RESUMO
Pyometra is a life-threatening disease, the severity of which depends on cervical patency status. This study investigated cervical inflammation status as well as the expression patterns and localization of aquaporin (AQP1, AQP2, AQP3, AQP5, and AQP9), and hormone receptors in cervical tissue that influences canine pyometra. Of the 36 animals enrolled in the study, 24 were diagnosed with pyometra and separated into two groups: open cervix pyometra and close cervix pyometra, while 12 healthy animals presented for elective ovariohysterectomies were allocated into the control group. Surgical treatment was performed for treatment of pyometra. After each operation, cervix samples were collected and analyzed for AQP and hormone receptor expression patterns determined by qPCR and protein expression by means of immunohistochemistry. Blood samples were also collected to determine serum progesterone concentrations. AQP9 expression was downregulated approximately 3-fold while and PGR expression was downregulated more than 2 fold in both pyometra groups compared to the control group. AQP3 and AQP5 gene expression levels were upregulated more than 3 fold in the open-cervix pyometra group than the closed-cervix pyometra group (P < 0.05). This is the first study to describe the expression patterns and immunolocalization of AQPs in canine cervical tissue based on pyometra patency status and to report AQP3 and AQP5 expression in cervical tissue linked to cervical patency.
Assuntos
Aquaporinas , Colo do Útero , Doenças do Cão , Regulação da Expressão Gênica , Piometra , Animais , Feminino , Cães , Piometra/veterinária , Piometra/metabolismo , Aquaporinas/genética , Aquaporinas/metabolismo , Doenças do Cão/metabolismo , Colo do Útero/metabolismo , Regulação da Expressão Gênica/fisiologiaRESUMO
Pyometra is a bacterial uterine infection that frequently affects intact older bitches. The treatment of choice is ovariohysterectomy, often associated with perioperative antimicrobial therapy. The aim of this retrospective investigation was to evaluate the antibiotic choice at different administration times (pre-surgery, at surgery/during hospitalization, and post-surgery) against complications and outcomes, considering the susceptibility profile of bacteria. The medical records of 51 bitches referred to the Veterinary Teaching Hospital of the University of Turin (January 2021-November 2023) and subjected to ovariohysterectomy and bacteriological examination (bacterial culture and susceptibility tests) of the uterine exudate, were analysed. All animals had a positive outcome without surgical site infections, with a longer hospitalization time in case of peritonitis or sepsis; antimicrobials were administered for an average of 7 days. Comparing the susceptibility of the isolated bacteria towards the antimicrobials administered before, during and after surgery, complete efficacy was observed in 42â¯%, 46â¯% and 50â¯% of cases, respectively. In addition, 5/16 peritonitis cases were treated with an in vitro ineffective antimicrobial, and 30â¯% of the bitches never received a fully effective antibiotic, according to susceptibility tests using the minimum inhibitory concentration method (MIC). Cephazolin resulted the best option for Escherichia coli, the most frequently isolated bacterium. Our study confirms that pyometra has a good prognosis following ovariohysterectomy and antibiotic administration. Monitoring the clinical evolution without changing the antibiotic according to bacterial susceptibility could represent the right choice in uncomplicated cases. Evaluation of outcomes without postoperative antibacterial treatment or with a shorter course would be another topic worth investigating, with the aim to judiciously reduce the use of antibiotics.
Assuntos
Antibacterianos , Doenças do Cão , Histerectomia , Ovariectomia , Piometra , Animais , Cães , Feminino , Piometra/veterinária , Piometra/cirurgia , Piometra/tratamento farmacológico , Doenças do Cão/tratamento farmacológico , Doenças do Cão/microbiologia , Doenças do Cão/cirurgia , Histerectomia/veterinária , Estudos Retrospectivos , Ovariectomia/veterinária , Antibacterianos/uso terapêutico , Antibacterianos/administração & dosagem , Testes de Sensibilidade Microbiana/veterinária , Resultado do TratamentoRESUMO
Pyometra is a common disease in intact female canines characterized by an infection of the uterus. If it is not treated immediately, it could result in various complications such as fistulous tract development, sepsis, hemorrhage, uveitis, conjunctivitis, pyelonephritis, urinary tract infection, and myocarditis. In this case report, we highlight the benefits of the application of a topical ointment on wound healing after ovariohysterectomy in canine Pyometra. Following surgical intervention, the dog developed necrosis in her nipples and lost a portion of her mammary tissues. A large cyst formed and later ruptured, leaving the animal with a large wound. The vet applied a topical ointment, AlpaWash, to the affected area and prescribed antibiotic, analgesic, and antiinflammatory drugs to help manage the condition. The vet reported complete healing of the wounds within one month from the commencement of the treatment regimen.
