Tracheal Wash Research Articles

Cytological Analysis of Tracheal Washing and Bronchoalveolar Lavage Fluid Obtained from Donkeys with Chronic Lung Disease

Pulmonary fibrosis, tracheal collapse and bronchoalveolar diseases belong to the most common causes of donkey deaths. The cytological analysis of tracheal washing (TW) and bronchoalveolar lavage fluid (BALF) have been proven in as useful tools for the investigation of lower respiratory airway diseases. Little is known about collection and analysis of TW and BALF in donkeys. The current study aimed at cytological analysis of TW and BALF in healthy donkeys and donkeys with chronic lung disease. TW and BALF fluid were collected from seventeen donkeys (five healthy and twelve affected with chronic lung disease) and were analysed for their cytological composition. In comparison to many other veterinary species, the percentage of eosinophils in TW and BALF was higher for both healthy and affected donkeys. The proportion of neutrophils in TW and BALF of affected donkeys was higher than that in control animals. The increase in the percentage of neutrophils and epithelial cells war higher in TW, when compared to BALF samples. Collectively, the comparative cytological analysis of TW and BALF samples from healthy and respiratory affected donkeys revealed that both TW and BALF could serve as helpful tools for the diagnosis of respiratory diseases in donkeys

Laboratory findings of tracheal wash and bronchoalveolar lavage in normal adult dairy cattle

ABSTRACT Tracheal Wash (TW) and bronchoalveolar lavage (BAL) are not well documented in adult cattle and published studies were undertaken on diseased animals aiming at isolating the causative agent of respiratory diseases. This study was undertaken to establish the normal cytological and microbiological findings of TW and BAL in normal adult cattle and compare between the laboratory analysis findings of both techniques. Eighteen healthy adult cattle were divided into two groups. BAL was completed the first group (n = 10) and TW was completed the second group (n = 8). Normal cytological findings of TW in healthy adult cattle were found to be primarily neutrophils (42.7 ± 35.7)% intermixed with lower numbers of columnar epithelial cells (26.2 ± 34.8)%, alveolar macrophages (14.7 ± 15.4)%, squamous epithelial cells (10 ± 28.6)%, lymphocytes (6.8 ± 16.1)% and rarely seen eosinophils (0.1 ± 0.0)% with a total cell count of 457 ± 310.1 cells/µl. Cytological findings of BAL were found to be mainly alveolar macrophages (94.3 ± 3.9)%, intermixed with lower number of neutrophils (4.3 ± 3.9)% and lymphocytes (1.3 ± 1.2)% and rarely seen eosinophils (0 ± 0.1)% with a total cell count of 238 ± 169 cells/µl. There are remarkable differences in TW and BAL cytological findings and the degree of contamination was higher in TW samples than that seen in BAL lavage.

Fungi in respiratory samples of horses with inflammatory airway disease.

BackgroundFungi contribute to the inflammatory response of lungs in horses with recurrent airway obstruction and in some forms of asthma in humans. The role of fungi in inflammatory airway disease (IAD) has not been assessed.ObjectivesEvaluate the prevalence of fungi in the respiratory samples of horses diagnosed with IAD, describe clinical signs associated with the presence of fungi in respiratory samples, and assess the risk factors associated with IAD and with the presence of fungi in the airways.AnimalsSeven‐hundred thirty‐one active horses referred to a specialized ambulatory practice for signs of respiratory disease or poor performance.MethodsA prospective observational study was performed, collecting clinical data, environmental conditions, and results of a tracheal wash (TW; cytology, fungal culture, and bacterial culture), and bronchoalveolar lavage (cytology).ResultsA positive fungal culture was obtained in 55% (402/731) of horses. Horses with fungal elements observed on the TW cytology had 2 times greater chance of having IAD than horses without fungi (odds ratio [OR] = 2.1; 95% CI 1.08‐3.33; P = .0003). Risks of being diagnosed with IAD and likelihood of fungi in TW were higher when horses were bedded on straw (OR = 2.0; 95% CI 1.2‐3.2 and OR = 1.9; 95% CI 1.3‐2.6, respectively) or fed dry hay (OR = 2.7; 95% CI 1.7‐4.4 and OR = 2.6; 95% CI 1.6‐3.4, respectively).Conclusions and Clinical ImportanceHorses inhaling aerosolized fungal particles are at a significantly higher risk of developing IAD. The type of bedding and forage represent significant risk factors for IAD and fungal contamination of equine airways.

