Diagnosis and Treatment of Pulmonary Disease in Sea Turtles (Caretta caretta)

Esophago-Gastric Tube (EG Tube) in Debilitated Sea Turtle Rehabilitation: Insight in 195 Loggerheads Caretta caretta, Southern Italy

Efficient nutritional support plays a pivotal role in the rehabilitation of sea turtles, ensuring a positive, swift, and successful recovery from clinical conditions for their reintroduction into the wild. For sea turtles in severely emaciated and underweight condition, the primary objective is to facilitate weight gain in terms of both muscle mass and fat reserves. Traditionally, many sea turtle rehabilitators have employed the practice of force-feeding, which also involves the daily insertion of an orogastric tube from the mouth to the stomach. However, this technique may be highly stressful for the animals, carrying the risks of regurgitation and potential harm, requiring the removal of the animal from the water, and subjecting it to uncomfortable and potentially dangerous handling. The procedure may also involve risks for operators. In this study, we explore the utilization of a permanent esophago-gastric tube (EG tube) in sea turtles as an alternative to force-feeding, providing a respectful and appropriate approach to meeting the nutritional needs of patients. The administration of food, essential medications, and fluids is performed directly with the turtle in its tank, minimizing the stress associated with handling, while ensuring the safety of operators. The study involves 195 marine turtles that underwent surgery for the placement of a permanent EG tube between 2008 and 2022. Of these, 116 animals were treated at the Sea Turtle Clinic of the Department of Veterinary Medicine at the University of Bari, South Adriatic Sea, Puglia (IT), and 79 patients were admitted to the Sea Turtle Rescue Center of Lampedusa, Central Mediterranean Sea, Sicily (IT). The loggerhead turtles (Caretta caretta) required EG tube placement due to their poor condition related to various diseases, which were systematically categorized. The duration of EG tube placement was analyzed regarding the specific condition of the animals and the nature of their injuries, considering any complications or differences between the two facilities. The results of the study will provide valuable information for the ongoing care and treatment of marine turtles in rehabilitation facilities.

Citrobacter freundii-associated lesions in stranded loggerhead sea turtles (Caretta caretta)

Citrobacter freundii, an opportunistic bacterial pathogen belonging to the family Enterobacteriaceae, has been sporadically reported in sea turtles. Here, the authors describe 3 unusual lesions associated with C. freundii infection in 3 loggerhead sea turtles stranded on the coast of Gran Canaria Island, Spain. It is possible that these 3 distinct lesions played a major role in the death of these turtles. The first turtle had caseous cholecystitis, a lesion not previously described in sea turtles. The second turtle had large intestinal diverticulitis, a rare condition in loggerheads. The third turtle had bilateral caseous salt gland adenitis. Histologically, numerous gram-negative bacilli were observed at the deepest edge of inflammation in all cases. Pure cultures of C. freundii were obtained from these 3 lesions. Molecular detection of C. freundii DNA in formalin-fixed paraffin-embedded samples from the lesions of the 3 turtles confirmed the microbiological isolation. These cases, in addition to expanding the limited body of knowledge on bacterial infections in sea turtles, highlight the potential pathogenic role of C. freundii in loggerhead turtles.

Antimicrobial-Resistant Bacteria from Free-Living Green Turtles (Chelonia mydas)

Bioindicator species are used to assess the damage and magnitude of possible impacts of anthropic origin on the environment, such as the reckless consumption of antimicrobials. Chelonia mydas has several characteristics that make it a suitable bioindicator of marine pollution and of the presence of pathogens that cause diseases in humans. This study aimed to investigate the green sea turtle as a reservoir of resistant bacteria, mainly because C. mydas is the most frequent sea turtle species in Brazilian coastal regions and, consequently, under the intense impact of anthropic factors. Free-living green sea turtles ranging from 42.8 to 92 cm (average = 60.7 cm) were captured from Itaipú Beach, Brazil. Cloaca samples (characterizing the gastrointestinal tract) and neck samples (representing the transient microbiota) were collected. Bacterial species were identified, and their was resistance associated with the antimicrobials cephalothin, ciprofloxacin, gentamicin, tetracycline, and vancomycin. Citrobacter braaki, Klebsiella oxytoca, K. variicola and Proteus mirabilis were found resistant to cephalothin and Morganella morganii and Enterococcus faecalis tetracycline-resistant isolates in cloaca samples. In neck samples, species resistant to tetracycline were Salmonella sp., Serratia marcescens, S. ureylitica and Proteus mirabilis. This data reinforces that the green turtle is a bioindicator of antimicrobial resistance (AMR).

