Survey on bacterial isolates from dogs with uri- in vitro R. PAPINI

Survey on bacterial isolates from dogs with urinary tract infections and their in vitro sensitivity
R. PAPINI1*, V.V. EBANI2, D. CERRI2 and G. GUIDI1
1 Dipartimento di Clinica Veterinaria, Viale delle Piagge 2, 56124 Pisa, Italy
2 Dipartimento di Patologia Animale, Profilassi e Igiene degli Alimenti, Viale delle Piagge 2, 56124 Pisa, Italy
* Corresponding author : Dr Roberto Papini, Dipartimento di Clinica Veterinaria, Facoltà di Medicina Veterinaria, Viale delle Piagge, 2 - 56124 Pisa, Italia.
Phone +39/050/2216801; Fax +39/050/2216813; e-mail: [email protected]
SUMMARY
RÉSUMÉ
Bacterial isolates from urine specimen of dogs with urinary tract infections in a geographical region of Central Italy were : Escherichia coli
(17.48%), Proteus mirabilis (16.59%), Pseudomonas aeruginosa (7.17%),
Staphylococcus aureus (6.72%), α-haemolytic streptococci (2.24%), and
Klebsiella sp. (0.89%). In vitro antibacterial agent sensitivity showed that
none of them was effectively susceptible to any of the antibacterial agents
tested, including amikacin, amoxicillin, amoxicillin-clavulanic acid, ampicillin, cefalexin, cefotaxin, doxicyclin, enrofloxacin, erythromycin, gentamycin, kanamycin, netilmycin, rifampicin, streptomycin, sulphamethoxazole/trimethoprim, and tetracyclin.
Enquête sur les souches bactériennes isolées et détermination de leur
sensibilité in vitro aux antibiotiques chez des chiens atteints d’infection
du tractus urinaire. Par R. Papini, V.V. Ebani, D. Cerri et G. Guidi.
Keywords : Dog - Urinary tract infection - In vitro sensitivity - Antibacterial agents.
Dans une région géographique de l’Italie centrale, les bactéries isolées de
chiens atteints d’infections urinaires ont été : Escherichia coli (17.48%),
Proteus mirabilis (16.59%), Pseudomonas aeruginosa (7.17%),
Staphylococcus aureus (6.72%), streptocoques α-hemolytiques (2.24%) et
Klebsiella sp. (0.89%). Les résultats de la sensibilité in vitro ont montré que
toutes les souches étaient très résistantes aux agents antibactériens testés,
incluant amikacine, amoxycilline, amoxycilline-acide clavulanique, ampicilline, céfalexine, céfotaxim, doxicycline, enrofloxacine, erythromycine,
gentamycine, kanamycine, netylmicine, rifampicine, streptomycine, sulphaméthoxazole/triméthoprime et tétracycline.
Mots-clés : Chien - Infections du tractus urinaire Sensibilité in vitro - Agents Antibactériens.
Introduction
Urinary tract infections (UTIs) are among the most common conditions requiring diagnostic and therapeutic intervention in small animal veterinary practices. They typically
involve bacteria and are estimated to affect approximately
14% of all dogs during their lifetime ; female dogs are more
often affected than male dogs [15]. Bacterial UTIs are more
common in older cats than in younger cats, and the incidence
increases with age [12]. They occur not only in companion
animals such as dogs and cats, but are also frequently observed among humans [2, 8, 9]. The causative pathogens in
dogs suffering from UTIs of bacterial origin are diverse.
Escherichia coli is the most important microorganism responsible for UTIs of dogs. Staphylococcus aureus and
Proteus mirabilis were also found to be among the most
common infecting bacteria in UTI cases in dogs. Alpha-haemolytic streptococci, Klebsiella pneumoniae, Pseudomonas
aeruginosa, Enterobacter spp., other Proteus spp., beta-haemolytic streptococci, and some other miscellaneous bacterial
species can be occasionally documented [14]. However, the
prevalence of the various species varies considerably from
study to study.
Factors thought to be important in preventing UTIs include
normal micturition, mucosal defense barrier, antibacterial
properties of urine, specific anatomic structures, and systemic immunocompetence. UTIs occur when there is a breach
(either temporary or permanent) in host defense mechanisms
and sufficient numbers of virulent microbe are allowed to
Revue Méd. Vét., 2006, 157, 1, 35-41
adhere, multiply, and persist in a portion of the urinary tract.