Metabolomics of tracheal wash samples and exhaled breath condensates in healthy horses and horses affected by equine asthma

The present work characterized the metabolomic profile of tracheal wash (TW) and exhaled breath condensate (EBC) in healthy horses and horses with respiratory disease. Six asthma-affected horses (group A) and six healthy controls (group H) underwent clinical, endoscopic and cytologic examinations of upper airways to confirm the active phase of asthma. TW and EBC samples were collected from each animal and investigated by proton nuclear magnetic resonance (1H-NMR) metabolomic analysis. A total of ten out of 38 metabolites found in the TW were significantly different between the groups (p < 0.05). Higher concentrations of histamine and oxidant agents, such as glutamate, valine, leucine and isoleucine, as well as lower levels of ascorbate, methylamine, dimethylamine and O-phosphocholine, were found in group A compared to group H. Eight metabolites were found in equine EBC, namely methanol, ethanol, formate, trimethylamine, acetone, acetate, lactate and butanone, previously observed also in human EBC. Despite the fact that this was a pilot study, the results showed that the metabolomic analysis of TW and EBC has the potentiality to serve as a basis for diagnostic tools in horses with asthma.

Equine Transport and Changes in Equid Herpesvirus' Status

The risk of respiratory disease in the transported horse can increase as a consequence of immunosuppression and stress associated primarily with opportunistic bacterial proliferation and viral reactivation. This study examines the ecology of equid herpesviruses (EHV) in these horses, exploring reactivation and changes in infection and shedding associated with transport, and any potential contributions to transport-related respiratory disease. Twelve horses were subjected to an 8-h road-transport event. Antibodies to EHV-1 and EHV-4 were detected by ELISA in serum collected prior to, immediately after and 2 weeks post transport. Respiratory tract endoscopy and tracheal washes were collected prior to and 5 days after transportation. Nasal swabs collected prior to, immediately after, 1 and 5 days following transport were screened for EHV-1,-2,-4,-5 using qPCR. Six horses had persistent neutrophilic airway infiltrates post transportation, indicative of subclinical respiratory disease. No horses were qPCR positive for either of the alphaherpesviruses (i.e., EHV-1/-4) nor did any seroconvert to either virus. Four out of nine horses positive for either EHV-2 or EHV-5 on qPCR prior to transport developed neutrophilic airway inflammation. Five horses showed increasingly positive readings on qPCR (i.e., reduced Cq) for EHV-2 after transportation and seven out of eleven horses positive for EHV-2 after transport shared strains of high sequence similarity with other horses in the study. One EHV-2 virus detected in one horse after transport was genetically different which may be due to reactivation. The clinical significance of EHV-2 and EHV-5 remains in question. However these results indicate that transportation may lead to increased shedding, transmission and reactivation of EHV-2 and EHV-5 but not EHV-1/-4. Unlike previous work focusing on the role of alphaherpesviruses, this research suggests that investigation of the gammaherpesviruses (i.e., EHV-2/-5) in transport-related disease should not be dismissed, particularly given that these viruses can encode suppressive immunomodulators that may affect host health.

Airway endoscopy and tracheal cytology of two-year-old Thoroughbred horses during the first year of race training

The immunological status of the respiratory tract is critical to racehorses’ performance. Respiratory diseases in young Thoroughbred (TB) racehorses are a major concern during their early athletic career. This study investigated the airway adaptations occurring in young TB race horses during their first year of race training. Eighteen animals were evaluated at five different time points over a one-year follow-up period. A physical examination was performed, followed by airway endoscopy, in which tracheal mucus (TM) and pharyngeal lymphoid hyperplasia (PLH) were observed. Differential cytology of the tracheal wash (TW) was also performed. The physical parameters in the five assessments and TM grade did not vary. The PLH grade was lower at time-points 3 (T3) and 4 (T4) than at the initial evaluation (T0) (P=0.028 and P=0.036, respectively). The cytological analysis revealed that neutrophil count decreased at T4 as compared with T0 (P=0.022). Epithelial cell count was increased, and macrophage count decreased, at T3 and T4, compared with T0 (P=0.004 and P=0.031, respectively). Haemosiderophage count was higher at T1 (P=0.020) and lower at T2 (P=0.003), compared to T0. A statistical correlation between mucus and all cell types was found, showing a non-specific immune response. In conclusion, young TB racehorses underwent airway modifications during the initial months of race training, and a thorough follow-up is needed during the initial period after stabling.

