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腹膜炎相关细菌感染:对160只家畜进行的大规模病例系列回顾性研究(2009 - 2022年)

Peritonitis-related bacterial infections: a large-scale case-series retrospective study in 160 domestic animals (2009-2022).

作者信息

Ribeiro Márcio Garcia, da Silva Ribeiro Ana Beatriz, da Silva Ana Beatriz Matias, Mariano Gabriel Henrique Gomes, de Sá Teles Bertunes Larissa, Portilho Fábio Vinicius Ramos, Filho Marcelo Fagali Arabe, Bello Thaís Spessotto, Meira Júlia, de Lima Paz Patrik Júnior, Siqueira Amanda Keller, Motta Rodrigo Garcia, de Souza Araújo Martins Motta Lorrayne, Bertolini Amanda Bezerra, Giuffrida Rogério, Casteleti Aline Garcia, Listoni Fernando José Paganini, Paes Antonio Carlos

机构信息

Department of Animal Production and Preventive Veterinary Medicine, Faculty of Veterinary Medicine and Animal Sciences- FMVZ, Infectious Diseases of Domestic Animals, Sao Paulo State University - UNESP, Botucatu, SP, 18618-681, Brazil.

Undergraduate Veterinary Medicine students, FMVZ, Sao Paulo State University - UNESP, Botucatu, SP, Brazil.

出版信息

Braz J Microbiol. 2024 Dec;55(4):4205-4217. doi: 10.1007/s42770-024-01551-3. Epub 2024 Oct 31.

Abstract

Bacterial peritonitis infections comprise a life-threatening clinical condition in domestic animals that commonly lead to sepsis and high mortality. A set of bacterial pathogens have been identified in septic peritonitis in livestock and companion animals. Nonetheless, most descriptions are restricted to case reports or limited to only one domestic species, and a restrict number of comprehensive studies involving this infection has focused on a great number of domestic animals. Here, we retrospectively investigated selected epidemiological data (with an emphasis in outcome), clinical signs, bacteriological culturing, and in vitro antimicrobial susceptibility patterns of microorganisms isolated of peritoneal fluid from 160 domestic animals (2009-2023) compatible with septic peritonitis. Bacteria were isolated from 71.9% (115/160) of the peritoneal fluid from 75 dogs (75/115 = 65.2%), 22 cats (22/115 = 19.1%), 14 horses (14/115 = 12.2%), and 4 cattle (4/115 = 3.5%). Among animals with bacterial isolation, Escherichia coli (34/115 = 29.6%), alfa-hemolytic Streptococcus (12/115 = 10.4%), Staphylococcus aureus (8/115 = 6.9%), beta-hemolytic Streptococcus (7/115 = 6.1%), and Pasteurella multocida (6/115 = 5.2%) were predominant in pure culture, in addition to a miscellaneous of other bacteria isolated in minor frequency, e.g., Pseudomonas sp., Trueperella pyogenes, Klebsiella pneumoniae, and Salmonella sp. In general, in vitro susceptibility tests of isolates revealed that florfenicol, chloramphenicol, and amoxicillin/clavulanic acid showed moderate effectivity (≥ 60%). Conversely, most of isolates exhibited resistance mainly to trimethoprim/sulfamethoxazole, enrofloxacin, and penicillin (> 60%). Additionally, multidrug resistance was found in 42.6% (49/115) of the isolates. Data related to the outcome were available in 37.4% (43/115) of animals that had bacterial isolation and, from these, the mortality rate was 79.1% (34/43), with a significant association (p < 0.036) between mortality and septic peritonitis by gram-negative bacteria. Neoplasia (7/43 = 16.3%), pneumonia/pulmonary abscess (5/43 = 11.6%), hepatitis (5/43 = 11.6%), metritis/pyometra (4/43 = 9.3%), and gall bladder rupture (3/43 = 7%) represented the probable main sources of septic peritonitis. Anorexia (34/115 = 29.6%), emesis (29/115 = 25.2%), lethargy (26/115 = 22.6%), respiratory distress (25/115 = 21.7%), ascites (20/115 = 17.4%), and fever (19/115 = 16.5%) were the most frequent clinical signs among animals with bacterial isolation. A variety of bacteria were isolated in the peritoneal fluid of animals, with a predominance of Enterobacteriaceae, streptococci, and staphylococci, highlighting the opportunistic nature of the pathogens in septic peritonitis. High in vitro multidrug resistance of isolates and high mortality of animals reinforce the need for early diagnosis and therapy based on the in vitro antimicrobial profile of the pathogens involved in septic peritonitis. Our results contribute to the etiological characterization, clinical-epidemiological findings, and vigilance of multidrug-resistant bacteria in septic peritonitis among livestock and companion animals.

摘要

细菌性腹膜炎感染是家畜中一种危及生命的临床病症,通常会导致败血症和高死亡率。在牲畜和伴侣动物的败血症性腹膜炎中已鉴定出一组细菌病原体。尽管如此,大多数描述仅限于病例报告或仅局限于一个家畜物种,并且涉及这种感染的综合研究数量有限,主要集中在大量家畜上。在此,我们回顾性调查了2009年至2023年期间160例符合败血症性腹膜炎的家畜腹膜液中分离出的微生物的选定流行病学数据(重点是结果)、临床症状、细菌培养及体外抗菌药敏模式。从115例(71.9%,115/160)家畜的腹膜液中分离出细菌,其中75只犬(75/115 = 65.2%)、22只猫(22/115 = 19.1%)、14匹马(14/115 = 12.2%)和4头牛(4/115 = 3.5%)。在分离出细菌的动物中,纯培养中主要有大肠杆菌(34/115 = 29.6%)、α溶血性链球菌(12/115 = 10.4%)、金黄色葡萄球菌(8/115 = 6.9%)、β溶血性链球菌(7/115 = 6.1%)和多杀性巴氏杆菌((6/115 = 5.2%),此外还分离出其他少量频率的杂菌,如假单胞菌属、化脓隐秘杆菌、肺炎克雷伯菌和沙门氏菌属。总体而言,分离株的体外药敏试验显示,氟苯尼考、氯霉素和阿莫西林/克拉维酸显示出中等有效性(≥60%)。相反,大多数分离株主要对甲氧苄啶/磺胺甲恶唑、恩诺沙星和青霉素耐药(>60%)。此外,42.6%(49/115)的分离株存在多重耐药。在分离出细菌的动物中,37.4%(43/115)有与结果相关的数据,其中死亡率为79.1%(34/43),革兰氏阴性菌引起的败血症性腹膜炎与死亡率之间存在显著关联(p < 0.036)。肿瘤(7/43 = 16.3%)、肺炎/肺脓肿(5/43 = 11.6%)、肝炎(5/43 = 11.6%)、子宫炎/子宫积脓(4/43 = 9.3%)和胆囊破裂(3/43 = 7%)可能是败血症性腹膜炎的主要来源。厌食(34/115 = 29.

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