The alterations in host defenses may be intrinsic to the
patient (i.e., diabetes mellitus) or iatrogenic (i.e., corticosteroid administration). UTIs caused by etiological bacterial
agents have been associated with urogenital disease such as
cystitis, nephritis, metritis and prostatitis in dogs and cats
[24]. Furthermore, some bacterial strains isolated from dogs
and cats with UTI were similar to strains isolated from
human UTI [12, 16]. These findings suggest that similar
strains might be able to cause the infection both in companion animals and humans.
Therapeutic management of UTIs is based on the type of
infection, duration of symptoms and aetiology. Surveillance
of the susceptibility of major pathogens to a range of antimicrobials can aid clinicians in prescribing the most appropriate antimicrobial agents for infections and is an essential
part of monitoring and detecting any increase in resistance.
Despite this, empirical treatment of UTIs must be often initiated before availability of laboratory results. Because UTIs
are frequently treated with empirically selected antimicrobial agents, assessment of changes in antimicrobial susceptibility patterns over time is important to ensure that the organisms remain susceptible to empirically selected antimicrobial agents. In addition, treatment of these infections is often
challenging because some of the isolates are frequently resistant to numerous antimicrobial agents, including those used
empirically. Because of the multi-drug resistant profile of
some of the isolates, in vitro antimicrobial susceptibility testing is advised to ensure appropriate antibiotic selection in
36
addition to allowing for monitoring the development of
resistant pathogens. Therefore, clarity with regard to the current susceptibility to antimicrobial agents among urinary isolates is important and benefit to veterinary clinicians for providing clinically appropriate and cost-effective therapy for
UTIs.
During the last years, there is considerable and growing
global concern about the increasing levels of antimicrobial
resistance in human and veterinary medicine [9, 22] such
that antimicrobial resistance surveillance studies are now a
necessity. Moreover, given that a transition in therapy may
easily occur or be imminent, it has become important to
define not only national and international rates of resistance
for a range of pathogens but local rates as well, since it has
been shown that differential resistance rates even exist for
specific pathogens and antimicrobial agents recovered from
restricted geographical areas [2, 8]. As already said, antimicrobial treatment of UTIs caused by the most common uropathogens in animals and humans may become complicated,
since it may be compromised by increasing antimicrobial
resistance. Continued concern about antimicrobial resistance
is warranted as are studies on the activities of new agents.
However, whereas the development of totally new antimicrobial agents takes several years, the re-evaluation of older
antibiotics can be conducted more rapidly. Therefore, the
present study was undertaken to assess the prevalence of
uropathogens isolated from uncomplicated UTIs of dogs in a
geographical region of Italy, to evaluate their in vitro susceptibility to antibiotics commonly used for the treatment of
such infections, and to compare the difference in antibiotic
susceptibility among different isolates, so that optimal empirical antibiotic therapy in dogs could be determined.
Materials and methods
A survey was carried out on 223 adult dogs (range from 3
to 15 years of age, mean ± standard deviation = 8.8 ± 3.7).
There were 116 female dogs and 107 male dogs. All the dogs
were from different areas of Tuscany, a geographical region
of Central Italy. They were presented with a history of clinical signs suggestive of UTIs at our Veterinary Medical
Teaching Hospital (Department of Veterinary Clinic,
University of Pisa, Italy) during a 6-month period, beginning
in January 1 and ending in June 30, 2004. Such signs included inappropriate urination, dysuria, stranguria, haematuria,
or pollakiura. None of the dogs had been given antimicrobial
agents, corticosteroids, or other immunosuppresive agents
within 15 days before sampling. However, the possibility of
prior treatments with antibiotics during the entire course of
their lives can not be fully excluded. Since the aim of our
study was to have an overview, we did not attempt to select
by gender, ages or specific breeds of dogs.
Urine samples were collected by antepubic cystocentesis.
An area of skin on the central midline, caudal to the umbelicus, was cleaned and disinfected using 2 per cent iodine w/v
solution in 70 per cent alcohol. The bladder was immobilised
by digital palpation and a one-inch long sterile needle was
inserted into the bladder. Urine specimens were drawn into a
PAPINI (R.) AND COLLABORATORS
sterile syringe. This method of urine collection was chosen
in order to avoid or reduce, as much as possible, the specimen contamination originating in the prepuce and urethra of
males, and in the urethra and vagina of females [5].