Assuntos
Piometra , Cicatrização , Animais , Feminino , Cães , Piometra/veterinária , Piometra/tratamento farmacológico , Cicatrização/efeitos dos fármacos , Histerectomia/veterinária , Doenças do Cão/tratamento farmacológico , Ovariectomia/veterinária , Pomadas , Ferida Cirúrgica/tratamento farmacológico , Ferida Cirúrgica/veterináriaRESUMO
AIMS: Pyometra and cystitis caused by Escherichia coli are common diseases identified in canine or feline females. The origin of pyometra infection remains uncertain, and effective prevention strategies for this disease are still unknown. This study aimed to provide a phenotypic characterization, including antimicrobial resistance and virulence profiles, of endometrial pathogenic (EnPEC) and uropathogenic (UPEC) E. coli strains isolated simultaneously from the same animal. METHODS AND RESULTS: Sixteen E. coli strains, from eight different animals, were analyzed in this study. The antimicrobial susceptibility profile of EnPEC and UPEC strains was determined using the disc diffusion method, which showed a similar susceptibility profile among strains (EnPEC and UPEC) from the same animal. The virulence profile of the strains was assessed through biofilm formation, as well as serum resistance abilities. EnPEC and UPEC strains from the same animal exhibited slight variations in their virulence and antimicrobial resistance capabilities. Overall, most of the strain pairs showed a high similarity in their ability to establish biofilms and survive in serum complement activity. CONCLUSIONS: Overall, strains of E. coli isolated from both pyometra and cystitis in the same animal, despite presenting distinct clinical diseases, exhibit a wide phenotypic similarity, suggesting a common origin for the strains.
Assuntos
Biofilmes , Doenças do Gato , Cistite , Infecções por Escherichia coli , Escherichia coli , Testes de Sensibilidade Microbiana , Fenótipo , Piometra , Animais , Cistite/microbiologia , Cistite/veterinária , Piometra/microbiologia , Piometra/veterinária , Feminino , Gatos , Cães , Infecções por Escherichia coli/microbiologia , Infecções por Escherichia coli/veterinária , Escherichia coli/isolamento & purificação , Escherichia coli/patogenicidade , Doenças do Gato/microbiologia , Biofilmes/crescimento & desenvolvimento , Virulência , Antibacterianos/farmacologia , Doenças do Cão/microbiologia , Escherichia coli Uropatogênica/isolamento & purificação , Escherichia coli Uropatogênica/patogenicidade , Farmacorresistência BacterianaRESUMO
Present study was designed to evaluate the role of virulence factor genes (papG, cnf1 and hylA) in the pathogenesis of canine pyometra. Antimicrobial susceptibility test and detection of virulence genes were performed Escherichia coli (E. coli) detected in uterine swab samples. Animals were divided into two groups based on the presence (VF+, n:14) or absence (VF-, n:7) of the virulence factor genes papG, cnf1 and hylA. Blood and tissue glutathione peroxidase activity, uterine histopathologic analysis and AQP3, ESR1, PGR, OXTR gene expressions were determined in both groups. Statistical analyses were performed using Stata version 15.1. All E. coli isolates were susceptible to amikacin, whereas resistant to ampicillin, amoxicillin/clavulanic acid and lincomycin. None of the isolates were susceptible to cefotaxime. E. coli isolates had at least one virulence gene. The most prevalent gene was fimH (100%), followed by fyuA (95.8%), usp (83.3%), sfa (75%), cnf1 and hlyA (70.8%) genes. Blood GPx activity was greater in VF+ animals. On the other hand, uterine tissue GPx activity was lower in VF+ group compared to the control group. Expression levels of AQP3 were upregulated more than fivefold in VF-dogs compared to the control group. In addition, AQP3 expression levels were found approximately threefold higher in VF (-) than VF (+) group (p < .05). Varying degree of inflammation noted for all animals with pyometra, but the presence of bacteria noted only in VF+ animals. In conclusion, the presence of virulence factor genes does not play a role in the histopathological degree of inflammation, the presence of bacteria was found to vary. Serum GPx activity increased in VF+ animals. While the hormone receptor expressions were similar, AQP expression was upregulated in the absence of virulence factor genes.