Bacterial Infections in Sea Turtles

Sea turtles are important for the maintenance of marine and beach ecosystems, but they are seriously endangered due to factors mainly related to human activities and climate change such as pollution, temperature increase, and predation. Infectious and parasitic diseases may contribute to reducing the number of sea turtles. Bacteria are widespread in marine environments and, depending on the species, may act as primary or opportunistic pathogens. Most of them are able to infect other animal species, including humans, in which they can cause mild or severe diseases. Therefore, direct or indirect contact of humans with sea turtles, their products, and environment where they live represent a One Health threat. Chlamydiae, Mycobacteria, and Salmonellae are known zoonotic agents able to cause mild or severe diseases in sea turtles, other animals, and humans. However, other bacteria that are potentially zoonotic, including those that are antimicrobially resistant, are involved in different pathologies of marine turtles.

Description of normal pulmonary radiographic findings in 55 apparently healthy juvenile Kemp's ridley sea turtles (Lepidochelys kempii)

A total of 55 digital radiographic studies from 53 individual juvenile Kemp's ridley sea turtles (Lepidochelys kempii) were retrospectively used to determine the normal radiographic anatomy of the lower respiratory tract in sea turtles that had been stranded due to hook-and-line injury and were otherwise clinically healthy. There were three or four projections available for each study: dorsoventral (DV), rostrocaudal (RoCd), and left and/or right lateral. The DV and RoCd were most conducive for assessing global lung volume and symmetry of lung volume. The DV and lateral views were most helpful for evaluating the main bronchus and its branching channels and for assessing lung margination. The RoCd view was most useful for assessing the symmetry of the lung opacity. The lateral views were most helpful for assessing the ventral margin of each lung lobe. On the lateral view, the main bronchus lay ventrally and coursed horizontally through the lung from cranial to caudal. On the DV view, the bronchus lay medially and was observed to be curvilinear coursing caudomedially. On the RoCd view, the main bronchus was located ventromedially. The RoCd view demonstrated the channels and niches end-on resulting in a reticulated or honeycomb appearance. The channels were seen as uniform striations coursing perpendicular to the main bronchus on the lateral views (vertical striations coursing dorsal to ventral) and DV views (horizontal striations coursing medially to laterally).

Clinical Findings, Management, Imaging, and Outcomes in Sea Turtles with Traumatic Head Injuries: A Retrospective Study of 29 Caretta caretta

Sea turtles are considered endangered species, largely due to anthropogenic activities. Much of the trauma in these species involves the carapace and skull, resulting in several degrees of damage to the pulmonary and nervous systems. Among traumatic injuries, those involving the skull can be complicated by brain exposure, and turtles with severe skull injuries that have nervous system impairment, emaciation, and dehydration can often die. Between July 2014 and February 2022, a total of 1877 loggerhead sea turtles (Caretta caretta) were referred for clinical evaluation at the Sea Turtle Clinic (STC) of the Department of Veterinary Medicine of the University of Bari. A retrospective study of 29 consecutive cases of loggerhead sea turtles (Caretta caretta) with skull lesions of different degrees of severity is reported. On admission, physical and neurological evaluations were performed to assess and grade the lesions and neurological deficits. In 20 of the 29 sea turtles with more serious head trauma, computed tomography (CT) findings in combination with physical and neurological assessment enabled the evaluation of the potential correlation between deficits and the extent of head injuries. All sea turtles underwent curettage of the skull wounds, and the treatment protocol included the use of the plant-derived dressing 1 Primary Wound Dressing^® (Phytoceutical AG, Endospin Italia) applied on the wound surface as a primary dressing. Out of 29 sea turtles, 21 were released after a time ranging from a few days to 8 months. To the best of our knowledge, the literature lacks specific data on the incidence, correlations with neurological deficits, complications, and survival rate of loggerhead sea turtles with traumatic head injuries.

Microbial composition of carapace, feces, and water column in captive juvenile green sea turtles with carapacial ulcers

Introduction

Green sea turtles are endangered marine reptiles. Carapacial ulcers will develop on juvenile green sea turtles during artificial rescue, seriously affecting their health and potentially leading to death.

