Cases Of Pyoderma Research Articles

Histopathological and clinical characterization of dermatopathy associated with toxic shock‐like syndrome in dogs

Toxic shock syndrome (TSS) in humans is a systemic disease caused by the release of bacterial toxins with superantigen activity. Most cases in humans are related to production of toxic shock syndrome toxin‐1 (TSST‐1) by strains of Staphylococcus aureus. Clinically, they manifest with high fever, hypotension, diarrhoea, myalgia, skin rash and oedema, often progressing to desquamation of the skin. External or internal infections may be the origin. In dogs, the most common bacterial organism isolated from cases of bacterial pyoderma is Staphylococcus intermedius. This bacterium has also been shown to produce exotoxins, including TSST‐1. Retrospectively, 11 dogs with clinical presentations and histopathological lesions closely resembling TSS in humans were evaluated. The animals ranged in age from 1.5 to 13 years, with a mean of 4.65 years. No sex predisposition was found. The breeds represented in the study were varied, including small breeds (pug, Boston terrier) and large breeds (golden retriever, Labrador retriever). The most common clinical presentation was multicentric to generalized cutaneous erythema (n = 10) and oedema (n = 7), in some cases with vesicles (n = 4) and pustules (n = 3) evolving to ulcers (n = 3). The extremities, ears and ventrum were frequently involved. Systemic signs were invariably present. Mild anaemia (n = 8), hypoalbuminaemia (n = 8), depression (n = 8) and neutrophilia (n = 7) were the most consistent abnormalities. Fever (n = 5) and thombocytopenia (n = 5) were also observed. Complete clinical history was not obtained in two cases that were compatible with this condition on histopathological exam. In general, there was a good response to systemic treatment with cephalexin (n = 4); in cases for which early antibiotic therapy was not instituted, the outcome was usually fatal(n = 5). In the only case cultured, pustular lesions yielded a mixed population of coagulase‐positive Staphylococcus spp. and Pseudomonas spp. Histologically, the most characteristic pattern was superficial dermatitis with epidermal neutrophilic exocytosis and necrotic (apoptotic) keratinocytes, often with neutrophilic satellitosis. The lesions evolved to panepidermal necrosis with ulceration in some dogs, a phenomenon unrelated to the final outcome. The pathogenesis of the skin lesions in human cases of TSS seems to be related to the nonspecific stimulation of lymphocytes by the bacterial superantigen and the release of high levels of cytokines, specifically TNFα. Until further characterization of the process is obtained, biopsies with features of neutrophilic exocytosis and apoptosis should warrant consideration of TSS, and immediate antibiotic treatment (cephalexin) should be instituted to prevent potential fatal progression of the disease. Funding: Self‐funded.

Topical tacrolimus (FK506) in the treatment of recalcitrant parastomal pyoderma gangrenosum associated with Crohn's disease: report of two cases.

Pyoderma gangrenosum is a rare idiopathic skin disorder associated with other diseases, including inflammatory bowel disease. The commonest site is the skin, but sometimes it can occur in the parastomal region. Most of these cases respond to treatment with systemic corticosteroids and cyclosporin or local Kenalog injections. The following are two cases of parastomal pyoderma in patients not responding to the standard measures. These patients were treated with topical tacrolimus. These patients showed dramatic improvement in one week with complete resolution and re-epithelialization of skin within two weeks. Pyoderma gangrenosum is a difficult problem to manage and its early resolution is important. In these two reported cases, the improvement was dramatic, therefore topical tacrolimus should be considered early in the management.

Methicillin‐resistant Staphylococcus aureus in community‐acquired pyoderma

Methicillin-resistant Staphylococcus aureus (MRSA) is an important nosocomial pathogen. It can also cause community-acquired infections. Indian reports about MRSA in community-acquired infections are rare. To evaluate the rate of MRSA in community-acquired pyoderma and the nasal colonisation with S. aureus in such patients. Two hundred and fifty patients with community-acquired pyoderma, who attended outreach camps around Mangalore, south India between January 2000 and July 2001, were studied. Swabs collected from the skin lesions and anterior nares were inoculated onto blood agar and MacConkey's agar. Antimicrobial sensitivity testing was performed using Kirby-Bauer disk diffusion, agar dilution, and agar screen. Of 250 pyoderma cases, S. aureus was isolated from 202 (80.8%) patients. Twenty-two (10.9%) S. aureus isolates were methicillin resistant, 179 (88.6%) were resistant to penicillin, and 114 (56.4%) were resistant to erythromycin. S. aureus colonization in the anterior nares was observed in 136 (54.4%) cases, 11.8% of which were MRSA. Antibiograms of clinical isolates of S. aureus matched with nasal isolates in 99 (49%) cases. The emergence of MRSA in the community is a warning. A high nasal carriage rate may contribute to recurrent pyoderma. A correct antimicrobial policy and the avoidance of inappropriate antimicrobial usage are mandatory to reduce the spread of MRSA in the community.