Assuntos
Aquaporina 3 , Doenças do Cão , Escherichia coli , Glutationa Peroxidase , Piometra , Útero , Fatores de Virulência , Animais , Feminino , Fatores de Virulência/genética , Fatores de Virulência/metabolismo , Aquaporina 3/genética , Aquaporina 3/metabolismo , Cães , Piometra/veterinária , Piometra/microbiologia , Piometra/patologia , Doenças do Cão/microbiologia , Útero/patologia , Útero/microbiologia , Útero/metabolismo , Escherichia coli/genética , Escherichia coli/patogenicidade , Glutationa Peroxidase/genética , Glutationa Peroxidase/metabolismo , Infecções por Escherichia coli/veterinária , Infecções por Escherichia coli/microbiologia , Antibacterianos/farmacologia , Regulação para Baixo , Testes de Sensibilidade Microbiana/veterináriaRESUMO
Despite extensive characterisation of uropathogenic Escherichia coli (UPEC) causing urinary tract infections (UTIs), the genetic background of non-urinary extraintestinal pathogenic E. coli (ExPEC) in companion animals remains inadequately understood. In this study, we characterised virulence traits of 104 E. coli isolated from canine pyometra (n = 61) and prostatic abscesses (PAs) (n = 38), and bloodstream infections (BSIs) in dogs (n = 2), and cats (n = 3). A stronger association with UPEC of pyometra strains in comparison to PA strains was revealed. Notably, 44 isolates exhibited resistance to third-generation cephalosporins and/or fluoroquinolones, 15 were extended-spectrum ß-lactamase-producers. Twelve multidrug-resistant (MDR) strains, isolated from pyometra (n = 4), PAs (n = 5), and BSIs (n = 3), along with 7 previously characterised UPEC strains from dogs and cats, were sequenced. Genomic characteristics revealed that MDR E. coli associated with UTIs, pyometra, and BSIs belonged to international high-risk E. coli clones, including sequence type (ST) 38, ST131, ST617, ST648, and ST1193. However, PA strains belonged to distinct lineages, including ST12, ST44, ST457, ST744, and ST13037. The coreSNPs, cgMLST, and pan-genome illustrated intra-clonal variations within the same ST from different sources. The high-risk ST131 and ST1193 (phylogroup B2) contained high numbers of ExPEC virulence genes on pathogenicity islands, predominating in pyometra and UTI. Hybrid MDR/virulence IncF multi-replicon plasmids, containing aerobactin genes, were commonly found in non-B2 phylogroups from all sources. These findings offer genomic insights into non-urinary ExPEC, highlighting its potential for invasive infections in pets beyond UTIs, particularly with regards to high-risk global clones.
Assuntos
Abscesso , Doenças do Cão , Farmacorresistência Bacteriana Múltipla , Infecções por Escherichia coli , Piometra , Infecções Urinárias , Cães , Animais , Infecções Urinárias/microbiologia , Infecções Urinárias/veterinária , Farmacorresistência Bacteriana Múltipla/genética , Masculino , Doenças do Cão/microbiologia , Gatos , Infecções por Escherichia coli/microbiologia , Infecções por Escherichia coli/veterinária , Piometra/microbiologia , Piometra/veterinária , Piometra/genética , Abscesso/microbiologia , Abscesso/veterinária , Feminino , Doenças do Gato/microbiologia , Escherichia coli Uropatogênica/genética , Escherichia coli Uropatogênica/efeitos dos fármacos , Escherichia coli Uropatogênica/patogenicidade , Escherichia coli/genética , Escherichia coli/patogenicidade , Escherichia coli/efeitos dos fármacos , Antibacterianos/farmacologia , Doenças Prostáticas/microbiologia , Doenças Prostáticas/veterinária , Doenças Prostáticas/genética , Virulência/genética , Fatores de Virulência/genéticaRESUMO
Pyometra is a prevalent and severe infectious disease that affects the reproductive systems of cattle worldwide. This study's main goal was to investigate the biomarkers for oxidative stress (OS), adiponectin, leptin and neopterin (NPT) in cows suffering from postpartum pyometra. The study also aimed to determine which bacteria were most commonly implicated in the development of the disease. A total of 74 cows with pyometra were examined and compared to a control group of healthy cows (n = 20). In comparison to the healthy control and post-treatment groups, the pyometra group showed higher mean values of leptin, adiponectin and malondialdehyde (MDA). In contrast, the glutathione (GSH) and superoxide dismutase (SOD) mean values were lower in the pyometra group as compared to the post-treatment and control groups. NPT levels in the post-treatment groups were lower than those in cows with pyometra but comparable to the healthy control group (p > .05). When compared to the other biomarkers, NPT, leptin and adiponectin showed higher sensitivity and specificity in identifying pyometra cases (AUC ≥0.99). The predominant bacterial isolates from the ptomtra-affected cows consisted of Escherichia coli (N = 29; 39.2%), Arcanobacterium pyogenes (N = 27; 36.5%) and Fusobacterium necrophorum (N = 13; 17.6%). Mixed infection was determined in nine samples (12.2%). Conclusively, OS, adiponectin, leptin and NPT play crucial roles in comprehending the development of postpartum pyometra in cows and have the potential to serve as biomarkers for the disease.
