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犬外耳炎抗菌单药治疗后的真菌失调

Fungal dysbiosis following antibacterial monotherapy in canine otitis externa.

作者信息

Juhola J, Brennan E, Ferguson E A, Loeffler A, Hendricks A, Frosini S M, Chang Y M, Bond R

机构信息

Department of Clinical Sciences and Services, University of London, Hatfield, UK.

Department of Pathobiology and Population Sciences, University of London, Hatfield, UK.

出版信息

J Small Anim Pract. 2025 Mar;66(3):149-157. doi: 10.1111/jsap.13801. Epub 2024 Nov 5.

Abstract

OBJECTIVES

To evaluate evidence of Malassezia overgrowth following successful topical antibacterial monotherapy of refractory canine bacterial otitis using semi-quantitative cultures.

MATERIALS AND METHODS

Twenty-nine dogs with bacterial otitis were treated topically with either fluoro-quinolone [0.5% enrofloxacin (18 dogs, 19 treatment events, 25 ears) or 0.1% marbofloxacin (1 ear), with 0.1% dexamethasone] ("FQ") SID, or 143 mg/mL piperacillin/18 mg/mL tazobactam ("PT") BID (11 dogs, 14 treatment events, 19 ears) for 8 to 36 days (mean 20 days). At visits 1 (V1) and 2 (V2), ear swab tips were washed in PBS + Triton X-100 and serial dilutions spread-plated onto blood, MacConkey (37°C, 48 hours) and modified Dixon's agar (32°C, 14 days) to generate semiquantitative counts. Microbes were identified by phenotype and MALDI-TOF.

RESULTS

Prior to treatment, Pseudomonas aeruginosa was isolated alone or in combination with other bacteria in 14 FQ-treated ears and 18 PT-treated ears; the next most frequent bacteria were Streptococcus canis (8 FQ, 2 PT) and Staphylococcus pseudintermedius (8 FQ, 1 PT). The proportions of dogs' ears (excluding cross-over treatments and contra-lateral affected ears) from which bacteria were isolated were significantly reduced by treatment with both FQ (V1, 13/15; V2, 5/15) and PT (V1, 14/14; V2, 2/14). The proportions of dogs' ears from which yeasts (Malassezia pachydermatis, Candida spp.) were isolated were significantly increased by treatment in dogs treated with PT (V1, 1/14; V2, 14/14) but not FQ (V1, 3/15; V2, 6/15).

CLINICAL SIGNIFICANCE

Otitis cases that receive potent antibacterial monotherapy must be monitored for yeast overgrowth.

摘要

目的

采用半定量培养法评估难治性犬细菌性中耳炎成功进行局部抗菌单药治疗后马拉色菌过度生长的证据。

材料与方法

29只患有细菌性中耳炎的犬,分别局部给予氟喹诺酮[0.5%恩诺沙星(18只犬,19次治疗,25只耳)或0.1%马波沙星(1只耳),加0.1%地塞米松](“FQ”)每日一次,或143mg/mL哌拉西林/18mg/mL他唑巴坦(“PT”)每日两次(11只犬,14次治疗,19只耳),治疗8至36天(平均20天)。在第1次(V1)和第2次(V2)就诊时,将耳拭子尖端在含曲拉通X - 100的磷酸盐缓冲盐水中冲洗,然后将系列稀释液涂布于血平板、麦康凯平板(37°C,48小时)和改良迪克森琼脂平板(32°C,14天)上以进行半定量计数。通过表型和基质辅助激光解吸电离飞行时间质谱法鉴定微生物。

结果

治疗前,在14只接受FQ治疗的耳和18只接受PT治疗的耳中分离出铜绿假单胞菌,单独或与其他细菌合并存在;其次最常见的细菌是犬链球菌(8只接受FQ治疗的耳,2只接受PT治疗的耳)和中间型葡萄球菌(8只接受FQ治疗的耳,1只接受PT治疗的耳)。用FQ(V1,13/15;V2,5/15)和PT(V1,14/14;V2,2/14)治疗后,分离出细菌的犬耳比例(不包括交叉治疗和对侧感染耳)均显著降低。接受PT治疗的犬中,分离出酵母(厚皮马拉色菌、念珠菌属)的犬耳比例显著增加(V1,1/14;V2,14/14),而接受FQ治疗的犬则未出现这种情况(V1,3/15;V2,6/15)。

临床意义

接受强效抗菌单药治疗的中耳炎病例必须监测酵母过度生长情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e69/11915478/16274a3a1fe7/JSAP-66-149-g003.jpg

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