administration. The sample for each timepoint was collected on a separate day, and concentrations of oxytetracycline were determined using high-performance liquid chromatography (HPLC).

RESULTS

There was a semi-logarithmic decline in the median tear concentration of oxytetracycline. The median (2.5th and 97.5th percentiles) tear concentrations of oxytetracycline at 2, 4, 6, 8, and 12 hours were 43.5 μg/mL (11.1-302.2 μg/mL), 28.7 μg/mL (8.04-113.7 μg/mL), 16.1 μg/mL (4.96-37.7 μg/mL), 9.2 μg/mL (4.52-28.1 μg/mL), and 6.11 μg/mL (4.36-26.7 μg/mL), respectively. Mean (±SD) drug recovery via HPLC was 88% (±7.5%).

CONCLUSIONS

Ophthalmic Terramycin™ achieves a substantially higher tear level than the MIC for common bacterial corneal pathogens up to 12 hours post-administration in normal eyes. Anti-collagenolytic tear levels were not achieved at the timepoints evaluated or with the manufacturer-prescribed dosing frequency. HPLC can be used to analyze tear concentrations of ophthalmic ointment formulations.

Evaluation of the bacterial ocular surface microbiome in ophthalmologically normal dogs prior to and following treatment with topical neomycin-polymyxin-bacitracin

The ocular surface microbiome of veterinary species has not been thoroughly characterized using molecular-based techniques, such as next generation sequencing (NGS), as the vast majority of studies have utilized traditional culture-based techniques. To date, there is one pilot study evaluating the ocular surface of healthy dogs using NGS. Furthermore, alterations in the ocular surface microbiome over time and after topical antibiotic treatment are unknown. The objectives of this study were to describe the bacterial composition of the ocular surface microbiome in clinically normal dogs, and to determine if microbial community changes occur over time or following topical antibiotic therapy. Topical neomycin-polymyxin-bacitracin ophthalmic ointment was applied to one eye each of 13 adult dogs three times daily for seven days, while contralateral eyes served as untreated controls. The inferior conjunctival fornix of both eyes was sampled via swabbing at baseline prior to antibiotic therapy (day 0), after 1 week of treatment (day 7), and 4 weeks after discontinuing treatment (day 35). Genomic DNA was extracted from the conjunctival swabs and primers targeting the V4 region of bacterial 16S rRNA genes were used to generate amplicon libraries, which were then sequenced on an Illumina platform. Data were analyzed using Quantitative Insights Into Molecular Ecology (QIIME 2.0). At baseline, the most relatively abundant phyla sequenced were Proteobacteria (49.7%), Actinobacteria (25.5%), Firmicutes (12%), Bacteroidetes (7.5%), and Fusobacteria (1.4%). The most common families detected were Pseudomonadaceae (13.2%), Micrococcaceae (12%), Pasteurellaceae (6.9%), Microbacteriaceae (5.2%), Enterobacteriaceae (3.9%), Neisseriaceae (3.5%), and Corynebacteriaceae (3.3%). Alpha and beta diversity measurements did not differ in both control and treatment eyes over time. This report examines the temporal stability of the canine ocular surface microbiome. The major bacterial taxa on the canine ocular surface remained consistent over time and following topical antibiotic therapy.

Outcome of medical therapy for keratomalacia in dogs

OBJECTIVES

To evaluate the clinical and visual outcomes following intensive medical therapy for keratomalacia in dogs.

MATERIALS AND METHODS

Medical records were screened to identify dogs with corneal ulcers and keratomalacia. All patients were given the same topical treatment protocol with frequent administrations of tobramycin in combination with equine serum. Surgical treatment during the first 15 days of follow-up was considered as medical treatment failure.

RESULTS

We report on 57 ulcers with keratomalacia from 53 dogs. Medical treatment was successful in 31 of 57 ulcers with a median healing time of 5 days (range 2 to 15 days). At 60 days after epithelialisation, 14/15 medically-treated eyes were visual. In one case, corneal perforation was observed 1 month after healing and required surgical stabilisation.

