scholarly journals Atypical Salmonellosis in a Horse: Implications for Hospital Safety

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Kristina L. Rothers ◽  
Eileen S. Hackett ◽  
Gary L. Mason ◽  
Brad B. Nelson
Keyword(s):  
Large Volume ◽  
Perceived Risk ◽  
Clinical Signs ◽  
Infectious Agent ◽  
Aerobic Culture ◽  
Hospital Safety ◽  
Quarter Horse ◽  
Gastric Reflux ◽  
Small Intestinal ◽  
Hospital Acquired

A 17-year-old Quarter Horse mare was evaluated for colic of 24-hour duration. Clinical signs and diagnostic evaluation were consistent with duodenitis-proximal jejunitis. The horse’s clinical condition deteriorated despite medical treatment and was euthanized. Aerobic culture collected from small intestinal ingesta was positive for Salmonella enterica subsp. enterica serovar Hadar. Salmonella sp. is commonly implicated in nosocomial infections in equine veterinary hospitals usually through feces containing the organism. Considering Salmonella sp. was cultured from the jejunal luminal contents and the large volume of nasogastric reflux that was evacuated in this case, a perceived risk of Salmonella sp. transmission from infected gastric reflux to other hospitalized cases was realized. Infectious agent biosecurity precautions should be undertaken in horses with nasogastric reflux to prevent hospital-acquired transmission.

Eosinophilic Gastroenteritis with Splendore-Hoeppli Material in the Ferret (Mustela putorius furo)

1992 ◽  
Vol 29 (1) ◽  
pp. 21-26 ◽  
Author(s):  
J. G. Fox ◽  
L. S. Palley ◽  
R. Rose
Keyword(s):  
Clinical Signs ◽  
Infectious Agent ◽  
Multiple Organ ◽  
Eosinophilic Gastroenteritis ◽  
Human Beings ◽  
Mesenteric Lymph Nodes ◽  
Mustela Putorius ◽  
Mesenteric Lymph ◽  
Small Intestinal ◽  
Mustela Putorius Furo

Eosinophilic gastroenteritis, focal or diffuse with eosinophilic infiltrations of the stomach or intestine, has been described in human beings, cats, dogs, and horses. In this paper, we describe infiltration of the gastrointestinal tract with eosinophils accompanied by a circulating eosinophilia in six ferrets ( Mustela putorius furo). Clinical signs included chronic weight loss, anorexia, and diarrhea. The small intestines from five ferrets had diffuse infiltrates of eosinophils. This resulted in focal or multifocal loss of the muscular tunic in three ferrets. Two of these ferrets also had eosinophilic gastritis. Eosinophilic granulomas with Splendore-Hoeppli material were present in mesenteric lymph nodes in four ferrets. Two ferrets had multiple organ involvement; one had eosinophilic granulomas in the liver, mesentery, and choroid plexus as well as moderate parapancreatic segmental arteritis with infiltration of eosinophils and mural thrombosis. The second ferret had, in addition to moderate diffuse gastric and small intestinal eosinophilic mucosal infiltrations, interstitial eosinophilic pulmonary infiltrates. Examination of all tissues failed to reveal an infectious agent.

Serum cobalamin concentrations and small intestinal ultrasound changes in 75 cats with clinical signs of gastrointestinal disease: a retrospective study

2016 ◽  
Vol 19 (1) ◽  
pp. 48-56 ◽  
Author(s):  
Maria C Jugan ◽  
John R August
Keyword(s):  
Small Intestine ◽  
Gastrointestinal Disease ◽  
Clinical Signs ◽  
Small Animal ◽  
Abdominal Ultrasound ◽  
Wall Layer ◽  
Normal Serum ◽  
Definitive Diagnosis ◽  
Albumin Concentration ◽  
Small Intestinal

