Planktonic and biofilm states of Staphylococcus aureus isolated from bone and joint infections and the in vitro effect of orally available antibiotics.

AIMS: To demonstrate the in vitro activity of orally available antibiotics against Staphylococcus aureus isolated from bone or orthopedic implant materials. The biofilm eradication of the combination of three antibiotics was also assessed. METHODS AND RESULTS: Clinical isolates from orthopedic infection samples were collected, and S. aureus isolates were classified according to their biofilm production and composition. Almost all S. aureus isolates (n = 36, 97.3%) produced biofilm and the major biofilm components were polysaccharides. Antimicrobial susceptibility was determined in planktonic (minimal inhibitory concentration; MIC) and biofilm cells (minimal biofilm eradication concentration; MBEC) using the MBEC Calgary Device. Overall, the MBEC ranged higher than the MIC. When combined at borderline-susceptible concentrations, moxifloxacin-rifampin and doxycycline-rifampin were both able to eradicate biofilms in a third of the strains whereas the doxycycline-moxifloxacin combination proved ineffective at eradicating biofilm, inhibiting it only in three strains. CONCLUSIONS: We propose rifampin in combination with moxifloxacin or doxycycline for the design of clinical trials of bone and/or orthopedic device infection without proper debridement or material retention.

Effects of Tocilizumab in COVID-19 patients: a cohort study.

BACKGROUND: Due to the lack of proven therapies, we evaluated the effects of early administration of tocilizumab for COVID-19. By inhibition of the IL-6 receptor, tocilizumab may help to mitigate the hyperinflammatory response associated with progressive respiratory failure from SARS-CoV-2. METHODS: A retrospective, observational study was conducted on hospitalized adults who received intravenous tocilizumab for COVID-19 between March 23, 2020 and April 10, 2020. RESULTS: Most patients were male (66.7%), Hispanic (63.3%) or Black (23.3%), with a median age of 54 years. Tocilizumab was administered at a median of 8 days (range 1-21) after initial symptoms and 2 days (range 0-12) after hospital admission. Within 30 days from receiving tocilizumab, 36 patients (60.0%) demonstrated clinical improvement, 9 (15.0%) died, 33 (55.0%) were discharged alive, and 18 (30.0%) remained hospitalized. Successful extubation occurred in 13 out of 29 patients (44.8%). Infectious complications occurred in 16 patients (26.7%) at a median of 10.5 days. After tocilizumab was administered, there was a slight increase in PaO2/FiO2 and an initial reduction in CRP, but this effect was not sustained beyond day 10. CONCLUSIONS: Majority of patients demonstrated clinical improvement and were successfully discharged alive from the hospital after receiving tocilizumab. We observed a rebound effect with CRP, which may suggest the need for higher or subsequent doses to adequately manage cytokine storm. Based on our findings, we believe that tocilizumab may have a role in the early treatment of COVID-19, however larger randomized controlled studies are needed to confirm this.

Prevalence, concordance and reproductive sequelae after Chlamydia trachomatis infection in Mexican infertile couples.

There are few concordance studies on the Chlamydia trachomatis (infection among infertile couples. The objective of this research was to know the prevalence, concordance and reproductive sequelae that couples may develop when both partners show a C. trachomatis infection. A cross-sectional study among 688 infertile couples using the C. trachomatis detection by real-time PCR was performed. The infertility causes were obtained from their medical records. The prevalence of infection was 8.68%. The percentage of concordance was 22.4% (13 couples). A presence of tubal occlusion was only associated with infected-discordant women [RR = 3.46, 95% CI (1.54-7.74), p < .003]. Seminal values were not associated with discordant men. The concordant couples showed association with the infection and tubal occlusion [RR = 3.19, 95% CI (1.09-9.34), p < .05], and oligozoospermia [RR = 12.17, 95% CI (4.29-34.54), p < .001], hypospermia [RR = 14.13, 95% CI (4.78-41.84), p < .001]. An alteration in semen quality was shown particularly in men whose sexual partners show a tubal pathology. This could occur due to a C. trachomatis infection in the testis, which underlines the need to carry out effective and efficient strategies to identify and treat all sexual partners exposed to C. trachomatis.