CLINICAL SIGNIFICANCE

Intensive medical therapy has the potential to achieve healing of some ulcers with keratomalacia. Surgical stabilisation in response to progression of stromal loss was required in less than half of the cases.

Streptococcus canis multilocus sequence typing in a case series of dogs with ulcerative keratitis

OBJECTIVE

To determine whether four isolates of Streptococcus canis (S canis) recovered from dogs diagnosed with ulcerative keratitis at the Animal Health Trust (AHT) were genetically related to other ocular isolates that are registered in the online database.

ANIMAL STUDIED

Four S canis corneal isolates.

PROCEDURES

Clinical and laboratory records between 2016 and 2017 were searched for dogs with ulcerative keratitis for which microbiology analysis was consistent with the growth of S canis. Genomic DNA was extracted for sequencing (Illumina MiSeq), and multilocus sequence types (STs) were determined using MLST 1.8 relative to the 44 sequence types of S canis available. A neighbor-joining tree was constructed in MEGA v4.0. A two-sided Fisher's exact test was used to determine any associations between the isolated strains and ocular infections of dogs.

RESULTS

Four strains were isolated from pugs (cases 1-4) with ulcerative keratitis. Genome sequencing identified ST-27 (case 1), ST-9 (case 3), and ST-13 (cases 2 and 4). STs 13 and 27 are members of Clonal Complex (CC)-13. Analysis of the multilocus sequence typing database revealed that CC-13 strains accounted for six of the twelve isolates recovered from the eye exudates of dogs (P = .0078).

CONCLUSIONS

There is early evidence that the CC-13 group of S canis is associated with ocular infections in dogs. We provide draft genome sequences toward the future identification of virulence mechanisms associated with streptococcal keratitis in dogs.

Comparison of bacterial culture results collected via direct corneal ulcer vs conjunctival fornix sampling in canine eyes with presumed bacterial ulcerative keratitis

OBJECTIVE

To compare aerobic bacterial culture results between samples obtained from the corneal ulcer versus lower conjunctival fornix in eyes with presumed bacterial ulcerative keratitis.

ANIMALS STUDIED

Fifty five client-owned dogs diagnosed with ulcerative keratitis.

PROCEDURES

Ophthalmic examinations were performed on each dog including slit-lamp biomicroscopy and indirect ophthalmoscopy. Microbial swabs were collected by direct sampling of the infected corneal ulcer as well as the lower conjunctival fornix, of the same eye, using a sterile rayon-tipped swab. Samples were submitted to an outside reference laboratory for aerobic bacterial culture and sensitivity.

RESULTS

One hundred twelve samples were obtained from 56 eyes (55 dogs). Sixty-eight samples yielded bacterial growth. Positive growth from both sites was obtained in 31 eyes (55%). Six eyes yielded bacterial growth from the conjunctival fornix but not from the cornea. No bacterial growth was obtained from either sampling site in 19 eyes. Overall, 31/56 (55%) corneal samples were positive and 37/56 (66%) conjunctival fornix samples were positive. Comparison of organisms isolated from the two collection sites of the same eye revealed an exact correlation in 42/56 (75%) eyes and differed in 14/56 (25%) eyes. Twenty different bacterial isolates were obtained from 68 positive samples. Gram-positive (71%) organisms were more common than Gram-negative (29%). The most commonly isolated organisms were Staphylococcus pseudintermedius (25%), beta-hemolytic Streptococcus spp. (23%), and Pseudomonas aeruginosa (12%). Methicillin-resistant organisms were isolated in 9% of samples.

CONCLUSION

Sampling from the conjunctival fornix may be a suitable alternative to direct ulcer sampling in eyes with compromised corneal structural integrity.