Objectives The aim of the study was to evaluate ultrasonographic changes in the small intestine of cats with clinical signs of gastrointestinal disease and low or low–normal serum cobalamin concentrations. Methods Records for client-owned cats presenting to the small animal hospital with signs of gastrointestinal disease and in which serum cobalamin concentrations were measured from 2000–2013 were reviewed. Inclusion criteria were cobalamin concentrations <500 ng/l, abdominal ultrasound within 1 month of cobalamin testing and definitive diagnosis. Results Of 751 serum cobalamin measurements, hypocobalaminemia or low–normal cobalamin was identified in 270 cats, abdominal ultrasound was performed in 207 of those cats and a diagnosis was available for 75 of them. Small intestinal ultrasound changes were detected in 49/75 (65%) cats. Abnormalities included thickening, loss of wall layer definition, echogenicity alterations and discrete masses. Serum cobalamin concentrations <500 ng/l were observed with diagnoses of inflammatory disease, neoplasia, infectious disease and normal histopathology. Cobalamin concentration was significantly lower in cats with lymphoma or inflammatory bowel disease compared with other gastrointestinal neoplasia ( P = 0.031). No difference was found between cobalamin concentration and the presence of ultrasound abnormalities, specific ultrasound changes or albumin concentration. Conclusions and relevance One-third of symptomatic cats with hypocobalaminemia or low–normal cobalamin concentrations may have an ultrasonographically normal small intestine. For the majority of cats in this study, histopathologic abnormalities were observed in the small intestine, regardless of ultrasound changes. These findings suggest gastrointestinal disease should not be excluded based on low–normal cobalamin concentrations, even with a concurrent normal ultrasound examination. Additional studies are needed in cats with low–normal serum cobalamin concentrations, as a definitive diagnosis was not pursued consistently in those cats. However, data from this study suggest that careful monitoring, histopathologic evaluation and future cobalamin supplementation may be warranted.

scholarly journals Study of a multisite prospective adverse event surveillance system

2019 ◽  
Vol 29 (4) ◽  
pp. 277-285 ◽  
Author(s):  
Alan J Forster ◽  
Allen Huang ◽  
Todd C Lee ◽  
Alison Jennings ◽  
Omer Choudhri ◽  
...  
Keyword(s):  
Adverse Event ◽  
Prospective Observational Study ◽  
General Medicine ◽  
Surveillance Period ◽  
Expert Review ◽  
Clinical Procedures ◽  
Hospital Safety ◽  
Surveillance Method ◽  
Hospital Acquired ◽  
Rule Out

BackgroundWe have designed a prospective adverse event (AE) surveillance method. We performed this study to evaluate this method’s performance in several hospitals simultaneously.ObjectivesTo compare AE rates obtained by prospective AE surveillance in different hospitals and to evaluate measurement factors explaining observed variation.MethodsWe conducted a multicentre prospective observational study. Prospective AE surveillance was implemented for 8 weeks on the general medicine wards of five hospitals. To determine if population factors may have influenced results, we performed mixed-effects logistic regression. To determine if surveillance factors may have influenced results, we reassigned observers to different hospitals midway through surveillance period and reallocated a random sample of events to different expert review teams.ResultsDuring 3560 patient days of observation of 1159 patient encounters, we identified 356 AEs (AE risk per encounter=22%). AE risk varied between hospitals ranging from 9.9% of encounters in Hospital D to 35.8% of encounters in Hospital A. AE types and severity were similar between hospitals—the most common types were related to clinical procedures (45%), hospital-acquired infections (21%) and medications (19%). Adjusting for age and comorbid status, we observed an association between hospital and AE risk. We observed variation in observer behaviour and moderate agreement between clinical reviewers, which could have influenced the observed rate difference.ConclusionThis study demonstrated that it is possible to implement prospective surveillance in different settings. Such surveillance appears to be better suited to evaluating hospital safety concerns within rather than between hospitals as we could not definitively rule out whether the observed variation in AE risk was due to population or surveillance factors.