Methods

To determine the pathogens causing ulcerative carapacial disease, we performed 16S and ITS high-throughput sequencing, and microbial diversity analysis on samples from carapacial ulcers, healthy carapaces, feces, and seawater of juvenile green sea turtles.

Results

Our analysis showed that changes in microbial diversity of green sea turtle feces and seawater were not significantly associated with ulcerative carapacial disease.

Discussion

Psychrobacter sp. is the dominant species in the carapacial ulcers of green sea turtles. The bacterium is present in both healthy turtles and seawater where carapacial ulcers did not occur and decreasing seawater temperatures are likely responsible for the infection of juvenile green turtles with Psychrobacter sp. This is the first study on carapacial ulcers in captive juvenile green sea turtles. Our research provides theoretical guidance for the prevention and control of carapacial ulcers in captive juvenile green sea turtles.

Fatal Bronchopneumonia and Tracheitis in a Green Turtle (Chelonia mydas) Caused by Serratia proteamaculans

A free-ranging subadult, male green turtle (Chelonia mydas) presented with radiographic evidence of pneumonia and died acutely. On necropsy, the trachea and bronchi were plugged by diphtheritic membranes, comprised of fibrin, necrotic debris, and colonies of bacilli, identified as Serratia proteamaculans. S. proteamaculans, typically considered an opportunistic plant pathogen, has rarely been described as causing disease in animals. This is the first report of S. proteamaculans causing severe necrotizing tracheitis and bronchopneumonia in a reptile.

Enrofloxacin—The Ruthless Killer of Eukaryotic Cells or the Last Hope in the Fight against Bacterial Infections?

Enrofloxacin is a compound that originates from a group of fluoroquinolones that is widely used in veterinary medicine as an antibacterial agent (this antibiotic is not approved for use as a drug in humans). It reveals strong antibiotic activity against both Gram-positive and Gram-negative bacteria, mainly due to the inhibition of bacterial gyrase and topoisomerase IV enzymatic actions. The high efficacy of this molecule has been demonstrated in the treatment of various animals on farms and other locations. However, the use of enrofloxacin causes severe adverse effects, including skeletal, reproductive, immune, and digestive disorders. In this review article, we present in detail and discuss the advantageous and disadvantageous properties of enrofloxacin, showing the benefits and risks of the use of this compound in veterinary medicine. Animal health and the environmental effects of this stable antibiotic (with half-life as long as 3–9 years in various natural environments) are analyzed, as are the interesting properties of this molecule that are expressed when present in complexes with metals. Recommendations for further research on enrofloxacin are also proposed.

Analysis of risk factors associated with gas embolism and evaluation of predictors of mortality in 482 loggerhead sea turtles

Sea turtles that are entrapped in static and towed nets may develop gas embolism which can lead to severe organ injury and death. Trawling characteristics, physical and physiologic factors associated with gas-embolism and predictors of mortality were analysed from 482 bycaught loggerheads. We found 204 turtles affected by gas-embolism and significant positive correlations between the presence of gas-embolism and duration, depth, ascent rate of trawl, turtle size and temperature, and between mortality and ascent time, neurological deficits, significant acidosis and involvement of > 12 cardiovascular sites and the left atrium and sinus venosus-right atrium. About 90% turtles with GE alive upon arrival at Sea Turtle Clinic recovered from the disease without any supportive drug therapy. Results of this study may be useful in clinical evaluation, prognostication, and management for turtles affected by gas-embolism, but bycatch reduction must become a priority for major international organizations. According to the results of the present study the measures to be considered to reduce the catches or mortality of sea turtles for trawling are to be found in the modification of fishing nets or fishing operations and in greater awareness and education of fishermen.

Antimicrobial Resistance in Loggerhead Sea Turtles (Caretta caretta): A Comparison between Clinical and Commensal Bacterial Isolates

Simple Summary

Gram negative organisms are frequently isolated from Caretta caretta and may contribute to the dissemination of antimicrobial resistance. In this study, commensal bacteria isolated from oral and cloacal samples of 98 healthy C. caretta were compared to clinical isolates isolated from the wounds of 102 injured animals, in order to investigate the presence of antimicrobial resistance bacteria in free-living loggerheads from the Adriatic Sea. A total of 410 bacteria were cultured and differences were noted in the isolated genera, as some of them were isolated only in healthy animals, while others were isolated only from injured animals. When tested for susceptibility to antimicrobials, clinical isolates showed highly significant differences in the antimicrobial resistance rates vs. commensal isolates for all the drugs tested, except for doxycycline. The detection of high antimicrobial resistance rates in loggerhead sea turtles is of clinical and microbiological significance since it impacts both the choice of a proper antibiotic therapy and the implementation of conservation programs.