Feline bacterial keratitis: Clinical features, bacterial isolates, and in vitro antimicrobial susceptibility patterns

OBJECTIVE

To describe clinical characteristics, bacterial isolates, and in vitro antimicrobial susceptibility patterns for cats with bacterial keratitis.

ANIMALS STUDIED

Eighty one cats with bacterial keratitis.

PROCEDURES

Medical records of cats with a clinical diagnosis of bacterial keratitis, confirmed by corneal culture, were reviewed from June 2004 to July 2017. Animal signalment, bacterial isolates, aerobic bacteria in vitro antimicrobial susceptibility test results, and pertinent clinical features were recorded. Percentages of susceptible aerobic bacterial isolates were statistically compared among selected antimicrobials.

RESULTS

There were 102 aerobic bacterial isolates recovered from corneal samples of the 81 cats presented with bacterial keratitis. The most frequent bacteria isolated were Staphylococcus species, which constituted 55% (56/102) of total isolates. All aerobic bacterial isolates grouped together had the highest percentage of susceptibility to ofloxacin (100%), ciprofloxacin (94%), chloramphenicol (93%), doxycycline (92%), ticarcillin (90%), gentamicin (89%), moxifloxacin (89%), tobramycin (86%), neomycin (85%), amikacin (84%), and cefazolin (84%). The same isolates had the lowest percentage of susceptibility to polymyxin B (2%), bacitracin (15%), and clindamycin (31%). When analyzed separately, the isolated Staphylococcus species had the highest percentage of susceptibility to ofloxacin (100%), tobramycin (93%), and neomycin (85%) and the lowest percentage of susceptibility to polymyxin B (3%) and bacitracin (13%).

CONCLUSIONS

Members of the Staphylococcus genus were the most frequent bacteria isolated from cases of feline bacterial keratitis. On the basis of in vitro susceptibility testing and mechanism of action, ofloxacin, ciprofloxacin, ticarcillin, gentamicin, or moxifloxacin are recommended for initial antimicrobial therapy of suspected bacterial keratitis in cats.

Veterinary ocular microbiome: Lessons learned beyond the culture

Ocular pathogens cause many painful and vision-threatening diseases such as infectious keratitis, uveitis, and endophthalmitis. While virulent pathogens and pathobionts play important roles in disease pathogenesis, the scientific community has long assumed disruption of the ocular surface occurs prior to microbial colonization and subsequent infection. While nonpathogenic bacteria are often detected in corneal and conjunctival cultures from healthy eyes, cultures also frequently fail to yield growth of common ocular pathogens or nonpathogenic bacteria. This prompts the following question: Is the ocular surface populated by a stable microbial population that cannot be detected using standard culture techniques? The study of the microbiome has recently become a widespread focus in physician and veterinary medicine. Research suggests a pivotal symbiotic relationship with these microbes to maintain healthy host tissues, and when altered is associated with various disease states ("dysbiosis"). The microbiota that lives within and on mammalian bodies have long been known to influence health and susceptibility to infection. However, limitations of traditional culture methods have resulted in an incomplete understanding of what many now call the "forgotten organ," that is, the microbiome. With the introduction of high-throughput sequencing, physician ophthalmology has recognized an ocular surface with much more diverse microbial communities than suspected based on traditional culture. This article reviews the salient features of the ocular surface microbiome and highlights important future applications following the advent of molecular techniques for microbial identification, including characterizing ocular surface microbiomes in our veterinary species and their potential role in management of infectious and inflammatory ocular diseases.