Study of the Coordination Modes of Hybrid NNCp Cyclopentadienyl/Scorpionate Ligands in Ir Compounds.

A new coordination mode for the hybrid scorpionate/cyclopentadienyl ligand bpzcp, [bpzcp = 2,2-bis(3,5-dimethylpyrazol-1-yl)-1,1-diphenylethylcyclopentadienyl] is observed in iridium complexes. The reaction of the lithium precursor, [Li(bpzcp)(THF)], with a range of [IrCl(diene)]2 compounds leads to an unprecedented binding mode of the hybrid scorpionate/cyclopentadienyl ligand as η5-Cp-coordinated and the formation of Ir(I) derivatives [Ir(η5-Cp-bpzcp)(η4-cod)] (1), [Ir(η5-Cp-bpzcp){η4-CH2═C(Me)C(Me)═CH2}] (2), [Ir(η5-Cp-bpzcp)(η2-coe)2] (3), and [Ir(η5-Cp-bpzcp)(η2-CH2═CH2)2] (4). The Ir(I) complex 4 reacts with CO or bromine to afford the compound [Ir(η5-Cp-bpzcp)(CO)2] (5) and the 18e- Ir(III) complex [Ir(κ-N-η5-Cp-bpzcpBr2)Br2] (6), respectively. Reaction of the iridium compounds (2-4) with CuI or [PdCl2(CH3CN)2] yields the heterobimetallic iridium-copper or iridium-palladium complexes [Ir(η5-Cp-bpzcp){η4-CH2═C(Me)C(Me)═CH2}(µ-bpzcp){CuI(κ2-NN-bpzcp)}] (7), [Ir(η5-Cp-bpzcp)(η2-coe)2}(µ-bpzcp){CuI(κ2-NN-bpzcp)}] (8), [Ir(η5-Cp-bpzcp)(η2-CH2═CH2)2}(µ-bpzcp){CuI(κ2-NN-bpzcp)}] (9), [Ir(η5-Cp-bpzcp)(coe)2}(µ-bpzcp){PdCl2(κ2-NN-bpzcp)}] (10), and [Ir(η5-Cp-bpzcp)(η2-CH2═CH2)2(µ-bpzcp){PdCl2(κ2-NN-bpzcp)}] (11). All products were characterized by spectroscopic methods and the X-ray crystal structures of 1, 2, 3, 4, and 6 were also established.

Eosinophilia in Preterm Born Infants Infected with Chlamydia trachomatis.

A higher than 350 eosinophils/mm(3) is strongly associated with Chlamydia trachomatis in term born babies coursing with respiratory distress. However, in preterm newborns infected with this pathogen, the levels of eosinophils are unknown. Forty newborn infants with clinical data of respiratory problems and/or sepsis were analyzed. DNA of leukocytes from peripheral blood was used to identify C. trachomatis. Detection of chlamydial infection was performed by amplifying the ompA gene by an in-house PCR, and eosinophil levels were evaluated in an XT-2000-hematology analyzer. Eighteen infants showed chlamydial infection and 14 of them showed pneumonia (RR = 2.6; CI95% 1.03-6.5; p =.027). Their eosinophil levels were 719 ± 614 cells/mm(3). A significant association between eosinophilia ≥1250 cells/mm(3) and gestational age of less than 29 weeks (RR = 5.8; 1.35; CI95% [1.4-24.5], p <.008) was observed. The preterm infants with chlamydial infection did not show higher eosinophil levels than uninfected infants.

Ruthenium(II) Complexes Containing Lutidine-Derived Pincer CNC Ligands: Synthesis, Structure, and Catalytic Hydrogenation of C-N bonds.

