ABSTRACT
Leptospirosis is a neglected zoonotic disease that commonly affects cattle, pigs, horses, and dogs in many countries. Infection in dogs is usually subclinical, but acute cases of leptospirosis may occur along with systemic failure, which may become fatal. After recovery from an acute infection, dogs may become asymptomatic carriers and shed pathogenic leptospires through urine for long periods of time. Here, a study of ten different cases of leptospirosis is presented, showing the relevance of dogs as asymptomatic carriers of pathogenic Leptospira. The diagnosis was confirmed via isolation and further serological and genetic identification. Four Leptospira isolates (LOCaS28, 31, 34, and 46) were obtained from the kidneys and urine samples of 58 dogs destined for destruction (6.89%) at a Canine Control Center in Mexico City. No spirochetes were observed in the urine samples of those Leptospira-positive dogs examined under dark-field microscopy, and no clinical signs of disease were observed either. Six additional isolates were obtained: two came from asymptomatic carrier dogs (CEL60 and UADY22); another isolate came from an asymptomatic dog that was a pack companion of a clinically ill dog with fatal leptospirosis (AGFA24); and finally, three isolates were taken from dogs that died of leptospirosis (LOCaS59, Citlalli, and Nayar1). Nine out of the ten isolates were identified as being from the serogroup Canicola via cross-absorption MAT using reference strains and specific antisera, and their identity was genetically confirmed as Canicola ST34 via multi-locus sequencing typing (MLST). In contrast, the isolate Nayar1 was identified as serovar Copenhageni ST2. Interestingly, the asymptomatic dogs from which Leptospira isolates were recovered consistently showed high antibody titers in the microscopic agglutination test (MAT), revealing values of at least 1:3200 against serogroup Canicola and lower titer values against other serogroups. Isolates showed different virulence levels in the hamster model. Taken as a whole, all these findings confirmed that dogs may act as asymptomatic carriers of pathogenic leptospires and possibly spread them out to the environment, thus representing an active public health risk. The results also showed that the Canicola ST34 clone is the most prevalent Leptospira serovar in dogs in Mexico, and finally that the old-fashioned MAT is a good alternative for the detection of presumptive Leptospira asymptomatic carrier dogs.
ABSTRACT
Accurate assessment of the hemodynamic status is vital for appropriate management of patients with critical illness. As such, there has been a constant quest for reliable and non-invasive bedside tools to assess and monitor circulatory status in order to ensure end-organ perfusion. In the recent past, point of care ultrasonography (POCUS) has emerged as a valuable adjunct to physical examination in various specialties, which basically is a clinician-performed bedside ultrasound to answer focused questions. POCUS allows visualization of the internal anatomy and flow dynamics in real time, guiding apt interventions. While both arterial (forward flow) and venous (organ outflow or afterload) limbs of hemodynamic circuit are important for tissue perfusion, the venous side remains relatively under-explored. With recent data underscoring the deleterious consequences of iatrogenic volume overload, objective evaluation of venous congestion is gaining attention. Bedside Doppler ultrasound serves this purpose and aids in diagnosing and monitoring the congestion/venous blood flow pattern. In this article, we summarize the rationale for integrating this technology into routine care of patients with volume-related disorders, discuss the normal and abnormal waveforms, limitations, and future directions.
ABSTRACT
The wide variety of pathogenic Leptospira serovars and the weak protection offered by the available vaccines encourage the search for protective immunogens against leptospirosis. We found that the secretin GspD of the type II secretion system (T2S) of Leptospira interrogans serovar Canicola was highly conserved amongst pathogenic serovars and was expressed in vivo during infection, as shown by immunohistochemistry. Convalescent sera of hamsters, dogs, and cows showed the presence of IgG antibodies, recognizing a recombinant version of this protein expressed in Escherichia coli (rGspDLC) in Western blot assays. In a pilot vaccination study, a group of eight hamsters was immunized on days zero and 14 with 50 µg of rGspDLC mixed with Freund's incomplete adjuvant (FIA). On day 28 of the study, 1,000 LD50 (Lethal Dose 50%) of a virulent strain of Leptospira interrogans serovar Canicola (LOCaS46) were inoculated by an intraoral submucosal route (IOSM). Seventy-five percent protection against disease (p = 0.017573, Fisher's exact test) and 50% protection against infection were observed in this group of vaccinated hamsters. In contrast, 85% of non-vaccinated hamsters died six to nine days after the challenge. These results suggest the potential usefulness of the T2S secretin GspD of Leptospira as a protective recombinant vaccine against leptospirosis.
ABSTRACT
Bovine leptospirosis causes high economic losses in cattle mainly due to reproductive failure, as well as representing public health risk. Since the last century, antibody titers against several Leptospira serovars have been detected by the microscopic agglutination test (MAT) in Mexico. With the exception of very few cases, the presence of serovars causing leptospirosis in cattle and other animal species has not been demonstrated by isolation in Mexico, and in such cases characterization had to be done abroad by complex and slow immunological approaches, by comparison with a number of reference strains. The present study was conducted to perform the molecular characterization of Leptospira isolates by multiple locus sequencing typing (MLST). A hundred and ninety seven sera and kidneys samples were collected immediately after slaughter, from grazing cattle coming from the south-eastern states of Mexico. Anti-Leptospira antibodies were detected by the MAT and kidneys were inoculated into EMJH and Fletcher's specific medium. A seropositivity of 60.4% (119 out of 197), with titers from 1:100 up to 1:3 200 was detected. Four isolates (2.03%), referred as CAL4, CAL6, CAL7 and MOCA45, were characterized by serology, ribotyping and MLST as L. kirschneri serovar Grippotyphosa; L. interrogans serovar Hardjo; L. santarosai serovar Mini and L. santarosai serovar Tarassovi, respectively. With the exception of serovar Hardjo, the three other isolates belong to serovars and species not previously isolated in Mexico. These findings make it necessary to evaluate the potential distribution of such serovars among cattle and their role on animal production and public health.
La leptospirosis bovina causa grandes pérdidas económicas a la ganadería por problemas reproductivos y también es un riesgo de salud pública. En México, desde el siglo pasado se ha registrado la presencia de anticuerpos contra serovariedades de Leptospira por la técnica de aglutinación microscópica (AM), en bovinos y otras especies animales. En muy pocos casos, la enfermedad fue demostrada por el aislamiento de Leptospira, y en tales casos, su caracterización se basó en métodos inmunológicos lentos que requirieron la comparación con cepas de referencia y que fueron realizados fuera de México. En el presente trabajo se realizó la caracterización molecular mediante la secuenciación de locus múltiples (MLST), de aislados de Leptospira obtenidos de riñones de bovinos recolectados en rastro, procedentes de las zonas Golfo y sur de México. Se obtuvieron muestras de suero y riñones de 197 bovinos para realizar la AM, y el cultivo en medios específicos EMJH y Fletcher. Se detectó una seropositividad del 60.4% (119 de 197), con títulos desde 1:100 hasta 1:3,200 y se obtuvieron cuatro aislados de Leptospira (2.03%), denominados CAL4, CAL6, CAL7 y MOCA45. Los aislados fueron caracterizados por serología, ribotipificación y MLST, como L. kirschneri serovariedad Grippotyphposa; L. interrogans serovariedad Hardjo; L. santarosai serovariedad Mini y L. santarosai serovariedad Tarassovi, respectivamente. A excepción de la serovariedad Hardjo, los aislados pertenecen a especies y serovariedades no aisladas anteriormente en la República Mexicana, esto sugiere la necesidad de evaluar su diseminación entre bovinos y su potencial efecto en la producción animal y en la salud pública.