Medical management of deep ulcerative keratitis in cats: 13 cases

CASE SERIES SUMMARY

Described are 13 cats diagnosed with deep ulcerative keratitis and successfully managed medically without grafting procedures. Typical treatment involved frequent topical application of serum and antibiotics (usually a fluoroquinolone and a cephalosporin). Seven cats also received systemic antibiotics. Analgesia was achieved using various combinations of topical atropine and systemic buprenorphine, robenacoxib or corticosteroids. Six cats were hospitalized for a median (range) period of 2.5 (1-8) days, typically because of frequent medication administration. Median (range) follow-up time was 41.5 (9-103) days. Median (range) number of recheck examinations was 4 (2-6). Median (range) time to corneal re-epithelialization was 21 (9-103) days. Median (range) topical antibiotic course was 29.5 (16-103) days. Median (range) duration of Elizabethan collar use was 28 (13-73) days. At the time of writing, no further recheck examinations were recommended for 10 cats; median (range) time between initial to final examinations in these cats was 35 (20-103) days. All cats retained the affected globes and were apparently comfortable and visual at the latest recheck examination.

RELEVANCE AND NOVEL INFORMATION

These cases reveal that aggressive medical management is highly successful in select cats with deep ulcerative keratitis, and can result in a cosmetically acceptable, apparently comfortable and visual globe. However, therapy is intensive with frequent administration of multiple topical and sometimes systemic medications, and requires multiple veterinary visits over many weeks. Referral to a veterinary ophthalmologist for consideration of surgical stabilization is recommended, as not all cases may be amenable to the medical therapy described here.

Bacterial contamination of slit lamps in veterinary ophthalmology

PURPOSE

Healthcare-associated infection (HAI) is a well-known problem in human medicine. The contamination of medical devices with pathogenic organisms is less studied in veterinary medicine. The purpose of this multicenter study was to evaluate the bacterial contamination of slit lamps throughout Europe and part of the United States. The efficacy of standard cleaning was additionally investigated.

METHODS

Samples from adjustment wheels of slit lamps were taken by different veterinary ophthalmologists and submitted for culture (n = 29). The efficacy of cleaning protocols was evaluated by taking a second sample after routine cleaning (n = 29). Sensitivity testing was performed for pathogenic bacteria using the minimum inhibitory concentration (MIC) or disc diffusion (Kirby-Bauer) method. Statistical analysis was performed using Fisher's exact test.

RESULTS

Seventeen of 29 slit lamps were contaminated before cleaning. The most frequently cultured bacteria were Staphylococcus spp. and coliform bacteria. Twelve of 29 slit lamps showed no bacterial growth before and after cleaning. There was a significant difference before and after cleaning (P = 0.0008), with only 4/29 contaminated samples after cleaning.

CONCLUSION

Contamination with pathogenic bacterial species is frequent in slit lamps used by veterinary ophthalmologists. A risk of cross-contamination in clinical patients has to be considered. Routine cleaning reduces bacterial contamination significantly.

Identification and antimicrobial susceptibility of microorganisms isolated from severe corneal ulcers of dogs in Thailand

This study aims to determine the microbiological profile and risk factors associated with antimicrobial-resistant bacteria in canine severe corneal ulcers. Thirty-two corneal and conjunctival swabs were collected from dogs with diagnosed severe corneal ulcers that presented to Prasu-Arthorn veterinary teaching hospital in Nakhon Pathom, Thailand from June 2015 to June 2016. Microorganisms were identified by means of genotypic and phenotypic approaches. Of 32 ulcers sampled, 26 (81.3%) yielded culturable microorganisms with 24 bacterial isolates and 7 fungal isolates. The most commonly isolated bacteria were Staphylococcus spp. (45.8%, 11/24) and Pseudomonas aeruginosa (20.8%, 5/24). Out of 11 staphylococcal isolates identified, 10 carried the mecA gene providing methicillin resistance. The extended-spectrum β-lactamase (ESBL) encoding genes blaCTX-M and blaVEB-1 were found in an Acinetobacter lwoffii isolate, and blaSHV was found in a P. aeruginosa isolate. Based on the Clinical Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoint criteria, minimum inhibitory concentrations values showed that all bacteria, except for staphylococci, were susceptible to current ophthalmic antibiotics. More than 50% of staphylococci were resistant to all generations of fluoroquinolones and fusidic acid. Chloramphenicol was highly active against staphylococci (81.3% susceptible). The width (P=0.02) and the depth (P=0.04) of ulcers predicted greater risk of yielding resistant bacteria. The identification of antimicrobial-resistant bacteria prompts practitioners to be prudent when choosing ophthalmic antibiotics for severe corneal ulcers.

