Descriptive epidemiological study of the use of antimicrobial drugs by companion animal veterinarians in New Zealand

Abstract

AIM: To describe the patterns of use of antimicrobial drugs by veterinary surgeons treating commonly presented bacterial infections in companion animals in New Zealand.

METHODS: A postal survey of 800 randomly selected companion animal veterinarians practicing in New Zealand was conducted between August and December 2008. Data were collected regarding the antimicrobials prescribed for recent cases of skin, ear and urinary tract infections; the use of culture and susceptibility testing; and veterinarian characteristics such as proportion of time spent treating companion animals and recent attendance at continuing professional development (CPD) events. Potential associations within the data were explored using extended mosaic plots and multivariable regression models.

RESULTS:Completed surveys from 393 respondents were available for analysis, providing data on systemic antimicrobial drug use for 1,799 cases of presumptive bacterial infections. The most frequently prescribed drugs were amoxicillin-clavulanic acid (864 cases, 48%), cephalexin (558, 31%), and fluoroquinolones (198, 11%). Of 359 cases of canine superficial pyoderma, 157 (44%) were treated with amoxicillin-clavulanic acid and 155 (43%) were treated with cephalexin with median reported treatment durations of 7 and 10 days, for these two drugs respectively. Culture and susceptibility tests had been used in 376 of 1,984 (19%) of all reported cases and 160 (43%) of these were suspected urinary tract infections. Practitioners that spent 100% of their time treating companion animals and who had attended a CPD course related to companion animals within the 12 months prior to completing the survey were more likely to submit a sample for culture and susceptibility testing and to prescribe longer courses of antimicrobials for the treatment of canine pyoderma than practitioners who spent less than 100% of their time treating companion animals and had not attended a CPD course in the last 12 months.

CONCLUSIONS: Broad-spectrum drugs considered by the World Health Organisation to be critically important for human health, such as fluoroquinolones and amoxicillin-clavulanic acid, are amongst the most frequently prescribed antimicrobials in companion animal medicine, and these drugs are often prescribed without submitting a sample for culture and susceptibility testing.

CLINICAL RELEVANCE: Many cases of superficial pyoderma were treated for less than the recommended duration of 21 days, which may contribute to a higher rate of recurrent pyoderma and the development of drug resistance within the causal bacteria. Veterinarians should be aware that the use of fluoroquinolones, in particular, should be based upon the results of a culture and susceptibility test.     

Age-related Variation of Plasma Concentrations of Skatole, Androstenone, Testosterone, Oestradiol-17β, Oestrone Sulphate, Dehydroepiandrosterone Sulphate, Triiodothyronine and IGF-1 in Six Entire Male Pigs

This study describes the age-related variation in boar taint compounds, skatole and androstenone, and testosterone, oestradiol-17 beta (E17 beta), oestrone sulphate (ES), dehydroepiandrosterone sulphate (DHEAS), triiodothyronine (T(3)) and insulin-like growth factor-1 (IGF-1) in six boars. Three pairs of littermates of crossbred entire male pigs (from three Yorkshire x Duroc dams and one Hampshire sire) were included. Blood samples were taken at the age of 9-15 weeks and thereafter at weekly intervals from the age of 20-32 weeks. Plasma concentrations of skatole, androstenone, testosterone, E17 beta, ES, DHEAS, T(3) and IGF-1 were measured. We found that skatole levels in boars increased at the age around puberty after an increase in the levels of testicular steroids. Levels of skatole were not associated with the levels of sex steroids, T(3) and IGF-1. However, the increased level of testicular steroids is probably the underlying factor needed for high skatole levels to occur although the specific mechanism leading to increased skatole levels remains unknown.     