Assuntos
Doenças dos Bovinos , Piometra , Feminino , Bovinos , Animais , Piometra/veterinária , Leptina , Adiponectina , Período Pós-Parto , Estresse Oxidativo , Glutationa , Biomarcadores , Doenças dos Bovinos/microbiologiaRESUMO
Cystic endometrial hyperplasia-pyometra complex (CEH-P) is a common disease in sexually mature bitches. Disease progression leads to oxidative stress, resulting in the depletion of uterine antioxidants and lipid peroxidation of associated cells, which further aggravates the condition. The concentration of antioxidant enzymes, the level of lipid peroxidation within the uterine tissue, and its reflection in the serum and urine need to be elucidated. The aim of this study was to analyze the concentration of antioxidants such as superoxide dismutase (SOD), catalase (CAT), glutathione (GSH), glutathione peroxidase (GPx), and the lipid peroxidation marker malonaldehyde (MDA) in three types of samples, i.e., serum, urine, and uterine tissue. For this purpose, 58 pyometra-affected and 44 healthy bitches were included in the present study. All animals underwent ovariohysterectomy (OVH). Our data indicated highly significant difference (p<0.01) in the antioxidant concentrations of uterine, serum and urine samples. Furthermore, there was a highly significant (p<0.01) difference in the serum levels of ferric reducing antioxidant power (FRAP) and free radical scavenging activity (FRSA) indicated poor capacity to overcome oxidative stress in the CEH-Pyometra condition. We showed that CEH-P induces oxidative stress, which further depletes the antioxidant enzyme reserves in the uterus. Thus, the weak antioxidant defence predisposes to uterine damage and disease progression. The simultaneous depletion of antioxidants and an increase in lipid peroxidation in the serum and urine may also act as early indicators of uterine pathology.
Assuntos
Doenças do Cão , Hiperplasia Endometrial , Piometra , Cães , Feminino , Animais , Hiperplasia Endometrial/veterinária , Hiperplasia Endometrial/metabolismo , Hiperplasia Endometrial/patologia , Piometra/veterinária , Piometra/metabolismo , Antioxidantes/metabolismo , Útero/metabolismo , Glutationa/metabolismo , Progressão da Doença , Peroxidação de LipídeosRESUMO
BACKGROUND: Pyometra is a disease characterized by the collection of pus in the uterus. The clinical characteristics and etiology of pyometra have not been sufficiently described. In this study, we investigated the clinical characteristics, epidemiology, outcomes, and risk factors of septic shock in patients with pyometra. METHODS: Patients with pyometra admitted to one of four university-affiliated hospitals between January 2010 to August 2022 were enrolled. Pyometra cases associated with peripartum infection and surgical site infection were excluded. Clinical characteristics and outcomes of pyometra were described, and pyometra patients with or without septic shock were compared. RESULTS: A total of 192 patients was included. Twenty-eight-day all-cause mortality was 5.0%, and the 1-year recurrence rate was 6.3%. Median patient age was 77.5 years. The two most common symptoms were abdominal pain (49.0%) and vaginal discharge (47.9%). Escherichia coli (40.1%), Klebsiella pneumoniae (16.7%), and Streptococcus spp.(16.0%) were the pathogens most frequently isolated by conventional culture; those isolated from polymerase chain reaction were Mycoplasma hominis (48.0%), and Ureaplasma spp. (32.0%). In multivariable analysis, fever, uterine perforation, and dementia were associated with increased incidence of septic shock, while vaginal discharge was associated with a lower incidence of septic shock. CONCLUSIONS: Our findings suggest that pyometra is a unique gynecological infectious syndrome in post-menopausal individuals. The most common associated pathogens are similar to those involved in urinary tract infections rather than those of sexually transmitted diseases. Decreased cognitive function could delay early diagnosis of pyometra and lead to septic shock and higher mortality.
Assuntos
Piometra , Choque Séptico , Descarga Vaginal , Idoso , Feminino , Humanos , Estudos de Coortes , Escherichia coli , Piometra/complicações , Piometra/epidemiologia , Piometra/diagnóstico , Fatores de Risco , Choque Séptico/epidemiologia , Descarga Vaginal/complicações , Estudos RetrospectivosRESUMO
Escherichia coli (E. coli) are widely related to pyometra and cystitis in dogs, and these infections can occur simultaneously. The goal of this study was to determine genetic and pathogenic insights of 14 E. coli isolated simultaneously from pyometra content and bladder urine of seven bitches. To achieve this, in silico and in vitro comparative analyses were conducted. Whole-genome comparisons demonstrated that E. coli isolated from pyometra and urine of the same animal were predominantly genetic extraintestinal E. coli clones belonging to the same Sequence Type and phylogroup. The E. coli clones identified in this study included ST372, ST457, ST12, ST127, ST646, and ST961. Five isolates (35.7%) belonged to the ST12 complex. Except for two E. coli, all other isolates belonged to the B2 Clermont phylogroup. Interestingly, some genomes of E. coli from urine carried more virulence genes than those E. coli from pyometra. Both pyometra and urine E. coli isolates demonstrated a strong affinity for adhering to HeLa and T24 cells, with a low affinity for invading them. However, certain isolates from urine exhibited a greater tendency to adhere to T24 cells in qualitative and quantitative assays compared to isolates from pyometra. In conclusion, this study revealed the high genomic similarity between pyometra and urine E. coli isolates, as well as the virulent capacity of both to colonize endometrial and urothelial cells. The findings of this study underscore the importance of concurrently managing both infections clinically and could potentially contribute to future resources for the prevention of cystitis and pyometra.