A novel approach to identifying and quantifying neutrophil extracellular trap formation in septic dogs using immunofluorescence microscopy

BackgroundCanine neutrophils release neutrophil extracellular traps (NETs) in response to lipopolysaccharide but NETs from clinical septic dogs had not been identified. The primary aim is to describe the methodology of identifying and quantifying neutrophil extracellular traps (NETs) in cytology samples of septic foci in dogs with sepsis using immunofluorescence microscopy. Cytology samples including endotracheal tracheal wash (ETW), bronchoalveolar lavage (BAL), abdominal and pleural effusion collected from 5 dogs (3 septic, 2 non-septic) were fixed, permeabilized and stained for myeloperoxidase (MPO), citrullinated histone H3 (citH3) and cell-free DNA (cfDNA). Fluorescence microscopy was used to identify and quantify NETs in 10 random views at 40× magnification. NETs were identified based on co-localization of MPO, citH3 and cfDNA. NETs were quantified as a ratio (number of NETs: number of neutrophils). Neutrophils were identified based on cytoplasmic MPO, cellular diameter and nuclear morphology.ResultsNETs were identified and quantified in all cytology samples collected from septic dogs. A small number of NETs was documented in one dog with sterile chronic bronchitis. No NETs were found in sterile abdominal effusion collected from one dog with congestive heart failure.ConclusionsImmunofluorescence microscopy could be a useful tool for the study of NETs in dogs with clinical sepsis.

Mineral supplement with pre- and probiotic improves respiratory immune status in yearling racing Thoroughbred horses: preliminary results

ABSTRACT: There are evidences of intestinal flora influence on the airway immune response. However, this information is scarce with regard to horses. The present preliminary study aimed to investigate the effects of a commercial mineral supplement containing probiotics and prebiotics on the respiratory immune response of horses supplemented with them during the first months of stabling and race training. Twelve TB yearlings were examined at the breeding farm at the beginning of the study (June 2016, henceforth M0) and then reexamined one (July 2016, henceforth M1) and five (November 2016, henceforth M2) months after being stabled at a racetrack in Curitiba, Brazil. Clinical and hematological examinations, airway endoscopy, and tracheal wash (TW) cytology were performed. After the initial examination, horses were randomly divided between the treatment group (TG), which received 10 grams of the supplement daily, and the control group (CG). There was no difference between the groups in terms of clinical parameters; in the hematological examination, eosinophil count was lower in the TG in M1 as compared with M0 (P = 0.045). Pharyngeal lymphoid hyperplasia (PLH) improved in the TG during M1 as compared with M0 (P = 0.007). However, on the CG, PLH remained unchanged. Relative number of eosinophils in the TW was 86.1% higher in M1 than M0 for the CG; in the TG; however, eosinophils were absent and remained within normal limits until M2. In conclusion, this study revealed a positive influence of probiotic and prebiotic supplementation on the respiratory immune response of young TB race horses. Further investigations are recommended.

Tracheal acid or surfactant instillation raises alveolar surface tension.

Whether alveolar liquid surface tension, T, is elevated in the acute respiratory distress syndrome (ARDS) has not been demonstrated in situ in the lungs. Neither is it known how exogenous surfactant, which has failed to treat ARDS, affects in situ T. We aim to determine T in an acid-aspiration ARDS model before and after exogenous surfactant administration. In isolated rat lungs, we combine servo-nulling pressure measurement and confocal microscopy to determine alveolar liquid T according to the Laplace relation. Administering 0.01 N (pH 1.9) HCl solution by alveolar injection or tracheal instillation, to model gastric liquid aspiration, raises T. Subsequent surfactant administration fails to normalize T. Furthermore, in normal lungs, tracheal instillation of control saline or exogenous surfactant raises T. Lavaging the trachea with saline and injecting the lavage solution into the alveolus raises T, suggesting that tracheal instillation may wash T-raising airway contents to the alveolus. Adding 0.01 N HCl or 5 mM CaCl2-either of which aggregates mucins-to tracheal lavage solution reduces or eliminates the effect of lavage solution on alveolar T. Following tracheal saline instillation, liquid suctioned directly out of alveoli through a micropipette contains mucins. Additionally, alveolar injection of gastric mucin solution raises T. We conclude that 1) tracheal liquid instillation likely washes T-raising mucins to the alveolus and 2) even exogenous surfactant that could be delivered mucin-free to the alveolus might not normalize T in acid-aspiration ARDS. NEW & NOTEWORTHY We demonstrate in situ in isolated lungs that surface tension is elevated in an acid-aspiration acute respiratory distress syndrome (ARDS) model. Following tracheal liquid instillation, also in isolated lungs, we directly sample alveolar liquid. We find that liquid instillation into normal lungs washes mucins to the alveolus, thereby raising alveolar surface tension. Furthermore, even if exogenous surfactant could be delivered mucin-free to the alveolus, exogenous surfactant might fail to normalize alveolar surface tension in acid-aspiration ARDS.

