Antibacterial susceptibility patterns of Pseudomonas strains isolated from chronic canine otitis externa

Development of antibiotic resistance in bacteria is a problem of great concern. It is important to establish the convenience of antimicrobial susceptibility tests in animal infections. The aim of this study was to test the susceptibility to antibiotics of Pseudomonas strains isolated from chronic canine otitis externa. We tested 23 strains of Pseudomonas: 19 Ps. aeruginosa, three Ps. fluorescens and one Pseudomonas spp. The most effective antibiotics were tobramycin (100% susceptible), marbofloxacin (91.3%) and ceftazidime (91.3%). Ticarcillin and gentamicin, commonly used for the treatment of otitis externa also showed good results (susceptibility of strains was 86 and 65.2% respectively). Lower susceptibility was found using enrofloxacin (52.1%) probably due to its indiscriminate use. We emphasize the need for a rational policy of antibiotic prescribing in order to prevent the selection of resistant strains.     

猪链球菌对氟喹诺酮类药物的耐药性与靶位突变相关性

旨在了解猪链球菌对氟喹诺酮类药物耐药性与parC、gyrA基因突变的相关性,通过微量稀释法测定34株猪链球菌对4种氟喹诺酮类药物的MIC值,采用PCR方法扩增并测序分析了临床分离的猪链球菌对氟唪诺酮类约物10株耐药株和9株敏感株的parC和gyrA基因喹诺酮耐药决定区(QRDRs).在氟喹诺酮类药物耐药菌株parC基因QRDRs发生Ser79→Phe、Arg 87→Leu的氨基酸突变,在4株高度耐药菌株gyrA基因QRDRs发生Arg66→Ser,Ser81→Arg氨基酸突变;当菌株对氟喹诺酮类药物敏感时,parC和gyrA基因的QRDR区均未有突变;而当MIC≥32 μg·L-1 时,parC的氨基酸发生了 Ser79→Phe的突变,同时发生gyrA氨基酸Arg66→Ser,Set81→Arg突变.结果表明,猪链球菌对氟喹诺酮类药物低水平类耐药是由parC单一位点突变引起,而高水平耐药是由parC和gyrA双位点突变引起.     

Antimicrobial susceptibility of Pseudomonas aeruginosa isolates from dogs with otitis externa

Pseudomonas aeruginosa is a common cause of otitis externa in dogs, and treatment of these infections is becoming problematic because of the increasing number of multiresistant strains. The aim of the present study was to compare the in vitro activities of cefepime, ceftazidime, enrofloxacin, ciprofloxacin, gentamicin and ticarcillin/clavulanic acid against 104 strains of P aeruginosa isolated from dogs with otitis externa. Antimicrobial susceptibility and minimum inhibitory concentrations, in μg/ml, were evaluated by the E test (bioMérieux). The most active compound was ceftazidime, with 100 per cent efficiency. The majority of tested strains were susceptible to ticarcillin/clavulanic acid (89.4 per cent), followed by ciprofloxacin (88.5 per cent) and cefepime (60.6 per cent). The highest resistance was observed to enrofloxacin (51.9 per cent) and gentamicin (43.3 per cent). Large numbers of strains were intermediately susceptible to antibiotics registered for use in veterinary medicine in Croatia--enrofloxacin (47.1 per cent) and gentamicin (41.3 per cent).     

The role of Pityrosporum pachydermatis in otitis externa of dogs: evaluation of a treatment with miconazole.

The bacterial and mycotic flora were assessed in 158 ears of dogs with otitis externa and in 101 ears of healthy control dogs. Pityrosporum pachydermatis occurred in 57 per cent of ears with otitis externa and in 17 per cent of clinically healthy ears. Staphylococci and Pseudomonas aeruginosa were the predominant bacteria in otitic ears, micrococci and Bacillus spp were the most frequent isolates from clinically healthy ears. P pachydermatis, Ps aeruginosa and Candida tropicalis occurred in monoculture in a significant number of mainly chronic cases of otitis externa. A combination preparation, containing miconazole, polymyzin B and prednisolone, was highly effective in controlling the clinical signs of otitis externa and eliminating flora from the affected ears. The data presented suggest that yeasts, and especially P pachydermatis, may be significant pathogens in otitis externa and that antimycotic treatment is an essential part of the treatment of otitis externa in dogs.     