Following collection, urine samples (8-10 mL) were either
processed for bacteriological investigation immediately or
refrigerated at 4°C within a few minutes from sampling,
until inoculations of bacteriologic media were completed
(not more than 4 hours later). Once arrived at the clinical
microbiology laboratory (Department of Animal Pathology,
Prophylaxis and Food Hygiene, University of Pisa, Italy),
well-mixed urine samples were divided into two aliquots in
sterile tubes. The approximate number of colony-forming
units/millilitre (CFU/mL) of urine was determined for each
specimen. For this purpose, an aliquot of 1.0 mL urine sample
was diluted in sterile saline solution from 10-1 to 10-5. One ml
of 10-3, 10-4, and 10-5 dilutions were inoculated in PlateCount agar plates and incubated at 37°C for 72 hours. The
counts were determined by the standard method. Four
groups were identified : a) <1,000 CFU/mL of urine b) between ≥1,000 and <10,000 CFU/mL c) from ≥10,000 to
<100,000 CFU/mL d) ≥100,000 CFU/mL. According to
CARTER [4], counts ≥10,000 to <100,000 CFU/mL can be
considered as suggestive of infection and a presence
≥100,000 CFU/mL can be considered as clinically important
bacteriuria. Therefore, the identity of bacterial isolates and
their sensitivity to antibacterial agents were only determined
from specimens yielding bacterial isolations ≥10,000 to
<100,000 CFU/mL or ≥100,000 CFU/mL, while all the other
cultures were discarded.
For this purpose, an aliquot of 5.0 mL urine specimen was
centrifuged for 20 minutes at 3,000 x g at room temperature.
After the supernatant was decanted, cultures were made
from the deposit. As indicated by LING et al. [15], blood
agar and MacConkey (Oxoid, Unipath S.p.A., Garbagnate
Milanese, Milano, Italy) agar plates were inoculated, using a
sterile loop from the urine sediment for each plate. All plates
were incubated aerobically at 37°C and were examined for
bacterial growth after overnight incubation, at which time
colony morphology was observed. Single bacterial colonies
were picked for identification of organisms by standard bacteriologic and biochemical procedures, as reported by CARTER [4].
Antibacterial sensitivity tests were performed using the
disc method. A bacterial colony was seeded from the agar
plate to Serum Broth and incubated. Samples from the broth
cultures with a turbidity corresponding to 0.5 McFarland
standard suspension were evenly smeared over the entire
surface of Mueller-Hinton agar plates [3]. After allowing the
surfaces of the plate to dry for approximately 2 minutes,
selected antibacterial discs (Oxoid, Unipath S.p.A.,
Garbagnate Milanese, Milano, Italy and Bayer, AG
Leverkusen, Germany) were placed on the inoculated surface. Discs were stored at 4°C until their use, according to
manufacturers’ instructions. The following antibacterials
were tested: amikacin (AK), 30 µg ; amoxicillin (AML),
10 µg ; amoxicillin-clavulanic acid (AMC), 20 µg + 10 µg ;
ampicillin (AMP), 10 µg ; cefalexin (CL), 30 µg ; cefotaxin
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SURVEY ON BACTERIAL ISOLATES FROM DOGS WITH URINARY TRACT INFECTIONS
(CTX), 30 µg ; doxicyclin (DO), 30 µg ; enrofloxacin
(ENR), 5 µg ; erythromycin (E), 15 µg ; gentamycin (CN),
10 µg ; kanamycin (K), 30 µg ; netilmycin (NET), 30 µg ;
rifampicin (RD), 30 µg ; streptomycin (S), 10 µg ; sulphamethoxazole/trimethoprim (SXT) 23.75 µg + 1.25 µg, and
tetracyclin (TE), 30 µg. Results were evaluated after incubation at 37°C for 24 hours. Based on the size of the zone of
bacterial growth inhibition, bacteria were classified as sensitive, intermediate or moderately sensitive, and resistant,
according to manufacturers’ instructions (Table I). As reported by the Oxoid manual, the category moderately sensitive
indicates a possible therapeutic use of antibiotics under particular clinical circumstances. For example, when antibiotics
can be used at high doses, or concentrate in particular sites of
infection such as the urinary tract due to their pharmacokinetic, or when an association of antibiotics can be employed.