Association of neutrophil morphology with bacterial isolates in equine tracheal wash samples.

Tracheal wash sample neutrophilia is common in lower airway inflammation of various causes; however, relevance of cytomorphological features to culture of bacterial pathogens has not been established. To investigate whether the presence of nondegenerate or degenerate neutrophils in tracheal washes is associated with culture of bacteria and, if so, whether this is influenced by age or temporal factors. Cross-sectional study. Tracheal wash samples submitted to Rossdales LLP from 1/1/2013 to 31/7/2015 were evaluated using set criteria. Neutrophilia and degenerate neutrophilia (graded ≥2/4 on Rossdales cytological scale [0-4]) were analysed in relation to bacterial isolates considered potentially pathogenic in respiratory disease. Statistical analyses included multivariable logistic regression to identify associations between two separate outcomes: 1) the presence of neutrophilia compared with no neutrophilia and 2) the presence of degenerate neutrophilia compared with nondegenerate neutrophilia and four independent variables. Sufficient data for inclusion in the multivariable model for nondegenerate neutrophilia were available from 1100 horses. Culture of potentially pathogenic bacteria was associated with increased odds of degenerate neutrophilia compared with samples with negative culture (OR 4.5, 95% CI 3.1, 6.4, P-value<0.001). Horses over 9 years old had lower odds of having degenerate neutrophilia than those aged 1-3 years (OR 0.6, 95% CI 0.4, 0.9, P-value<0.02). In the spring/summer, horses had reduced odds of a degenerate neutrophilia compared with winter (OR 0.4, 95% CI 0.3, 0.7, P-value <0.001). The study relied on routine laboratory submissions, with no control over sample collection or submitted clinical history. Cytological evaluation of tracheal washes should include cytomorphological features of the neutrophil response. The presence of degenerate neutrophils, especially in young horses, indicates added value of culture and sensitivity for antimicrobial therapeutics. The absence of degenerate changes, in combination with clinical factors, can help support diagnosis of a nonseptic cause of airway neutrophilia.

Gold nanoparticles conjugating recombinant influenza hemagglutinin trimers and flagellin enhanced mucosal cellular immunity

The immunogenicity of subunit vaccines can be augmented by formulating them into nanoparticles. We conjugated recombinant trimetric influenza A/Aichi/2/68(H3N2) hemagglutinin (HA) onto functionalized gold nanoparticle (AuNP) surfaces in a repetitive, oriented configuration. To further improve the immunogenicity, we generated Toll-like receptor 5 (TLR5) agonist flagellin (FliC)-coupled AuNPs as particulate adjuvants. Intranasal immunizations with an AuNP-HA and AuNP-FliC particle mixture elicited strong mucosal and systemic immune responses that protected hosts against lethal influenza challenges. Compared with the AuNP-HA alone group, the addition of AuNP-FliC improved mucosal B cell responses as characterized by elevated influenza specific IgA and IgG levels in nasal, tracheal, and lung washes. AuNP-HA/AuNP-FliC also stimulated antigen-specific interferon-γ (IFN-γ)-secreting CD4+ cell proliferation and induced strong effector CD8+ T cell activation. Our results indicate that intranasal co-delivery of antigen and adjuvant-displaying AuNPs enhanced vaccine efficacy by inducing potent cellular immune responses.

