O'Brien Carolyn R, Malik Richard, Globan Maria, Reppas George, McCowan Christina, Fyfe Janet A
1 Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Werribee, VIC 3030, Australia.
2 Centre for Veterinary Education, The University of Sydney, NSW 2006, Australia.
J Feline Med Surg. 2017 Sep;19(9):919-932. doi: 10.1177/1098612X17706470.
This paper, the last in a series of three on 'feline leprosy', provides a detailed description of disease referable to the previously unnamed species, Candidatus 'Mycobacterium lepraefelis', a close relative of the human pathogens Mycobacterium leprae and Mycobacterium lepromatosis.
Cases were sourced retrospectively and prospectively for this observational study, describing clinical, geographical and molecular microbiological data for cats definitively diagnosed with Candidatus 'M lepraefelis' infection.
A total of 145 cases of feline leprosy were scrutinised; 114 'new' cases were sourced from the Victorian Infectious Diseases Reference Laboratory (VIDRL) records, veterinary pathology laboratories or veterinarians, and 31 cases were derived from six published studies. Thirty-eight cats were definitively diagnosed with Candidatus 'M lepraefelis' infection. Typically, cats tended to be middle-aged or older when first infected, with a male predilection. Affected cats typically had widespread cutaneous lesions, in some cases after initially localised disease. Advanced cases were often systemically unwell. All cats had outdoor access. The histological picture was lepromatous in the majority of patients, although two cases had tuberculoid disease. In one case that underwent necropsy, lesions were evident in the liver, spleen and lungs. Treatment was varied, although most cats received a combination of oral clarithromycin and rifampicin. Prognosis for recovery was variable, but typically poor.
Candidatus 'M lepraefelis' typically causes high bacterial index (lepromatous) feline leprosy that in some cases progresses to systemic mycobacteriosis. The disease has a variable clinical course and prognosis. Many cases either died or were euthanased due to the infection. Multilocus sequence analysis reveals a heterogeneous picture and further analysis of draft genome sequencing may give clues to the taxonomy and epidemiology of this organism. Prospective treatment trials and/or additional drug susceptibility testing in specialised systems would further inform treatment recommendations. Comparative aspects: This paper finishes with a discussion of comparative aspects of infection caused by the three feline leproid disease agents that have been the subject of this series: Candidatus 'Mycobacterium tarwinense', Mycobacterium lepraemurium and Candidatus 'M lepraefelis'.
本文是关于“猫类麻风病”的系列三篇论文中的最后一篇，详细描述了由先前未命名的物种——“假结核分枝杆菌猫亚种”（Candidatus 'Mycobacterium lepraefelis'）引起的疾病，该物种是人类病原体麻风分枝杆菌（Mycobacterium leprae）和瘤型麻风分枝杆菌（Mycobacterium lepromatosis）的近亲。
本观察性研究通过回顾性和前瞻性方式收集病例，描述确诊感染“假结核分枝杆菌猫亚种”的猫的临床、地理和分子微生物学数据。
共审查了145例猫类麻风病病例；114例“新”病例来自维多利亚传染病参考实验室（VIDRL）记录、兽医病理实验室或兽医，31例病例来自六项已发表的研究。38只猫被确诊感染“假结核分枝杆菌猫亚种”。通常，猫首次感染时多为中年或老年，且雄性居多。受影响的猫通常有广泛的皮肤病变，有些病例最初为局部疾病后发展至此。晚期病例往往全身状况不佳。所有猫都有户外接触史。大多数患者的组织学表现为瘤型，不过有两例为结核样型。在一例进行尸检的病例中，肝脏、脾脏和肺部有明显病变。治疗方法多样，尽管大多数猫接受了口服克拉霉素和利福平的联合治疗。恢复预后各不相同，但通常较差。
“假结核分枝杆菌猫亚种”通常引起高细菌指数（瘤型）猫类麻风病，在某些情况下会发展为全身性分枝杆菌病。该病临床病程和预后各异。许多病例因感染死亡或被安乐死。多位点序列分析显示情况各异，对草图基因组测序的进一步分析可能为该生物体的分类学和流行病学提供线索。在专门系统中进行前瞻性治疗试验和/或额外的药敏试验将为治疗建议提供更多信息。比较方面：本文最后讨论了本系列研究的三种猫类类麻风病病原体引起的感染的比较方面：“塔文假结核分枝杆菌”（Candidatus 'Mycobacterium tarwinense'）、鼠麻风分枝杆菌（Mycobacterium lepraemurium）和“假结核分枝杆菌猫亚种”。
