EVALUATION OF CLINICAL DIAGNOSTICS FOR PROVENTRICULAR NEMATODIASIS DUE TO SYNHIMANTUS NASUTA IN LORIKEETS (TRICHOGLOSSUS SPP.).

In this case series, clinical investigations were pursued during a Synhimantus nasuta infection in a lorikeet (Trichoglossus spp.) flock outbreak situation to better describe and document clinical presentations. In 11 lorikeets suspected to be infected with Synhimantus based on at least one abnormal finding on their physical examination (lethargy, feather-damaging behavior on the ventrum, weight loss, pale iris), the presence of five additional parameters was documented: anemia, relative eosinophilia, increased proventricular diameter-to-keel height ratio (PKR), proventricular barium filling defect, and positive fecal occult blood detection test. A total score (X of 9) was calculated by combining all these findings. Synhimantus nasuta infection was confirmed in four of these individuals by modified Wisconsin fecal examination. Suspected cases (n = 7 of 11) presented only with low scores (1-3 of 9), whereas birds with confirmed infections (n = 4 of 11) presented with both low (1-3 of 9, n = 2 of 4) and high (6-7 of 9, n = 2 of 4) total scores. High scores were associated with clinical anemia. Fecal occult blood was present in all confirmed cases and 4 of 7 suspected cases. An enlarged proventriculus was only observed in birds with active shedding (n = 3 of 4). Follow-up evaluations after 6 mon of treatment with ivermectin and selamectin suggested complete recovery with lowered or normalized total scores. In conclusion, during an S. nasuta outbreak, a rapid physical examination helps to identify suspect cases, including individuals requiring immediate medical attention. In the absence of ova shedding, infection cannot be excluded on the basis of scarce clinical findings, but the detection of occult fecal blood and an increased PKR should raise the index of suspicion.

Usefulness of Xpert® Carba-R on enrichment broth for the early detection of carbapenemase-producing Enterobacterales.

Early detection of patients colonized with carbapenemase-producing Enterobacterales is crucial to limit their spread. Molecular biology tests are rapid but might miss low-level carriage. Culture-based methods using enrichment are cheap and detect low-level carriage but cause delay. Two clinical cases are reported, which demonstrated that molecular biology (Xpert® Carb-R) on enriched broth cumulates advantages of both strategies. In both cases, this strategy enabled early detection of patients colonized at low-level with carbapenemase-producing Enterobacterales because it saved 24 hours in detection time.

Corrigendum to 'Rhinitis due to Aspergillus pseudoviridinutans in an orange-winged Amazon parrot (Amazona amazonica)'[Med. Mycol. Case Rep. 30 (2020) 46-50].

[This corrects the article DOI: 10.1016/j.mmcr.2020.11.001.].

Uncovering the novel Enterobacter cloacae complex species responsible for septic shock deaths in newborns: a cohort study.

BACKGROUND: Enterobacter cloacae complex contains nosocomial pathogens responsible for infection outbreaks. Identification at the species level within the E cloacae complex remains difficult. Using whole genome sequencing, our aim was to decipher the transmission routes that led to the death of six of seven neonates who had bacteraemia caused by E cloacae complex isolates in a neonatal intensive care unit (NICU) over a 13 month period. METHODS: In this cohort study, E cloacae complex isolates were taken from 186 newborns in an NICU: 14 were clinical samples (eg, blood cultures), 728 rectal swab samples, and 38 environmental samples (20 from siphons, 18 from incubators, and one from a mattress). The samples were analysed to decipher the possible role of manual cross transmission or environmental source in an outbreak of fatal septic shocks related to E cloacae complex bacteraemia. After the replacement of the incubators suspected to be the reservoir of some outbreak-related isolates on Feb 1, 2018, E cloacae complex strains were screened again for 10 months (503 rectal swab samples from 163 newborns). The 71 E cloacae complex isolates recovered from screening, clinical, and environmental samples across both study periods were compared by whole genome sequencing. The pathogenicity of E cloacae complex isolates responsible for fatal septic shocks was assessed using a Galleria mellonella in-vivo model. FINDINGS: From Dec 9, 2016, to Jan 31, 2018, 249 (34%) of 728 rectal swab samples were positive for E cloacae complex, with 66 (35%) of 186 newborns colonised. E cloacae complex were also recovered from four (20%) of 20 siphons and 11 (61%) of 18 incubators. During this period, whole genome sequencing identified that the isolates responsible for the six fatal septic shocks were all Enterobacter bugandensis. A G mellonella infection model showed a higher virulence of E bugandensis. Genomic analysis highlighted the role of incubators as a long-term reservoir and source of cross contamination, leading to their replacement on Feb 1, 2018. Following incubator replacement, a 10-month follow-up investigation identified a physiological gut colonisation with polyclonal E cloacae complex in 52 (34%) of 163 neonates within a median of 9 days (5-14), but no E cloacae complex-related septic shocks. INTERPRETATION: Despite around 30% of neonates being physiologically colonised with E cloacae complex, fatal sepsis was systematically linked with bacteraemia caused by E bugandensis. Our findings highlight the need for accurate identification methods to detect the hypervirulent species within the E cloacae complex recovered in neonates. FUNDING: Assistance Publique-Hôpitaux de Paris.