Results
All of the 223 urine specimens yielded bacterial growth.
However, 99 of them (44.39%) showed bacterial counts
<1,000 CFU/mL of urine specimen, 11 (4.93%) counts bet-
ween ≥1,000 and <10,000 CFU/mL, 32 (14.34%) from
≥10,000 to <100,000 CFU/mL, and finally 81 (36.32%)
≥100,000 CFU/mL. Therefore, the identity of bacterial isolates and their sensitivity to antibacterial agents were determined from 114 (51.12%) urine specimens yielding bacterial
counts suggestive of infections or clinically significant. Only
one species was found in each sample. Altogether, 6 bacterial species were identified in culture-positive specimens.
Overall, E. coli was isolated from 39 (17.48%) specimens, P.
mirabilis from 37 (16.59%), P. aeruginosa from 16 (7.17%),
S. aureus from 15 (6.72%), α-haemolytic streptococci from
5 (2.24%), and Klebsiella sp. from 2 (0.89%). Percentages
referred to the totality of cases where bacteriuria was suggestive of infections or clinically important are reported in
Table II.
In the present study, none of the bacterial isolates was
effectively susceptible to any of the antimicrobial agents tested. Their sensitivity to antibacterial agents is shown in Table
III. E. coli isolates were completely resistant to AK, CL, DO,
E, K and S (39/39, 100%). Likewise, great numbers of them
were resistant to AML, AMP and RD (37/39, 94.87%), TE
(36/39, 93.30%), SXT (33/39, 84.61%), AMC (32/39,
AK : amikacin ; AML : amoxicillin ; AMC : amoxicillin-clavulanic acid ; AMP : ampicillin ; CL : cefalexin ;
CTX : cefotaxin ; DO : doxicyclin ; ENR : enrofloxacin ; E : erythromycin ; CN : gentamycin ; K : kanamycin ; NET : netilmycin ; RD : rifampicin ; S : streptomycin ; SXT : sulphamethoxazole/trimethoprim ;
TE : tetracyclin.
TABLE I. — Diameters (mm) of bacterial growth inhibition induced by the antibacterial agents tested in vitro.
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PAPINI (R.) AND COLLABORATORS
*Percentages are referred to the totality of cases where bacteriuria was suggestive of
infections (≥10,000 to <100,000 CFU/mL) or clinically important (≥100,000
CFU/mL).
TABLE II. — Bacterial isolates from 114 out of 223 cases of urinary tract infections in
dogs.
82.05%), NET (31/39, 74.48%), CN (26/39, 66.66%), CTX
and ERN (21/39, 53.84%). A small part showed susceptibility to ENR (13/39, 33.33%), CN (10/39, 25.64%), CTX and
NET (8/39, 20.51%), SXT (6/39, 15.38%), AMC (4/39,
10.25%), TE (3/39, 7.69%), AML, AMP and RD (2/39,
5.12%). Consequently, very small numbers showed moderate susceptibility to CTX (10/39, 25.64%), ENR (5/39,
12.82%), AMC and CN (3/39, 7.69%).
All the P. mirabilis isolates were highly resistant to DO, E,
K and TE (37/37, 100%). A great number of the isolates was
also resistant to AK and S (36/37, 97.29%), AMP, CL and
RD (35/37, 94.59%), AML (34/37, 91.89%), ENR and SXT
(32/37, 86.48%), followed by NET (22/37, 59.45%), AMC
(19/37, 51.35%), CTX (12/37, 32.43%) and CN (10/37,
27.02%). Decreasing numbers of them showed sensitivity to
CN (19/37, 51.35%%), CTX (17/37, 45.94%), NET (13/37,
35.13%), AMC (12/37, 32.43%), SXT (5/37, 13.51%), ENR
(4/37, 10.81%), AK, AML, AMP, RD and S (1/37, 2.70%).
In general, a smaller part of these isolates showed moderate
sensitivity to CTX and CN (8/37, 21.62%), AMC (6/37,
16.21%), AML, CL and NET (2/37, 5.40%), AMP, ENR and
RD (1/37, 2.70%).
P. aeruginosa isolates were completely (16/16, 100%) or
almost completely (13 to 15/16, 81.25 to 93.75%) resistant to
all the antibacterial agents tested in the present study, with
the exception of CN (7/16, 43.75%), to which a half (8/16,
50%) of the isolates showed susceptibility. Sporadically,
moderate susceptibility to CL (3/16, 18.75%), ENR (2/16,
12.5%), AMC, CN and NET (1/16, 6.25%) was observed, as
well as very low susceptibility to AK, AMP, CTX, ENR and
NET (1/16, 6.25%).