Evaluation of microbial contamination of canine plasma eyedropper bottles following clinical use in canine patients

OBJECTIVE

To investigate microbial contamination of canine plasma eye drops when used clinically and to compare the effect of two different eyedropper bottles on contamination rate.

METHODS

Forty-six bottles containing plasma were randomly dispensed for use on 42 dogs with ulcerative keratitis. Of these, 23 were standard eyedropper bottles and 23 were Novelia^® bottles designed to prevent contamination. After use for up to 2 weeks, samples for bacterial culture were obtained from a drop of plasma, the bottle tip, the plasma inside the bottle, and the corneal surface. Fungal culture was performed from a drop of plasma.

RESULTS

The overall microbial contamination rate was 17.4% (8/46 bottles); however, only one bottle had growth from the plasma inside the bottle. There was a lower contamination rate of Novelia^® bottles (3/23 = 13.0%) compared to standard bottles (5/23 = 21.7%), but this difference was not statistically significant (P = .57). There were also no significant differences in contamination rate of bottles used greater than 7 days compared to less than or equal to 7 days, or in bottles used greater than 4 times daily compared to 4 times daily or less. Three corneal samples (6.5%) had bacterial growth, but none matched contamination from the bottles.

CONCLUSIONS

Novelia^® bottles may decrease contamination of plasma eye drops used clinically. However, while microbial contamination of plasma bottles was documented, no clinically relevant complications were observed. This study supports safe use of plasma eye drops for up to 2 weeks when refrigerated and dispensed from either Novelia^® or standard eyedropper bottles.

Susceptibilidade antibiótica de isolados bacterianos em diferentes tipos de ceratites ulcerativas de cães na cidade de Cuiabá

RESUMO: Objetivou-se identificar microrganismos isolados de diferentes tipos de ceratite ulcerativa em cães, juntamente com a sua susceptibilidade a antimicrobianos. O resultado do tratamento médico e cirúrgico também foi correlacionado com o tipo de isolado. Amostras para microbiologia foram obtidas com auxílio de swab estéril em 104 olhos de 72 pacientes sem histórico prévio de tratamento com antibióticos tópicos, atendidos no período de maio de 2012 a março de 2015. Os antibióticos testados foram: neomicina, gentamicina, tobramicina, cloranfenicol, polimixina B, ciprofloxacino, ofloxacino e moxifloxacina. No total, 131 bactérias foram isoladas de 96/104 olhos estudados, sendo o gênero Staphylococcus (48,09%) predominante, seguido por Pseudomonas aeruginosa (16,01%). O Shih Tzu foi a raça mais prevalente (33,33%) e o número de isolados gram-negativos foi significativamente maior nessa raça, comparativamente aos Pinschers (p=0,003), aos Filas, aos Poodles e aos sem raça definida (p=0,046). As bactérias isoladas neste estudo apresentaram maior susceptibilidade ao ofloxacino (84,55%), que foi significativamente mais eficaz em relação a neomicina e a polimixina B (p<0,0001), ao cloranfenicol (p=0,0001), a tobramicina (p=0,0007), a gentamicina (p=0,0021) e as outras fluorquinolonas, ciprofloxacino (p=0,0004) e moxifloxacino (p<0,0001). Os organismos gram-positivos foram isolados de um número significativamente maior de olhos que apresentavam ceratite ulcerativa não complicada, comparativamente àqueles com olhos acometidos por ceratite ulcerativa complicada (p=0,011). Igualmente, o número de bactérias gram-positivas foi maior que o de gram-negativas, tanto nos casos que receberam tratamento médico, como nos que foram operados, sem significativa estatística (p=0,745). Na presente pesquisa, Staphylococcus sp. foi a bactéria mais encontrada nas ceratites ulcerativas não complicadas. Já nos olhos com ceratites complicadas, embora a Pseudomonas aeruginosa tenha sido a bactéria mais predominante, o tratamento clínico foi suficiente para cura da afecção corneal na maior parte dos casos. O ofloxacino e a gentamicina foram os agentes mais eficazes contra a maioria dos isolados, com exceção do Streptococcus sp., onde o cloranfenicol se mostrou o mais eficaz. Ceratites ulcerativas sem complicações que apresentem culturas negativas podem evoluir para ceratites ulcerativas complicadas, salientando a necessidade de tratamento anti-colagenolítico em todos os casos.