In vitro antimicrobial activity of orbifloxacin against Staphylococcus intermedius isolates from canine skin and ear infections

The objective of the study was to evaluate the in vitro activity of orbifloxacin against Staphylococcus intermedius strains isolated in France from canine skin and ear infections. The minimum inhibitory concentrations (MICs) of orbifloxacin against 240 field S. intermedius isolates (69 skin and 171 ear isolates) ranged from 0.016 to 8 mg l −1, with MIC 50 and MIC 90 equal to 0.5 and 1 mg l −1, respectively. Only one strain, a pyoderma isolate was resistant (MIC=8 mg l −1). Orbifloxacin was tested at different concentrations for killing rate against five isolates obtained from pyoderma cases and against a reference strain ( Stapylococcus aureus ATCC® 29213). Orbifloxacin expressed a concentration-dependent bactericidal activity against the S. aureus reference strain, but a time-dependent bactericidal activity against S. intermedius. Orbifloxacin induced bactericidal effect against the S. intermedius strains tested with concentrations equal to or two times MIC.

Diagnosis and management of pyoderma in the dog

PYODERMA - bacterial skin infection - is one of the most frequently seen conditions in small animal practice and yet also one of the most frustrating to treat. Around 90...

Equine pyoderma associated with malnutrition and unhygienic conditions due to neglect in a herd.

Twelve horses kept at a riding club suffered from pyoderma. All the horses displayed crusting, scaling and alopecia. The lesions were distributed in the chest, back, rump and limbs. Some of the horse patients also showed epilation with an attached crust similar to a 'paintbrush lesion' of dermatophilosis, but normal skin flora or opportunistic pathogenic bacteria were only isolated from the lesions. Some patients clearly showed weight loss, anemia and low levels of serum protein and cholesterol. General condition and skin lesions of the patients were improved gradually with improvement of feed and environment after being moved to new stables. Malnutrition under conditions of poor hygiene and poor management due to neglect might be associated with these equine cases of pyoderma in the herd.

Antimicrobial resistance in staphylococci from canine pyoderma: a prospective study of first-time and recurrent cases in Sweden

In a prospective study involving eight veterinary clinics during 1995 and 1996, samples from first-time and recurrent cases of canine pyoderma were collected by a needle technique. Three hundred and...

Altered immunohistochemical staining for desmoglein in skin biopsies in canine pemphigus foliaceus.

In this study, 50 cases of canine pemphigus foliaceus and 49 cases of canine superficial pyoderma were examined by immunohistochemical staining for patterns of desmoglein expression. In 31/50 (62%) of pemphigus foliaceus cases, there was an altered staining pattern for desmoglein consisting of distinct clumped deposits at the periphery of keratinocytes and/or dark cytoplasmic staining of acantholytic cells (consistent with internalization of desmoglein). In contrast, desmoglein staining in biopsies from cases of superficial pyoderma was diffusely pale without evidence for clumping or distinct internalization. This study demonstrates that epidermal desmoglein expression is altered in some cases of pemphigus foliaceus in dogs and suggests that immunohistochemical staining for this protein may be useful in diagnosis.

Post-antibiotic effect of cephalexin against isolates of Staphylococcus intermedius obtained from cases of canine pyoderma.

The post-antibiotic effect in vitro (PAE) of cephalexin was determined according to a broth dilution method against 5 isolates of Staphylococcus intermedius obtained from cases of canine pyoderma. Two durations of exposure and 3 concentrations were tested. The PAE increased when time of exposure or concentration increased. The mean PAE ranged from 0.7 to 3.3 h. The PAE of cephalexin against Staph-ylococcus intermedius may be clinically relevant when selecting a dosage regimen to treat pyoderma in dogs.