A series of Ru complexes containing lutidine-derived pincer CNC ligands have been prepared by transmetalation with the corresponding silver-carbene derivatives. Characterization of these derivatives shows both mer and fac coordination of the CNC ligands depending on the wingtips of the N-heterocyclic carbene fragments. In the presence of tBuOK, the Ru-CNC complexes are active in the hydrogenation of a series of imines. In addition, these complexes catalyze the reversible hydrogenation of phenantridine. Detailed NMR spectroscopic studies have shown the capability of the CNC ligand to be deprotonated and get involved in ligand-assisted activation of dihydrogen. More interestingly, upon deprotonation, the Ru-CNC complex 5 e(BF4 ) is able to add aldimines to the metal-ligand framework to yield an amido complex. Finally, investigation of the mechanism of the hydrogenation of imines has been carried out by means of DFT calculations. The calculated mechanism involves outer-sphere stepwise hydrogen transfer to the C-N bond assisted either by the pincer ligand or a second coordinated H2 molecule.

[Chlamydia trachomaatis DNA in leukocytes of peripheral blood from neonates]. / ADN de Chlamydia trachomatis en leucocitos de sangre periférica de neonatos.

INTRODUCTION: Diagnosis of Chlamydia trachomatis infection in newborns is difficult; however, this diagnosis is performed by cell culture or by detection of IgM antibodies against C. trachomatis. Detection of C. trachomatis DNA in peripheral blood leukocytes using polymer chain reaction (PCR) may be a better tool for the diagnosis of infection by this pathogen. MATERIAL AND METHODS: A total of 44 premature newborns, all weighing less than 2500g, were included in the study. A blood sample and nasopharyngeal lavages were obtained from each newborn. Leukocyte DNA was obtained by phenol-chloroform extraction technique. Detection of C. trachomatis was performed by amplifying the ompA gene using the PCR endpoint. Cell culture tests and the detection of IgM antibodies against C. trachomatis by microimmunofluorescence assay were also performed. RESULTS: Twenty newborns were PCR-positive (45.5%), with this test being significantly associated with the presence of pneumonia (RR=2.28; 95%CI: 1.01 to 5.17; P=.035). The cell culture of nasopharyngeal lavage was positive in only 7 samples and no significant association was observed with any clinical or laboratory data. The titer of IgM antibodies against C. trachomatis associated with PCR-positive was 1:32 (RR=2.74; 95%CI: 1.21 to 6.23; P=.008), however this titer was not associated with the presence of pneumonia. CONCLUSION: DNA detection in peripheral blood leukocytes could be useful for diagnosis of C. trachomatis infection.

Biofilm Eradication and Inhibition of Methicillin-resistant Staphylococcus Clinical Isolates by Curcumin-Chitosan Magnetic Nanoparticles.

Biofilm-producing methicillin-resistant Staphylococcus aureus (MRSA) and coagulase-negative Staphylococci (MR-CoNS) are a clinical challenge for the treatment of healthcare-associated infections. As alternative antimicrobial options are needed, we aimed to determine the effect of curcumin-chitosan magnetic nanoparticles on the biofilm of staphylococcal clinical isolates. MRSA and CoNS clinical isolates were identified by MALDI-TOF mass spectrometry. Antimicrobial susceptibility testing was performed by broth microdilution. Nanoparticles were synthesized by co-precipitation of magnetic nanoparticles (MNP) and encapsulation by ionotropic gelation of curcumin (Cur) and chitosan (Chi). Biofilm inhibition and eradication by nanoparticles with and without the addition of oxacillin was assessed on staphylococcal strains. Cur-Chi-MNP showed antimicrobial activity on planktonic cells of MRSA and MR-CoNS strains and inhibited biofilm of MRSA. The addition of OXA to Cur-Chi-MNP increased biofilm inhibition and eradication activity against all Staphylococci strains (p=0.0007); higher biofilm activity was observed in early biofilm stages. Cur-Chi-MNP showed antimicrobial and biofilm inhibition activity against S. aureus. The addition of OXA increased biofilm inhibition and eradication activity against all Staphylococci strains. A combination treatment of Cur-Chi-MNP and OXA could be potentially used to treat staphylococcal biofilm-associated infections in its early stages before the establishment of biofilm bacterial cells.