Assuntos
Doenças do Cão , Infecções por Escherichia coli , Escherichia coli , Piometra , Animais , Cães , Piometra/veterinária , Piometra/microbiologia , Piometra/urina , Feminino , Doenças do Cão/microbiologia , Doenças do Cão/urina , Escherichia coli/genética , Escherichia coli/isolamento & purificação , Escherichia coli/patogenicidade , Infecções por Escherichia coli/veterinária , Infecções por Escherichia coli/microbiologia , Infecções por Escherichia coli/urina , Genoma Bacteriano , FilogeniaRESUMO
OBJECTIVE: To compare results from 2 previously published surveys aimed at determining how pyometra is treated in high-quality, high-volume spay-neuter clinics (HQHVSNCs) and private practices (PPs), with a specific focus on identifying opportunities for partnership between the clinic types to improve access to care in pyometra treatment. SAMPLE: Responses from 123 PPs and 87 HQHVSNCs. METHODS: A previously published survey of PPs conducted from June to July 2021 and a similar previously published survey of HQHVSNCs conducted from June to July 2020 were compared regarding demographics, pyometra treatment availability, estimated outcome, alternative outcome, disruption, cost, and protocol between HQHVSNCs and PPs. A comparison was also run of the surveys' responses regarding referral of a pyometra to an HQHVSNC by a PP. RESULTS: Although PPs estimated that economic euthanasia is the most likely alternative outcome for 13% of patients unable to access care at their practice, 80% would be reluctant to refer to an HQHVSNC. The 3 primary reasons indicated by PPs with a reluctance to refer were a perceived lack of prompt appointment availability (20%), lack of aftercare (18%), and lack of adequate equipment (14%). In contrast, most HQHVSNCs estimated that they generally accept referrals the same day (50%) or the next day (30%) and 95% of HQHVSNCs reported having the resources needed to treat most pyometras. CLINICAL RELEVANCE: There are several opportunities for partnership between PPs and HQHVSNCs in the treatment of pyometra. The most frequent concerns expressed by PPs regarding referral to HQHVSNCs were not shared by HQHVSNCs or could be ameliorated by referral to an HQHVSNC for surgery and transfer back to the PP for aftercare.
Assuntos
Piometra , Feminino , Animais , Piometra/veterinária , Piometra/cirurgia , Acessibilidade aos Serviços de Saúde , Prática Privada , Inquéritos e Questionários , Cães , Doenças do Cão/cirurgia , Doenças do Cão/terapia , Medicina Veterinária/organização & administraçãoRESUMO
The binding of steroid hormones to their specific receptors is necessary to exert their effects on target cells. Progesterone (P4), a steroid hormone, carries out its effects through both genomic and non-genomic (the cell membrane-associated) receptors. This study aimed to ascertain luteal expression patterns of genomic and non-genomic progesterone receptors in bitches in physiological (early dioestrus and early pregnant) and pathological (pyometra) reproductive states. Luteal tissue was collected from the bitches at early dioestrus (ED, n = 5), early pregnant (EP, n = 5), and pyometra (PY, n = 5). The expression profiles of Steroidogenic Acute Regulator Protein (STAR), Progesterone Receptor (PGR), Membrane Progestin Receptors (PAQR5, PAQR7 and PAQR8), and Progesterone Membrane Components (PGMRC1 and PGMRC2) were examined at the mRNA levels using Real-Time Polymerase Chain Reaction (RT-PCR). Protein levels of PGR, PGMRC1 and PGMRC2 were detected by western blotting (WB). The STAR expression was found in all groups, with a statistical difference observed between EP and PY groups (P < 0.05). The protein level of PGR was determined to be highest in the EP group and lowest in the PY group. The expression of PAQR8 increased in the EP group (P < 0.05). The PAQR5 exhibited high expression in the EP group and low expression in the PY group (P < 0.05). PGRMC1 was more elevated in the EP group and lower in the PY group (P < 0.05). Protein levels of PGMRC1 and PGMRC2 were also observed at the highest expression in EP group. According to the altered expression profiles for examined receptors, we suggest that those progesterone receptors have roles in early pregnancy or pyometra in bitches.
