Biofilm production of Pseudomonas spp. isolates from canine otitis in three different enrichment broths.

BACKGROUND: Pseudomonas spp. are commonly isolated from dogs with clinical otitis and have been shown to produce biofilm. There is a paucity of studies demonstrating biofilm growth in veterinary medicine. HYPOTHESIS/OBJECTIVES: To compare biofilm production of Pseudomonas spp. isolated from dogs with otitis using three different enrichment broths at two different time points. Speciation was performed. ANIMALS: One hundred isolates from 98 dogs with clinical otitis were assessed for biofilm production. METHODS AND MATERIALS: One hundred isolates were assessed for biofilm production using a microtitre plate assay. Biofilm production in Luria-Bertani Broth (LBB), Mueller-Hinton Broth (MHB) and Tryptic Soy Broth (TSB) were assessed after 18 and 24 h of incubation. RESULTS: At 18 h, biofilm production was demonstrated in 87% of LBB, 91% of TSB and 93% of MHB grown isolates. By 24 h, this was 92% of LBB, 96% of TSB and 99% of MHB isolates. Biofilm production was significantly increased after 24 h incubation compared to 18 h. A significant difference was noted in biofilm production between LBB and MHB (P = 0.0349), but not between LBB and TSB (P = 0.3727) or MHB and TSB (P = 0.3687) at 24 h incubation. Two isolates were speciated as P. fluorescens and 98 as P. aeruginosa. CONCLUSION AND CLINICAL IMPORTANCE: Not all enrichment broths were equivalent to one another and 24 h incubation was superior to 18 h. Biofilm production was high in this population of Pseudomonas spp. isolates.

Study to assess in vitro antimicrobial activity of nine ear cleaners against 50 Malassezia pachydermatis isolates.

BACKGROUND: Ear cleaning is an important part of the successful therapy of otitis externa. HYPOTHESIS/OBJECTIVES: To evaluate the in vitro activity of nine commercially available ear cleaners (Cerumaural(®), CleanAural Dog(®), Epi-Otic(®), MalAcetic Aural(®), Otoclean(®), Otodine(®), Sancerum(®), Surosolve(®) and TrizUltra™ + Keto) against 50 Malassezia pachydermatis isolates from clinical cases of canine otitis externa. To the authors' knowledge, this is the first study to analyse the in vitro susceptibility of a large number of M. pachydermatis isolates to a variety of ear cleaner products. ANIMALS: Forty-nine hospital population dogs diagnosed with otitis externa with Malassezia spp. present on cytological examination of ear swabs and culture. METHODS: The antimicrobial activity of nine ear cleaners was tested against 50 M. pachydermatis isolates from 49 clinical cases of canine otitis externa using an in vitro agar diffusion test. RESULTS: There were statistically significant differences in activity between ear cleaners, with five showing excellent in vitro anti-Malassezia activity (CleanAural Dog(®), Epi-Otic(®), MalAcetic Aural(®), Sancerum(®) and TrizUltra™ + Keto), two moderate activity (Otodine(®) and Surosolve(®)), one variable activity (Otoclean(®)) and one no activity (Cerumaural(®)). There was a significant overall difference in susceptibility between M. pachydermatis isolates tested (P < 0.001). CONCLUSIONS AND CLINICAL IMPORTANCE: Ear cleaners with activity against Malassezia may help to reduce the unnecessary use of antibiotic-containing polypharmaceutical ear medications. This study shows that the use of a large number of isolates may provide a more accurate account of the in vitro activity of a product.

Temporal, Spatial, and Genomic Analyses of Enterobacteriaceae Clinical Antimicrobial Resistance in Companion Animals Reveals Phenotypes and Genotypes of One Health Concern.

BACKGROUND: Antimicrobial resistance (AMR) is a globally important one health threat. The impact of resistant infections on companion animals, and the potential public health implications of such infections, has not been widely explored, largely due to an absence of structured population-level data. OBJECTIVES: We aimed to efficiently capture and repurpose antimicrobial susceptibility test (AST) results data from several veterinary diagnostic laboratories (VDLs) across the United Kingdom to facilitate national companion animal clinical AMR surveillance. We also sought to harness and genotypically characterize isolates of potential AMR importance from these laboratories. METHODS: We summarized AST results for 29,330 canine and 8,279 feline Enterobacteriaceae isolates originating from companion animal clinical practice, performed between April 2016 and July 2018 from four VDLs, with submissions from 2,237 United Kingdom veterinary practice sites. RESULTS: Escherichia coli (E. coli) was the most commonly isolated Enterobacteriaceae in dogs (69.4% of AST results, 95% confidence interval, CI, 68.7-70.0) and cats (90.5%, CI 89.8-91.3). Multi-drug resistance was reported in 14.1% (CI 13.5-14.8) of canine and 12.0% (CI 11.1-12.9) of feline E. coli isolates. Referral practices were associated with increased E. coli 3rd generation ≤ cephalosporin resistance odds (dogs: odds ratio 2.0, CI 1.2-3.4). We selected 95 E. coli isolates for whole genome analyses, of which seven belonged to sequence type 131, also carrying the plasmid-associated extended spectrum ß-lactamase gene bla CTX-M- 15. The plasmid-mediated colistin resistance gene mcr-9 was also identified for the first time in companion animals. CONCLUSIONS: Linking clinical AMR data with genotypic characterization represents an efficient means of identifying important resistance trends in companion animals on a national scale.

Anesthetic considerations in intracranial aneurysm surgery.

Rupture of an intracranial aneurysm generally has a poor outcome, though perioperative treatments have improved. At the present time, the important factors in the management of intracranial aneurysm surgery appear to be the maintenance of adequate cerebral perfusion pressure and the avoidance of hyperglycemia. Relevant features of the anesthetic management of this surgery are discussed.

Impact of a Didactic Lecture on Professionalism in Increasing Knowledge Amongst Faculty and Residents in an Academic Department.

BACKGROUND: The ACGME require compliance with six core competencies - professionalism is one of them. Non-professional behavior is the most common reason for disciplinary action against physicians by the Medical Boards. Professionalism should be taught and measured at an early stage of the physician's career. METHODS: IRB approval was obtained to carry out this study. The subjects were faculty and residents of the anesthesia department. The pretest was administered and followed by a lecture and discussion on professionalism by Anesthesia faculty. This was followed by the posttest. The test consisted of 22 questions related to professionalism. RESULTS: Eighteen subjects completed the pretest while 14 completed the posttest. Age range was 39.72 +/- 10.58. The pretest scores were 59.6+/- 12.5, while the posttest scores were 57.8 +/- 12.8. Correct answers for each question ranged from 5.6 to 100% for the pretest and 0 to 100% for the post test. Correct answers for each subject ranged from 31.8 to 77.3% for both pre and post tests. No statistically significant difference was found in scores between the pre-test and post-test. CONCLUSIONS: Based on these initial findings, teaching professionalism is extremely difficult and feed back from the participants using tools like a pretest and post-test may help identify if knowledge transfer has actually occurred. Teaching and assessment of professionalism should take into consideration the students pre-existing knowledge-base, cultural background and environment.