Infection withMycobacterium simiaecomplex in four captive Micronesian kingfishers

Applying the One Health Concept to Mycobacterial Research - Overcoming Parochialism

Mycobacterial infections remain a public health problem. Historically important, globally ubiquitous and with a wide host range, we are still struggling to control mycobacterial infections in humans and animals. While previous reviews have focused on individual mycobacterial infections in either humans or animals, a comprehensive review of the zoonotic aspect of mycobacteria in the context of the One Health initiative is lacking. With the purpose of providing a concise and comprehensive resource, we have collated literature to address the zoonotic potential of different mycobacterial species and elaborate on the necessity for an inter-sectorial approach to attain a new vision to combat mycobacterial infections.

Evaluation of Multidrug Therapy With Azithromycin, Rifampin, and Ethambutol for the Treatment of Mycobacterium avium subsp avium in Ring-neck Doves (Streptopelia risoria): An Uncontrolled Clinical Study

An uncontrolled clinical study was conducted to evaluate the efficacy of a multidrug protocol in 16 ring-neck doves ( Streptopelia risoria ) from a flock naturally infected with Mycobacterium avium subsp avium. The doves were considered infected on the basis of a high prevalence of infection in a group of 29 birds that were euthanatized from the same flock and clinical signs and pathologic results consistent with infection in the remaining birds. All birds were treated with azithromycin (43 mg/kg), rifampin (45 mg/kg), and ethambutol (30 mg/kg) administered orally once daily for 180 days. Five birds died during treatment and were confirmed positive for mycobacteriosis on postmortem examination. Of the remaining 11 birds, infection and disease were present in 9 (81.8%) at the end of the treatment. Postmortem investigation showed that 2 mycobacterial isolates were resistant to ethambutol, intermediately sensitive to rifampin, and sensitive to azithromycin. Microscopic examination of liver sections equivalent of those that would be taken for biopsy showed that biopsy as a method of monitoring birds for treatment success had poor sensitivity. Toxicity associated with drug therapy was not observed in these doves nor in 6 outwardly healthy ring-neck doves exposed to the same treatment. The results of this study showed that this protocol of azithromycin, rifampin, and ethambutol has poor efficacy when administered for 180 days for treatment of doves infected with M avium subsp avium.

Disseminated avian mycobacteriosis in a free-living grey heron (Ardea cinerea)

Wild birds share with humans the capacity for moving fast over large distances. During migratory movements, birds carry pathogens that can be transmitted between species. One of these concerning pathogens is Mycobacterium spp. A necropsy was performed in a grey heron (Ardea cinerea) that had been medically treated for a polyarthritic process. Grossly, firm white-yellowish nodules of various size, resembling granulomas, were observed in right carpal joint, both patellar joints, neck musculature, palate, pharynx, larynx, nasal sinuses, pericardial sac, air sacs, proventriculus and intestinal serosa, pancreas, kidneys, adrenal glands, and oviduct. Microscopically, these lesions were composed of multinucleated giant cells, large macrophages, and lymphocytes, with a central zone of necrosis and in some cases with peripheral fibrosis. Acid-fast bacilli were detected within these lesions. Lesions were cultured and Mycobacterium avium subsp. avium was identified. To the best of our knowledge this is the first description of mycobacteriosis in grey herons. Although the grey heron is currently considered a least-concern species, avian mycobacteriosis remains a threat on the conservation management of endangered avian species, and constitutes a public health concern as well.

Taking a rational approach in the treatment of avian mycobacteriosis

Treatment for avian mycobacteriosis is still in its infancy and based on extrapolations from human medicine. The optimum drug choice, dose, or length of treatment has yet to be determined for most exotic animal species. Treatment should include multiple drugs for extended periods of time with appropriate monitoring of both drug levels and overall animal health. Risk to owners and handlers needs to be minimized through appropriate identification of the species of mycobacteri causing disease. More research is necessary on the pharmacokinetics of these drugs in other animal species and antibiotic resistance. Currently, euthanasia remains the most common action in the face of active mycobacteriosis.

Pathology of mycobacteriosis in birds

Avian mycobacteriosis is a disease that affects companion, captive exotic, wild, and domestic birds. The disease in birds is generally caused by Mycobacterium avium subsp avium but more than 10 other species of mycobacteria infect birds. Oral route of infection appears to be the primary mode of transmission. In some cases, the extensive involvement of the respiratory system suggests an airborne mode of transmission. Molecular diagnostic techniques have improved the ability to confirm the disease. Avian mycobacteriosis is an important veterinary and economic risk in birds and mammals. Exposure of humans to infected birds may cause a zoonotic infection.