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Objective—To evaluate the efficacy of various endotracheal tube disinfection strategies for elimination of Streptococcus zooepidemicus and Bordetella bronchiseptica.
Design—Experimental in vitro study.
Sample—12 sterile endotracheal tubes.
Procedures—Endotracheal tubes were inoculated with S zooepidemicus or B bronchiseptica and subjected to 1 of 5 treatments (spraying with accelerated hydrogen peroxide solution [AHP] or soaking in one of the following: AHP, 0.5% chlorhexidine gluconate solution [CHG], 0.3% triclosan-containing soap solution, or tap water) or left untreated (controls). After 5 minutes, tubes were rinsed with water and swabbed for direct and enrichment culture. Culture results were scored semiquantitatively. Each isolate was tested separately (10 endotracheal tubes/isolate/treatment).
Results—No growth was identified by direct culture of any samples collected from CHG-treated endotracheal tubes, whereas S zooepidemicus and B bronchiseptica were each identified from 1 of 10 tubes sprayed or soaked with AHP and from all tubes (10/10 each) treated by other methods or used as controls. The CHG and AHP treatments resulted in significantly lower median growth scores after direct culture than did other treatments. After enrichment culture, samples from CHG-treated tubes had significantly lower growth scores than samples from AHP-treated tubes, which had significantly lower scores than samples from other treatment groups.
Conclusions and Clinical Relevance—High-level disinfection (ie, elimination of all vegetative bacterial growth) was not achieved with any treatment tested. Although optimal approaches are not known, processing of endotracheal tubes with CHG or AHP appears to be the best approach when sterilization is not feasible.
Objective—To evaluate contents of commercial probiotic products marketed for veterinary or human administration.
Design—Microbiologic culture assay.
Sample Population—8 veterinary probiotics and 5 human probiotics.
Procedure—Quantitative bacteriologic culture was performed on all products, and isolates were identified via biochemical characteristics. Comparison of actual contents versus label claims was performed.
Results—Label descriptions of organisms and concentrations accurately described the actual contents of only 2 of 13 products. Five veterinary products did not specifically list their contents. Most products contained low concentrations of viable organisms. Five products did not contain 1 or more of the stated organisms, and 3 products contained additional species. Some products contained organisms with no reported probiotic effects; some of these organisms could be pathogens.
Conclusions and Clinical Relevance—Most commercial veterinary probiotic preparations are not accurately represented by label claims. Quality control appears to be poor for commercial veterinary probiotics. (J Am Vet Med Assoc 2002;220:794–797)
Objective—To evaluate patterns of antimicrobial use and the impact of antimicrobial use guidelines at a small animal veterinary teaching hospital.
Sample Population—All antimicrobial prescriptions for dogs and cats admitted to the hospital in 1995 through 2004.
Procedure—Pharmacy records were reviewed, and antimicrobial prescriptions for all dogs and cats admitted during the study period were recorded. Amounts of individual drugs dispensed directly to the intensive care and surgical units were determined. Changes in antimicrobial use during the study period were assessed; changes in antimicrobial use patterns in 2000 through 2004 were evaluated to assess the impact of implementation of antimicrobial use guidelines in 2001.
Results—There was a significant decrease in prescriptions/1,000 admissions during the study period. From 1995 to 2004, the use of first-generation cephalosporins, fluoroquinolones, penicillins, and trimethoprim-sulfonamides decreased, whereas the use of metronidazole increased. The use of first-generation cephalosporins, fluoroquinolones, and penicillins decreased from 2000 to 2004. First-line drugs accounted for 90.7% of prescriptions during the study period. The use of third-line drugs decreased from 2000 to 2004.
Conclusions and Clinical Relevance—Characterization of antimicrobial use is an important step in defining and evaluating the prudent use of antimicrobials. Whereas the true effect of antimicrobial use guidelines is unclear, these results suggest that the guidelines may have had an effect on antimicrobial prescription patterns in this small animal veterinary teaching hospital. Analysis of objective data regarding antimicrobial use and changes in antimicrobial use patterns over time is important in veterinary practices.
Objective—To evaluate the efficacy of Lactobacillus pentosus WE7, an equine-origin organism with potentially beneficial in vitro properties, as a probiotic for prevention of neonatal diarrhea in foals.
Design—Randomized controlled clinical trial.
Procedure—Foals were enrolled at 24 to 48 hours of age and randomly assigned to treatment or control groups. The treatment group received approximately 2 × 1011 CFU of freeze-dried L pentosus WE7 orally once daily for 7 days, whereas the control group received a placebo. Clinical monitoring was performed for 14 days.