Similarly, the majority of the S. aureus isolates were completely (15/15, 100%) or highly (10 to 14/15, 66.66 to
93.33%) resistant to a great number of the antimicrobial
agents tested. Approximately, half of the isolates were susceptible to CN and ENR (8 and 7/15, 53.33 and 46.66 %, respectively). In the other cases, low susceptibility to CTX and
RD (4/15, 26.66%), AMC and SXT (3/15, 20.0%), AK and
NET (2/15, 13.33%), CL, E and TE (1/15, 6.66%) was detected, as well as moderate susceptibility to CTX (4/15,
26.66%), AMC and CL (2/15, 13.33%), AK, AMP, DO and
CN (1/15, 6.66%).
The five isolates of α-haemolytic streptococci were totally
(5/5, 100%) resistant to AK, AML, AMP, DO, NET, RD and
TE, or almost totally (4/5, 80.0%) resistant to ENR, E, CN,
K and SXT. Approximately, half (3 or 2/5, 60.0 or 40.0%) of
the isolates were also resistant to CTX and S or AMC and
CL. In decreasing order, the isolates showed susceptibility to
CL (3/5, 60.0%), S (2/5, 40.0%), AMC, CTX, E, and K (1/5,
20.0%), or moderate susceptibility to AMC (2/5, 40.0%),
CTX, ENR, CN and SXT (1/5, 20.0%).
Finally, the two isolates of Klebsiella sp. were resistant to
all the tested antimicrobial agents except one (20%) case of
moderate susceptibility to CTX.
Discussion
This study represents an evaluation of the species distribution of bacterial uropathogens in dogs from a geographical
area of Italy. In addition, an evaluation was performed of the
in vitro effectiveness of a representative panel of antibiotics
against a number of isolates obtained from dogs with UTI. E.
coli, P. mirabilis, P. aeruginosa, S. aureus, α-haemolytic
streptococci, and Klebsiella spp. were isolated from the urine
of dogs with UTIs. Some investigators reported data on bacterial isolates from urine specimens of dogs in many countries. However, to the best of our knowledge, no data are
available from Italy. In the United States, HOGLE [10]
observed that the bacteria most frequently isolated from
selected specimens of canine urine were P. aeruginosa,
Proteus spp., E. coli, and S. aureus. Later, WOLLEY and
BLUE [24] showed that the most frequently cultured bacteria from canine urine specimens were E. coli, Proteus spp., S.
aureus, and P. aeruginosa. Otherwise, E. coli, Streptococcus
(Enterococcus) faecalis, Staphylococcus epidermidis and
Proteus spp. were the most common bacteria isolated from
dogs with UTIs in the United Kingdom [23]. OXENBORG
et al. [19] found that Proteus spp., E. coli and
Staphylococcus spp. were the most common isolates from
dogs affected with UTIs in Australia. PERSON et al. [20]
reported that in France the most frequently isolated bacteria
from canine urine specimens were P. mirabilis, E. coli, S.
aureus, P. aeruginosa and Acinetobacter spp. Later, in further investigations carried out in the United States, E. coli
was the most common isolate, along with Stapylococcus
Revue Méd. Vét., 2006, 157, 1, 35-41
Revue Méd. Vét., 2006, 157, 1, 35-41
TABLE III. — In vitro sensitivity to the tested antibacterial agents of bacterial isolate from canine urine specimen.
S : Sensitive ; I/MS : Intermediate or Moderately Sensitive ; R : Resistant.
AK : amikacin ; AML : amoxicillin ; AMC : amoxicillin-clavulanic acid ; AMP : ampicillin ; CL : cefalexin ; CTX : cefotaxin ; DO : doxicyclin ; ENR : enrofloxacin ; E : erythromycin ; CN : gentamycin ; K : kanamycin ;
NET : netilmycin ; RD : rifampicin ; S : streptomycin ; SXT : sulphamethoxazole/trimethoprim ; TE : tetracyclin.
