Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA 95616, USA.
J Vet Intern Med. 2011 Nov-Dec;25(6):1195-208. doi: 10.1111/j.1939-1676.2011.00821.x. Epub 2011 Nov 1.
This report offers a consensus opinion on the diagnosis, epidemiology, treatment, and control of the primary enteropathogenic bacteria in dogs and cats, with an emphasis on Clostridium difficile, Clostridium perfringens, Campylobacter spp., Salmonella spp., and Escherichia coli associated with granulomatous colitis in Boxers. Veterinarians are challenged when attempting to diagnose animals with suspected bacterial-associated diarrhea because well-scrutinized practice guidelines that provide objective recommendations for implementing fecal testing are lacking. This problem is compounded by similar isolation rates for putative bacterial enteropathogens in animals with and without diarrhea, and by the lack of consensus among veterinary diagnostic laboratories as to which diagnostic assays should be utilized. Most bacterial enteropathogens are associated with self-limiting diarrhea, and injudicious administration of antimicrobials could be more harmful than beneficial. Salmonella and Campylobacter are well-documented zoonoses, but antimicrobial administration is not routinely advocated in uncomplicated cases and supportive therapy is recommended. Basic practices of isolation, use of appropriate protective equipment, and proper cleaning and disinfection are the mainstays of control. Handwashing with soap and water is preferred over use of alcohol-based hand sanitizers because spores of C. difficile and C. perfringens are alcohol-resistant, but susceptible to bleach (1:10 to 1:20 dilution of regular household bleach) and accelerated hydrogen peroxide. The implementation of practice guidelines in combination with the integration of validated molecular-based testing and conventional testing is pivotal if we are to optimize the identification and management of enteropathogenic bacteria in dogs and cats.
本报告就犬猫原发性病原菌的诊断、流行病学、治疗和控制提供了共识意见，重点介绍了与难辨梭菌、产气荚膜梭菌、弯曲杆菌属、沙门氏菌属和与拳师犬肉芽肿性结肠炎相关的大肠杆菌。兽医在尝试诊断疑似细菌相关性腹泻的动物时面临挑战，因为缺乏经过严格审查的实践指南，这些指南为实施粪便检测提供了客观建议。这个问题因腹泻和不腹泻动物中假定的细菌性肠病原体的分离率相似，以及兽医诊断实验室之间缺乏共识，即应该使用哪些诊断检测而变得更加复杂。大多数细菌性肠病原体与自限性腹泻有关，不合理使用抗生素可能弊大于利。沙门氏菌和弯曲杆菌是有据可查的人畜共患病，但在简单病例中不常规推荐使用抗生素，建议采用支持性治疗。基本的隔离措施、适当的防护设备的使用以及正确的清洁和消毒是控制的主要方法。与使用含酒精的手部消毒剂相比，用肥皂和水洗手是首选，因为难辨梭菌和产气荚膜梭菌的孢子对酒精有抵抗力，但易受漂白剂（普通家用漂白剂的 1:10 至 1:20 稀释）和加速过氧化氢的影响。如果我们要优化犬猫肠致病性细菌的鉴定和管理，那么实施实践指南与整合经过验证的基于分子的检测和常规检测是至关重要的。