Reactivity studies of iridium pyridylidenes [Tp(Me2)Ir(C(6)H(5))(2)(C(CH)(3)C(R)NH] (R=H, Me, Ph).

The reactivity of a series of iridiumpyridylidene complexes with the formula [Tp(Me2) Ir(C6 H5 )2 (C(CH)3 C(R)NH] (1 a-1 c) towards a variety of substrates, from small molecules, such as H2 , O2 , carbon oxides, and formaldehyde, to alkenes and alkynes, is described. Most of the observed reactivity is best explained by invoking 16 e(-) unsaturated [Tp(Me2) Ir(phenyl)(pyridyl)] intermediates, which behave as internal frustrated Lewis pairs (FLPs). H2 is heterolytically split to give hydridepyridylidene complexes, whilst CO, CO2 , and H2 CO provide carbonyl, carbonate, and alkoxide species, respectively. Ethylene and propene form five-membered metallacycles with an IrCH2 CH(R)N (R=H, Me) motif, whereas, in contrast, acetylene affords four-membered iridacycles with the IrC(CH2 )N moiety. C6 H5 (CO)H and C6 H5 CCH react with formation of IrC6 H5 and IrCCPh bonds and the concomitant elimination of a molecule of pyridine and benzene, respectively. Finally the reactivity of compounds 1 a-1 c against O2 is described. Density functional theory calculations that provide theoretical support for these experimental observations are also reported.

[Persistence of Chlamydia trachomatis in endometrium and peritoneal fluid of infertile patients with negative cervical culture]. / Persistencia de Chlamydia trachomatis en el endometrio y líquido peritoneal de pacientes con infertilidad pero cultivo cervical negativo.

BACKGROUND: Chlamydia trachomatis infection is considered a public health problem due to its high prevalence, and because is asymptomatic in 70% of women and provokes reproductive sequelae when it is not detected and treated timely. OBJECTIVE: To search for C. trachomatis in endometrium and peritoneal fluid of infertile women without detection of this pathogen in cervical secretions. PATIENTS AND METHOD: A retrospective and cross-sectional study was done in 38 patients with infertility only 18 showed peritoneal fluid infection and/or endometrial infection, eight of them were negative for the amplificated product of 129-bp from CT ompA gene in cervical secretions. Laparoscopic data showed that five of them had pelvic inflammatory disease. CONCLUSION: The non-detection of Chlamydia trachomatis in endocervix does not reflect what happens in the upper genital tract, that's why we need to do a deliberate search of infection by this pathogen in endometrium of suspected women with infertility.

Rapid methicillin resistance detection and subspecies discrimination in Staphylococcus hominis clinical isolates by MALDI-TOF MS.

PURPOSE: Staphylococcus hominis is a coagulase-negative opportunistic pathogen responsible for implanted medical device infections. Rapid identification and virulence factors detection are crucial for appropriate antimicrobial therapy. We aimed to search protein biomarker peaks for rapid classification of antibiotic resistance and subspecies of S. hominis using MALDI-TOF MS. METHODS: S. hominis clinical isolates (n = 148) were screened for subspecies differentiation by novobiocin resistance. Biofilm composition and formation were determined by detachment assay and crystal violet staining, respectively. Antibiotic susceptibility was performed by the broth microdilution method. The search for potential biomarkers peaks was enabled by ClinProTools 3.0, flexAnalysis 3.4, and Biotools 3.2 for statistical analysis, peak visualization, and protein/peptide alignment, respectively. RESULTS: Of 148 isolates, 12.16% were classified as S. hominis subsp. novobiosepticus, 77.77% were biofilm producers, and ˃ 50% were multidrug-resistant. Two potential biomarker peaks, 8975 m/z and 9035 m/z were detected for the discrimination of methicillin resistance with a sensitivity of 96.72%. The following peaks were detected for subspecies differentiation: 2582 m/z, 2823 m/z, and 2619 m/z with 88.89-98.28% of sensitivity. CONCLUSIONS: We found potential biomarker peaks to predict methicillin resistance and discriminate S. hominis subspecies during routine MALDI-TOF MS identification in a clinical setting to enable better antibiotic treatment.

