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Prevalência e suscetibilidade a antibióticos de isolados bacterianos de úlceras de córnea em cães
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As úlceras de córnea estão entre as principais afeções oftálmicas em cães, sendo responsáveis por um grande número de perdas do globo ocular. A maioria das úlceras tem a participação de microrganismos, especialmente bactérias, envolvidos no agravamento do quadro. Medidas de controlo da infeção devem ser tomadas de forma rápida e precisa. Por isso, culturas e testes de suscetibilidade a antimicrobianos (TSAs) são indicados para a tomada de decisão. Terapia empírica com antimicrobianos está recomendada quando não é possível realizar os exames ou até o resultado destes. Foi realizado estudo retrospetivo e prospetivo baseado nos resultados de culturas e TSAs a partir de isolados de 117 úlceras (5 bilaterais) em 112 cães atendidos em um serviço especializado de oftalmologia veterinária em Berlim, Alemanha, entre maio de 2021 e junho de 2024. Os isolados foram identificados por MALDI-TOF e o teste de suscetibilidade por concentração inibitória mínima (CIM). As raças braquicefálicas representaram 79,5% do levantamento, com predomínio de Buldogue Francês (50,9%). As úlceras foram classificadas em estromais (46,1%), indolentes (29%), em melting (19,7%), crónicas associadas a distrofias (4,3%) e perfuradas (0,9%). Foram isolados 108 microganismos, sendo 107 bactérias e um fungo (Aspergillus fumigatus), com crescimento de dois ou mais agentes em 17 culturas. Houve predomínio de Staphylococcus spp. (43,5%), com preponderância de S. pseudintermedius (27,8%). Na sequência, Streptococcus β-hemolíticos (19,4%), enterobactérias (15,7%) e Pseudomonas spp. (8,3%), entre outros isolados menos frequentes. Foram realizados testes de suscetibilidade de 100 isolados, excluindo-se os potenciais contaminantes. Os principais agentes mostraram altos níveis de resistência às penicilinas, polimixina B e ácido fusídico, e boa sensibilidade às fluoroquinolonas, aos aminoglicosídeos, ao cloranfenicol e à tetraciclina. Foi possível identificar 4 (4%) isolados como Staphylococcus pseudintermedius resistentes a meticilina (MRS). A classificação quanto ao padrão de multirresistências, revelou 27% de isolados multirresistentes a drogas. Para exercer comparação sobre possíveis diferenças relacionadas à idade e ao clima, além da apresentação e análise dos resultados gerais, os achados foram divididos entre faixas etárias e nos binómios outono/inverno e primavera/verão. Embora fossem observadas diferenças numéricas e percentuais, somente a relação de faixa etária com úlceras indolentes foi estatisticamente significativa. O estudo reforça a importância de realizarem culturas e testes de suscetibilidade aos antibióticos nos casos de ceratites ulcerativas
ABSTRACT - Prevalence and antibiotic susceptibility of bacterial isolates from corneal ulcers in dogs - Corneal ulcers represent a significant ophthalmic condition in canine patients, frequently leading to ocular loss. The majority of these ulcers are associated with microbial involvement, particularly bacterial organisms, which exacerbate the clinical condition. Prompt and precise infection control measures are imperative. Hence, the implementation of cultures and antimicrobial susceptibility tests (ASTs) is critical for therapeutic decision-making. Empiric antimicrobial therapy is advised in scenarios where testing is unfeasible or until test results are obtained. This research encompasses retrospective analyses of cultures and TSAs conducted on 117 ulcers (5 bilateral) in 112 dogs treated at a specialized veterinary ophthalmology clinic in Berlin, Germany, from May 2021 to June 2024. Identification of isolates was achieved using MALDI-TOF and the susceptibility testing by minimum inhibitory concentration (MIC). Notably, brachycephalic breeds constituted 79.5% of the cohort, with a significant representation of French Bulldogs (50.9%). Ulcer classifications included stromal (46.1%), indolent (29%), melting (19.7%), chronic associated with dystrophy (4.3%), and perforated (0.9%). A total of 108 microorganisms were isolated, 107 bacteria and one fungus (Aspergillus fumigatus), with growth of two or more agents in 17 cultures. The predominant isolate was identified