HAKAN SALCI, Serpi KAHYA, Melike ÇETİN, AHMET AKKOÇ, AHMET SAMİ BAYRAM

Evaluation of Pulmonary Infection Risk in Dogs with Pulmonary Contusion

Pulmoner kontüzyon sonrası antibiyotik kullanımı ve seçimi hakkında bir çelişki vardır. Bu nedenle bu çalışma pulmoner kontüzyonlu köpeklerde pulmoner enfeksiyon riskinin değerlendirmesini amaçladı. Çalışmaya pulmoner kontüzyonlu 11 köpek dahil edildi. Pulmoner kontüzyon tanısı ve derecelendirilmesi klinik ve radyolojik bulgular temelinde belirlendi. Genel anestezi altında, 0, 24 ve 48. saatlerde köpeklerde bronkoskopi ve bronkoalveolar lavaj (BAL) uygulandı ve BAL numunesi alındı. BAL numunelerin sitolojik muayenesi, kültür ve antibiyotik duyarlılık analizleri yapıldı. Klinik olarak hafif, orta ve şiddetli derece pulmoner kontüzyon tanıları konuldu, ancak radyolojik bulgular tüm köpeklerde şiddetli derecede pulmoner kontüzyonu belirtti. Bronkoskopi, biri hariç tüm köpeklerde hemoptiziyi gösterdi. Sitolojik olarak, tüm preparatlar 0. saatte enflamasyon bulgularına sahipti ve bu bulgular 24 ve 48. saatlerde artıyordu. Ek olarak, enfeksiyon varlığı, dört köpeğin (olgu 1, 2, 5 ve 8) 0, 24 ve 48. saatlerde alınan sitoloji preparatlarında belirlendi. Bu sitolojik bulgular olgu 1, 2, 5 ve 8'in mikrobiyolojik bulguları ile uyumluydu. Sırasıyla, Pasteurella multocida olgu 1 ve 2'de, Escherichia coli olgu 5 ve 8'de BAL numunelerinden kültüre edilen mikroorganizmalardı. P. multocida gentamisin, eritromisin ve oksitetrasiklin'e dirençli iken, E. coli sadece sulfametoksazol/trimetoprim'e dirençliydi. Sonuç olarak, pulmoner kontüzyononun yangısal süreci tetikleyebildiği ve eğer alt solunum yollarında patojenik fırsatçı bir flora var ise akciğerdeki yangısal sürece enfeksiyonun da eşlik edebileceği söylenebilir. Bu yüzden, antibiyotik kullanımı olanaklar elveriyor ise BAL kültür ve antibiyogram sonuçları göz önüne alınarak kurgulanmalıdır

Pulmoner Kontüzyonlu Köpeklerde Pulmoner Enfeksiyon Riskinin Değerlendirilmesi

There is a dilemma about usage and selection of the antibiotics following pulmonary contusion. Thus, this study aimed to evaluate pulmonary infection risk in dogs with pulmonary contusion. In total, eleven dogs with pulmonary contusion included in the study. Diagnosis of the pulmonary contusion and its degrees were determined based on the clinical and radiological findings. Under general anesthesia, bronchoscopy and bronchoalveolar lavage (BAL) was applied on 0, 24 and 48th h and BAL samples were collected. Cytological examination, culture and antibiotic susceptibility analysis of the BAL samples were performed. Clinically, mild, moderate and severe degree pulmonary contusions were diagnosed, but radiological results pointed out severe degree of pulmonary contusion in all dogs. Bronchoscopy showed the hemoptysis in all dogs except one. Cytologically, all preparations had the inflammatory results at 0th hour and these were increased at 24 and 48th hours. Additionally, evidence of infection was determined in the cytological preparations of four dogs (case 1, 2, 5 and 8) taken at 0, 24 and 48th hours. These cytological results were compatible with microbiological results of case 1, 2, 5 and 8. Pasteurella multocida in case 1 and 2, and Escherichia coli in case 5 and 8 was cultured microorganism from the BAL samples, separately. While P. multocida was resistant to gentamicin, erythromycin and oxytetracycline; E. coli was resistant only sulfamethoxazole/trimethoprim. In conclusion, it may be stated that pulmonary contusion triggers inflammation process, and if there is a pathogenic opportunistic flora in the lower respiratory tracts, the pulmonary infections might accompany with inflammation process. Thus, if it is able, antibiotic usage must be planned considering to the results of BAL culture and antibiogram tests