Bacteriology and mycology of otitis externa in dogs]

The bacterial and fungal flora of 1118 ears of dogs with otitis externa and 100 ears of healthy control dogs were studied in order to isolate the causative agents. The yeast Malassezia pachydermatis (56%) was by far the most common organism in otitic dogs followed by the bacteria Staphylococcus intermedius (23%), Pseudomonas aeruginosa (12%), Proteus spp. (6%) and Streptococcus canis (5%). A statistical analysis of observed results showed that the incidence of these organisms is significant in otitic dogs. Many strains of S.intermedius, P.aeruginosa and Proteus spp. are resistant to antimicrobial agents commonly used to treat otitis externa. Therefore an antimicrobial susceptibility testing was performed using "Cobas Bact" for these bacterias. Furthermore, 80 strains of M.pachydermatis were submitted to identification-kits (API 20 CAUX, API STAPH, Cobas Micro). The observed results showed that an identification with these tests was not possible.     

抗生素压力下不同血清型沙门氏菌耐药性研究

本研究旨在探讨不同血清型沙门氏菌在环丙沙星抗生素压力下突变频率及在耐药发展过程中靶位基因突变、外排泵及调控基因表达的差异。选取临床分离的印第安纳型、肠炎型和鼠伤寒型沙门氏菌的敏感菌株,在环丙沙星压力下诱导耐药突变,分别获得一系列不同程度的耐药突变株。分别检测不同血清型沙门氏菌突变株的突变频率、靶位基因喹诺酮耐药决定区(QRDRs)和外排泵调控基因ramR-ramA突变及外排泵相关基因的表达水平;同时检测了母株在羰基氰化物间氯苯腙(CCCP)存在情况下环丙沙星药物的蓄积浓度,以确定母株是否存在外排泵的作用。结果表明,在环丙沙星压力下,印第安纳型沙门氏菌较肠炎型和鼠伤寒型有更高的突变频率,易获得耐药株;印第安纳血清型菌株耐药性的获得主要是由于靶位基因gyrA发生单突变,协同外排泵外排作用增强而获得高水平耐药;肠炎型沙门氏菌耐药性获得主要是由于靶位基因gyrA发生83和87位双位点突变,并随着gyrB和parC基因的多位点同时突变而获得高水平耐药,耐药性的发展过程中没有外排泵作用参与;而鼠伤寒沙门氏菌在抗生素压力下不易发展成耐药菌,耐药性发生主要是由于靶位基因gyrB发生突变,而伴随parC基因突变及微弱的外排泵作用导致耐药水平增加。     

沙门氏菌耐药株gyrA基因和parC基因突变特征分析

提取沙门氏菌染色体DNA，设计引物扩增gyrA基因和parC基因片段，克隆测序寻找耐药菌株的突变位点，通过系统的比较，分析氟喹诺酮类药物（以环丙沙星为代表）对各沙门氏菌MIC和耐药突变位点之间的关系。通过对耐药突变位点的研究，可以为下一步研究耐药性监测的快速方法提供理论基础。     

鸡源性沙门氏菌DNA旋转酶与耐氟喹诺酮类药物关系研究

取临床分离的、对5种氟喹诺酮类药物（环丙沙星、氧氟沙星、恩诺沙星、单诺沙星和沙拉沙星）均耐药的9株鸡源性沙门氏菌耐药株,提取其染色体DNA。设计引物gyrAF和gyrAR、gyrBF和gyrBR,分别扩增菌株DNA旋转酶gyrA基因和gyrB基因的氟喹诺酮类耐药决定区（QRDR）,对PCR扩增产物进行测序及序列分析。与质控菌株相比,9株临床分离耐药株中只有菌株38和60的gyrA基因发生单碱基突变,菌株38的gyrA基因第371位碱基发生C→T突变,菌株60的gyrA基因第350位碱基发生A→C突变,两处突变均位于QRDR内,其余菌株的核苷酸未发生任何突变。菌株38的碱基突变导致gyrA基因第99位氨基酸发生R→C取代,即Arg→Cys;菌株60的碱基突变导致gyrA基因第92位氨基酸发生M→L取代,即Met→Leu。9株临床分离鸡源性沙门氏菌氟喹诺酮类耐药株gyrB基因QRDR的核苷酸序列与质控菌株完全相同;只有菌株42的gyrB基因第1592位碱基发生C→A突变,但其位于gyrB基因QRDR之外,且菌株42的gyrB基因的碱基突变并没有导致相应氨基酸的改变。上述结果提示,DNA旋转酶gyrA基因和gyrB基因QRDR突变可能并非沙门氏菌耐药性产生的主要原因。     