Evaluation of the Novodiag CarbaR+, a Novel Integrated Sample to Result Platform for the Multiplex Qualitative Detection of Carbapenem and Colistin Resistance Markers.

Objectives: This study evaluated the performance of the Novodiag® CarbaR+ an automated qualitative nucleic acid-based diagnostic assay detecting the blaVIM, blaNDM, blaIMP, blaOXA-48, blaKPC, blaOXA-23, blaOXA-58, blaOXA-24, and ISAba1 associated blaOXA-51 carbapenemase genes and colistin resistance mcr-1 gene from clinical isolates or directly from rectal swabs. Materials and Methods: CarbaR+ was evaluated on 201 clinical isolates and on 100 rectal swabs (80 selected swabs from patients that were evaluated by culture method and/or Xpert Carba-R assay and 20 spiked samples). PCR-sequencing on colonies was considered as the gold standard. Results: The CarbaR+ detected all the variants of the targeted resistance genes (39 blaVIM-, 30 blaNDM-, 20 blaIMP-, 19 blaOXA-48-, 15 blaKPC-, 19 blaOXA-23-, 13 blaOXA-58-, 4 blaOXA-24-, 8 ISAba1-blaOXA-51-, and 3 mcr-1-like genes) with sensitivity and specificity of 98.2% and 99.7%, respectively. On the 80 rectal swabs, 71 CarbaR+ results were fully concordant with the results on selective culture media (66 positive samples with 1 to 3 carbapenemases and 5 negative samples). In eight rectal swabs, CarbaR+ identified additional carbapenemase genes. One false negative result with an Escherichia coli producing-OXA-181 was observed and one CarbaR+ result for OXA-48 was in agreement with Xpert Carba-R assay, without growth on culture media. A concordance of 100% was observed on spiked samples. Conclusions: Novodiag CarbaR+ is a random-access fully automated system that achieves excellent performances for the detection of carbapenemase and/or colistin resistance determinants either from cultured clinical isolates or directly from rectal swabs in 80 minutes.

Medical Causes of Feather Damaging Behavior.

Feather damaging behavior (FDB), also referred to as feather picking, feather plucking, or pterotillomania, is one of the most common and frustrating clinical presentations in captive psittacines. The clinical approach to identify underlying medical conditions associated with FDB is reviewed. Primary feather or skin diseases as well as systemic diseases may lead to this syndrome. This article focuses on the medical causes of FDB documented in the current avian literature. Medical causes are presented using the VITAMIN D algorithm. Key components of the multifaceted therapeutic approach in managing FDB of medical origin are discussed.

Sterile traumatic panniculitis in a captive Brent goose.

A captive, adult female Brent goose (Branta bernicla) with a history of severe feather picking by its mate, was presented with 0.5-2.5 cm skin nodules on the head and neck. Histologic examination revealed a well-delineated dermal mass that surrounded an intact feather follicle and was composed of lakes of proteinaceous fluid and fibrin with scattered foamy macrophages and multinucleate giant cells. No bacteria or fungi were identified with histology, microbial culture, or PCR. Sterile panniculitis is an infrequent finding in animals and traumatic panniculitis is rarely sterile.

Successful use of culture and enrichment for the detection of OXA-181-producing Escherichia coli from rectal swab samples falsely categorized as negative by Xpert® Carba-R.