Pattern of Skin Diseases at King Khalid National Guard Hospital: A 12-Month Prospective Study

Pattern of Skin Diseases at King Khalid National Guard Hospital: A 12-Month Prospective Study

Clinico-bacteriological study of pyodermas in children.

One hundred cases of pyodermas in children were investigated clinically and bacteriologically. Nasal and throat swabs from all cases were subjected to bacteriological examination. Most of the children (42%) were in the 1-4 year age group. The majority (58%) belonged to lower socio-economic groups with poor standards of hygiene. A history of over-crowding was obtained from 87% of cases, 82% were undernourished. Most of the children (68%) reported during the hot and humid months of June, July, August, and September. Primary pyodermas were observed in 72% of the children, and secondary pyodermas in 28%. Impetigo was the commonest primary pyoderma (48.61%); among secondary pyodermas, infected scabies was noted predominantly (42.86%). The face and legs were more commonly involved. Bacteriological cultures from pyoderma lesions revealed a single microorganism in the majority of the patients (84%). Staphylococcus aureus was isolated in pure culture from 48% and pure beta-hemolytic streptococci from 36%. A combination of both was obtained from 16%. No other organism was isolated from any case. A similar pattern was also observed in cultures from the nose and throat. Only 46 out of the 64 strains (84.3%) of Staphylococcus aureus isolated from pyoderma were typable. The majority (39.1%) showed a mixed pattern of phages; the second commonest was the non-allocated phage type (30.4%). Nasal flora had more of the non-allocated phage type (50%); two out of the three strains (66.6%) isolated from the throat showed a mixed pattern. All the strains of beta hemolytic streptococci, isolated either from lesions of pyoderma, nose, or throat belonged to group A. Staphylococcus aureus and showed a high sensitivity to netilmycin (100%), ofloxacin (98.4%), amoxycillin/clavulanic acid (96.9%), ciprofloxacin (89.1%) and gentamycin (84.4%) but a high resistance to penicillin (85.9%). A greater correlation was noted between nasal flora and organisms causing pyodermas. A change in the pattern of organisms causing pyodermas in children and their antibiotic sensitivities in this part of the globe has been observed in this study. The role of endogenous nasal and throat flora in the causation of pyodermas has also been highlighted.

An investigation of phagocytosis and intracellular killing of Staphylococcus intermedius by canine neutrophils in vitro

Bacterial infection (pyoderma) of the canine skin is largely caused by Staphylococcus intermedius and may be a primary, idiopathic disease or secondary to a range of other dermatological disorders. The immune response to this organism involves phagocytosis and killing by neutrophils. In this study, the effect of opsonisation of S. intermedius by clinical sera ( n = 60) and sera from normal dogs ( n = 20) was investigated by in vitro phagocytosis and killing assays. All sera from dogs with pyoderma were significantly more efficient at opsonisation for phagocytosis than normal dog sera ( p < 0.001). Further, fresh serum was more effective at opsonisation of S. intermedius than heat-inactivated serum in this assay ( p < 0.001). The results indicate that opsonisation is enhanced by serum from dogs with pyoderma; therefore the humoral response in clinical cases of canine pyoderma is, in terms of phagocytosis, protective. The small but significant reduction in phagocytosis of S. intermedius opsonised by heat-inactivated serum compared to fresh frozen serum suggests that complement plays a role, although minor, in opsonisation. An in vitro killing assay showed that normal canine neutrophils were able to effectively kill phagocytosed S. intermedius over a 90-min time course, but there was no significant enhancement of killing by prior incubation of the bacteria with any clinical serum as opposed to normal sera. This suggests that the humoral response to S. intermedius does not affect intracellular killing per se.

Comparative ribotyping of Staphylococcus intermedius from dogs, pigeons, horses and mink

Strains of Staphylococcus (S.) intermedius from dogs, pigeons, horses and mink were typed by comparison of rRNA gene restriction fragment length polymorphisms (ribotyping) and the resulting ribotypes examined by cluster-analysis. Digestion of whole-cell DNA with HindIII resulted in 9 ribotypes with 3 to 4 bands. Separation of isolates from different host animal species was not possible. EcoRI yielded 11 different patterns with 4 to 9 fragments. The EcoRI-ribotypes of all canine strains grouped in one cluster encompassing four closely related ribotypes. Isolates were indistinguishable with respect to their origin from cases of canine pyoderma or from healthy carriers. In contrast, pigeon and equine strains expressed a greater variety of ribotypes including some strains with patterns similar to canine isolates. However, for canine versus pigeon and equine strains the difference in distribution among ribotypes was significant ( P < 0.001). The data might suggest that pigeons and horses carry S. intermedius transiently and might be able to spread these bacteria to other animal species.

