Infectious disease Flashcards
What class of antibiotic is Meropenem? what is it effective against?
Meropenem is a β-lactam antibiotic of the carbapenem class with a wide spectrum, active against many aerobic and anaerobic gram-positive (except MRS and MREnterococcus species) and gram-negative bacteria and it is relatively stable against the hydrolysis of many β-lactamases. Carbapenems are more potent bactericidal and have longer post-antibiotic effect than other β-lactams because they bind to PBP-1 and PBP-2. PK studies have been done in cats at 10mg/kg
Name a side effect of minocycline in cats? what dose is recommended based on PK studies?
Vomiting. Dose 8.8mg/kg q 24hour
Does sucralfate affect the bioavailability of ciprofloxacin or enrofloxacin? Does delayed administration improve?
JVIM 2015: Ciprofloxacin is reduced, to 48%. Delaying sucralfate by 2 hours improves bioavailability
What sort of serological testing is used for Bartonella. What is the reported Sn and Sp? Does testing for more strains improve?
IFA testing. JVIM 2018: Sn 62, Sp 85%. Lack of agreement with PCR. IFA panels is technically time consuming, increases the cost of diagnostic testing and, based upon the results of our study, does not substantially enhance overall diagnostic sensitivity.
What clinical syndromes have been associated with Bartonella rochalimae?
JVIM 2020: Endocarditis, lameness, antibiotic responsive polyarthropathy and seizures
What is the agent that causes Lyme disease? How is it transmitted? Name a test to diagnose. What types of vaccines exist against it?
Borrelia bugdorferi sensu lato. Transmitted by Ixodes ticks. Serology; C6 assay. Vaccines include bacterin (lysed spirochetes) or subunit (often OspA and OspC proteins)
What type of pathogen is brucella Canis? what testing is available?
Gram negative bacteria. Serology is available (rapid slide agglutination, gel immunodiffusion) but can take up to 12 weeks to seroconvert. PCR good Sn and Sp but expensive. Blood culture and fluid culture options (zoonotic risk)
What is a common bacteria reported in IVC cultures? What factors are associated with IV complications?
JVIM 2018: Acinetobacter. Association with junior staff and steroidal anti inflammatories
Do whole blood units have a good sanitary shelf life during commercial storage (42 days)
JVIM 2016; Yes. Most organisms detected via PCR were not implicated in reactions. Very low numbers of genome equivalents
What type of organism is Rhodococcus equi? What is the clinical syndrome reported in cats?
Aerobic, intracellular, gram positive coccobacillus. Pulmonary disease common; alveolar lung changes, pleural effusion, pneumothorax - pyogranulomarous lesions. Cutaneous lesions, hepatomegaly. Mortality 67%. Azithromycin and fluoroquinolones usually effective
What is the incidence of owner reported adverse events post leptospirosis vaccination?
JAVMA 2015: 53/10,000 dogs (compared to 26.3 for other vaccines). Hypersensitivity rare (6.3/10000). Safe vaccine
What coagulation disorders are documented in leptospirosis? what is the prognostic significance?
JVIM 2017: Anaemia, thrombocytopenia, hyperfibrinogenaemia. TEM profiles can be hyper or hypo coagulable. Hypocoagulable associated with worse prognosis (Mortality 57% for hypocoagulable vs 21% for hyper coagulable)
What are the two main pathogenic leptospirosis species? What antigen is used for serotyping?
L interrogans and L kirschneri. O antigen
What were the findings by JVIM 2018 regarding 3 serological methods (poc and MAT) for leptospirosis testing in experimentally infected dogs?
Seroconversion was detected in all dogs by day 10 by Witness. SNAP did not perform well (only detected 3). witnesses identified dogs earlier than the MAT
How can PCR be used to identify leptospirosis serovar? JAVMA 2016, which was the most common serovar in USA dogs?
Variable number tandem repeat analysis can be used on the DNA confirmed through PCR. L. grippotyphosa was most common (80%)
What type of bacteria is Listeria? Name a clinical syndrome described in cats
Facultative anaerobe, gram positive bacillus. Saprophytic. Rare cause of mesenteric lymphadenitis in cats. Possible association with raw meat.
A JAVMA meta analysis in 2017 found mycoplasma was associated with a. URT or b. LRT disease in cats? What was this dependent on?
URT disease, providing non shelter cat (asymptomatic carriage in shelter cats)
Which mycoplasma was found to be associated with LRT disease in dogs? Name a commensal.
JVIM 2019. M cynos considered a pathogen. M canis considered commensal.
What is the mechanism of action of fluoroquinolones? Are they bacteriostatic/cidal?
Blocks DNA replication via blocking DNA topoisomerase IV or gyrase (3rd generation do both). Bacteriocidal
What is the mechanism of action of tetracyclines?
Blocks tRNA access to the 30s ribosomes. Bacteriostatic
What are some differences between dogs presenting for anaphylaxis and sepsis?
JAVMA 2017: Anaphylaxis: higher Eo, higher ALT, lower pH. Sepsis: higher bands, higher ALP, higher globulins, lower glucose
What is MALDI-TOF used for?