Corneal ulcerative disease in dogs under primary veterinary care in England: epidemiology and clinical management

BACKGROUND

Corneal ulcerative disease (CUD) has the potential to adversely affect animal welfare by interfering with vision and causing pain. The study aimed to investigate for the first time the prevalence, breed-based risk factors and clinical management of CUD in the general population of dogs under primary veterinary care in England.

RESULTS

Of 104,233 dogs attending 110 clinics participating within the VetCompass Programme from January 1st to December 31st 2013, there were 834 confirmed CUD cases (prevalence: 0.80%, 95% confidence interval (CI) 0.75-0.86). Breeds with the highest prevalence included Pug (5.42% of the breed affected), Boxer (4.98%), Shih Tzu (3.45%), Cavalier King Charles Spaniel (2.49%) and Bulldog (2.41%). Purebred dogs had 2.23 times the odds (95% CI 1.84-2.87, P < 0.001) of CUD compared with crossbreds. Brachycephalic types had 11.18 (95% CI 8.72-14.32, P < 0.001) and spaniel types had 3.13 (95% CI 2.38-4.12, P < 0.001) times the odds for CUD compared with crossbreds. Pain was recorded in 385 (46.2%) cases and analgesia was used in 455 (54.6%) of dogs. Overall, 62 (7.4%) cases were referred for advanced management and CUD contributed to the euthanasia decision for 10 dogs.

CONCLUSIONS

Breeds such as the Pug and Boxer, and conformational types such as brachycephalic and spaniels, demonstrated predisposition to CUD in the general canine population. These results suggest that breeding focus on periocular conformation in predisposed breeds should be considered in order to reduce corneal disease.

Alterations in conjunctival bacteria and antimicrobial susceptibility during topical administration of ofloxacin after cataract surgery in dogs

OBJECTIVE To evaluate changes in conjunctival bacteria and antimicrobial susceptibility of bacteria after cataract surgery in dogs. ANIMALS 16 client-owned dogs. PROCEDURES Samples for aerobic and anaerobic culture were obtained from the conjunctival fornices of both eyes of dogs 24 hours before (week 0) and 1, 3, and 6 weeks after cataract surgery. Topical administration of ofloxacin (every 6 hours) was initiated 12 hours before surgery and continued for 3 weeks. In vitro antimicrobial susceptibility was determined by Kirby-Bauer disk diffusion and a commercially available test for ofloxacin. RESULTS Frequency of positive culture results was significantly higher at week 6 than at weeks 0 and 1. Bacterial load was more likely to be moderate or high at weeks 3 and 6 than at weeks 0 and 1. The most frequently cultured organism was Staphylococcus pseudintermedius (21/78 [26.9%]), followed by coagulase-negative Staphylococcus spp (19/78 [24.4%]). Staphylococcus pseudintermedius was the organism most frequently cultured at weeks 0 (5/12), 1 (4/12), and 6 (8/19), whereas frequency of this organism was lowest at week 3 (1/20). In contrast, coagulase-negative Staphylococcus spp were the most frequently cultured organisms at week 3 (10/20). There was a significant increase in the proportion of organisms resistant to ofloxacin at week 3, compared with the proportion at week 0. CONCLUSIONS AND CLINICAL RELEVANCE The number of bacterial organisms increased and the population of conjunctival bacteria was altered and had a higher proportion resistant to ofloxacin during the 6 weeks after cataract surgery for dogs treated by use of this protocol.

