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多重耐药性对感染……的角膜溃疡犬临床结局的影响

Impact of multi-drug resistance on clinical outcomes of dogs with corneal ulcers infected with .

作者信息

Mauer Ashley N, Allbaugh Rachel A, Kreuder Amanda J, Sebbag Lionel

机构信息

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States.

Department of Veterinary Microbiology and Preventive Medicine, College of Veterinary Medicine, Iowa State University, Ames, IA, United States.

出版信息

Front Vet Sci. 2022 Nov 24;9:1083294. doi: 10.3389/fvets.2022.1083294. eCollection 2022.

Abstract

OBJECTIVE

Compare characteristics and clinical outcomes of dogs with infectious keratitis from considered to be multidrug-resistant (MDR) or not.

PROCEDURES

isolated as the primary pathogen from canine patients with ulcerative keratitis were considered MDR if resistant to at least one agent in three or more classes of antibiotics. Medical records were reviewed for history, patients' characteristics, clinical appearance, therapeutic interventions, and clinical outcomes.

RESULTS

Twenty-eight dogs (28 eyes) were included. Compared to non-MDR cases, MDR diagnosis was significantly more common in dogs with recent (≤30 days) anesthesia (7/15 vs. 1/13, = 0.038) and more common in non-brachycephalic dogs (8/15 vs. 2/13, = 0.055). Clinical appearance (ulcer size/depth, anterior chamber reaction, etc.) did not differ significantly between groups ( ≥ 0.055). Median (range) time to re-epithelialization was longer in MDR vs. non-MDR eyes [29 (10-47) vs. 22 (7-42) days] but the difference was not significant ( = 0.301). Follow-up time was significantly longer in dogs with MDR keratitis [47 (29-590) vs. 29 (13-148) days, = 0.009]. No other significant differences were noted between MDR and non-MDR eyes in regard to time for ulcer stabilization [4 (1-17) days vs. 4 (1-12), = 0.699], number of eyes requiring surgical stabilization (7/15 vs. 7/13, = 0.246) or enucleation (1/15 vs. 2/13, = 1.000), success in maintaining globe (14/15 vs. 11/13, = 0.583) or success in maintaining vision (12/15 vs. 10/13, = 1.000).

CONCLUSIONS

MDR infections may prolong corneal healing time but did not appear to affect overall clinical outcomes in dogs with bacterial keratitis. Further research is warranted in a larger canine population and other bacterial species.

摘要

目的

比较被认为是多药耐药(MDR)和非多药耐药的感染性角膜炎犬的特征和临床结果。

程序

从患有溃疡性角膜炎的犬类患者中分离出的主要病原体,如果对三类或更多类抗生素中的至少一种药物耐药,则被认为是多药耐药。回顾病历以获取病史、患者特征、临床表现、治疗干预措施和临床结果。

结果

纳入28只犬(28只眼)。与非多药耐药病例相比,多药耐药诊断在近期(≤30天)接受过麻醉的犬中显著更常见(7/15对1/13,P = 0.038),在非短头犬中更常见(8/15对2/13,P = 0.055)。两组之间的临床表现(溃疡大小/深度、前房反应等)无显著差异(P≥0.055)。多药耐药眼与非多药耐药眼相比,重新上皮化的中位(范围)时间更长[29(10 - 47)天对22(7 - 42)天],但差异不显著(P = 0.301)。多药耐药性角膜炎犬的随访时间显著更长[47(29 - 590)天对29(13 - 148)天,P = 0.009]。在溃疡稳定时间方面,多药耐药眼与非多药耐药眼之间未发现其他显著差异[4(1 - 17)天对4(1 - 12)天,P = 0.699],需要手术稳定的眼数(7/15对7/13,P = 0.246)或眼球摘除数(1/15对2/13,P = 1.000),维持眼球的成功率(14/15对11/13,P = 0.583)或维持视力的成功率(12/15对10/13,P = 1.000)。

结论

多药耐药感染可能会延长角膜愈合时间,但似乎并未影响细菌性角膜炎犬的总体临床结果。有必要在更大的犬类群体和其他细菌种类中进行进一步研究。

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