Determination of the intramammary dose of benzylpenicillin required to maintain an adequate concentration in the milk to inhibit Gram-positive bacteria in the clinically normal udder for 24 hr

The aim of this study was to determine the intramammary dose of benzylpenicillin required to maintain a concentration in the milk above the MIC for the Gram-positive bacteria that cause mastitis. The product used in this study was a commercially available procaine benzylpenicillin in an oily suspension with micronized particles. Three dose levels were used: 200,000, 300,000, and 600,000IU. Concentrations of benzylpenicillin in cow milk and plasma were determined after a single intramammary dose was administered into one quarter of each of the five cows in each treatment group. Samples were analyzed using an HPLC-MS/MS method, which was validated during the study. Concentrations in the milk were well above the MIC for the target pathogens for all doses tested. There was a linear dose-dependent increase in the mean AUCs of benzylpenicillin concentrations in plasma and milk. At the first milking, 12hr after dosing, there was a significant difference between the mean milk benzylpenicillin concentrations in cows treated with a dose of 600,000IU, and those treated with 200,000 or 300,000IU. Although this study shows a linear relationship between the dose of procaine benzylpenicillin administered and the concentration in the milk in the healthy udder, it would be useful to conduct studies on cows with mastitis to define the optimum dose and duration of intramammary treatment with benzylpenicillin.Peer reviewe

Infection prevention and control interventions in the first outbreak of methicillin-resistant Staphylococcus aureus infections in an equine hospital in Sweden

<p>Abstract</p> <p>Background</p> <p>The first outbreak of methicillin-resistant <it>Staphylococcus aureus </it>(MRSA) infection in horses in Sweden occurred in 2008 at the University Animal Hospital and highlighted the need for improved infection prevention and control. The present study describes interventions and infection prevention control in an equine hospital setting July 2008 - April 2010.</p> <p>Method</p> <p>This descriptive study of interventions is based on examination of policy documents, medical records, notes from meetings and cost estimates. MRSA cases were identified through clinical sampling and telephone enquiries about horses post-surgery. Prospective sampling in the hospital environment with culture for MRSA and genotyping of isolates by <it>spa</it>-typing and pulsed-field gel electrophoresis (PFGE) were performed.</p> <p>Results</p> <p>Interventions focused on interruption of indirect contact spread of MRSA between horses via staff and equipment and included: Temporary suspension of elective surgery; and identification and isolation of MRSA-infected horses; collaboration was initiated between authorities in animal and human public health, human medicine infection control and the veterinary hospital; extensive cleaning and disinfection was performed; basic hygiene and cleaning policies, staff training, equipment modification and interior renovation were implemented over seven months.</p> <p>Ten (11%) of 92 surfaces sampled between July 2008 and April 2010 tested positive for MRSA <it>spa</it>-type 011, seven of which were from the first of nine sampling occasions. PFGE typing showed the isolates to be the outbreak strain (9 of 10) or a closely related strain. Two new cases of MRSA infection occurred 14 and 19 months later, but had no proven connections to the outbreak cases.</p> <p>Conclusions</p> <p>Collaboration between relevant authorities and the veterinary hospital and formation of an infection control committee with an executive working group were required to move the intervention process forward. Support from hospital management and the dedication of staff were essential for the development and implementation of new, improved routines. Demonstration of the outbreak strain in the environment was useful for interventions such as improvement of cleaning routines and interior design, and increased compliance with basic hygienic precautions. The interventions led to a reduction in MRSA-positive samples and the outbreak was considered curbed as no new cases occurred for over a year.</p

Characterisation of bacterial growth and antimicrobial susceptibility patterns in canine urinary tract infections

BACKGROUND: Bacterial urinary tract infection (UTI) is a common reason for antimicrobial therapy in dogs. A reported increase in multi-drug resistance in canine bacterial pathogens, including resistance to extended-spectrum cephalosporins (ESC) is of concern as antimicrobial resistance complicates therapy in dogs. In addition, it is a possible public health concern. The objectives of this study were to investigate the relative prevalence of pathogens in urine samples from dogs with urinary tract infection sampled at referral hospitals, clinics and mixed veterinary practices and to investigate if this was influenced by sample material or by contamination of the culture. The second objective was to assess the susceptibility patterns to clinically relevant antimicrobials and to investigate if this was influenced by whether the samples originated from smaller clinics or from referral hospitals and to perform active screening for the presence of Enterobacteriaceae resistant to ESC. RESULTS: Escherichia coli was the most frequently isolated pathogen (68%) followed by staphylococci (11%). E. coli isolates were found significantly more often in pure culture than in contaminated samples. Staphylococcus pseudintermedius and Staphylococcus aureus isolates were significantly more prevalent in pre-incubated samples compared to samples submitted as non-incubated media. Susceptibility to the majority of the tested first-line antimicrobials was common. Multiresistance was rare, and these isolates were all susceptible to at least one relevant antimicrobial. Isolates in samples from small animal clinics or mixed veterinary practices were less likely to be susceptible compared to isolates originating from referral animal hospitals. ESC-resistant Enterobacteriacae isolates were found in one per cent of the positive cultures. Bacteria with transferable ESC resistance were confirmed in one dog. The gene demonstrated was bla(CMY2). CONCLUSIONS: Choice of sample material might influence the possibility of detecting Staphylococcus pseudintermedius and Staphylococcus aureus isolates in clinical cases of UTI in dogs. Based on the study results, use of first-line antimicrobials is a rational empirical antimicrobial therapy for the studied dog population. E. coli was the most prevalent pathogen, but prevalence of infection with ESC resistant Enterobacteriaceae including E. coli was low, as such isolates were found in only one per cent of the positive cultures

Rapid detection of antibiotic resistance in positive blood cultures by MALDI-TOF MS and an automated and optimized MBT-ASTRA protocol for Escherichia coli and Klebsiella pneumoniae

Introduction: For fast and effective antibiotic therapy of serious infections like sepsis, it is crucial with rapid information about antibiotic susceptibility, especially in a time when the number of infections caused by multi resistant bacteria has escalated in the world.Methods: Here, we have used a semi-quantitative MALDI-TOF-MS based method for antibiotic resistance detection, MBT-ASTRA™, which is based on the comparison of growth rate of the bacteria cultivated with and without antibiotics. We demonstrate a new protocol where several parameters have been optimized and automated leading to reduced hands-on time and improved capacity to simultaneously analyse multiple clinical samples and antibiotics.Results: Ninety minutes of incubation at 37 °C with agitation was sufficient to differentiate the susceptible and resistant strains of E. coli and K. pneumoniae, for the antibiotics cefotaxime, meropenem and ciprofloxacin. In total, 841 positive blood culture analyses of 14 reference strains were performed. The overall sensitivity was 99%, specificity 99% and the accuracy 97%. The assay gave no errors for cefotaxime (n = 263) or meropenem (n = 289) for sensitive and resistant strains, whilst ciprofloxacin (n = 289) gave six (0.7%) major errors (false resistance) and four (0.5%) very major errors (false susceptibility). The intermediate strains showed a larger variety compared to the E-test MIC values.Conclusions: The hands-on time and the analysis time to detect antibiotic resistance of clinical blood samples can be substantially reduced and the sample capacity can be increased by using automation and this improved protocol