SURVEY ON BACTERIAL ISOLATES FROM DOGS WITH URINARY TRACT INFECTIONS
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spp., Proteus spp. and Klebsiella spp. as bacterial genera [15,
17]. More recently, E. coli and Streptococcus/Enterococcus
spp. were the most frequently isolated microorganisms from
cases of persistent UTIs and reinfections in dogs [21].
Therefore, the spectrum of bacteria observed in our survey is
similar to those previously reported by other authors.
Different percentages of bacterial isolations have been
reported. This may be due to differences of the population
studied and to the different number of specimens examined.
It is evident that E. coli and P. mirabilis in our study were the
main organisms associated with UTIs in dogs accounting for
17.48% and 16.59%, respectively, of the 114 cases suggestive of infection or with clinically important bacteriuria
(Table II).
In earlier studies no bacteria were isolated from relatively
high percentages of canine urine specimens. For instance,
WOOLEY and BLUE [24] reported that no bacteria were
isolated from 21.9% of canine urines. In our study all the
samples yielded bacterial growth, although small numbers of
bacteria were isolated from approximately a half of the
samples. This is in agreement with previous results of other
authors. PERSON et al. [20] showed that 49% of canine
urine specimens yielded not significant (<100,000 CFU/mL)
bacterial growth. LING et al. [15] reported that 21.8% of
urine isolates from male dogs and 18.0% of isolates from
female dogs had colony counts ≤10,000 CFU/mL in samples
collected by cystocentesis.
Since the aim of our study was to have an overview, we did
not attempt to select by gender, ages or specific breeds of
dogs. However, it has been previously demonstrated that
host age, sex and breed can represent some important predisposing factors to UTIs and even to some of the bacterial species isolated [15, 20].
E. coli, P. mirabilis, P. aeruginosa, S. aureus, α-haemolytic streptococci, and Klebsiella spp. are ubiquitous in the
environment. Usually considered as contaminants they have
emerged as important pathogens. These organisms cause a
variety of infections including UTI [14]. Uropathogens have
shown a slow but steady increase in resistance to several
antibiotics over the last decade and antibiotic resistance is a
remarkable clinical problem in treating infections caused by
these microorganisms. For instance, E. coli and other
Enterobacteriaceae have become less susceptible to commonly used antibiotics such as ampicillin, amoxycillin, sulphonamides, trimethoprim and fluoroquinolones [21]. Our
results signal the problem of multi-drug resistant microorganisms. Considering the totality of isolates, general resistance
rates varied from 96.48% to 99.12% for tetracyclines (TE
and DO), and from 49.12% to 97.36% for aminoglycosides
(CN, NET, K, AK and S). These latter were the most represented antibiotic group in the present survey, and the lowest
(49.12%) resistance rate was recorded to gentamycin.
Overall, resistance rates to beta-lactam antibiotics varied
from 51.75% to 95.61%. In particular, this accounted for
70.17% to 95.61% in the penicillin group (AMC, AMP and
AML), and for 51.75% to 90.35% in the cephalosporin group
(CTX and CL). To the other groups of antibiotics, recorded
resistance rates in decreasing order were 98.24% to erythromycin (belonging to the group of macrolides), 92.98% to
PAPINI (R.) AND COLLABORATORS
rifampicin (group of rifamycins), 85.96% to the association
sulphametoxazole/trimethoprim, and finally 69.29% to enrofloxacin (group of quinolones). Therefore, all the antimicrobial agents that we studied demonstrated very high levels of
in vitro resistance, which suggests that in this case none of
them would have been useful as adequate therapy for dogs
with UTI, and that probably they would have virtually been
useless for treatment of other infections caused by the same
bacterial isolates. As a consequence, the role of new agents
not tested in this study should have needed to be considered
based on available susceptibility/resistance data. Despite
this, it is worth noting that susceptibility tests may yield misleading results, since discs placed on the cultures approximate concentrations of antibacterial achievable in blood,
whereas urinary antibacterials achieve 10 to 100 times these
concentrations. Therefore, results read out as resistant in
vitro may not really be resistant in vivo. However, results
read out as susceptible should really be effective.