scholarly journals Diagnosis and management of a case of retroperitoneal eosinophilic sclerosing fibroplasia in a cat

2019 ◽  
Vol 5 (2) ◽  
pp. 205511691986717
Author(s):  
Maureen E Thieme ◽  
Anastasia M Olsen ◽  
Andrew D Woolcock ◽  
Margaret A Miller ◽  
Micha C Simons
Keyword(s):  
Abdominal Mass ◽  
Clinical Signs ◽  
Surgical Excision ◽  
Clinical Findings ◽  
Peripheral Eosinophilia ◽  
Aerobic Culture ◽  
Complete Surgical Excision ◽  
History Of ◽  
Amoxicillin Clavulanic Acid ◽  
The Masses

Case summary A 4-year-old neutered male cat was presented with a 2-month history of intermittent constipation that progressed to obstipation. Primary clinical findings included a large, multi lobulated mass in the caudodorsal abdomen, peripheral eosinophilia and hyperglobulinemia. Abdominal imaging revealed a multilobulated, cavitated mass in the sublumbar region. Exploratory celiotomy revealed multiple firm masses in the sublumbar retroperitoneal space causing ventral displacement and compression of the descending colon with extension of the masses into the pelvic canal. Histopathology was consistent with feline gastrointestinal eosinophilic sclerosing fibroplasia (FGESF). Aerobic culture was positive for Staphylococcus aureus. The cat was treated with prednisolone (2 mg/kg PO q24h), lactulose (0.5 g/kg PO q8h), amoxicillin/clavulanic acid (62.5 mg/cat PO q12h for 1 month) and fenbendazole (50 mg/kg PO q24h for 5 days). Six months postoperatively, the cat had no recurrence of clinical signs. Repeat evaluation and imaging at day 732 postoperatively revealed marked improvement of the abdominal mass, resolution of peripheral eosinophilia and no clinical signs with continued prednisolone therapy (0.5 mg/kg PO q24h). Relevance and novel information This is a report of a primary extramural FGESF lesion, and the first description of characteristics of FGESF on CT. Previous evidence suggests that the most favorable outcomes require immunosuppressive therapy and complete surgical excision; however, this case demonstrates a favorable outcome with medical management alone.

scholarly journals Determination of the Infectious Agent of Translucent Post-Larva Disease (TPD) in Penaeus vannamei

Pathogens ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. 741 ◽  
Author(s):  
Ying Zou ◽  
Guosi Xie ◽  
Tianchang Jia ◽  
Tingting Xu ◽  
Chong Wang ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Infectious Agent ◽  
Systematic Investigation ◽  
Shrimp Farming ◽  
Histopathological Analysis ◽  
Penaeus Vannamei ◽  
Challenge Tests ◽  
Acute Hepatopancreatic Necrosis Disease ◽  
Farming Industry

A new emerging disease called “translucent post-larvae disease” (TPD) or “glass post-larvae disease” (GPD) of Penaeus vannamei, characterized by pale or colorless hepatopancreas and digestive tract, has become an urgent threat to the shrimp farming industry. Following this clue that treatment of an antibacterial agent could alleviate the disease, systematic investigation of the potential infectious agent of TPD was conducted using bacterial identification and artificial challenge tests to fulfill Koch’s postulates. A dominant bacterial isolate, Vp-JS20200428004-2, from the moribund individuals was isolated and identified as Vibrio parahaemolyticus based on multi-locus sequence analysis. However, Vp-JS20200428004-2 differed from the V. parahaemolyticus that caused typical acute hepatopancreatic necrosis disease. Immersion challenge tests revealed that Vp-JS20200428004-2 could cause 100% mortality within 40 h at a dose of 1.83 × 106 CFU/mL, and experimental infected shrimp showed similar clinical signs of TPD. The Vp-JS20200428004-2 could be re-isolated and identified from the experimental infected individuals. Moreover, histopathological analysis of diseased samples indicated that Vp-JS20200428004-2 caused severe necrosis and sloughing of epithelial cells of the hepatopancreas and midgut in shrimp individuals both naturally and experimentally infected. Our present results indicated that Vp-JS20200428004-2 is a highly virulent infectious agent associated with the TPD and deserves further attention.

