Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, Davis, California, USA.
Department of Veterinary Clinical Sciences, The Melbourne Veterinary School, University of Melbourne, Werribee, Victoria, Australia.
J Vet Intern Med. 2021 Jan;35(1):273-283. doi: 10.1111/jvim.16013. Epub 2020 Dec 21.
Mycobacterial infections in cats are challenging to treat and incompletely described.
HYPOTHESIS/OBJECTIVES: To describe the features of mycobacterial infections in cats from northern California.
Nineteen cats, all with nontuberculous mycobacterial (NTM) infections; 4 with Mycobacterium avium infection, 15 with rapid-growing mycobacterial (RGM) infection.
Retrospective study. Cases with positive mycobacterial culture, species identification, and susceptibility testing were included. Descriptive statistics were used. Fisher's exact test and Mann-Whitney U test were used for comparisons between M avium and RGM infections (P ≤ .05).
Rapid-growing mycobacterial cases included Mycobacterium smegmatis (9), Mycobacterium fortuitum (4), Mycobacterium abscessus (1), and Mycobacterium thermoresistibile (1). Mycobacterium avium infections were more likely than RGM infections to be disseminated (3/4 vs 0/15; P = .004). Disease of the skin/subcutis (15/15 vs 0/4; P < .001) and outdoor access (14/15 vs 0/4; P = .001) were primary features of RGM infections. Resistance to fluoroquinolones and aminoglycosides was common among M avium isolates. A high prevalence of resistance to third- and fourth-generation cephalosporins was noted in RGM species. Death/euthanasia was noted only in M avium cases (3/4). Twelve of 15 cats with RGM infection had available follow-up; 4 of these cats achieved remission.
The most prevalent RGM species isolated from cats from northern California are M smegmatis and M fortuitum. Susceptibility to prescribed antimicrobials does not appear to guarantee treatment success. Combination drug treatment is recommended. Repeat culture and susceptibility testing should be performed when disease is persistent/relapsing.
猫分枝杆菌感染的治疗具有挑战性，且描述不完整。
假设/目的：描述加利福尼亚北部猫分枝杆菌感染的特征。
19 只猫，均患有非结核分枝杆菌（NTM）感染；4 只感染鸟分枝杆菌，15 只感染快速生长分枝杆菌（RGM）感染。
回顾性研究。纳入分枝杆菌培养阳性、菌种鉴定和药敏试验的病例。采用描述性统计分析。采用 Fisher 确切检验和 Mann-Whitney U 检验比较鸟分枝杆菌和 RGM 感染（P ≤ .05）。
RGM 病例包括脓肿分枝杆菌（9 只）、偶然分枝杆菌（4 只）、耻垢分枝杆菌（1 只）和耐热分枝杆菌（1 只）。与 RGM 感染相比，鸟分枝杆菌感染更可能为播散性（3/4 比 0/15；P =.004）。皮肤/皮下组织疾病（15/15 比 0/4；P < .001）和户外接触（14/15 比 0/4；P =.001）是 RGM 感染的主要特征。鸟分枝杆菌分离株对氟喹诺酮类和氨基糖苷类药物的耐药率较高。RGM 种对第三代和第四代头孢菌素的耐药率也很高。仅在鸟分枝杆菌感染病例中观察到死亡/安乐死（3/4）。15 只患有 RGM 感染的猫中有 12 只获得了随访；其中 4 只猫获得缓解。
从加利福尼亚北部猫中分离的最常见的 RGM 种是耻垢分枝杆菌和脓肿分枝杆菌。对规定的抗菌药物的敏感性似乎不能保证治疗成功。建议联合药物治疗。当疾病持续/复发时，应重复进行培养和药敏试验。