PDF

___

1. Scheepens ET, Peeters ME, L’eplattenier HF, Kirpensteijn J: Thoracic bite trauma in dogs: A comparison of clinical and radiological parameters with surgical results. J Small Anim Pract, 47, 721-726, 2006. DOI: 10.1111/j.1748- 5827.2006.00114.x
2. De Laforcade A: Management of thoracic trauma. Tufts Animal Expo Conference Proceedings, 1 September 2002. Retrieved January 1, 2010 from Veterinary Information network website: (http://www.vin.com/Members/ Proceedings/Proceedings.plx?CID=tufts2002&PID=pr01953&O=VIN);
3. Hosgood G: Thoracic wall and cavity. Harari J (Ed): Small Animal Surgery. 105-106, Williams & Wilkins, Philadelphia, 1996.
4. Dewitt JH: Blunt thoracic trauma: Anesthesia, assessment and management. Can J Anaesth, 40, 29-39, 1993. DOI: 10.1007/BF03020683
5. Özaydın İ: Toraks Travmaları. In, Özaydın İ (Ed): Veteriner Acil Klinik: İlkyardım-Transport-İlk Müdahale, 159-162, Eser Ofset Matbaacılık, Erzurum, 2004.
6. Campbell VL, King LG: Pulmonary function, ventilator management, and outcome of dogs with thoracic trauma and pulmonary contusions: 10 cases (1994-1998). JAVMA, 217, 1505-1509, 2000. DOI: 10.2460/javma. 2000.217.1505
7. Hackner SG: Emergency management of traumatic pulmonary contusions. Compend Contin Educ Pract Vet, 17, 677-686, 1995.
8. Thurmon JC, Tranquilli WJ, Benson GJ: Veterinary anesthesia. Williams & Wilkins, Philadelphia, 835-836, 1996.
9. Gorgul OS, Yavru N, Atalan G, Bilgili H, Demirkan İ, Kılıç N, Sarıerler M, Taş A, Altuğ ME, Kibar M, Pekzan Z, Salci H, Kürüm B: Veteriner Özel Cerrahi, Medipress, Malatya, 2012.
10. Witt AL, Mathews KA, Holmberg DL: Successful management of traumatic right atrial rupture. Vet Emerg Crit Care, 10, 85-89, 2000. DOI: 10.1111/j.1476-4431.2000.tb00004.x
11. Swan KG Swan BC, Swan KG: Decelerational thoracic injury. J Trauma Acute Care Surg, 51, 970-974, 2001.
12. Woods KS, Defarges AMN, Abrams-Ogg ACG, Viel L, Brisson BA, Bienzle D: Comparison of manual and suction pump aspiration techniques for performing bronchoalveolar lavage in 18 dogs with respiratory tract disease. J Vet Intern Med, 28, 1398-1404, 2014. DOI: 10.1111/jvim.12403
13. Hawkins EC, DeNicola DB, Kuehn NF: Bronchoalveolar lavage in the evaluation of pulmonary disease in the dog and cat. J Vet Intern Med, 4, 267-274, 1990. DOI: 10.1111/j.1939-1676.1990.tb03120.x
14. Creevy KE: Airway evaluation and flexible endoscopic procedures in dogs and cats: laryngoscopy, transtracheal wash, tracheobroncoscopy, and bronchoalveolar lavage. Vet Clin North Am: Small Anim Pract, 39, 869-880, 2009. DOI: 10.1016/j.cvsm.2009.05.001
15. Johnson LR, Queen EV, Vernau W, Sykes JE, Byrne BA: Microbiologic and cytologic assessment of bronchoalveolar lavage fluid from dogs with lower respiratory tract infection: 105 cases (2001-2011). J Vet Intern Med, 27, 259-267, 2013. doi: 10.1111/jvim.12037
16. Peeters DE, McKiernan BC, Weisiger RM, Schaeffer DJ, Clercx C: Quantitative bacterial cultures and cytological examination of bronchoalveolar lavage specimens in dogs. J Vet Intern Med, 14, 534-541, 2000. DOI: 10.1111/j.1939-1676.2000.tb02272.x
17. Gonul R, Koenhemsi L, Or ME, Uysal A, Sonmez K, Gurel A, Bagcigil AF, Ozgur NY, Yardibi H, Altunatmaz K: Biochemical and cytological analysis of bronchoalveolar lavage (BAL) fluid and effects on arterial blood gases in dogs with lower respiratory airway disease. Revue Med Vet, 161, 233-238, 2010.
18. Fossum TW: Small Animal Surgery. 658-661, Mosby, St. Louis, 2002. 19. Burkhardt F: Prüfung biochemister merkmale von mikroorganismen. Burkhardt F (Ed): Microbiologische Diagnostik. 652-700, Georg Thieme Verslag, Stuttgart New York, 1992.
20. CLSI: Performance standards for antimicrobial susceptibility testing; twentieth informational supplement, CLSI document M100-S20, Clinical and Laboratory Standards Institute, Wayne, PA, USA, 2010.
21. Boldt J, Piper S, Uphus D, Füssle R, Hemplemann G: Preoperative microbiologic screening and antibiotic prophylaxis in pulmonary resection operations. Ann Thorac Surg, 68, 208-211,1999. DOI: 10.1016/S0003- 4975(99)00400-2
22. Hawkins EC, DeNicola DB, Plier ML: Cytological analysis of bronchoalveolar lavage fluid in the diagnosis of spontaneous respiratory tract disease in dogs: A retrospective study. J Vet Intern Med, 9, 386-392, 1995.
23. Johnson LR, Johnson EG, Vernau W, Kass PH, Byrne BA: Broncoscopy, imaging, and concurrent diseases in dogs with bronchiectasis: (2003-2014). J Vet Intern Med, 30, 247-254, 2016. DOI: 10.1111/jvim.13809
24. Berkwitt L, Berzon JL: Thoracic trauma. Newer concepts. Vet Clin North Am: Small Anim Pract, 15, 1031-1039, 1985. DOI: 10.1016/S0195- 5616(85)50108-4
25. Davidson EB: Managing bite wounds in dogs and cats. Part I. Compend Contin Educ Pract Vet, 20, 811-820, 1998.
26. Lawrence DT, Lang J, Culvenor J, Mischol G, Haynes S, Swinney G: Intrathoracic tracheal rupture. J Feline Med Surg, 1, 43-51, 1999. 27. Plunkett SJ: Emergency Procedures for the Small Animal Veterinarian, 51-52, W.B. Saunders, St. Louis, 2001.
28. Mercier E, Bolognin M, Hoffman AC, Tual C, Day MJ, Clercx C: Influence of age on broncoscopic findings in healthy beagle dogs. Vet J, 187, 225-228, 2011. DOI: 10.1016/j.tvjl.2009.12.007
29. McCarthy TC: Veterinary endoscopy for the small animal practitioner. Elsevier Saunders, St. Louis, 224-227, 2005.
30. Tillson DM: Thoracostomy tubes. Part II. Placement and maintenance. Compend Contin Educ Pract Vet, 12, 1331-1338, 1997.