Transudate microflora in dogs with infected pancreonecrosis and sensitivity to antimicrobials remedies
Abstract
Optimizing the use of antimicrobial agents for acute destructive pancreatitis and pancreonecrosis is an important and far-reaching problem. The lethality, which is often observed in acute destructive pancreatitis and pancreonecrosis in dogs is in most cases caused by toxemia, multiple organ failure and the development of infected pancreonecrosis (complication of "sterile" pancreonecrosis).
Infectious complications, including involvement in the pathological process of surrounding tissues (infected pancreonecrosis, infected cysts, peritoneum phlegmon) are observed in most animals with pancreonecrosis.
According to existing veterinary medicine tactics for the canine acute destructive pancreatitis and pancreonecrosis treatment, the main focus is on timely diagnosis of infectious complications, however, recently, the priorities of therapy are shifting towards the prevention of translocations of bacteria.
The purpose of our study was to determine the microbial composition of pancreatic effusion in case of infected pancreonecrosis, and to justify the feasibility of using antibiotic prophylaxis taking into account the sensitivity of microorganisms.
The detected microorganisms exhibited intermediate resistance to piperacillin in combination with tazobactam, tobramycin and sulfamethoxazole. The highest sensitivity is set to colistin sulfate and ciprofloxacin.
Infection of the pancreas and surrounding tissues is due to microorganisms of the KES group, and to a lesser extent Enterobacter sakazakii and Escherichia coli. No cases of mono-infection were reported during the study.
The most effective means of early prevention of purulent and septic complications in dogs for pancreonecrosis is colistin sulfate and ciprofloxacin, which is confirmed by a test for the sensitivity of the detected microflora.
The microflora isolated from hemorrhagic and serous effusions in dogs with pancreonecrosis resistant to gentamicin, doxycycline, levofloxacin and exhibiting intermediate resistance to piperacillin / tazobactam, tobramycin and sulphanilamide – sulfamethoxide.
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References
Bakker, O. J., Van Santvoort, H. C., Van Brunschot, S., Geskus, R. B., Besselink, M. G., Bollen, T. L., … Timmer, R. (2012). Endoscopic Transgastric vs Surgical Necrosectomy for Infected Necrotizing Pancreatitis: A Randomized Trial. JAMA, 307(10), 1053–1061. doi:10.1001/jama.2012.276.
Baron, T.H., & Morgan, D.E. (1999). Acute necrotizing pancreatitis The New England journal of medicine, 340 (18), 1412–1417.
Beger, H.G. (1986). Bacterial contamination of pancreatic necrosis. A prospective clinical study. Gastroenterology, 91 (2), 433–438.
Bradley, E. L. (1993). A Clinically Based Classification System for Acute Pancreatitis: Summary of the International Symposium on Acute Pancreatitis. Archive Surgery, 128(5), 586590. doi:10.1001/archsurg.1993.01420170122019.
Chiu, C. H., Lin, T.Y., & Wu, J. L. (1996). Acute Pancreatitis Associated with Streptococcal Toxic Shock Syndrome, Clinical Infectious Diseases, 22(4), 724–726. doi:/10.1093/clinids/22.4.724.
Cusack, T. P., Ashley, E. A., Ling, C. L., Rattanavong, S., Roberts, T., Turner, P., Wangrangsimakul, T., & Dance, D.A.B. (2019). Impact of CLSI and EUCAST breakpoint discrepancies on reporting of antimicrobial susceptibility and AMR surveillance. Clinical Microbiology and Infection, 25, 7, 910-911. doi:10.1016/j.cmi.2019.03.007.
De Waele, J.J., Vogelaers, D., Blot, S., & Colardyn, F. (2003). Fungal Infections in Patients with Severe Acute Pancreatitis and the Use of Prophylactic Therapy, Clinical Infectious Diseases, 37(2), 208–213, doi:/10.1086/375603.
Drudy, D., Mullane, N. R., Quinn, T., Wall, P. G., & Fanning, S. (2006). Enterobacter sakazakii: An Emerging Pathogen in Powdered Infant Formula. Clinical Infectious Diseases, 42, 7, 1, 996–1002. doi:/10.1086/501019.
DuPont, H. (2012). Approach to the patient with infectious colitis. Current Opinion in Gastroenterology, 28(1), 39–46 doi: 10.1097/MOG.0b013e32834d3208.
EUCAST Definitive document (1998). Methods for the determination of susceptibility of bacteria to antimicrobial agents. Terminology. Clinical Microbiology and Infection, 4, 291296. doi:10.1111/j.1469-0691.1998.tb00061.x.
Gurieva, T., Dautzenberg, J. D., Gniadkowski, M., Derde, L.P.G., Bonten, M.J.M., & Bootsma, M.C.J. (2018). The Transmissibility of Antibiotic-Resistant Enterobacteriaceae in Intensive Care Units. Clinical Infectious Diseases, 66, (4), 489–493. doi:/10.1093/cid/cix825.
Kumar, S., Ooi, C.Y., Werlin, S., et al. (2016). Risk Factors Associated With Pediatric Acute Recurrent and Chronic Pancreatitis: Lessons From INSPPIRE. JAMA Pediatrics, 170(6), 562569. doi:10.1001/jamapediatrics.2015.4955.
Maravi-Poma, E. (2003). Early antibiotic treatment (prophylaxis) of septic complications in severe acute necrotizing pancreatitis: a prospective, randomized, multicenter study comparing two regimens with imipenem-cilastatin. Intensive care medicine, 29 (11), 1974–1980.
Montgomery, R. S., & Wilson, S. E. (1996). Intraabdominal Abscesses: Image-Guided Diagnosis and Therapy Clinical Infectious Diseases, 23(1), 28–36, doi:10.1093/clinids/23.1.28.
NCCLS (2019). Performance Standards for Antimicrobial Susceptibility Testing. M 100, 29, 68.
Sanchez-Bautista, A., Coy, J., Garcia-Shimizu, P., & Rodriguez, J.C. (2018). From CLSI to EUCAST guidelines in the interpretation of antimicrobial susceptibility: what is the effect in our setting? Enferm Infecc Microbiol Clin., 36, 229–232.
Semrad, C. E. (2011). Approach to the patient with diarrhea and malabsorption. Cecil Medicine, 24, 142.
Tsang, A. T., & Belsley, S. (2017). Acute Pancreatitis After Pancreaticoduodenectomy. JAMA Surgery, 152(8), 795796. doi:10.1001/jamasurg.2017.1597.
Validazione del Sistema FAECAL WELL D-ONE in campioni fecali. Comparazione con metodi tradizionali. FAECAL Well D-ONE Technical File, C.M.P. sas 2013 [In Italian].
Windsor, J.A. (2011). Infected pancreatic necrosis: drain first, but do it better. HPB (Oxford), 13(6), 367-368.
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