Assuntos
Piometra , Receptores de Progesterona , Gravidez , Feminino , Animais , Receptores de Progesterona/genética , Receptores de Progesterona/metabolismo , Progesterona/farmacologia , Luteína , Piometra/veterinária , GenômicaRESUMO
A 14-year-old intact female diabetic dog presented with seizures and hyperglycemic hyperosmolar syndrome. Radiographs revealed gas-filled tubular structures in the right and left caudal abdomen, raising concerns of emphysematous pyometra or small intestinal ileus. Ultrasonography played a pivotal role in confirming emphysematous pyometra, a technique previously documented only once in veterinary practice. This report also presents the first documented case of emphysematous pyometra in a diabetic dog attributed to Klebsiella pneumoniae and complicated by emphysematous hepatitis.
Assuntos
Doenças do Cão , Infecções por Klebsiella , Klebsiella pneumoniae , Piometra , Animais , Cães , Infecções por Klebsiella/veterinária , Infecções por Klebsiella/diagnóstico , Infecções por Klebsiella/complicações , Feminino , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/microbiologia , Doenças do Cão/diagnóstico , Klebsiella pneumoniae/isolamento & purificação , Piometra/veterinária , Piometra/complicações , Piometra/diagnóstico por imagem , Enfisema/veterinária , Enfisema/diagnóstico por imagem , Ultrassonografia/veterinária , Hepatite Animal/diagnóstico , Hepatite Animal/microbiologia , Hepatite Animal/diagnóstico por imagem , Hepatite Animal/complicações , Complicações do Diabetes/veterinária , Antibacterianos/uso terapêuticoRESUMO
Carbapenemase-producing Enterobacterales (CPE) are a serious concern in human clinical settings. Companion animal-origin CPE have been only rarely identified in several countries, but they have not yet been identified in Japan. In this study, we present the first case of a canine infected with CPE in Japan. The patient was hospitalized due to pyometra. The pus discharged from the patient's uterus was subjected to bacteriological analysis. As a result, E. coli was identified in the pus and exhibited resistance to piperacillin, amoxicillin-clavulanic acid, cefazolin, ceftazidime, cefepime, meropenem, amikacin, and sulfamethoxazole-trimethoprim and susceptibility to aztreonam, minocycline, and levofloxacin. Results of the sodium mercaptoacetic acid double-disk synergy test showed that the E. coli isolate was positive for metallo-ß-lactamases. Next-generation sequencing identified the blaNDM-5 gene, which was located in the IncFII-type plasmid together with blaTEM-1b, rmtB, aadA2, bleMBL, sul1, qacE, and dfrA12. The case was treated successfully with doxycycline and orbifloxacin. Our finding emphasizes that close attention should be paid to the significance of CPE harboring multidrug-resistance plasmid in companion animals, based on the perspective of One Health approach in Japan as well as in other countries.
Assuntos
Antibacterianos , Doenças do Cão , Infecções por Escherichia coli , Escherichia coli , Testes de Sensibilidade Microbiana , Piometra , beta-Lactamases , Animais , Cães , Japão , Feminino , beta-Lactamases/genética , Escherichia coli/genética , Escherichia coli/isolamento & purificação , Escherichia coli/efeitos dos fármacos , Doenças do Cão/microbiologia , Doenças do Cão/tratamento farmacológico , Infecções por Escherichia coli/microbiologia , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/veterinária , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Piometra/microbiologia , Piometra/tratamento farmacológico , Piometra/veterinária , Farmacorresistência Bacteriana Múltipla/genética , Plasmídeos/genéticaRESUMO
This study aimed to investigate blood flow, hemodynamical features by Doppler ultrasound, the oxidative stress biomarkers from serum samples, and histopathology from uterine tissue, in healthy queens and queens with pyometra. Twenty queens were categorized into two groups, according to signs, history, and ultrasound findings, as pyometra and control healthy queens. Doppler ultrasonography, total antioxidant capacity (TAC), malondialdehyde (MDA), albumin, bacteriological isolation, histopathology, and immunohistochemistry of tumor necrosis factor-alpha (TNF-α) and nuclear factor kappa B (NF-κB) P65 were performed. Uterine diameter and thickness increased significantly in the pyometra group compared to control. Uterine peak velocity and flow rate were significantly higher in the control group. The pyometra group showed a significant decrease in albumin, TAC, and a significant increase in MDA. Fibrosis and mononuclear inflammatory cell infiltration were seen in the pyometra samples. The mean area percentage of TNF-α expression in the uteri of the pyometra group was higher. The expression of NF-κB P65 in the uteri in the pyometra group was significantly higher. Doppler ultrasonography can provide valuable information for diagnosing pyometra in queens by elevating the uterine thickness with reducing blood flow rate. Oxidative stress, TNF-α, and NF-κB expression alterations varied between pyometra and control groups.