Chloramphenicol resistance in Staphylococcus intermedius from a single veterinary centre: evidence for plasmid and chromosomal location of the resistance genes

A total of seven Staphylococcus intermedius cultures isolated from cases of canine pyoderma were investigated for the genetic basis of chloramphenicol resistance (Cm r). All of these S. intermedius isolates mediated Cm r via the expression of the Cm-inactivating enzyme chloramphenicol acetyltransferase (CAT); the respective cat genes were found to be located on small multicopy plasmids of 3.1 to 4.1 kb in four of the seven cultures. The four Cm r plasmids, designated pSCS20–23, differed upon restriction endonuclease mapping. Hybridization experiments identified all of them to belong to the pC221-family of staphylococcal Cm r plasmids. The expression of all four plasmid-encoded cat genes was inducible with chloramphenicol. The remaining three S. intermedius isolates also harboured an inducible cat gene of the pC221-type which, however, was found to be located in the chromosomal DNA. These differences in the subcellular localisation and consequently in the number of cat gene copies per S. intermedius cell had no influence on the MIC values of Cm exhibited by the respective S. intermedius isolates.

Characterization of Staphylococcus intermedius from healthy dogs and cases of superficial pyoderma by DNA restriction endonuclease patterns

In order to study the possible clonal relation of Staphylococcus (S.) intermedius from canine superficial pyoderma and from healthy carriers, isolates from pustular swabs and from vaginal, nasal and normal skin swabs were typed using macrorestriction analysis with Sma I and pulsed-field gel electrophoresis. From the size of the resulting fragments the size of the chromosomes of S. intermedius could be determined to be roughly 1500 ± 200 kb on the average. The fingerprints were very heterogeneous though characteristically distinct from patterns of (human) S. aureus as published by others. Strains from superficial pyoderma were not found to be more similar to each other than strains from healthy carriers. Therefore it was concluded that strains from this type of skin infection probably did not belong to a certain subpopulation of S. intermedius, which might have indicated a higher virulence of these strains.

Characterisation of Staphylococcus intermedius isolates from canine pyoderma and from healthy carriers by SDS-PAGE of exoproteins, immunoblotting and restriction endonuclease digest analysis

Ten Staphylococcus intermedius isolates from cases of canine pyoderma and 10 from healthy carriers were examined by SDS-PAGE of exoproteins, immunoblotting and restriction endonuclease digest analysis. Similarities between banding patterns of the isolates were calculated as Dice coefficients for all three methods. For SDS-PAGE and immunoblotting, no significant differentiation was found between the pyoderma and "healthy" groups. Analysis of DNA digested with BglII indicated that S. intermedius is genetically heterogeneous; Dice coefficients for the pyoderma group were distinct from those for the healthy group (p < 0.001), and cluster analysis confirmed that the pyoderma isolates (9) formed a group separate from the majority (6 of 9) of the normal isolates.

The serotypes of Streptococcus pyogenes present in Britain during 1980-1990 and their association with disease.

A total of 16,909 cultures of Streptococcus pyogenes (Lancefield group A) isolated in Britain during 1980-90 were examined for T- and M-protein antigens. One or other M antigen was detected in 92.6% of the strains. The numbers of isolates of some serotypes, such as M3 and M12, did not show great variation from year-to-year, whereas there were nationwide epidemics, extending over several years, caused by strains of serotypes M1 and M49. Isolates of serotypes M1 and M3 were associated particularly with invasive disease and fatal infections. Representatives of serotypes M80, M81 and the provisional types PT180, PT1658 and PT5757 were isolated most often from cases of pyoderma. Erythromycin resistance was detected in 30 serotypes but one half of all of the resistant isolates belonged to serotype M4.