as Staphylococcus spp. (43.5%), particularly S. pseudintermedius (27,8%). Other notable isolates included β-hemolytic Streptococcus (19.4%), Enterobacteriaceae (15.7%), and Pseudomonas spp. (8.3%), among others of lesser frequency. Susceptibility tests were conducted on 100 isolates, excluding potential contaminants. The primary bacterial agents displayed high resistance patterns to penicillins, polymyxin B, and fusidic acid, while demonstrating good susceptibility to fluoroquinolones, aminoglycosides, chloramphenicol, and tetracycline. Methicillin-resistant Staphylococcus pseudintermedius (MRS) was identified in 4 (4%) samples. The classification of microorganisms revealed that 27% exhibited multidrug resistance. To assess potential variations associated with age and climatic factors, findings were analyzed based on age groups and the seasonal binomials of autumn/winter and spring/summer. Although differences in numerical and percentage terms were observed, only the association between age group and indolent ulcers reached statistical significance. This study underscores the necessity of conducting cultures and antibiotic susceptibility tests in cases of ulcerative keratitis
ABSTRACT - Prevalence and antibiotic susceptibility of bacterial isolates from corneal ulcers in dogs - Corneal ulcers represent a significant ophthalmic condition in canine patients, frequently leading to ocular loss. The majority of these ulcers are associated with microbial involvement, particularly bacterial organisms, which exacerbate the clinical condition. Prompt and precise infection control measures are imperative. Hence, the implementation of cultures and antimicrobial susceptibility tests (ASTs) is critical for therapeutic decision-making. Empiric antimicrobial therapy is advised in scenarios where testing is unfeasible or until test results are obtained. This research encompasses retrospective analyses of cultures and TSAs conducted on 117 ulcers (5 bilateral) in 112 dogs treated at a specialized veterinary ophthalmology clinic in Berlin, Germany, from May 2021 to June 2024. Identification of isolates was achieved using MALDI-TOF and the susceptibility testing by minimum inhibitory concentration (MIC). Notably, brachycephalic breeds constituted 79.5% of the cohort, with a significant representation of French Bulldogs (50.9%). Ulcer classifications included stromal (46.1%), indolent (29%), melting (19.7%), chronic associated with dystrophy (4.3%), and perforated (0.9%). A total of 108 microorganisms were isolated, 107 bacteria and one fungus (Aspergillus fumigatus), with growth of two or more agents in 17 cultures. The predominant isolate was identified as Staphylococcus spp. (43.5%), particularly S. pseudintermedius (27,8%). Other notable isolates included β-hemolytic Streptococcus (19.4%), Enterobacteriaceae (15.7%), and Pseudomonas spp. (8.3%), among others of lesser frequency. Susceptibility tests were conducted on 100 isolates, excluding potential contaminants. The primary bacterial agents displayed high resistance patterns to penicillins, polymyxin B, and fusidic acid, while demonstrating good susceptibility to fluoroquinolones, aminoglycosides, chloramphenicol, and tetracycline. Methicillin-resistant Staphylococcus pseudintermedius (MRS) was identified in 4 (4%) samples. The classification of microorganisms revealed that 27% exhibited multidrug resistance. To assess potential variations associated with age and climatic factors, findings were analyzed based on age groups and the seasonal binomials of autumn/winter and spring/summer. Although differences in numerical and percentage terms were observed, only the association between age group and indolent ulcers reached statistical significance. This study underscores the necessity of conducting cultures and antibiotic susceptibility tests in cases of ulcerative keratitis
Descrição
Dissertação de Mestrado Integrado em Medicina Veterinária, área científica de Clínica
Palavras-chave
Córnea Antimicrobianos Microrganismos Resistência Cão Cornea Antimicrobials Microorganisms Resistance Dog
Contexto Educativo
Citação
Siqueira, AM. 2024. Prevalência e suscetibilidade a antibióticos de isolados bacterianos de úlceras de córnea em cães [dissertação de mestrado]. Lisboa: FMV-Lisboa
Editora
Universidade de Lisboa, Faculdade de Medicina Veterinária