Comparison of Tracheal Wash and Bronchoalveolar Lavage Cytology in 154 Horses With and Without Respiratory Signs in a Referral Hospital Over 2009-2015.

Most equine lower respiratory diseases present as increased airway neutrophilia, which can be detected in tracheal wash (TW) or bronchoalveolar lavage fluid (BALF) cytology samples. The aim was to compare the TW and BALF results in a population of client-owned horses with and without clinical respiratory disease signs. A secondary aim was to determine the sensitivity (Se) and specificity (Sp) of TW and BALF neutrophilia in detecting respiratory disease. The cutoff values for neutrophils were also evaluated. Retrospective data from 154 horses of various breeds that had been subject to both TW and bronchoalveolar lavage (BAL) sampling at rest during 2009−2015 were used. The horses were divided into three groups based on the presenting signs, physical examination, and endoscopy mucus score. Neutrophil counts of >20% in TW and >5% in BAL were considered abnormal. Cytology results between groups, correlations between TW and BALF cell types, and tracheal mucus score were analyzed. Two graph receiving operating characteristic (ROC) curves of the neutrophil percentage values of TW and BALF were created to determine the optimal cutoff values and to calculate the diagnostic Se and Sp for diagnosing airway inflammation in horses with and without clinical respiratory signs. The Se and Sp of TW and BALF neutrophil percentages were further estimated using a two-test one-population Bayesian latent class model. The two tests showed substantial agreement, and only 17.5% of the horses were classified differently (healthy vs. diseased). The neutrophil percentage was found to correlate between TW and BALF. The Se and Sp of TW were generally higher than for BAL when estimated with area under the curve or Bayesian model. Cutoff values of 17.7% for TW and 7% for BALF were indicated by the ROCs. We conclude that TW is a more sensitive and specific method in our patient population. We suggest that the current neutrophil cutoff values of 20% for TW and 5% for BALF would still be appropriate to use in clinical diagnosis of airway inflammation. However, further studies with other cell types and in other populations are warranted to determine the best sampling method for individual horses.

Behaviour during transportation predicts stress response and lower airway contamination in horses.

This study aimed to document the effects of an eight hour journey on behavioural, clinical, haematological, environmental and respiratory parameters, and to identify possible associations between factors. Twelve horses underwent clinical examination, respiratory endoscopy with tracheal wash (TW) aspiration, and collection of venous and arterial blood before (BJ) and after the journey (AJ). TW were submitted for conventional quantitative bacteriological evaluation and genetic microbiome analyses. Behaviour was assessed in stables prior to transportation and throughout the journey. Transportation caused mild, but significant, effects on fluid and electrolyte balance and an acute phase response, characterized by neutrophilia, hyperfibrinogenaemia and hyperglobulinaemia. The proportion of neutrophils in TW, tracheal mucus and TW bacterial concentration was increased AJ, with preferential replication of Pasteurellaceae. Horse behaviour en route predicted clinical and respiratory outcomes. The frequency of stress related behaviours was greatest in the first hour of the journey, and balance-related behaviours were most common in the final hour of the journey. Horses which lowered their heads less frequently en route and showed more stress-related behaviours had higher physiological stress (serum cortisol and heart rate on arrival), increased tracheal mucus and inflammation scores, and higher TW bacterial concentration AJ (P<0.05). Six horses with abnormal lung auscultation AJ proved to have had higher tracheal inflammation scores at preloading (P = 0.017), an overall higher concentration of bacteria in their TW (P = 0.013), and an increased percentage of neutrophils in TW at five days AJ (P = 0.003) in comparison to the other horses. While transport-related health problems are multifactorial, clinical examination, including auscultation and endoscopic inspection of the lower respiratory tract before and after journey, and behavioural observation en route may identify animals at increased risk of transport associated respiratory disease.

Clinical, pathological, and molecular investigation of Mycoplasma pulmonis-induced murine respiratory mycoplasmosis in a rat (Rattus norvegicus) colony.

