Multi-drug-resistant Enterococcus spp. as a cause of non-responsive septic synovitis in three horses

Abstract

CASE HISTORY: Three Thoroughbred horses, a 6-week-old filly (Case 1), a 15-year-old broodmare (Case 2) and a yearling filly (Case 3), sustained synovial sepsis secondary to trauma.

CLINICAL FINDINGS: Case 1 presented with a heel bulb laceration communicating with the distal interphalangeal joint. Arthroscopic lavage was performed and treatment commenced using systemic and local broad spectrum antimicrobial drugs. A pure growth of multi-drug-resistant (MDR) Enterococcus gallinarum was cultured from samples of synovium and joint fluid. Antimicrobial treatment was changed according to the susceptibility results. Response to treatment was poor and despite repeat arthroscopic lavage and intra-osseous regional perfusion of antimicrobials the filly was subject to euthanasia 24 days after the initial injury. Post-mortem examination confirmed septic synovitis, cartilage degeneration and osteomyelitis.

Case 2 sustained a full thickness wound to the carpus which was sharply debrided and closed. The wound dehisced with effusion within the tendon sheath. Drainage was established and treatment included systemic broad spectrum antimicrobials, topical lavage with povodine-iodine and manuka honey infusion. A mixed infection including MDR Enterococcus faecalis was cultured from the synovial fluid. Antebrachiocarpal joint effusion developed 21 days after initial injury and joint sepsis was confirmed. Arthroscopic lavage and tendon sheath debridement were performed, followed by treatment with systemic and local antimicrobials. The mare improved and was discharged. Three months later lameness recurred and corticosteroids were administered intra-articularly. The mare became non-weight bearing lame and was subject to euthanasia. Post-mortem examination confirmed joint sepsis of the antebrachiocarpal and intercarpal joint.

Case 3 presented with a complete articular open fracture of the tibial crest. Under general anaesthesia the fracture was stabilised and the wounds debrided and closed. Systemic broad-spectrum antimicrobials were administered. Six days later the wound dehisced and a bone fragment was removed. Three weeks post-surgery the wound deteriorated with a purulent discharge. Culture of the discharge revealed a mixed bacterial infection, including a MDR Enterococcus faecalis. Femoropatellar joint involvement was confirmed, and treatment included joint lavage, local and systemic antibiosis, and manuka honey instilled into the wound. The filly initially improved, and then deteriorated such that euthanasia was performed.

DIAGNOSIS: All three cases had synovial sepsis with MDR Enterococcus spp.

CLINICAL RELEVANCE: Increased awareness of MDR pathogens in equine wound infections is essential. Prompt diagnostic testing, appropriate therapy, infection control strategies and on-going monitoring and management are vital to limit the clinical impact of these organisms.     

Veterinarians' preferences for anticonvulsant drugs for treating seizure disorders in dogs and cats

Objective   To identify veterinarians' approaches and concerns when managing canine and feline patients with acute and chronic seizure disorders.
Design   Cross-sectional survey.
Method   A questionnaire was distributed to veterinarians to determine how many dogs and cats they were actively treating for seizures, their anticonvulsant drug (ACD) preferences for treating acute and chronic seizure disorders and whether serum anticonvulsant concentrations and/or biochemical analytes were routinely measured. Additional questions involved the respondent's year and place of graduation and identified concerns they faced when managing patients with seizure disorders.
Results   Phenobarbitone was the most commonly used ACD for managing chronic seizure disorders in both dogs and cats, with 82% of respondents using a combination of phenobarbitone and potassium bromide to manage refractory seizure disorders in dogs. Most respondents (96%) felt comfortable managing seizures in dogs, but only 63% were comfortable managing affected cats. Routine monitoring of serum ACD concentrations and of liver biochemical analytes was performed routinely by 71% and 45% of respondents, respectively. Of the respondents, 86% graduated from Australian universities and of these 53% had graduated after 1985.
Conclusion   Veterinarians identified when to commence medication, whether regular monitoring of serum ACD concentrations and liver enzyme activity was necessary, and if the cost was justified. Veterinarians also identified the need to balance dose rates and side-effects by using combination therapy, and the importance of providing accurate information to clients about what to expect in terms of seizure control for their pet.     

Enzyme-linked immunosorbent assay (ELISA) detection of infectious pancreatic necrosis virus (IPNV) in culture fluids and tissue homogenates of the rainbow trout, Salmo gairdneri Richardson

Abstract. A double antibody enzyme-linked immunosorbent assay (ELISA) for the detection of infectious pancreatic necrosis virus (IPNV) is described. The sensitivity of the assay reached 10² TCID₅₀ per 0·1 ml of culture fluid. The specificity of anti-IPNV sera and of the assay was confirmed by agar-gel immunodiffusion, by the direct immunoperoxidase technique for the deletion of IPNV in tissue cultures and by the ELISA inhibition test. High values of specific inhibition (over 90% at serum dilutions 1:40–1:2560) and low values of non-specific inhibition (8·4% at serum dilution 1:160) demonstrated the quality of the rabbit anti-IPNV serum. The results of ELISA agreed well with those of virological examinations. The potential of ELISA for investigations of a large series of field samples is discussed.     

Long-term development of fish populations in the Římov Reservoir

Abstract  The inshore fish community of the Římov Reservoir in the Czech Republic was evaluated over 21 years using shore seining at night. The development of the fish community was divided into two separate phases: a highly dynamic and unstable phase dominated by perch, Perca fluviatilis L., was replaced by an extremely stable cyprinid phase dominated by roach, Rutilus rutilus (L.), and bream, Abramis brama (L.). The abundance of both these species oscillated during the cyprinid phase, but with decreasing amplitude. The proportion of piscivorous fish species such as asp, Aspius aspius (L.), pike, Esox lucius L., and pikeperch, Sander lucioperca (L.), increased slightly with time but remained low. The biomass of large Cladocera was negatively correlated with fish biomass only during the perch phase. The Shannon–Weaver index of diversity increased during the fish community succession, mainly because of greater evenness amongst the species.     

Effects of stocking on the genetic structure of brown trout,Salmo trutta,in Central Europe inferred from mitochondrial and nuclear DNA markers

Abstract Stocking has had a considerable effect on wild brown trout, Salmo trutta L., populations throughout Europe. To elucidate this impact and to outline further management strategies, the genetic structure of 25 wild populations and five hatchery stocks from Czech Republic and Slovakia were analysed using mitochondrial (control region) and nuclear DNA (microsatellites, LDH‐C1*) markers. Stocking practices have caused massive hybridisation between the Atlantic and Danube brown trout strains in the central Danube basin and have lead to a loss of among‐population divergence in Slovakia and the eastern part of Czech Republic. Comparison with studies from neighbouring countries revealed substantial differences in haplotype, allele frequencies and genetic diversity across Central Europe. Differences in stocking management and origin of breeding stocks appear to be crucial factors for the spatial variability of the genetic structure of brown trout.