Identification of Chlamydia trachomatis genotypes in newborns with respiratory distress.

INTRODUCTION: One hundred thirty million Chlamydia trachomatis infections are reported worldwide each year. Nineteen serotypes of this pathogen can cause infection in pregnant women and neonates. The distribution of these genotypes in newborns with respiratory infections in Mexico is unknown. MATERIAL AND METHODS: We tested 1062 bronchial lavage samples from neonates with respiratory distress syndrome for Chlamydia infection. The diagnosis of Chlamydia was made by plasmid detection with an in-house PCR assay, and genotypes were identified using a PCR-RFLP assay for the ompA gene. RESULTS: The genotyping of 40 strains identified 14 as I/Ia (35%), 13 as E (32.5%), 7 as D (17.5%), 5 as F (12.5%), and 1 as L2 (2.5%). The relative risk analysis showed that genotype D was associated with neonatal sepsis (RR, 5.83; 95% confidence interval [CI], 1.51-25.985; P < .02), while the I/Ia genotype was significantly associated with chorioamnionitis in the mother (2.8; 95% CI, 1.4-5.5; P < .05). CONCLUSIONS: Although C. trachomatis genotypes I/Ia and E of were the strains involved most frequently in respiratory infections in Mexican neonates, 80% of patients with genotype F developed respiratory disease. In contrast, genotype D was associated with neonatal sepsis, and genotype I/Ia with chorioamnionitis.

Amperometric biosensor for oxalate determination in urine using sequential injection analysis.

An amperometric flow biosensor for oxalate determination in urine samples after enzymatic reaction with oxalate oxidase immobilized on a modified magnetic solid is described. The solid was magnetically retained on the electrode surface of an electrode modified with Fe (III)-tris-(2-thiopyridone) borate placed into a sequential injection system preceding the amperometric detector. The variables involved in the system such as flow rate, aspired volumes (modified magnetic suspension and sample) and reaction coil length were evaluated using a Taguchi parameter design. Under optimal conditions, the calibration curve of oxalate was linear between 3.0-50.0 mg·L⁻¹, with a limit of detection of 1.0 mg·L⁻¹. The repeatability for a 30.0 mg·L⁻¹ oxalate solution was 0.7%. The method was validated by comparing the obtained results to those provided by the spectrophotometric method; no significant differences were observed.

Improvement of antimicrobial susceptibility testing in biofilm-growingcoagulase-negative Staphylococcus hominis.

Coagulase-negative Staphylococcus hominis causes bloodstream infections and often can form biofilms on medical devices. This study aimed to improve the current methodology for antimicrobial susceptibility testing (AST) in biofilm-growing S. hominis isolates. Biofilm production of S. hominis was assessed using the crystal violet staining method in trypticase soy broth supplemented with 1% glucose (TSBglu1%), Mueller-Hinton broth (MHB), or MHBglu1% using flat-bottom plates or the Calgary device. Susceptibility to antibiotics was assessed using the broth microdilution method (MHB and TSBglu1%) in planktonic cells (round-bottom plates) and biofilm cells (flat-bottom plates and the Calgary device). Biofilm determination using TSBglu1% yielded better performance over MHB, and flat-bottom plates without agitation were preferred over the Calgary device. Higher fold dilution values between the minimum biofilm eradication concentration (MBEC) and the minimum inhibitory concentration (MIC) were obtained in MHB for almost all antibiotics, except for linezolid. TSBglu1% and flat-bottom polystyrene plates were preferred over MHB and the Calgary device for biofilm determination. AST in biofilm-growing S. hominis showed better performance using TSBglu1% compared to MHB. Therefore, when comparing MBEC and MIC values, AST in planktonic cells could also be performed using TSBglu1% instead of MHB.