An OXA-181 producing Escherichia coli isolate that went recurrently undetected directly from rectal swab sample using Xpert® Carba-R, was successfully detected using ertapenem supplemented broth enrichment followed by culture-based method. Our data suggest that implementation of culture-based methods plus enrichment might be crucial for the efficient screening of patients considered to be at "high-risk" of colonization with carbapenemase producers and who are colonized at low level.

Evaluation of the BD MAX Check-Points CPO Assay for the Detection of Carbapenemase Producers Directly from Rectal Swabs.

A novel real-time multiplex PCR assay, BD MAX Check-Points CPO, was evaluated to detect carbapenemase-producing organisms in clinical settings on the BD MAX system. A total of 175 well-characterized isolates (including 123 carbapenemase producers) and 128 rectal swab specimens (including 83 positives) of patients considered at high risk for carriage of carbapenemase producers were included. Bacterial suspensions were used to spike true-negative rectal swabs to mimic a clinical sample. Sample (50 µL), containing either the spiked or the patient's sample, was processed. The BD MAX Check-Points CPO assay detected carbapenemases KPC, VIM/IMP, NDM, and OXA-48-like producers with a high sensitivity and specificity of 97.1% and 98.8%, respectively. Rare variants of the IMP type (IMP-11, IMP-13, and IMP-14) and one rare and distantly related OXA-48 variant (OXA-535) remained undetected. With patients' rectal swabs, sensitivity and specificity were 92.8% and 97.8%, respectively. Failure of detection was due to weak inoculum. The time to result was short: approximately. 2.5 hours for 12 samples (including extraction and PCR). The automated sample-in results-out platform is an efficient, quick, and easy-to-use tool for the detection of the main five carbapenemases. The lack of distinction between producers of VIM and IMP may be limiting in countries where these enzymes are widespread, as in Asia, but not in France, where IMP producers are extremely rare.

ENDOSCOPIC REMOVAL OF A FOREIGN BODY IN A MEXICAN AXOLOTL (AMBYSTOMA MEXICANUM) WITH THE USE OF MS222-INDUCED IMMOBILIZATION.

This communication briefly describes the use of tricaine methanesulfonate (MS222) to induce chemical restraint/general anesthesia of a Mexican axolotl (Ambystoma mexicanum) for the endoscopic retrieval of a gastric foreign body. There is very little published scientific literature concerning the anesthesia of Mexican axolotls. The anesthesia used in this case was an immersion bath of tricaine methanesulfonate where the concentration of tricaine methanesulfonate was gradually increased to 500 mg/L (ppm) over a 15-min period. A loss of righting reflex was observed within 3 min of attaining the final concentration of the anesthetic bath. The first voluntary movements following the transfer to a freshwater bath occurred within 7 min. The recovery was uneventful. Tricaine methanesulfonate in this case proved to be an effective anesthetic agent for a short, minimally invasive procedure.

Preliminary Findings of Structure and Expression of Opioid Receptor Genes in a Peregrine Falcon ( Falco peregrinus), a Snowy Owl ( Bubo scandiacus), and a Blue-fronted Amazon Parrot ( Amazona aestiva).

To further knowledge of the physiology of opioid receptors in birds, the structure and expression of the µ-, δ-, and κ-opioid receptor genes were studied in a peregrine falcon ( Falco peregrinus), a snowy owl ( Bubo scandiacus), and a blue-fronted Amazon parrot ( Amazona aestiva). Tissue samples were obtained from birds that had been euthanatized for poor release prognosis or medical reasons. Samples were taken from the brain (telencephalon, thalamus, pituitary gland, cerebellum, pons, medulla oblongata, mesencephalon), the spinal cord and dorsal root ganglions, and plantar foot skin. Messenger RNA was recovered, and reverse transcription polymerase chain reaction (RT-PCR) was performed to generate complementary DNA (cDNA) sequences. Gene structures were documented by directly comparing cDNA sequences with recently published genomic sequences for the peregrine falcon and the blue-fronted Amazon parrot or by comparisons with genomic sequences of related species for the snowy owl. Structurally, the avian µ-opioid receptor messenger RNA (mRNA) species were complex, displaying differential splicing, alternative stop codons, and multiple polyadenylation signals. In comparison, the structure of the avian κ-receptor mRNA was relatively simple. In contrast to what is seen in humans, the avian δ-receptor mRNA structure was found to be complex, demonstrating novel 3-prime coding and noncoding exons not identified in mammals. The role of the δ-opioid receptor merits further investigation in avian species.