Aim:Mycoplasma pulmonis (MP) remains potentially important rodent pathogen causing murine respiratory mycoplasmosis (MRM) which may go undiagnosed due to its asymptomatic nature. In the present study, we carried out clinical, pathological, and molecular investigations of MP-induced MRM in a rat colony.Materials and Methods:Two female Wistar rats were observed to be diseased in animal facility of NISER, Bhubaneswar, and were kept in isolation for further investigation. Both the animals were found to be positive for MP after serological and molecular tests. Thereafter, whole rat colony comprising of 36 animals was segregated based on clinical symptoms and further sampled for histopathological, serological, and molecular investigations. Tracheal washing and infected lung tissue were collected during necropsy examination for DNA extraction. Molecular diagnosis was done by polymerase chain reaction (PCR) assay using species-specific primers.Result::Classical symptoms of MP-associated respiratory tract infection were observed in only 2 of 36 infected animals, and most of the animals were found asymptomatic to the disease; however, all the animals were found to be carrier after necropsy and PCR assay. Gross and histopathological finding suggested severe congestion of the lungs along with suppurative and necrotizing pneumonia. The disease is confirmed by molecular diagnosis using species-specific primers in PCR assay.Conclusion:MRM may go undiagnosed due to asymptomatic nature. Detailed study of clinical symptoms, pathology, serology, and PCR-based molecular approach may aid in health monitoring and detection of MRM in a rodent colony reared for experimental purpose.

A comparison of nanoparticullate CpG immunotherapy with and without allergens in spontaneously equine asthma-affected horses, an animal model.

IntroductionNew therapeutic strategies to modulate the immune response of human and equine allergic asthma are still under extensive investigation. Immunomodulating agents stimulating T‐regulatory cells offer new treatment options beyond conventional symptomatic treatment or specific immunotherapy for human and equine allergic airway diseases, with the goal of a homoeostatic T‐helper cell balance. The aim of this study was to evaluate the effects of a nebulized gelatin nanoparticle‐CpG formulation (CpG‐GNP) with and without specific allergens for the treatment of spontaneous allergic equine asthma as a model for human asthma.MethodsTwenty equine asthma‐affected horses were treated either with CpG‐GNP alone or CpG‐GNP with allergens. Two specific allergens were selected for each horse based on history and an in‐vitro test. Each horse received seven administrations of the respective nebulized composition and was examined before treatment, immediately after and 6 weeks after the treatment course.ResultsClinical parameters such as breathing rate, indirect interpleural measurement, arterial blood gases, amount of tracheal mucus and percentage of neutrophils and cytokines in tracheal washes and serum samples were evaluated. Treatment with CpG‐GNP alone as well as in combinations with relevant allergens resulted in clinical improvement of nasal discharge, breathing rate, amount of secretion and viscosity, neutrophil percentage and partial oxygen pressure directly after and 6 weeks after treatment. There were no significant differences between the two treatments in clinical parameters or local cytokine profiles in the tracheal wash fluid (IL‐10, IFN‐g, and IL‐17). IL‐4 concentrations decreased significantly in both groups.ConclusionNonspecific CpG‐GNP‐based immunotherapy shows potential as a treatment for equine and possibly also human allergic asthma.

Virulence, resistance, and genetic relatedness of Escherichia coli and Klebsiella sp. isolated from mule foals

ABSTRACT Respiratory diseases are common in young horses but little is known about such infections in mule foals. This study aimed to characterize Escherichia coli and Klebsiella sp. isolated from tracheal wash (TW) and fecal samples (FS) of mule foals, with or without cytological evidence of respiratory disease. Strains were analyzed against 13 antimicrobials, for presence of Extended spectrum beta-lactamase (ESBL), and virulence genes. Phylogrouping and Randomic (RAPD)-PCR profiles were used to evaluate their genetic relatedness. E. coli strains from TW and FS showed greatest resistance to tetracycline, while Klebsiella strains were mainly resistant to ampicillin; multidrug resistance and ESBL production were also detected. The blaCTX gene prevailed among the E. coli isolates, while the blaSHV gene was more frequently found in K. pneumoniae. The fimH gene was detected in most of the isolates and multiple virulence factors were identified in three E. coli isolates. Most of the E. coli isolates belonged to the B1 phylogroup, but B2 strains displayed more virulence genes. The RAPD assay revealed genetic diversity among strains and was able to distinguish FS isolates from TW isolates. Knowledge of the bacteria associated with the respiratory tract of mule foals is important in the treatment of sick animals.