Clinical pharmacist input on HIV management may improve antiretroviral prescribing for psychiatric patients.

PURPOSE: The results of a study to determine the difference in HIV management with clinical pharmacist input in an adult psychiatric hospitalized patient population are reported. METHODS: Single-center, retrospective study of patients admitted to a psychiatric hospital on antiretroviral (ARV) medication(s) from October 2016 to March 2017 (phase I: no pharmacist involvement), October 2017 to March 2018 (phase II: partial pharmacist involvement), and November 2018 to January 2019 (phase III: consistent pharmacist involvement). Patients were excluded if less than 18 years of age, pregnant, incarcerated, or taking ARV medication(s) for non-HIV indications. The primary outcome was difference in appropriateness of ARV therapy prior to and during pharmacist involvement. Secondary outcomes were appropriateness of opportunistic infection (OI) prophylaxis, laboratory testing, and comprehensive HIV management. RESULTS: Thirty-seven patients were included per phase. An increased number of appropriate ARV regimens were initiated in phase II compared to phase I (62% vs 32%; P = 0.01) and in phase III compared to phase II (84% vs 62%; P = 0.036). Increased laboratory monitoring was seen with partial and consistent pharmacist involvement. Among the patients requiring OI prophylaxis, appropriate prophylaxis was initiated in more patients in phase III (57%) than in phase II (50%) or phase I (11%). More patients had comprehensive HIV management in phase II compared to phase I (38% vs 5%; P < 0.001) and in phase III compared to phase II (46% vs 38%; P = 0.48). CONCLUSION: Pharmacist involvement in HIV management in a psychiatric patient population increased appropriateness of ARV therapy, laboratory testing, and OI prophylaxis.

Development and Implementation of a COVID-19 Disease Response Protocol at a Large Academic Medical Center.

In response to the rapid spread of novel coronavirus disease 2019 (COVID-19), health-care systems should establish procedures for early recognition and management of suspected or confirmed cases. We describe the various steps taken for the development, implementation, and dissemination of the interdisciplinary COVID-19 protocol at Jackson Health System (JHS), a complex tertiary academic health system in Miami, Florida. Recognizing the dynamic nature of COVID-19, the protocol addresses the potential investigational treatment options and considerations for special populations. The protocol also includes infection prevention and control measures and routine care for suspected or proven COVID-19 patients.

Synthetic, mechanistic, and theoretical studies on the generation of iridium hydride alkylidene and iridium hydride alkene isomers.

Experimental and theoretical studies on equilibria between iridium hydride alkylidene structures, [(Tp(Me2))Ir(H){=C(CH(2)R)ArO}] (Tp(Me2) = hydrotris(3,5-dimethylpyrazolyl)borate; R = H, Me; Ar = substituted C(6)H(4) group), and their corresponding hydride olefin isomers, [(Tp(Me2))Ir(H){R(H)C=C(H)OAr}], have been carried out. Compounds of these types are obtained either by reaction of the unsaturated fragment [(Tp(Me2))Ir(C(6)H(5))(2)] with o-C(6)H(4)(OH)CH(2)R, or with the substituted anisoles 2,6-Me(2)C(6)H(3)OMe, 2,4,6-Me(3)C(6)H(2)OMe, and 4-Br-2,6-Me(2)C(6)H(2)OMe. The reactions with the substituted anisoles require not only multiple C-H bond activation but also cleavage of the Me-OAr bond and the reversible formation of a C-C bond (as revealed by (13)C labeling studies). Equilibria between the two tautomeric structures of these complexes were achieved by prolonged heating at temperatures between 100 and 140 degrees C, with interconversion of isomeric complexes requiring inversion of the metal configuration, as well as the expected migratory insertion and hydrogen-elimination reactions. This proposal is supported by a detailed computational exploration of the mechanism at the quantum mechanics (QM) level in the real system. For all compounds investigated, the equilibria favor the alkylidene structure over the olefinic isomer by a factor of between approximately 1 and 25. Calculations demonstrate that the main reason for this preference is the strong Ir-carbene interactions in the carbene isomers, rather than steric destabilization of the olefinic tautomers.