Chondroblastic osteosarcoma of the middle ear in a guinea pig (Cavia porcellus).

A 3-year-old intact female guinea pig (Cavia porcellus) was presented for acute anorexia. Medical and surgical treatments for cystitis and ovarian cysts, respectively, did not prevent continuous weight loss. Computed tomography and histopathological analysis revealed a chondroblastic osteosarcoma of the right middle ear, which has not been reported in this species.

Ostéosarcome chondroblastique de l'oreille moyenne chez un cobaye(Cavia porcellus). Un cobaye (Cavia porcellus) femelle de 3 ans a été présentée pour une anorexie d'apparition aiguë. Malgré la prise en charge médicale et chirurgicale d'une cystite et de kystes ovariens, l'individu continuait de perdre du poids. L'examen tomodensitométrique et l'analyse histologique ont mis en évidence un ostéosarcome chondroblastique de l'oreille moyenne, ce qui n'a jamais été rapporté dans cette espèce.(Traduit par Dre Ophélie Cojean).

Diaphragmatic hernia in a pet chinchilla (Chinchilla lanigera).

A 10-year-old pet chinchilla (Chinchilla lanigera) was referred for ultrasound investigation of a thoracic mass. The mass was initially believed to be a pulmonary abscess or tumor based on radiographs and ultrasound. Cytological examination suggested the presence of a gastrointestinal structure in the thorax, and necropsy revealed a true diaphragmatic hernia subdividing the stomach into thoracic and abdominal portions.

Hernie diaphragmatique chez un chinchilla de compagnie(Chinchilla lanigera). Un chinchilla (Chinchilla lanigera) domestique mâle castré de 10 ans a été référé pour investigation échographique d'une masse thoracique. Basé sur les radiographies et l'échographie, il fut initialement pensé que la masse était un abcès ou une tumeur pulmonaire. L'analyse cytologique suggérait la présence d'une structure gastro-intestinale dans le thorax et la nécropsie a révélé une vraie hernie diaphragmatique qui divisait l'estomac en une partie thoracique et une partie abdominale.(Traduit par les auteurs).

Overview of Drug Delivery Methods in Exotics, Including Their Anatomic and Physiologic Considerations.

Drug delivery to exotic animals may be extrapolated from domestic animals, but some physiologic and anatomic differences complicate treatment administration. Knowing these differences enables one to choose optimal routes for drug delivery. This review provides practitioners with a detailed review of the currently reported methods used for drug delivery of various medications in the most common exotic animal species. Exotic animal peculiarities that are relevant for drug administration are discussed in the text and outlined in tables and boxes to help the reader easily find targeted information.

Chylous ascites associated with abdominal trauma and intestinal resection-anastomosis in a pet ferret (Mustela putorius furo).

CASE DESCRIPTION A 10-week-old 0.73-kg (1.6-lb) castrated male domestic ferret (Mustela putorius furo) was referred for exploratory laparotomy because of pneumoperitoneum and possible septic peritonitis after being bitten by the owner's dog. CLINICAL FINDINGS Abdominal exploration revealed a large laceration of the duodenum, tears of the jejunal mesentery, and 2 small tears in the abdominal wall. Chylous abdominal effusion developed 48 hours after surgery. TREATMENT AND OUTCOME Postoperative care included supportive treatment, analgesia, and antimicrobials. An abdominal drain was placed during the laparotomy and enabled monitoring of abdominal fluid production. Enteral feeding was provided through an esophagostomy tube. The chylous fluid production rapidly decreased after treatment with octreotide was initiated, and the ferret improved. Chyloabdomen resolved after 8 days of hospitalization and medical treatment. CLINICAL RELEVANCE Findings suggested that chylous ascites can potentially develop secondary to blunt abdominal trauma in ferrets. In this ferret, chyloabdomen was successfully treated with octreotide administration and abdominal drainage.

Use of percutaneous cystolithotomy for removal of urethral uroliths in a pot-bellied pig.

A 6-month-old neutered male pot-bellied pig was presented for an obstructive urethral stone which was successfully removed by percutaneous cystolithotomy (PCCL). The pig recovered well although suspected urethral spasms and pollakiuria persisted for 2 weeks after surgery. The owner reported a good urine stream 2 months after discharge. This novel minimally invasive approach provided excellent visualization and allowed complete evaluation of the lower urinary tract. Percutaneous cystolithotomy holds great promise for the future treatment of various lower urinary tract disorders in this species.