Comparison of the in Vitro Susceptibility of Rodent Isolates of Pseudomonas Aeruginosa and Pasteurella Pneumotropica to Enrofloxacin

The objectives of this study were to determine and compare the in vitro enrofloxacin susceptibility of 94 Pseudomonas aeruginosa isolates obtained from enrofloxacin-treated and untreated mice and that of 40 Pasteurella pneumotropica strains and also to assess the efficacy and effects of enrofloxacin treatment of laboratory mice. The minimum inhibitory concentrations (MICs) of enrofloxacin against all the Ps. aeruginosa isolates were in the range of 1 to 4 μg/ml, whereas those against all the P. pneumotropica strains were less than 0.5 μg/ml. The mutation frequency in 54% of the Ps. aeruginosa isolates on treatment with enrofloxacin ranged from 10−6 to 10−8; however, none of the P. pneumotropica strains could grow on medium containing more than 3 μg/ml enrofloxacin. Comparison of in vitro enrofloxacin susceptibilities suggested that enrofloxacin was effective for eliminating P. pneumotropica but not for eliminating Ps. aeruginosa for which the MIC of enrofloxacin was more than 1 μg/ml. These results indicated that the enrofloxacin susceptibility of P. pneumotropica was higher than that of Ps. aeruginosa, and that the enrofloxacin treatment might not affect the susceptibility of Ps. aeruginosa.

Bacterial isolates, antimicrobial susceptibility, and clinical characteristics of bacterial keratitis in dogs presenting to referral practice in Australia

OBJECTIVE

To identify clinical characteristics, bacterial isolates, and their antimicrobial susceptibility patterns in a prospective study of dogs presenting with suspected bacterial keratitis to aid selection of appropriate therapy.

ANIMALS

Seventy-one client-owned dogs presenting to two referral hospitals in Australia.

PROCEDURE

Corneal swabs and clinical information were collected from dogs presenting with suspect bacterial keratitis from April 2012 to December 2014. Cytology and bacteriologic culture were performed on samples with in vitro antimicrobial susceptibility performed on bacterial isolates.

RESULTS

Positive cultures were obtained from 42 of the 71 ulcers sampled (59%), with 45 bacteria isolated. The most commonly isolated bacteria were β-hemolytic Streptococcus (14/45, 31%), Pseudomonas (14/45, 31%), and Staphylococcus species (8/45, 18%). β-Hemolytic Streptococcus spp. were resistant to neomycin, polymyxin B, gentamicin, framycetin and fusidic acid and >80% were resistant to ciprofloxacin but remained susceptible to chloramphenicol and cephalexin. Pseudomonas aeruginosa isolates were resistant to chloramphenicol, cephalexin, and fusidic acid; however, >90% were susceptible to ciprofloxacin, polymyxin B, and gentamicin. Brachycephalic breed (34/42, 81%), previous ocular surgery (15/42, 36%), prior use of a topical corticosteroid (13/42, 31%), and concurrent ocular surface disease (10/42, 24%) were common in dogs with bacterial keratitis.

CONCLUSION

Our study identified β-hemolytic Streptococcus and Pseudomonas spp. as the most common bacterial pathogens in canine bacterial keratitis presenting for referral. Many cases exhibited clinical factors known to influence corneal integrity that may predispose them to ulceration and infection. Based on in vitro antimicrobial susceptibility patterns and clinical outcomes, monotherapy with a fluoroquinolone may be ineffective in ulcers caused by β-hemolytic Streptococcus spp.