Assuntos
Piometra , Humanos , Feminino , Gatos , Animais , Piometra/veterinária , Piometra/diagnóstico , Fator de Necrose Tumoral alfa/metabolismo , NF-kappa B/metabolismo , Estresse Oxidativo , Antioxidantes/metabolismo , Albuminas/metabolismoRESUMO
OBJECTIVE: To describe a standing hand-assisted laparoscopic ovariohysterectomy in a mare. ANIMAL: A 15-year-old maiden Oldenburg mare. CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES: The mare was presented for evaluation of bucking under saddle and uncharacteristic aggressive behavior. Evaluation of a 24-hour video of the mare in a stall showed behavior consistent with caudal visceral abdominal discomfort. Reproductive evaluation revealed a pyometra secondary to complete transluminal cervical adhesions. The mare was initially managed medically with disruption of the adhesions and uterine lavage, but the adhesions reformed within 6 weeks and could not be manually disrupted. TREATMENT AND OUTCOME: To eliminate the recurrence of pyometra, the mare underwent standing hand-assisted laparoscopic ovariohysterectomy through bilateral flank incisions. The only complication was a seroma at 1 flank incision that resolved after drainage. CLINICAL RELEVANCE: Complete ovariohysterectomy in the mare is a challenging procedure and has previously been performed under general anesthesia. This is the first report of the procedure being performed completely in the standing mare without inversion of the uterus through the cervix.
Assuntos
Laparoscopia Assistida com a Mão , Doenças dos Cavalos , Piometra , Cavalos , Feminino , Animais , Piometra/cirurgia , Piometra/veterinária , Laparoscopia Assistida com a Mão/efeitos adversos , Laparoscopia Assistida com a Mão/veterinária , Histerectomia/veterinária , Histerectomia/métodos , Ovariectomia/veterinária , Ovariectomia/métodos , Reprodução , Doenças dos Cavalos/cirurgiaRESUMO
Cystic endometrial hyperplasia (CEH)-pyometra complex is the most common uterine infection in adult and elderly bitches and can cause renal dysfunction. The aim of this study was to measure and compare urinary creatinine, urea, symmetric dimethylarginine (SDMA), urinary protein-creatinine ratio (UPC), measurement of systolic blood pressure (SBP), and Doppler velocimetry of renal arteries in patients with CEH-pyometra complex before and after an average of 6 months of treatment, evaluating the possibility of the changes persisting. The evaluation was conducted at two moments: M1 (at the diagnosis of CEH-pyometra, n = 36) and M2 (after an average of six months of treatment, n = 16). For the control group, eight bitches with no changes in blood tests or history of conditions underwent Doppler ultrasound evaluation of the renal arteries. At both M1 and M2, we measured creatinine, urea, and serum SDMA, UPC, SBP, and Doppler ultrasound of the renal arteries. Patients were evaluated according to the following groups: azotemic (AZO) and non-azotemic (NAZO), and open and closed cervix pyometra. The parameters were compared between animals present in both moments presented as M1R (bitches that were in M1 and M2) and M2. Statistical significance was considered when p < .05. The medians found for creatinine in M1 were as follows: 1.15 mg/dL, being 1.8 mg/dL for AZO (12/36) and 0.95 mg/dL for NAZO (24/36); and in M2: 0.85 mg/dL (16/16), being 1.15 mg/dL for AZO (4/16) and 0.8 mg/dL for NAZO (12/36). For urea, in M1 it was 36 mg/dL (32/36), with AZO being 103 mg/dL (11/32) and 33 mg/dL in NAZO (21/32); and in M2 32 mg/dL (16/ 16), being 29 mg/dL for AZO (4/36), and 31 mg/dL for NAZO (3/15). The median SDMA measured in M1R was 17 µg/dL (15/16), with AZO being 31 µg/dL (3/15), and NAZO being 16.5 µg/dL (12/15); and in M2, SDMA was 12 µg/dL (16/16), with AZO being 12.5 µg/dL (4/16), and NAZO being 12 µg/dL (12/16). The median UPC measured in M1 was 1.15 (10/36), with AZO being 0.25 (1/10), and NAZO being 1.38 (9/10); and in M2, it was 0.2 (13/16), being 0.1 in AZO (4/13), and 0.2 (9/16) in NAZO. For SBP, in M1, it was 118 mmHg (30/36), with AZO being 102 mmHg (10/30) and 133 mmHg in NAZO (20/30); and in M2 142.5 mmHg (12/16), being 155 mmHg for AZO (4/12), and 140 mg/dL for NAZO (8/12). When comparing animals with open and closed cervixes, a difference was found between SDMA measurements (p = .001). There was a distinction between PI and RI of the left and right kidneys consecutively (p = .007; p = .033; p = .019; p = .041). Correlations found in M1: SDMA × PI RIM DIR (r = 0.873; p = .002), SDMA × PSV RIM ESQ (r = 0.840; p = .004), SDMA × EDV RIM ESQ (r = 0.675; p = .046). With this study, we conclude a return to normality of renal biomarkers and clinical parameters after six months. Yet, there is a persistence of Doppler velocimetric measurements between the two moments. Thus, this parameter is not suitable for identifying and classifying chronic kidney injury in bitches with pyometra.