Utilisation de la technique de cystolithotomie transcutanée pour le retrait d'un calcul urétral chez un cochon vietnamien. Un cochon vietnamien mâle castré de 6 mois a été présenté suite à un calcul urétral obstructif qui a pu être retiré par cystolithotomie transcutanée. Le cochon s'est bien remis bien qu'une pollakiurie persistante possiblement secondaire à des spasmes urétraux fut observée pendant deux semaines après la procédure. Le propriétaire a rapporté la présence d'un bon jet urinaire deux mois après la procédure. Cette nouvelle technique minimalement invasive permet une excellente visualisation et évaluation de l'ensemble du système urinaire inférieur. C'est une option thérapeutique d'avenir dans la gestion des cas d'affection du système urinaire chez cette espèce.(Traduit par les auteurs).

Diaphragmatic hernia in a pet chinchilla (Chinchilla lanigera).

A 10-year-old pet chinchilla (Chinchilla lanigera) was referred for ultrasound investigation of a thoracic mass. The mass was initially believed to be a pulmonary abscess or tumor based on radiographs and ultrasound. Cytological examination suggested the presence of a gastrointestinal structure in the thorax, and necropsy revealed a true diaphragmatic hernia subdividing the stomach into thoracic and abdominal portions.

Hernie diaphragmatique chez un chinchilla de compagnie(Chinchilla lanigera). Un chinchilla (Chinchilla lanigera) domestique mâle castré de 10 ans a été référé pour investigation échographique d'une masse thoracique. Basé sur les radiographies et l'échographie, il fut initialement pensé que la masse était un abcès ou une tumeur pulmonaire. L'analyse cytologique suggérait la présence d'une structure gastro-intestinale dans le thorax et la nécropsie a révélé une vraie hernie diaphragmatique qui divisait l'estomac en une partie thoracique et une partie abdominale.(Traduit par les auteurs).

Pneumatosis coli in a domestic ferret (Mustela putorius furo).

A 4-year-old spayed female ferret was presented with acute diarrhea and partial anorexia. Pneumatosis coli and segmental enteropathy were identified by ultrasonography and radiography. Fecal culture did not identify any pathogenic bacteria. Medical management of concurrent diseases and antibiotic therapy resulted in resolution of clinical signs and pneumatosis coli.

Pneumatose chez un furet domestique(Mustela putorius furo). Un furet femelle stérilisé âgé de 4 ans a été présenté avec une diarrhée aiguë et de l'anorexie partielle. Une pneumatose et une entéropathie segmentaire ont été identifiés par échographie et radiographie. Une culture fécale n'a pas permis de mettre en évidence une bactérie pathogène. La gestion médicale de maladies concomitantes et d'une thérapie antibiotique ont produit une résolution des signes cliniques et de pneumatose.(Traduit par Isabelle Vallières).

Glomerular filtration rate determination by computed tomography in two pet rabbits with renal disease.

CASE DESCRIPTION A 3-year-old and a 7-year-old spayed female rabbit (Oryctolagus cuniculus) were evaluated because of digestive stasis associated with renal asymmetry. CLINICAL FINDINGS Neoplasia of the right kidney was diagnosed via cytologic analysis in the 3-year-old rabbit. Ureterolithiasis of the left kidney was diagnosed via abdominal ultrasonography in the 7-year-old rabbit. To evaluate whether unilateral nephrectomy was indicated, evaluation of glomerular filtration rate by dynamic CT (CT-GFR) was performed on both rabbits. On the basis of the functional and morphological CT-GFR results, radical nephrectomy was recommended for the rabbit with renal neoplasia whereas a more conservative approach was recommended for the other rabbit. TREATMENT AND OUTCOME The rabbit with renal neoplasia underwent radical nephrectomy without complication. The rabbit with ureterolithiasis underwent ureteral stent placement, and the renal pelvic dilatation resolved. Both rabbits maintained unremarkable serum urea and creatinine concentrations after surgery. CLINICAL RELEVANCE GFR is a highly useful and reliable variable for the evaluation of renal function but is difficult to assess with routine clinical laboratory tests. The CT-GFR technique described here was quickly performed, was technically suitable for rabbits, and provided clinically relevant information. Studies are required to establish reference values for CT-GFR in rabbits.