Abstract

Gram negative organisms are frequently isolated from Caretta caretta turtles, which can act as reservoir species for resistant microorganisms in the aquatic environment. C. caretta, which have no history of treatment with antimicrobials, are useful sentinel species for resistant microbes. In this culture-based study, commensal bacteria isolated from oral and cloacal samples of 98 healthy C. caretta were compared to clinical isolates from the wounds of 102 injured animals, in order to investigate the presence of AMR bacteria in free-living loggerheads from the Adriatic Sea. A total of 410 isolates were cultured. Escherichia coli and genera such as Serratia, Moraxella, Kluyvera, Salmonella were isolated only in healthy animals, while Acinetobacter, Enterobacter, Klebsiella and Morganella were isolated only from the wounds of the injured animals. When tested for susceptibility to ampicillin, amoxicillin + clavulanic acid, ceftazidime, cefuroxime, gentamicin, doxycycline, ciprofloxacin and enrofloxacin, the clinical isolates showed highly significant differences in AMR rates vs. commensal isolates for all the drugs tested, except for doxycycline. The detection of high AMR rates in loggerheads is of clinical and microbiological significance since it impacts both the choice of a proper antibiotic therapy and the implementation of conservation programs.

Antimicrobial-resistance profiles of gram-negative bacteria isolated from green turtles (Chelonia mydas) in Taiwan

The green turtle (Chelonia mydas) is listed as a globally endangered species and is vulnerable to anthropogenic threats, including environmental pollution. This study investigated the antimicrobial resistance of Gram-negative bacteria isolated from wild green turtles admitted to a sea turtle rehabilitation center in Taiwan. For this investigation, cloacal and nasal swab samples were collected from 28 green turtles between 2018 and 2020, from which a total of 47 Gram-negative bacterial isolates were identified. Among these, Vibrio spp. were the most dominant isolate (31.91%), and 89.36% of the 47 isolates showed resistance to at least one of 18 antimicrobial agents tested. Isolates resistant to one (6.38%), two (8.51%), and multiple (74.47%) antimicrobials were observed. The antimicrobial agents to which isolates showed the greatest resistance were penicillin (74.47%), followed by spiramycin, amoxicillin, and cephalexin. The antimicrobial-resistance profiles identified in this study provide useful information for the clinical treatment of sea turtles in rehabilitation facilities. The results of our study also imply that wild green turtles may be exposed to polluting effluents containing antimicrobials when the turtles traverse migratory corridors or forage in feeding habitats. To benefit sea turtle conservation, future research should focus on (1) how to prevent pollution from antimicrobials in major green turtle activity areas and (2) identifying sources of antimicrobial-resistant bacterial strains in coastal waters of Taiwan.

Detection of multi-drug resistance and AmpC β-lactamase/extended-spectrum β-lactamase genes in bacterial isolates of loggerhead sea turtles (Caretta caretta) from the Mediterranean Sea

Sea turtles are useful sentinels to monitor the dissemination of antimicrobial resistance (AMR) in the marine coastal ecosystems. Forty Gram negative bacteria were isolated from wounds of 52 injured Caretta caretta, living in the Mediterranean Sea. Bacteria were identified using 16S rRNA gene sequencing and tested for susceptibility to 15 antibiotics. In addition, NGS amplicon sequencing was performed to detect the presence of AmpC β-lactamase genes (bla_AmpC) and extended-spectrum β-lactamase (ESBL) genes (bla_CTX-M,bla_SHV,bla_TEM). Seventy-five percent of the isolates (30/40 isolates) exhibited multidrug resistance (MDR) phenotypes and 32.5% (13/40 isolates) were confirmed to be positive for at least one gene. The variants of ESBLs genes were bla_CTX-M-3,bla_TEM-236 and bla_SHV-12. Variants of the bla_AmpCβ-lactamase gene i.e., bla_ACT-24, bla_ACT-2, bla_ACT-17, bla_DHA-4 and bla_CMY-37, were also detected. In addition, 4 isolates were found simultaneously harboring CTX and AmpC genes while 2 strains harbored 3 genes (bla_{ACT-2+TEM-236+SHV-12}, and bla_{CTX-M-3+ACT-24+TEM-236}).