Assuntos
Hiperplasia Endometrial , Piometra , Humanos , Animais , Feminino , Hiperplasia Endometrial/diagnóstico por imagem , Hiperplasia Endometrial/veterinária , Piometra/veterinária , Creatinina , Rim , Biomarcadores , Ureia , ReologiaRESUMO
RATIONALE: Uterine abscess is a rare gynecologic entity and only a few cases have been reported so far. This study aimed to describe our clinical experience in this case. Initially, hematoma was diagnosed without detail previous medical record. Finally, laparotomy was performed due to refractory fever and highly possible diagnosis of uterine abscess. We successfully performed a hysterectomy and the patient had an uneventful recovery. PATIENT CONCERNS: A 44-year-old nulliparous woman underwent myomectomy in the local hospital, 45 days ago. She complained of irregular fever (up to 40 °C) without abdominal pain since the surgery. DIAGNOSES: Due to lack of her detail medical record, equivocal images and her strong intention to preserve uterus, she was misdiagnosed with hematoma and treated with antibiotic treatment. Finally, intraoperative findings revealed that the huge myometrial abscess contained a mass of pus. INTERVENTIONS: Laparotomy was performed due to refractory high-grade fever and highly possible diagnosis of uterine abscess. Total hysterectomy was performed to avoid the possibility of life-threatening sepsis. OUTCOMES: The postoperative course was uneventful and the patient was discharged 10 days after surgery. LESSONS: Complete imaging examinations are recommended prior myomectomy to facilitate the differential diagnosis of postoperative complications. In addition, several measures, such as maintaining aseptic conditions during surgery and postoperative drainage, play a critical role in preventing nosocomial infections. Rare uterine abscess is often mistaken for hematoma with fever. If the patient develops high fever after myomectomy, accompanied by a mass in the myometrium, the possibility of infection or even abscess formation should not be excluded. For women who need to preserve their fertility, the early diagnosis and timely administration of appropriate medication is crucial for preventing uterine loss.
Assuntos
Abscesso Abdominal , Piometra , Miomectomia Uterina , Adulto , Feminino , Humanos , Abscesso Abdominal/diagnóstico , Hematoma , Piometra/diagnóstico , Miomectomia Uterina/efeitos adversosRESUMO
BACKGROUND: Infection by Dialister micraerophilus, an obligate anaerobic gram-negative bacillus, has rarely been described, and its clinical characteristics remain unclear. CASE PRESENTATION: We report a case of bacteremia caused by D. micraerophilus, Enterocloster clostridioformis, and Eggerthella lenta in a 47-year-old woman, associated with pyometra. D. micraerophilus was identified using 16S rRNA gene sequencing and matrix-assisted laser desorption ionization time-of-flight mass spectrometry. D. micraerophilus was detected by polymerase chain reaction using D. micraerophilus-specific primers and E. clostridioformis and E. lenta was isolated from the drainage pus sample obtained from the pyometra uterus. The patient achieved a cure after abscess drainage and 2-week antibiotic treatment. CONCLUSIONS: To the best of our knowledge, this is the first report of D. micraerophilus bacteremia. D. micraerophilus may be associated with gynecological infections. Clinicians should consider both oral and gynecological sites when searching to identify the focus of D. micraerophilus infection.
Assuntos
Actinobacteria , Bacteriemia , Clostridiales , Piometra , Veillonellaceae , Feminino , Humanos , Pessoa de Meia-Idade , Piometra/complicações , Piometra/diagnóstico , RNA Ribossômico 16S/genética , Bacteroides , Clostridium , Bacteriemia/diagnóstico , Bacteriemia/tratamento farmacológicoRESUMO
To identify functional differences between vertebrate clathrin light chains (CLCa or CLCb), phenotypes of mice lacking genes encoding either isoform were characterised. Mice without CLCa displayed 50% neonatal mortality, reduced body weight, reduced fertility, and â¼40% of aged females developed uterine pyometra. Mice lacking CLCb displayed a less severe weight reduction phenotype compared with those lacking CLCa and had no survival or reproductive system defects. Analysis of female mice lacking CLCa that developed pyometra revealed ectopic expression of epithelial differentiation markers (FOXA2 and K14) and a reduced number of endometrial glands, indicating defects in the lumenal epithelium. Defects in lumen formation and polarity of epithelial cysts derived from uterine or gut cell lines were also observed when either CLCa or CLCb were depleted, with more severe effects from CLCa depletion. In cysts, the CLC isoforms had different distributions relative to each other, although they converge in tissue. Together, these findings suggest differential and cooperative roles for CLC isoforms in epithelial lumen formation, with a dominant function for CLCa.