Bacterial identification via protein patterns and mass spectrometry. Can provide rapid identification
What is cfDNA and nucleosomes? what may be evaluated in and what significance do they have?
Cell free DNA (released from dying cells or NETs) and nucleosomes (DNA + histone proteins - also a cellular content). Markers of cell death and NETs and so can be used in sepsis/SIRS. JVECC 2019: cfDNA higher in dogs with sepsis/SIRS than healthy controls. Nucleosomes higher in sepsis compared to controls. Ratio of cfDNA to neutrophil count higher in non survivors.
What glucose difference between plasma and peritoneal fluid supports a septic abdomen?
JAVMA 2015: 38g/dl (2.1 mmo/L) between plasma and peritoneal fluid. Whole blood was less sensitive (41%) but 100% specific
What factors are associated with recurrence of septic peritonitis in dogs post surgery?
JVECC 2018: low albumin, higher HCT, foreign body and GI source in general
What disease is REM sleep behaviour disorder associated with? What is the prevalence reported and prognosis?
Tetanus. Developed in 46% of surviving dogs in one study. Spontaneously resolved in 43% of affected dogs within 6 months
Name the agent most commonly implicated in:
- SNA Aspergillosis in dogs
- SNA Aspergillosis in cats
- SOA Aspergillosis in cats
- Disseminated Aspergillosis in dogs
- Disseminated Aspergillosis in cats
- SNA: A fumigatus in both dogs and cats
- SOA Cat: A felis
- Disseminated dog: A terreus, but can be others
- Disseminated cat: A fumigatus
What serological test is superior for SNA Aspergilosis in cats, IgA or IgG? What is the reported Sn/Sp?
JVIM 2016: IgG Sn 100% and Sp 91.4%. IgA detected in most cats with SNA, but didn’t add any benefit to doing IgG alone (ELISA)
What was the median number of treatments required for canine SNA via minimally invasive approach, JVIM 2018
2
What serology testing is available for Blastomycosis and what is its limitations?
JAVMA 2015: A antigen immunoassay assay has low Sn 65%. recombinant BAD-1 antibody EIA is more sensitive; 95%, though Sp 88% in histoplasmosis dogs, 95% in healthy dogs.
Antigen testing is the most sensitive, in urine and blood, but cross reacts with histoplasmosis
What markers of hypercoagulability have been demonstrated in blastomycosis cases?
JVIM 2015: Hyperfibrinogenaemia, increased thrombin-antithrombin complexes, hypercoagulable on thromboelastography, increased thrombin generation on thrombography
What endocrine derangement can dogs with blastomycosis have? Does this have prognostic significance?
Reduced 25(OH)D and PTH and higher concentrations of ionized calcium than did control dogs. No impact on survival, though neutrophil counts were higher in dogs with lower vitamin D concentrations
What % of Coccidiodomycosis infected dogs had proteinuria in 2016 JVIM study?
63%. 54% who had renal biopsies had immune complex deposition
Which is superior for the treatment of histoplasmosis? fluconazole or itraconazole? Name a positive prognostic indicator
JAVMA 2018: either itraconazole or fluconazole can be used to achieve clinical remission, and a remission rate of approximately 67% may be possible. Diarrhoea was a positive prognostic indicator
Can histoplasmosis antigen be used to predict remission in cats?
It can be used and is sensitive (90%) but not specific for remission (64% urine, 52% blood). Generally reduce before clinical remission. Urine also more sensitive for diagnosis. Become concerned for relapse if concentrations increase again
How does the histoplasmosis IMMY in cats compare to the traditional antigen EIA?
POC IMMY (antibody based urine histoplasmosis antigen immunoassay) Had a Sn of 89%, Sp of 80% and diagnostic accuracy of 83% with a cutoff of 0.25ng/ml in JVIM 2018. The traditional immunoassay for antigen was more Sn/Sp (94/97%) and the two had moderate aggreement
What is the difference in PK between compounded itraconazole and reference itraconazole in healthy cats?
JAVMA 2018: Poor and inconsistent absorption. Relative absorption was only 2-8% of reference formulations
What is the bioavailability of posaconazole in cats?
15.9%. Dosing options include 30mg/kg loading followed by 15mg/kg q 48 hours, or 15mg/kg loading followed by 7.5mg/kg q 24hours
What has higher bioavailability in dogs, the liquid or tablet itraconazole?
Liquid. However, overall concentrations similar, elimination half lives identical and no recommendation to alter dose based on formulation
In which of the systemic fungal mycosis is antigen testing not recommended?
Coccidiodomycosis; Sn is 20%. Antibody testing (EIA) is sensitive and specific, so preferred
What are the performance of POC crypto tests IMMY and Biosynex, compared to LCAT as reference? Are these antigen or antibody tests?
In dogs and cats: IMMY 92% S and Sp 93%, Biosynex 80% Sn and Sp 94.9%. Both are antigen tests
How long should dogs with H3N2 be isolated for?
JAVMA 2016: Shedding was documented up to 20 days after the first positive PCR and onset of clinical signs. Dogs should be isolated for 21d+