高效液相色谱法研究牛乳源耐药金黄色葡萄球菌对环丙沙星的蓄积作用

近年来研究发现,金黄色葡萄球菌的NorA、NorB和NorC外排泵蛋白介导对氟喹诺酮类药物的耐药.本文采用临床分离的牛乳源环丙沙星耐药的金黄色葡萄球菌,通过建立的高效液相色谱法(HPLC-FLD),测定了临床分离的耐药、敏感菌及金黄色葡萄球菌标准菌株ATCC 29213对环丙沙星积聚量的差异,为临床检测通过外排泵介导的氟喹诺酮类药物耐药的金黄色葡萄球菌提供了方法学上的依据.     

Action of EDTA-Tris and antimicrobial agent combinations on selected pathogenic bacteria

The concentration of EDTA-Tris (3.22 mM EDTA and 0.05 M Tris) used as a lavage to treat otitis externa, cystitis or other persistent infections in dogs and cats, was found to prevent the growth of Pseudomonas aeruginosa, Staphylococcus aureus and beta streptococci when present in growth media. Pseudomonas aeruginosa was rapidly lysed in this solution. Escherichia coli and Proteus vulgaris grew in the presence of EDTA-Tris, but to a lesser extent than the controls without these compounds. Minimal inhibitory concentrations (MIC) for 8 antimicrobial agents with and without EDTA-Tris were determined for E. coli and P. vulgaris. A potentiation effect on E. coli (greater than 50% decrease MIC) was observed when EDTA-Tris was combined with penicillin, oxytetracycline or chloramphenicol. A similar effect was observed with P. vulgaris when combinations of EDTA-Tris plus gentamicin, oxytetracycline, polymyxin-B or triple sulfa were used. The results of this study indicate that EDTA-Tris appears to have merit in selected cases of otitis externa, cystitis or other persistent infections where lavage might be used.     

A nucleotide mutation associated with fluoroquinolone resistance observed in gyrA of in vitro obtained Rhodococcus equi mutants

In this study, the quinolone resistance-determining region (QRDR) in gyrA and gyrB of in vitro fluoroquinolone-resistant Rhodococcus equi mutants was sequenced. These mutants were selected from four R. equi strains on blood agar plates containing ciprofloxacin or enrofloxacin. Each mutant became 8- to 64 or greater-fold resistant to fluoroquinolones compared with their parent strains. From the results of sequence analysis of QRDR in gyrA and gyrB, a nucleotide mutation of codon GAC for GGC in gyrA was detected in all mutants, but no mutation was observed in gyrB. This mutation leads to amino acid substitution of Asp for Gly in putative GyrA in R. equi. The position of this substitution corresponds to position 87 of GyrA in Escherichia coli. Our results suggest that the mutation of QRDR in gyrA, which was observed in in vitro fluoroquinolone-resistant R. equi mutants in this study, is closely associated with fluoroquinolone resistance.     

Mechanisms of quinolone resistance in Salmonella.

As in other Gram-negative bacteria, mechanisms of resistance to quinolones in Salmonella include target gene mutations, active efflux, and decreased outer membrane permeability. However, the exact contribution of these individual mechanisms to resistance, which may nevertheless interplay to reach high-level resistance, has not yet clearly been defined as in other bacteria such as Escherichia coli. This paper reviews the current state of knowledge of quinolone resistance mechanisms in Salmonella by comparison with that of E. coli and future directions of research with particular attention to the recent development of efflux pump inhibitors as possible means of avoiding the emergence and spread of fluoroquinolone resistance.     

Fluoroquinolone-resistant Campylobacter in animal reservoirs: dynamics of development, resistance mechanisms and ecological fitness

Thermophilic Campylobacter species, including Campylobacter jejuni and Campylobacter coli, are responsible for foodborne campylobacteriosis in humans and are increasingly resistant to fluoroquinolone (FQ) antimicrobials. The therapeutic use of FQ antimicrobial agents in food animal production, particularly in poultry, has become a concern for public health, because the practice may promote the emergence of FQ-resistant Campylobacter that can be transmitted to humans through the food chain. Recent studies have indicated that Campylobacter displays a hypermutable phenotype in response to in vivo treatment with FQ antimicrobials, resulting in the rapid emergence of resistant mutants. Distinct from other Gram-negative bacteria, the acquisition of FQ resistance in Campylobacter does not require stepwise accumulation of gyrA mutations and overexpression of efflux pumps, and is mainly mediated by single-step point mutations in gyrA in the presence of a constitutively expressed multidrug efflux pump, CmeABC. The simplicity of the resistance mechanisms may facilitate the rapid adaptation of Campylobacter to FQ treatment. The FQ-resistant Campylobacter mutants derived from chickens do not show a fitness cost in vivo and are ecologically competitive in the colonization of chickens even in the absence of antimicrobial selection pressure. These findings suggest that FQ-resistant Campylobacter may continue to persist regardless of antimicrobial usage, and highlight the need for extra effort to prevent the occurrence and spread of FQ-resistant Campylobacter in animal reservoirs.     

