Cystitis in a bitch with chronic kidney disease caused by multidrug-resistant Escherichia coli

Background: In dogs with bacterial cystitis that is resistant to multiple antibiotics, resulting from repeated infections andantimicrobial administration, especially if the dog has impaired renal function and the induction of systemic side effectsby intravenous or oral administration is a concern, intravesical instillation of antibiotics might represent an alternativetreatment option. In human and veterinary medicine, a number of studies showed intravesical instillation of antibiotics iseffective for the therapy multidrug-resistant bacterial urinary tract infection (UTI). This report firstly illustrates successfulintravesical meropenem treatment of a UTI caused by multidrug-resistant Escherichia coli with no systemic side effectsin dog with chronic kidney disease (CKD).Case: A 15-year-old spayed female Maltese was presented with recurrent bacterial cystitis. The risk factors for the recurrent UTI were spinal cord injury and CKD which had been managed for 1 year. Ultrasound-guided cystocentesis wasperformed to obtain a urine sample for urinalysis, bacteriologic culture, and antibiotic susceptibility testing. Bacterialcystitis caused by multidrug-resistant Escherichia coli was diagnosed on the basis of bacterial culture, and antimicrobialsusceptibility testing. Because the dog had CKD, reducing the clearance of meropenem, intravesical instillation of antibiotics was initiated. The intravesical instillation process consisted of the emptying of the urinary bladder, infusion of adiluted meropenem solution (8.5 mg/kg diluted in 20 mL of saline solution) into the bladder through a urethral catheter,and retention of the meropenem solution in the bladder for 1 h, and its removal. The procedure was repeated every 8 h. Onday 8 of the intravesical instillation therapy, bactereologic culture yielded a growth of E. coli (50,000 CFUs/mL), whichwas less than previously obtained. the concentration of the meropenem solution...

Cystitis in a bitch with chronic kidney disease caused by multidrug-resistant Escherichia coli

Background: In dogs with bacterial cystitis that is resistant to multiple antibiotics, resulting from repeated infections andantimicrobial administration, especially if the dog has impaired renal function and the induction of systemic side effectsby intravenous or oral administration is a concern, intravesical instillation of antibiotics might represent an alternativetreatment option. In human and veterinary medicine, a number of studies showed intravesical instillation of antibiotics iseffective for the therapy multidrug-resistant bacterial urinary tract infection (UTI). This report firstly illustrates successfulintravesical meropenem treatment of a UTI caused by multidrug-resistant Escherichia coli with no systemic side effectsin dog with chronic kidney disease (CKD).Case: A 15-year-old spayed female Maltese was presented with recurrent bacterial cystitis. The risk factors for the recurrent UTI were spinal cord injury and CKD which had been managed for 1 year. Ultrasound-guided cystocentesis wasperformed to obtain a urine sample for urinalysis, bacteriologic culture, and antibiotic susceptibility testing. Bacterialcystitis caused by multidrug-resistant Escherichia coli was diagnosed on the basis of bacterial culture, and antimicrobialsusceptibility testing. Because the dog had CKD, reducing the clearance of meropenem, intravesical instillation of antibiotics was initiated. The intravesical instillation process consisted of the emptying of the urinary bladder, infusion of adiluted meropenem solution (8.5 mg/kg diluted in 20 mL of saline solution) into the bladder through a urethral catheter,and retention of the meropenem solution in the bladder for 1 h, and its removal. The procedure was repeated every 8 h. Onday 8 of the intravesical instillation therapy, bactereologic culture yielded a growth of E. coli (50,000 CFUs/mL), whichwas less than previously obtained. the concentration of the meropenem solution...(AU)