Spotted Fever Group – Rickettsiae in the Tyrols: Evidence by Seroepidemiology and PCR

The aim of our study was to assess the occurrence of Rickettsia in the inner‐alpine valleys of the Eastern Alps and to determine the amount of seroreaction among the local human population. Ticks were investigated by PCR and the percentage of seropositives was determined among local blood donors by an in‐house immunofluorescence assay. The local cut‐off titre for screening of IgG was set at 1 : 128 with a well‐characterised low‐risk collective according to WHO‐guidelines. Positive sera were confirmed by independent re‐testing. Rickettsia is present in ticks north and south of the continental divide. Of 259 ticks investigated, 12.4% are positive for Rickettsia. Of over 1200 blood donors tested so far, 7.7% bear IgG at a titre of 1 : 128 or higher against R. helvetica. R. helvetica is present in the study area, causes immunoreaction among local residents and is associated with anamnestic erythema. Furthermore, screening with a second Spotted Fever Group Rickettsia indicates that significant parts of the Tyrolean population are exposed to a Rickettsia other than R. helvetica.     

Chronic moderate heat dermatitis (erythema ab igne) in five dogs,three cats and one silvered langur

Erythema ab igne, an old and rare disease in the human literature, is an erythematous, often pigmented, reticular, macular dermatosis that occurs at the site of repeated exposure to moderate heat. We identified lesions consistent with erythema ab igne in five dogs, three cats and one silvered langur (Trachypithecus cristatus[Raffles, 1821]). In dogs and cats, the cutaneous lesion distribution typically reflected chronic exposure to moderate heat during lateral or sternal recumbency. The silvered langur developed cutaneous lesions on the dorsal neck from exposure to a heat lamp. Principal clinical lesions consisted of irregular areas of alopecia (7/9) and erythema (7/9), sometimes with hyperpigmentation (3/9). Principal histological features consisted of karyomegaly (9/9) and keratinocyte atypia (4/9), scattered apoptotic or vacuolated basal cells and/or apoptotic keratinocytes (6/9), mild mixed mononuclear interstitial or interface dermatitis (9/9) with adnexal atrophy (8/9), and a variable number of wavy eosinophilic elastic fibres (9/9). The presence of these cutaneous lesions in an animal indicates that the environment should be evaluated for exposure to chronic moderate heat, and the heat source should be eliminated or modified to prevent further exposure and progression of lesions.     

Heat Shock Protein 70 and Sex Steroid Receptors in the Follicular Structures of Induced Ovarian Cysts

The purpose of this study was to estimate the expression and relative amounts of estrogen (ER) and progesterone receptors (PR) and their isoforms as well as heat shock protein 70 (HSP70) in ovaries of rats with induced cystic ovarian disease (COD). Primary, secondary, tertiary, atretic and cystic follicles were evaluated by immunohistochemistry and total ovarian proteins were analyzed by Western blot. In the granulosa layer, growing and cystic follicles in the treated group have a higher expression of ERα than growing follicles of control individuals. In the theca interna layer, tertiary follicles presented a significantly higher expression of ERα in the treated group. An increase in total ERα protein was detected in the treated group. Granulosa cells of all growing, atretic and cystic follicles show a lower expression of ERβ in animals with COD, and the total protein expression of ERβ was lower in this group. The expression of PR was lower in the granulosa cell layer of tertiary and cystic follicles in treated animals, and theca interna layer had less intense immunostaining in this group. Although there were no differences in the expression of PR-B by Western blotting, the expression of PR-A was higher and the expression of PR-C was smaller in the treated group. An intense HSP70 immunostaining was observed in the cells of cystic follicles. By Western blotting, higher protein expression of HSP70 was detected in the ovarian samples of the control group than those of the treated ones. Ovaries of animals with COD exhibited an altered steroid receptor expression and subtype balance as compared with control animals, and an increase in HSP70 immunoexpression.     

Analysis of the risk of introduction and spread of porcine reproductive and respiratory syndrome virus through importation of raw pigmeat into New Zealand

AIMS: To determine the frequency with which porcine reproductive and respiratory syndrome (PRRS) virus (PRRSv) would become established in a non-commercial pig herd in New Zealand due to illegal feeding of uncooked food waste containing virus-contaminated pigmeat. To determine the likelihood of a single incursion resulting in a multi-farm outbreak of the disease, and describe the spatio-temporal characteristics of such an outbreak.