Emergence of fluoroquinolone resistance in Campylobacter jejuni in chickens exposed to enrofloxacin treatment at the inherent dosage licensed in Japan

The objective of the present study was to determine whether selection of fluoroquinolone resistance could be easily induced in Campylobacter jejuni-colonized chickens by treatment with enrofloxacin of representative fluoroquinolones at the inherent dosage licensed in Japan (50 ppm in drinking water for 3 days). In the case of isolates from chickens of study 1, an increase in the population of susceptible isolates appeared after the cessation of treatment and maintained throughout the experiments. On the contrary, our results of study 2 demonstrated that administration of enrofloxacin generated a rapid increase of fluoroquinolone resistance in C. jejuni showing the mutation of Asp-90-Asn in the gyrA gene. Present results indicate that the enrofloxacin treatment for broilers at the inherent dosage is able to select fluoroquinolone resistance in C. jejuni. We conclude that whatever enrofloxacin dosage is used, an emergence of fluoroquinolone resistant of C. jejuni occurs.     

鸡和人志贺菌gyrA、parC基因突变与喹诺酮类耐药的关系

通过药敏实验检测了鸡鲍氏、人鲍氏和人福氏三株志贺菌对12种常用抗生素的耐药情况,发现三者均未产生对喹诺酮类药物的耐药性。用聚合酶链反应(PCR)分别扩增三株志贺菌的DNA旋转酶A亚单位(gyrA)和拓扑异构酶ⅣC亚单位(parC)基因,并对其中的耐喹诺酮类决定区(QRDR)进行了分析。发现鸡和人鲍氏志贺菌QRDR区的序列没有发生任何碱基突变,这与药敏试验结果相吻合。人福氏志贺菌虽然也对喹诺酮类无耐药性,但其gyrA基因存在83位Ser83(TCG)→Leu(TTG)的突变,由于只有83位点一处突变,所以尚未表现出耐药性表征,parC基因中存在58位Ser58(AGC)→Ile(ATC)的突变,该突变点与常见的80、84位氯基酸的改变有所不同,却仍在QRDR区域之中,虽然暂时还无法根据这一结果判断该突变与喹诺酮类耐药性之间的关系,但至少表明该菌株正处在耐药性演变进程之中,其在志贺菌耐药性中的确切作用还有待进一步研究。     

Development of resistant bacteria isolated from dogs with otitis externa or urinary tract infections after exposure to enrofloxacin in vitro

Minimum inhibitory concentrations for enrofloxacin were determined for 63 bacterial isolates from dogs with otitis externa or urinary tract infections. Development of resistant mutants was determined after exposing the isolates to enrofloxacin in vitro for up to five serial passages. Results indicated that Pseudomonas aeruginosa and Enterococcus spp isolates exposed to enrofloxacin developed resistance rapidly, whereas Klebsiella, Proteus, and Streptococcus spp were less likely to develop resistance. Despite the presence of enrofloxacin pressure, no resistant bacteria developed in the Escherichia coli and staphylococcal isolates. In many isolates, susceptibility patterns changed from susceptible to intermediate.     