Results—Probiotic administration was significantly associated with development of signs of depression, anorexia, and colic and the need for veterinary examination and treatment. Probiotic-treated foals also had more days of diarrhea, compared with the control group, although not significantly. In a multivariate model, probiotic administration was significantly associated with development of diarrhea and diarrhea plus additional clinical abnormalities.
Conclusions and Clinical Relevance—Administration of L pentosus WE7 did not prevent diarrhea; rather, it was associated with development of diarrhea and, most importantly, development of diarrhea plus additional clinical abnormalities and the need for veterinary intervention. The promising in vitro properties of L pentosus WE7 were not evident in vivo. Results raise concern about the variety of untested probiotic products that are commercially available. Safety and efficacy testing needs to be performed for all potential equine probiotics. (J Am Vet Med Assoc 2005;226: 2031–2034)
Objective—To evaluate perioperative antimicrobial use associated with elective surgery for cranial cruciate ligament rupture in dogs.
Design—Retrospective case series.
Procedures—Medical records were reviewed and antimicrobial use practices were evaluated for dogs with no other problems that would affect antimicrobial use decisions.
Results—Antimicrobials were administered before or during surgery to 75 of 83 (90%) dogs. Timing of administration with respect to first incision, intraoperative administration, and duration of administration were variable. Antimicrobial administration began after surgery in 3 (3.6%) dogs. Fifty-five of 65 (85%) dogs treated before surgery received the first dose within 60 minutes of the first incision. Time from first antimicrobial administration to closure of the incision ranged from 15 to 285 minutes (mean ± SD, 141 ± 53 minutes). If a guideline of repeated administration every 2 hours after first administration until closure of the surgical site was used, 22 of 43 (51%) dogs received the required intraoperative dose, whereas 6 of 32 (19%) dogs that did not require intraoperative treatment were treated. Twenty-four (29%) dogs received antimicrobials after surgery.
Conclusions and Clinical Relevance—Certain discrepancies between antimicrobial use practices in this study and standard guidelines used in human medicine were evident.
Objective—To investigate bacterial culture practices in veterinary clinics, with an emphasis on laboratory biosafety and on quality of laboratory practices.
Design—Survey-based prospective study.
Sample Population—166 veterinarians.
Procedures—Veterinarians were recruited through the Veterinary Information Network (an Internet-based network restricted to veterinary personnel). All Network-registered veterinarians were eligible to participate. A standardized questionnaire regarding bacterial culture practices in veterinary clinics was completed electronically by study participants.
Results—720 veterinarians completed the survey; 166 (23%) indicated that bacterial culture was performed in his or her clinic. Clinic practices ranged from preliminary aerobic bacterial culture only with submission of isolates to a diagnostic laboratory for further testing (93/160 [58%]) to bacterial culture, identification, and antimicrobial susceptibility testing (19/160 [12%]). Most commonly, urine samples were cultured (151/162 [93%] clinics). Several prob-lematic practices were identified regarding quality and quality control, including inadequate facilities, equipment, supervision, interpretation of data, and culture methods. Biosafety infractions were also common, including inadequate laboratory location, lack of biosafety protocols, and dangerous disposal practices. Ninety-four percent of respondents stated that continuing education regarding culture practices and laboratory safety would be useful.
Conclusions and Clinical Relevance—Data confirmed that bacterial culture was commonly performed in clinics, but that major deficiencies in laboratory methods were widespread. These could result in negative effects on testing quality and increased risk of laboratory-acquired infections among clinic personnel. Veterinary practices in which bacterial cultures are performed must ensure that adequate equipment, facilities, personnel, and training are provided to enable accurate and safe sample testing.
Case Description—A 2-year-old dog was evaluated because of complications that developed following tibial plateau leveling osteotomy. Infection of the surgical site developed following removal of the failed implant.
Clinical Findings—The dog was lame with evidence of a deep surgical site infection, and Staphylococcus pseudintermedius was isolated from the surgical site. Results of in vitro testing indicated that the isolate was resistant to multiple antimicrobials but susceptible to cefoxitin. Subsequent testing confirmed that the isolate was methicillin-resistant S pseudintermedius and was in fact resistant to cefoxitin.
Treatment and Outcome—On the basis of results of follow-up testing, doxycycline was administered before and after surgery to remove the surgical implant. The dog recovered without further complications.
Clinical Relevance—Findings suggested that certain strains of methicillin-resistant S pseudintermedius, which appears to be an emerging pathogen in dogs, may be falsely identified as methicillin susceptible on the basis of results of testing for cefoxitin susceptibility because cefoxitin may not induce the mecA gene as reliably in S pseudintermedius as it does in Staphylococcus aureus. Isolates of S pseudintermedius should be considered to likely be methicillin resistant when multidrug resistance is identified, even if susceptibility to some β-lactam antimicrobials is reported.