Pharmacokinetics of single-dose oral pregabalin administration in normal dogs.

OBJECTIVE: To describe the pharmacokinetics of pregabalin in normal dogs after a single oral dose. STUDY DESIGN: Prospective experiment. ANIMALS: Six adult Labrador/Greyhound dogs (four females and two males) aged 2.6 (2.6-5.6) years old (median and range) weighing 33.4 (26.8-42.1) kg. METHODS: After jugular vein catheterization, the dogs received a single oral dose of pregabalin ( approximately 4 mg kg(-1)). Blood samples were collected at: 0 (before drug administration), 15 and 30 minutes and at 1, 1.5, 2, 3, 4, 6, 8, 12, 24 and 36 hours after drug administration. Plasma pregabalin concentration was measured by HPLC. Noncompartmental analysis was used to estimate pharmacokinetic variables. RESULTS: No adverse effects were observed. The median (range) pharmacokinetic parameters were: Area under the curve from time 0 to 36 hours = 81.8 (56.5-92.1) microg hour mL(-1); absorption half-life = 0.38 (0.25-1.11) hours; elimination half-life = 6.90 (6.21-7.40) hours; time over 2.8 microg mL(-1) (the presumed minimal effective concentration) = 11.11 (6.97-14.47) hours; maximal plasma concentration (C(max)) = 7.15 (4.6-7.9) microg mL(-1); time for C(max) to occur = 1.5 (1.0-4.0) hours. Assuming an 8-hour dosing interval, predicted minimal, average, and maximal steady state plasma concentrations were 6.5 (4.8-8.1), 8.8 (7.3-10.9), and 13.0 (8.8-15.2) microg mL(-1). The corresponding values assuming a 12-hour interval were 3.8 (2.4-4.8), 6.8 (4.9-7.9), and 10.1 (6.6-11.6) microg mL(-1). CONCLUSIONS AND CLINICAL RELEVANCE: Pregabalin 4 mg kg(-1) PO produces plasma concentrations within the extrapolated therapeutic range from humans for sufficient time to suggest that a twice daily dosing regime would be adequate. Further study of the drug's safety and efficacy for the treatment of neuropathic pain and seizures in dogs is warranted.

Incidence of surgical site infection in dogs undergoing soft tissue surgery: risk factors and economic impact.

OBJECTIVES: To determine (1) the incidence of surgical site infection (SSI) in patients undergoing soft tissue surgery at a veterinary teaching hospital and to study (2) and describe the main risk factors associated with SSI and (3) assess the economic impact of SSI. DESIGN: Prospective cohort study. SETTING: Veterinary teaching hospital. PARTICIPANTS: 184 dogs undergoing soft tissue surgery during a 12-month period (October 2013 to September 2014). PRIMARY OUTCOME MEASURE: Surgical site infection. RESULTS: Out of the 184 patients analysed, SSI was diagnosed in 16 (8.7 per cent) patients, 13 (81.3 per cent) were classified as superficial incisional infection, 2 (12.5 per cent) as deep incisional infection and 1 (6.3 per cent) as organ/space infection. The administration of steroidal anti-inflammatory drugs (P=0.028), preoperative hyperglycaemia (P=0.015), surgical times longer than 60 minutes (P=0.013), urinary catheterisation (P=0.037) and wrong use of the Elizabethan collar (P=0.025) were identified as risk factors. Total costs increased 74.4 per cent, with an increase in postsurgical costs of 142.2 per cent. CONCLUSIONS: The incidence of SSI was higher than the incidence reported in other published studies, although they were within expected ranges when a surveillance system was implemented. This incidence correlated with an increase in costs. Additionally new important risk factors for its development were detected.