scholarly journals HOSPITAL ACQUIRED INFECTIONS IN A MEDICAL INTENSIVE CARE UNIT- A RETROSPECTIVE STUDY

2020 ◽  
pp. 37-38
Author(s):  
Dr Anbarasu. D ◽  
Nirmal kumar N S ◽  
Kundana Kundana
Keyword(s):  
Nosocomial Infections ◽  
Surveillance System ◽  
Critical Care Unit ◽  
Medical Intensive Care Unit ◽  
Infectious Agent ◽  
Hospital Acquired Infections ◽  
Medical Intensive Care ◽  
Time Of Admission ◽  
Hospital Acquired ◽  
Systemic Condition

Infections in critical care unit are high, and of serious hospital problems. Infections acquired during the hospital stay are generally called nosocomial infections, initially known as infections arising after 48 h of hospital admission.[1,2] National Nosocomial Infections Surveillance system defines a nosocomial infection as a localized or systemic condition that results from adverse reaction to the presence of an infectious agent (s) or its toxin (s) that was not present or incubating at the time of admission to the hospital.[1]

scholarly journals Disease Risk and Mortality Prediction in Intensive Care Patients with Pneumonia. Australian and New Zealand Practice in Intensive Care (ANZPIC II)

2005 ◽  
Vol 33 (1) ◽  
pp. 101-111 ◽  
Author(s):  
R. J. Boots ◽  
J. Lipman ◽  
R. Bellomo ◽  
D. Stephens ◽  
R. F. Heller
Keyword(s):  
Intensive Care ◽  
New Zealand ◽  
Clinical Signs ◽  
Community Acquired Pneumonia ◽  
Ventilator Associated Pneumonia ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

This study of ventilated patients investigated pneumonia risk factors and outcome predictors in 476 episodes of pneumonia (48% community-acquired pneumonia, 24% hospital-acquired pneumonia, 28% ventilator-associated pneumonia) using a prospective survey in 14 intensive care units within Australia and New Zealand. For community acquired pneumonia, mortality increased with immunosuppression (OR 5.32, CI 95% 1.58–17.99, P<0.01), clinical signs of consolidation (OR 2.43, CI 95% 1.09–5.44, P=0.03) and Sepsis-Related Organ Failure Assessment (SOFA) scores (OR 1.19, CI 95% 1.08–1.30, P<0.001) but improved if appropriate antibiotic changes were made within three days of intensive care unit admission (OR 0.42, CI 95% 0.20–0.86, P=0.02). For hospital-acquired pneumonia, immunosuppression (OR 6.98, CI 95% 1.16–42.2, P=0.03) and non-metastatic cancer (OR 3.78, CI 95% 1.20–11.93, P=0.02) were the principal mortality predictors. Alcoholism (OR 7.80, CI 95% 1.20–17.50, P<0.001), high SOFA scores (OR 1.44, CI 95% 1.20–1.75, P=0.001) and the isolation of “high risk” organisms including Pseudomonas aeruginosa, Acinetobacter spp, Stenotrophomonas spp and methicillin resistant Staphylococcus aureus (OR 4.79, CI 95% 1.43–16.03, P=0.01), were associated with increased mortality in ventilator-associated pneumonia. The use of non-invasive ventilation was independently protective against mortality for patients with community-acquired and hospital-acquired pneumonia (OR 0.35, CI 95% 0.18–0.68, P=0.002). Mortality was similar for patients requiring both invasive and non-invasive ventilation and non-invasive ventilation alone (21% compared with 20% respectively, P=0.56). Pneumonia risks and mortality predictors in Australian and New Zealand ICUs vary with pneumonia type. A history of alcoholism is a major risk factor for mortality in ventilator-associated pneumonia, greater in magnitude than the mortality effect of immunosuppression in hospital-acquired pneumonia or community-acquired pneumonia. Non-invasive ventilation is associated with reduced ICU mortality. Clinical signs of consolidation worsen, while rationalising antibiotic therapy within three days of ICU admission improves mortality for community-acquired pneumonia patients.