Antibiotic Resistance in Staphylococcus intermedius Isolated from Cases of Pyoderma in the Dog

Abstract— A study was made of the microbial flora of pyoderma in dogs to determine microbial species and, for staphylococci, the antibiotic resistance patterns in relation to therapy.Samples from 120 cases of canine pyoderma yielded 96 isolates of Staphylococcus intermedius, 17 samples yielded only Gram‐negative bacilli and seven gave no aerobic bacterial growth. Multiresistant staphylococci and Gram‐negative bacilli were more common in samples from referred cases than from primary consultations and from deep rather than from superficial lesions. Prior antibiotic therapy had been more extensive in animals from which multi‐resistant staphylococci or Gram‐negative bacteria were recovered. Few plasmids mediating antibiotic resistance were carried by the S. intermedius isolates suggesting that resistance is chromosomally located.Résumé— Une étude de la flore microbienne des pyodermites chez la chien a éte entreprise pour déterminer les espèces microbiennes présentes et, pour les Staphylocoques, l'antibiorésistance en fonction des traitements.Les échantillons provenants de 120 cas de pyodermites canines ont permis d'isoler 96 fois un Staphylococcus intermedius, 17 fois uniquement des Gram négatifs en 7 fois aucune bactérie aérobie. Les staphylocoques multirésistants et les bacilles Gram négatifs étaient plus fréquents dan les cas référés que dans les cas vus pour la premiére fois et plus souvent lors de pyodermite profande que lors de pyodermite superficielle. L'antibiothérapie avait été plus importante chez les animaux chez lesquels des bactéries Gram négatives et des Staphylocoques multirésistants ont été isolées. Quelques plasmides médiateurs d'une antibiorésistance ont été isolés, suggérant que celle‐ci est d'origine chromosomique.Zausammenfassung— Bei 120 Proben von kaniner Pyodermie wurde in 96 Fällen Staphylococcus intermedius und in 17 Fällen ausschließlich Gram‐negative Bacillus‐Arten isoliert. Bei 7 Proben trat kein Wachstum aerober Bakterien ein. Multiresistente Staphylokokken und Gram‐negative Bacillus‐Arten waren in den Proben von öberweisungsfällen häufiger als in denen von Erstkonsultationen, ebenso kamen sie in tiefen Läsionen öfter vor als in oberflächlichen. Tiere, bei denen multiresistente Staphylokokken oder Gram‐negative Bakterien entdeckt wurden, hatten eine umfassendere vorausgegangene antibiotische Therapie erhalten. Da Isolate von S. intermedius einige Plasmide enthielten, die die Antibiotikaresistenz übermitteln, ist anzunehmen, daß die Resistenz in den Chromsomen lokalisiert ist.Resumen Un estudio de la flora microbiana del pioderma canino fué llevado a cabo para determinar las especies microbianas, y la resistencia a antibióticos de los stafilococos en relación con la terapia utilizada. En 120 muestras de pioderma canino se aislaron 96 Staphylococcus intermedius; en 17 muestras, solamente bacilos gran negativos; y en 7, no se logró el cultivo de bacterias aeróbicas. También se observó que los stafilococos multiresistentes y los bacilos gram negativos eran mucho más comunes en muestras de casos referidos, que aquellos procedentes de primera consulta, y también más frecuentemente de lesiones profundas, que de lesiones superficiales. La terapia con antibióticos instaurada previamente había sido más extensiva en muestras de donde se aislaron stafilococos con multiresistencia o bacilos gram negativos. Los S. intermedius aislados contenían unos plásmidos mediadores de resistencia, lo cual sugirió la posibilidad de la ubicación cromosómica de la resistencia bacteriana.

Proteolytic Zymograms ofStaphylococcus intermediusIsolates from Cases of Canine Pyoderma and Healthy Carriers

The extracellular proteases of Staphylococcus intermedius were separated on native polyacrylamide gels and characterised by relative mobility using zymograms showing caseinolysis. No clear differences between isolates from cases of canine pyoderma and healthy carriers were demonstrated. Keywords: Staphylococcus intermedius ; Staphylococci; Canine pyoderma; Virulence; Protease.

Proteolytic Zymograms ofStaphylococcus intermedinsIsolates from Cases of Canine Pyoderma and Healthy Carriers

Proteolytic Zymograms of<i>Staphylococcus intermedins</i>Isolates from Cases of Canine Pyoderma and Healthy Carriers