METHODS: A Monte Carlo simulation model was constructed to determine the expected annual frequency of PRRSv infection being initiated in a non-commercial pig herd as a result of inadvertent feeding of pigmeat imported from countries endemically infected with the disease. Once the likelihood of PRRSv becoming established in a single pig herd was determined, stochastic spatially explicit infectious disease modelling software was utilised to model the temporal and spatial characteristics of the resulting epidemic.

RESULTS: Assuming the proportion of imported pigmeat remained at current levels, consumption patterns of pigmeat in households in New Zealand remained steady, and limited compliance with recently reintroduced regulations to prevent feeding of uncooked food waste, at least 4.3 pig herds per year were predicted to become infected with PRRSv. Simulation modelling of PRRSv epidemics related to initial infection of a non-commercial farm produced an estimate that 36% of these incursions would spread from the initial herd, and that these outbreaks would involve 93 herds on average in the first year. By increasing the estimated persistence of PRRSv infection in small herds, an average of 205 herds became infected in the first year.

CONCLUSIONS: Given a mean of 4.3 infected premises per year and a 36% probability of infection spreading beyond the initial infected herd, there was a 95% likelihood of a multi-farm PRRS outbreak occurring within 3 years.

CLINICAL RELEVANCE: Introduction of PRRSv through importation of virus-contaminated pigmeat presents a high risk for establishment of the disease in the pig industry in New Zealand.     

Understanding foot-and-mouth disease virus transmission biology: identification of the indicators of infectiousness

The control of foot-and-mouth disease virus (FMDV) outbreaks in non-endemic countries relies on the rapid detection and removal of infected animals. In this paper we use the observed relationship between the onset of clinical signs and direct contact transmission of FMDV to identify predictors for the onset of clinical signs and identify possible approaches to preclinical screening in the field. Threshold levels for various virological and immunological variables were determined using Receiver Operating Characteristic (ROC) curve analysis and then tested using generalized linear mixed models to determine their ability to predict the onset of clinical signs. In addition, concordance statistics between qualitative real time PCR test results and virus isolation results were evaluated. For the majority of animals (71%), the onset of clinical signs occurred 3–4 days post infection. The onset of clinical signs was associated with high levels of virus in the blood, oropharyngeal fluid and nasal fluid. Virus is first detectable in the oropharyngeal fluid, but detection of virus in the blood and nasal fluid may also be good candidates for preclinical indicators. Detection of virus in the air was also significantly associated with transmission. This study is the first to identify statistically significant indicators of infectiousness for FMDV at defined time periods during disease progression in a natural host species. Identifying factors associated with infectiousness will advance our understanding of transmission mechanisms and refine intra-herd and inter-herd disease transmission models.     

Use of laser photocoagulation for treatment of cutaneous angiomatosis in one dog and two cats.

One dog and 2 cats were evaluated because of multiple progressively enlarging cutaneous vascular plaques. Biopsies were performed and revealed small well-circumscribed dermal nodules of dilated fully enclosed blood-filled spaces lined by single layers of endothelial cells aligned on thin fibrous walls, with minimal mitotic activity. A diagnosis of cutaneous angiomatosis was made in all 3 animals. Cutaneous angiomatosis is a progressive proliferative lesion of vascular tissue involving the dermis and subcutaneous tissues of dogs and cats. Lasers of selected wavelengths have been used to induce photothermal coagulation of hemoglobin-containing cutaneous lesions in humans; argon-pumped dye and neodymium:yttrium-aluminum-garnet lasers were used to treat the cutaneous lesions in the animals of this report. Laser treatment may provide an alternative to wide surgical resection or limb amputation for management of this condition in veterinary patients.