scholarly journals Incidence of Hospital-Acquired Bacterial Pneumonia and Its Resistance Profiles in Patients Admitted to Intensive Care Unit

2016 ◽  
Vol 9 (3) ◽  
pp. 73 ◽  
Author(s):  
Vahid Boostani ◽  
Farzaneh Dehghan ◽  
Afsaneh Karmostaji ◽  
Nader Zolghadri ◽  
Afsaneh Shafii
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Antimicrobial Resistance ◽  
Bacterial Pneumonia ◽  
Clinical Signs ◽  
Resistance Rate ◽  
Gram Negative Bacteria ◽  
Cross Sectional ◽  
Gram Negative ◽  
Hospital Acquired

<p>Hospital-acquired bacterial pneumonia (HABP) is one of the most important causes of morbidity, mortality and economic problems especially for patients admitted in the intensive care unit (ICU) ward. The aim of this study was to determine the incidence of nosocomial pneumonia in ICU, identify the causative bacteria and their resistance profiles. This cross sectional study was performed on 214 patients who were admitted in the ICU ward of a general hospital requiring mechanical ventilation for at least 48 h. Identification of HABP was based on the clinical signs manifested 48 h or more after admission, new chest X-ray infiltrates and microbiologic examination of endo tracheal secretion. Data were analyzed using SPSS 21 to perform the descriptive statistics. The isolated gram negative bacteria were <em>Klebsiella pneumoniae</em> (50%), <em>Staphylococcus aureus</em> (18.7%), <em>Acinetobacter baumannii</em> (12.5%), <em>Escherichia coli</em> (12.5%) and <em>Pseudomonas aeroginosa</em> (6.3%). The maximum antimicrobial resistance of gram negative bacteria was to Cefazolin (100%) and Ampicillin (84.6%), while antimicrobial resistance to Clindamycin, Azithromycin, Amoxycillin+clavulanate, Trimethoprim+sulfamethoxazole and Ciprofloxacin was 33.3%. No resistance was seen towards carbapenems.The most frequent gram negative isolated bacterium was <em>K. pneumoniae, </em>and maximum antimicrobial resistance rate was observed for Cefazolin and Ampicillin, which is due to betalactamase production.</p>

scholarly journals Canine Visceral Leishmaniasis: Dermatological Aspects and Associated Dermatoses

2018 ◽  
Vol 44 (1) ◽  
pp. 4
Author(s):  
Nayara Benites Moreira ◽  
Arleana Do Bom Parto Ferreira de Almeida ◽  
Andressa Zelenski de Lara Pinto ◽  
Emmanuelle Rosa Mutzemberg ◽  
Isabela De Godoy ◽  
...  
Keyword(s):  
Visceral Leishmaniasis ◽  
High Frequency ◽  
Skin Diseases ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Infectious Agent ◽  
Fungal Culture ◽  
Cutaneous Lesions ◽  
Exfoliative Dermatitis ◽  
System L