Epidemiological and Clinical Characteristics of Streptococcus pneumoniae Infections in a Tertiary Care Center in Bahrain (2010-2014)

Objective: &#x0D; To describe the epidemiology of invasive and non-invasive pneumococcal disease during a 5-year period in a major hospital in Bahrain.&#x0D; &#x0D; Design and Setting: &#x0D; Retrospective study of cases of pneumococcal diseases among patient ≥ 14 years old during a five-year period (2010-2014), who attended Salmaniya Medical Complex, Bahrain.&#x0D; &#x0D; Patients and Methods:&#x0D; Laboratory data was obtained on Streptococcus pneumoniae isolates. Patients ≥14 years old of age, both inpatient and outpatient with cultures positive for Streptococcus pneumoniae were included. Only samples from blood, cerebrospinal fluid (CSF), pleural fluid, sputum, deep tracheal aspirate (DTA), bronchial wash, eye discharge and middle ear fluid were included. Demographics and clinical records from medical files were then reviewed.&#x0D; &#x0D; Results:&#x0D; A total of 130 culture samples met the inclusion criteria and were analyzed. One-hundred twenty-six patients with pneumococcal disease were identified; with 65% being non-invasive and 35% being invasive pneumococcal disease. Overall, non-bacteremic Pneumonia was the most frequent manifestation, followed by bacteremia. Pneumococcal disease was more common among male patients (62.7%). Mean age was 57.67 (15-95 years). The most common comorbidities were hypertension, Diabetes Mellitus followed by cardiovascular disease. Twenty-seven patients received mechanical ventilation during their admission, 13 patients were admitted to the intensive care unit, and 6 patients developed para-pneumonic effusion as a complication. In-hospital Mortality rate was 13.5%. &#x0D; &#x0D; Conclusion: &#x0D; This study supports the current literature where pneumococcal infection is more prevalent in elderly and those with comorbidities. Mortality was related to age, certain chronic medical illness, admission to intensive care unit and need for mechanical ventilation.

Association of Neutrophil Morphology with Bacterial Isolates in Equine Tracheal Wash Samples

Association of Neutrophil Morphology with Bacterial Isolates in Equine Tracheal Wash Samples

Microbiological Findings in Tracheal Wash From Mule Foals With and Without Clinical Evidence of Respiratory Disease

Respiratory diseases are common in horses; however, there is a lack of information in the literature on respiratory disease affecting mule foals. The objective of this study was to investigate the presence of aerobic bacteria in tracheal wash samples from 20 mule foals up to 6 months of age, with and without clinical evidence of respiratory disease. Samples were collected via endoscopy in two separate occasions and sent for cytology, microbial culture, and PCR for detection of Rhodococcus equi. Based on clinical evidence, 32.5% (13/40) of the samples were obtained from mule foals displaying signs of a respiratory condition, whereas 50% (20/40) of the samples showed cytologic evidence of respiratory tract infection. One hundred percent of samples provided positive cultures with Escherichia coli (45%), Enterococcus (37.5%), and coagulase-negative Staphylococcus (30%) being the most common bacterial genera isolated. R. equi was not identified in any of the samples. The correlation between isolated bacterial agents and the presence of respiratory infection was not statistically significant. The microorganisms found in the samples may be naturally present in the soil, feces, and environment in which the animals live, presenting a risk of opportunistic respiratory infection.

Investigation of the presence of Mycoplasma as an etiologic agent of inflammatory airway diseases in thoroughbred racehorses in İstanbul Province

Mycoplasma equirhinis and Mycoplasma felis are thought to be infectious etiologic agents of inflammatory airway disease (IAD), which, after musculoskeletal injuries, is the second most common cause of poor performance in thoroughbred racehorses. The aims of this study were to investigate for the first time the presence of M. equirhinis , M. felis , and other Mycoplasma spp. in the lower respiratory tract of racehorses in Istanbul Province in Turkey and to statistically evaluate the association between clinical signs of IAD and the presence of mycoplasmas. Tracheal wash (TW) samples were collected from 111 English and Arabian thoroughbred horses that showed clinical signs of IAD. TW samples were examined by culture and PCR methods. The detection rates of Mycoplasma spp., M. felis , and M. equirhinis were found to be 16.2%, 0%, and 18% by culture and 59.5%, 1.8%, and 6.3% by PCR in TW samples, respectively. According to statistical evaluations, a significant association was found for the presence of M. felis in English thoroughbred racehorses. However, no significant association was found between clinical signs of IAD and the presence of M. equirhinis , M. felis , and other spp.