In the present study, P. aeruginosa, E. coli, S. aureus, αhaemolytic streptococci and Klebsiella exhibited high level
of drug resistance to all the antibiotics. Lowest resistances
(27.02% and 32.43%, respectively) were shown by P. mirabilis to CN and CTX. The resistance rates to antimicrobials
has increased over the years and vary from country to country [8]. Although it is inaccurate to compare prevalence data
of studies which used different antibacterial sensitivity tests,
the results we obtained are different to those described in
other publications for the same pathogens in other areas of
the world. In one study from the United States, all the isolates with the exception of P. aeruginosa exhibited 100%
susceptibility to one, two or three of the tested antimicrobial
agents [9]. Results from another study showed that susceptibility of the different isolates varied from 80 to 100% to
some of the tested bactericidal agents [23]. Only ten out of
one-hundred-ten isolates were resistant to all agents in a survey carried out in the United Kingdom [22]. Strains of E. coli
and Proteus spp. isolated from Australia were 100% sensitive to gentamycin, whereas E. coli was susceptible (>80%)
to nitrofurantoin and nalidixic acid too [18]. In France, a
representative panel of antibiotics was effective against a
number of isolates obtained from dogs with UTI [19]. In a
more recent investigation carried out in the United States,
70.5% of the bacterial isolates were susceptible to at least
one commonly prescribed antibiotic per os, and 18.5% of
them were resistant to all commonly prescribed antibiotics
administered per os, but were susceptible to a secondary
antibiotic [20]. There is no obvious explanation for all these
differences. These may be due to geographical variations or
to differences in the number of animals and type of population surveyed, or may be attributable to differences of the
antibacterial sensitivity tests performed. In the present investigation, we can not completely exclude the possibility that
the isolates could have acquired drug resistance after exposure to prior treatments with antibiotics, undertaken because
of various bacterial pathologies occurring in the course of
animals’ life. In addition, we did not attempt to investigate
and identify mechanisms of antibacterial drug resistance,
since this was beyond the aim of our study. However, it can
be presumed that one or more of the most common mechanisms of bacterial resistance could have been occurred, as
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SURVEY ON BACTERIAL ISOLATES FROM DOGS WITH URINARY TRACT INFECTIONS
reviewed by DEVER and DERMODY [7].
As known, a global trend of increase in antibiotic resistance has been shown worldwide [9]. One of the main reasons for this trend is the increase in antibiotic consumption,
because increased usage of antibiotics in a patient population
may affect the rate of infections caused by resistant bacteria
in that population. The use of antimicrobial drugs in animals
is another of the major factors selecting for the emergence of
resistant bacterial stains. As a consequence, the veterinary
use of antimicrobials has received much publicity recently
and is now under close scrutiny because of the importance of
preserving the efficacy of antimicrobial therapy. At present,
investigations in veterinary species are concentrated on production animals owing to the extensive use of antimicrobials
in agriculture and the well-documented transfer of resistant
bacteria from animals to human beings in food [1]. Since
antimicrobial usage in production animals has been shown to
lead to the emergence of resistant bacteria, surveillance protocols have been established in many countries, and several
countries have now banned the use of certain antibiotics as
growth promoters. Therefore, there is a substantial pool of
information for livestock species. In contrast, there is comparatively little information about antimicrobial resistance in
domestic pets such as dogs and cats. The development of
antimicrobial resistance in companion animals and the
implications to human health are poorly documented.
Companion animals occupy a unique position among the
domestic species because they are kept in the home. A
recent report suggests an increasing trend in the development
of resistance in companion animal pathogens [22]. The interrelationship of antimicrobial resistance in the flora of human
beings and domestic pets was confirmed by DAVIES and
STEWART [6]. Therefore, since the use of antimicrobial
drugs for companion animals is far more liberal than for food
producing animals [18], it is also very important to evaluate
their use in companion animals because they may act as
reservoirs of drug-resistant bacteria. UTI is one of the most
common diseases in dogs and is also observed both in
humans and other companion animals such as cats. From the
results in some studies, it has been presumed that dogs and
cats may be alternative reservoirs for humans [12, 16]. In the
present study, the fact that 49.12% to 96.49% of isolates
were resistant to all the antimicrobial agents tested is of great
importance and means these antibiotics cannot be used as
empirical therapy for UTI in dogs. Probably, the transmission of strains or genetic determinants like these to people
could be a threat [22]. This information needs to be considered when empirical therapy for UTIs in dogs is chosen. As
the magnitude and variation of antimicrobial resistance in
human medicine grow, so does the need for continuous surveillance in veterinary medicine. Clearly, continued surveillance is essential to maintaining the safety and costeffectiveness of empirical therapy as a management strategy
for UTI in dogs.
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