耐氟喹诺酮类药物禽源大肠埃希菌gyrA基因的检测分析

探讨不同禽源大肠埃希菌中喹诺酮类药物的耐药情况及耐药基因gyrA的分布和突变特征。采用K-B药敏纸片法、gyrA基因的PCR扩增,对9株大肠埃希菌进行喹诺酮类药物试验,并将gyrA基因的PCR产物测序,对测序结果采用DNA MAN、DNA Star、MEGA6等软件分析。药敏试验结果表明,C1、C2、C3菌株对左氧沙星、氧氟沙星、环丙沙星、诺氟沙星敏感,D1、D2、D3、B1、B2和B3菌株对左氧沙星、氧氟沙星、环丙沙星、诺氟沙星均表现为耐药和中介;gyrA基因的测序结果表明,除B1菌株有1处核苷酸突变位点和B2菌株有14处核苷酸突变位点;B2菌株gyrA基因的氨基酸突变发生在87位Ile→Val替代、101位Leu→Met替代、102位Ala→Ser替代、129位Lys→Gln替代。9株禽源大肠埃希菌的同源性和进化树分析表明,不同禽源耐氟喹诺酮类药物的大肠埃希菌菌株中B2菌株gyrA基因与其他9株菌株相比,同源性在90%左右,进化树不在一个分支上,研究中的B2菌株将为大肠埃希菌的氟喹诺酮类耐药机制的研究提供候选菌株。     

Update on antimicrobial susceptibilities of bacterial isolates from canine and feline otitis externa

The in vitro susceptibility of a total of 1819 bacterial isolates from canine and 103 isolates from feline otitis externa cases to 13 antimicrobial drugs over a 5-year period was evaluated. Among topically used drugs, 90% of isolates were susceptible to gentamicin. Susceptibility of Pseudomonas aeruginosa to gentamicin was 85%, and to polymyxin B 100%. For isolates other than the Pseudomonas sp., susceptibility was highest to amoxicillin-clavulanic acid.     

Identification and antimicrobial susceptibility patterns of bacteria causing otitis externa in dogs

Bacterial agents are considered important pathogens causing external otitis in dogs. It is essential to carry out bacterial culture and antimicrobial susceptibility test in the case of otitis externa, particularly for chronic or recurring cases. Sterile swab samples were obtained from terminal part of vertical ear canals of 74 dogs with otitis externa for cytology, bacterial culture and antimicrobial susceptibility test. Cytologic smears were stained using Gram and Giemsa staining methods. Aerobic bacterial culture performed on blood agar and MacConkey agar. Among total number of 92 isolated bacteria, 68 were Staphylococcus intermedius. Other isolated bacteria included: Pseudomonas aeruginosa, Proteus mirabilis, Escherichia coli, Pasteurella canis, and six other species of coagulase-negative Staphylococcus. Antimicrobial susceptibility test were performed for all isolated bacteria using 14 antibiotics. Based on the results of this study, all isolated Staphylococcus spp. were sensitive to amikacin, enrofloxacin, and rifampin, and had low resistance to gentamicin, cephalothin and ceftriaxone. More than half of gram-positive isolates were resistant to penicillin and ampicillin. Generally, all isolated gram-negative bacteria, were sensitive to amikacin and enrofloxacin, and had low resistance to ceftriaxone and gentamicin. They were highly resistant to penicillin, eythromycin, and cephalothin. Regarding the results of this study, in cases of uncomplicated otitis externa, it is possible to select antimicrobial drugs merely based on cytology, but it is recommended to perform bacterial culture and antimicrobial susceptibility test. However, in complicated or refractory cases, antimicrobials should be selected based on bacterial culture and antimicrobial susceptibility test.     

Comparative assessment of genotypic and phenotypic correlates of Staphylococcus pseudintermedius strains isolated from dogs with otitis externa and healthy dogs

Staphylococcus pseudintermedius is considered a primary pathogen of canine skin and soft tissue infections, and the rapid emergence of methicillin-resistant S. pseudintermedius worldwide is a major issue. In the current study, genotypic and phenotypic correlates associated with S. pseudintermedius causing canine otitis externa were evaluated using 41 S. pseudintermedius strains isolated from dogs with otitis externa (n = 26) and healthy dogs (n = 15). The S. pseudintermedius strains were subjected to a comparative analysis of (i) genotypes (multilocus sequence typing, agr, and spa types), (ii) methicillin resistance and SCCmec types, (iii) multidrug resistance (MDR), (iv) biofilm formation, and (v) susceptibility to canine cathelicidin (K9CATH). A high degree of genetic diversity was observed in both groups of S. pseudintermedius strains, regardless of methicillin resistance. Almost all methicillin-resistant strains (>95%) harbored SCCmec V and displayed MDR. Although there was no difference in biofilm formation, S. pseudintermedius strains derived from otitis externa exhibited enhanced resistance to cationic antimicrobial peptide (K9CATH) compared with strains from healthy dogs. The high degree of heterogeneity in MLST, agr, and spa types prevented the identification of correlations between any specific genotype and virulence phenotype in otitis externa caused by S. pseudintermedius, These findings provide an important basis for monitoring and treating canine skin and soft tissue infections in Korea.