Multidrug-resistant Escherichia coli isolated from a dog with a history of urolithiasis: case report / Escherichia coli multirresistente isolada de cão com histórico de urolitíase: relato de caso

Bacterial resistance is a reality in both human and veterinary health, it limits the therapeutic arsenal and raises the costs of the patient's treatment. A dog with signs of cystitis received treatment with 5mg/kg enrofloxacin at three consecutive times, with low effectiveness. The presence of urethral uroliths was identified and urohydropulsion was done. The animal presented a new obstruction, for which a cystotomy was performed, but continued with signs of infection. Uroculture and antimicrobial susceptibility test were then performed. Escherichia coli was identified, which was resistant to 13 antibiotics, being sensitive only to piperacillin-tazobactam and amikacin. In the screening test for ß-lactamase, the production of ESßL was detected. The qPCR indicated the presence of the bla CTXm, bla DHA, bla OXA, bla IMP, bla TEM, bla GIM, bla SIM, bla SPM and bla SME genes, which may lead to a phenotypic resistance profile for ampicillin, amoxicillin-clavulanate, aztreonam, cefepime cefoxitin, cefuroxime, ceftazidime, ceftriaxone, imipenem, and piperacillin-tazobactam. This case reaffirms the value that laboratory analysis adds to the diagnosis and treatment of cystitis and urolithiasis, which can define the direction of evolution of the prognosis and the speed at which the patient's health will be restored.(AU)

A resistência bacteriana aos antibióticos é uma realidade, tanto na saúde humana quanto veterinária, limita o arsenal terapêutico e eleva os custos relacionados ao tratamento do paciente. Um cão, com sinais de cistite, recebeu tratamento com enrofloxacina, na dose de 5mg/kg, em três momentos seguidos, com baixa efetividade. Identificou-se presença de urólitos uretrais e foi feita uro-hidropropulsão. O animal apresentou nova obstrução, para a qual foi realizada uma cistotomia, mas continuou com sinais de infecção. Realizou-se, então, urocultura e teste de antibiograma. Foi identificada Escherichia coli, que se mostrou resistente a 13 antibióticos, sendo sensível somente à piperacilina-tazobactam e amicacina. No teste de triagem para ß-lactamase, detectou-se a produção de ESßL. A qPCR indicou presença dos genes blaCTXm, blaDHA, blaOXA, blaIMP, blaTEM, blaGIM, blaSIM, blaSPM e blaSME, que podem conduzir um perfil fenotípico de resistência para ampicilina, amoxicilina-ácido clavulânico, aztreonam, cefepima, cefoxitina, cefuroxima, ceftazidima, ceftriaxona, imipenem, piperacilina-tazobactam. Este caso reafirma o valor que a análise laboratorial agrega ao diagnóstico e tratamento da cistite e da urolitíase, podendo definir o sentido de evolução do prognóstico e a velocidade em que a saúde do paciente será restabelecia.(AU)

Evaluation of intraluminal pressure in cystorrhaphies with and without intestinal serosal patch supplementation from canine cadavers

PURPOSE:To evaluate the maximal intraluminal pressure (MIP) supported by canine cadaveric urinary bladders that underwent cystotomy followed by cystorraphy, with and without serosal patching-supplementation.METHODS:Two groups (n=8 each) were formed, and in one (conventional) the cystotomy was closed with cushing pattern. In the other group (serosal), the same procedure was performed, and a piece of jejunum was used for the construction of the serosal patching over the cystorraphy. MIP was measured by means of an invasive blood pressure transducer with closed stopcock attached to a multiparameter monitor. At the end of each measurement, the bladder body circumference was assessed.RESULTS:Mean±SD MIP sustained for the conventional and serosal groups were 28.88±5.08 and 65.38±10.99 mmHg, respectively (p<0.0001). Bladder circumference did not change significantly between groups (p=0.35) and did not correlate with MIP assessed in conventional (p=0.27; r=0.4379) and serosal groups (p=0.37; r=-0.3637).CONCLUSION:Serosal patch-supplemented cystorraphies were able to sustain intraluminal pressures 55.8% higher, than nonsupplemented cystorraphies in specimens from canine cadavers.

Cistoplastia experimental em coelhos (Oryctolagus cuniculus) com peritônio bovino conservado em glicerol a 98 por cento / Experimental cystoplasty in rabbits (Oryctolagus cuniculus) with bovine peritoneum conserved in 98 percent glycerol

Neste estudo foi implantado um retalho de membrana peritoneal bovina em substituição a um fragmento da face ventral da bexiga de coelhos albinos, raça Nova Zelândia, adultos, machos não-castrados (n=12), com o intuito de avaliar o processo de reparação tecidual no que se refere à biocompatibilidade, à capacidade de reparação tecidual e a possíveis complicações. Aos sete, 14, 30 e 60 dias de pós-operatório, os animais foram eutanasiados, três em cada período, mediante o emprego de tiopental sódico (200mg kg-1), para posterior avaliação macroscópica e análise histopatológica da interface do implante com o tecido nativo. Macroscopicamente, foram observadas, em todos os períodos, aderências de estruturas adjacentes ao local do implante, presença de cálculos e ausência de sinais de rejeição. Sob microscopia de luz, aos sete, 14 e 30 dias de observação, o implante ainda estava presente, havia intensa reação inflamatória mista, neovascularização, fibroplasia e escassas fibras musculares, contudo, o epitélio e a lâmina própria não estavam reconstituídos. Aos 60 dias de avaliação, o implante não estava mais presente e todas as camadas vesicais encontravam-se reparadas. O implante foi biocompatível e forneceu arcabouço para orientação e desenvolvimento das camadas teciduais da bexiga, mediante processos de reparação, restabelecendo a estrutura do órgão.

Bovine peritoneum was utilized to replace a section of ventral face of the bladder of New Zealand rabbits, adult and entire males (n=12) with the purpose of evaluating the tissue repair process in regard of its biocompatility, scar formation ability and possible complications. The animals were euthanized at 7, 14, 30 and 60 days post operative, three in each period, by the use of sodium thiopental (200mg kg-1), followed by macroscopic evaluation and histopathological analysis of the implant interface with the native tissue. Macroscopically it was observed, in all time periods, structure adherence to the implant site, presence of calculi and absence of rejection signs. Under light microscopy at the 7th, 14th and 30th observation days, the implant was present; a mixed intense inflammatory reaction could be observed, neovascularization, fiberplasic process and rare muscle fibers, however the epithelium and sheath weren't also reconstituted. At the 60th day of evaluation the implant wasn't anymore present and all vesicle layers were repaired. The implant was biocompatible and provided the mainframe for orientation and development of the tissue layers of the bladder, through repairing processes thus reestablishing the organ's structure.