Background: Visceral leishmaniasis (VL) is a zoonotic disease caused by Leishmania chagasi (syn. L. infantum). The dog is the main reservoir for this infectious agent in the urban environment. Among the various systemic signs of viscerotropic infection by L. chagasi, cutaneous lesions, including exfoliative dermatitis, cutaneous ulcers and nodules, alopecia, papular or pustular dermatitis, and onychogryphosis, are the most common in dogs. This study aimed to describe the major cutaneous lesions, evaluate the skin parasite L. chagasi by PCR, and investigate the main dermatoses associated with this zoonosis.Materials, Methods & Results: This study evaluated 50 seropositive dogs of various breeds and sizes for VL by ELISA and IFA and for the dermatological signs associated with VL. Moreover, molecular analysis of skin fragments was performed with primers 150 and 152 for the genus Leishmania, and the species was verified as L. chagasi with RV1 and RV2 primers. Deep skin scraping for mites and fungal culture analysis were performed in all dogs. Of the 50 dogs, 15 (30%) were free of systemic or cutaneous signs; however, changes in skin and annexes were observed in 35 (70%) dogs. Thirty-one dogs (62%) presented infection with dermatophytes, 26 (83.9%) with Microsporum sp., and 5 (16.1%) with Trichophyton sp.; only one dog showed parasitism by Sarcoptes scabiei. A statistically significant association was observed between skin alterations and dermatological infection by dermatophytes (P = 0.61). Of the 29 dogs from which skin fragments were used to perform PCR with specific primers, 19 (65.5%) showed L. chagasi DNA amplification.Discussion: Symptomatic dogs are more common than asymptomatic ones; therefore, sampling was set up in the hospital for reagents dogs with clinical suspicion of this zoonosis. Dermatological signs accounted for 70% of the clinical symptoms presented by the dogs, which were evaluated as described by other authors. Exfoliative dermatitis was the most common skin lesion followed by onychogryphosis and alopecia. This is because of granulomatous or pyogranulomatous inflammation, inflammation in different structures of the skin, or deposition of immune complexes. Only few studies have described the co-existence of VL and dermatophytosis in dogs. We found dermatophyte fungal infection in more than half of the dogs (70%), most frequently Microsporum sp. followed by infection with Trichophyton sp. Regarding the clinical signs, no statistical difference was observed between the dogs with and without dermatophyte infection, which reinforces the lack of specificity in clinical signs that may hinder the diagnosis of both diseases when present as co-morbidities or in isolation. The high frequency of dermatophytosis in dogs with VL may result from a compromised immune system. L. chagasi DNA detected in 65.5% of samples tested by conventional PCR can be related to the host’s immune response, as well as to the uneven distribution of the parasite in different tissues. These results support the high frequency of skin changes and concomitant skin diseases like ringworm observed in dogs with LV, highlighting the importance of researching other differential diagnoses in endemic areas.

scholarly journals Detection of the Disease-Associated Isoform of the Prion Protein in Formalin-Fixed Tissues by Western Blot

2007 ◽  
Vol 19 (5) ◽  
pp. 548-552 ◽  
Author(s):  
Eric M. Nicholson ◽  
Robert A. Kunkle ◽  
Amir N. Hamir ◽  
Semakaleng Lebepe-Mazur ◽  
Dennis Orcutt
Keyword(s):  
Western Blot ◽  
Prion Protein ◽  
Prion Disease ◽  
Clinical Signs ◽  
Infectious Agent ◽  
Disease Diagnosis ◽  
Detection Methods ◽  
Serological Tests ◽  
Fresh Tissue ◽  
Formalin Fixed

Clinical signs of prion disease are not specific and include a variety of differential diagnoses. Serological tests and nucleic acid-based detection methods are not applicable to prion-disease-agent detection because of the unusual nature of the infectious agent. Prion-disease diagnosis is primarily conducted by means of immunodetection of the infectious agent, typically by at least 2 distinct procedures with immunohisto-chemistry and Western blot being the most informative. These approaches differ in the need for formalin-fixed and frozen or fresh tissue respectively. This work describes a method for the detection of the disease-associated isoform of the prion protein by Western blot using formalin-fixed tissues. The approach requires only minimal modification of existing Western-blot procedures and could readily be incorporated into existing detection schemes for confirmatory purposes when fresh or frozen tissues are unavailable.

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