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Optimizing antibiotic use in the treatment of Pyometra
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A piómetra em cadelas e gatas é uma infeção uterina frequente e potencialmente fatal, sendo um dos principais motivos de utilização de antibióticos em animais de companhia. Este estudo teve como objetivo caracterizar a microbiota vaginal e uterina de fêmeas com piómetra e avaliar se as culturas vaginais podem orientar de forma fiável a antibioterapia empírica. Realizou-se um estudo retrospetivo, observacional e transversal num hospital universitário, incluindo 39 fêmeas inteiras (27 cadelas, 69,2%; 12 gatas, 30,8%), nas quais se obtiveram zaragatoas emparelhadas da vagina e do útero para cultura aeróbia, sequenciação do gene 16S rRNA e testes de suscetibilidade por difusão em disco. Escherichia coli foi o agente mais frequentemente isolado em ambas as espécies e locais de colheita, destacando-se nas amostras uterinas de cadelas (78,6%). Nos casos caninos com amostras emparelhadas (n = 34), verificou-se concordância entre os agentes vaginais e uterinos em 18 casos (52,9%), enquanto 16 (47,1%) apresentaram isolados discordantes; nas gatas (n = 11), a concordância foi de 63,6% (7/11) e a discordância de 36,4% (4/11). Os padrões de suscetibilidade antimicrobiana foram globalmente favoráveis, com a maioria dos isolados a manter suscetibilidade a cefovecina, amoxicilina-clavulanato, gentamicina e cefalosporinas, em linha com a literatura recente. Estes resultados sugerem que as culturas vaginais podem fornecer informação útil, mas incompleta sobre a infeção uterina, reforçando a necessidade de colheitas uterinas sempre que possível e evidenciando oportunidades para otimizar a antibioterapia empírica e promover o uso responsável de antibióticos no tratamento da piómetra.
ABSTRACT: Pyometra in bitches and queens is a common and potentially life-threatening uterine infection and a major indication for antibiotic use in companion animals. This study aimed to characterize the vaginal and uterine microbiota of females with pyometra and to assess whether vaginal cultures can reliably guide empirical antimicrobial therapy. A retrospective, observational, cross-sectional study was conducted at a university veterinary hospital, including 39 intact females (27 dogs, 69.2%; 12 cats, 30.8%), from which paired vaginal and uterine swabs were collected for aerobic culture, 16S rRNA gene sequencing, and disk diffusion susceptibility testing. Escherichia coli was the most frequently isolated bacterial species across both species and sampling sites, particularly in uterine samples from bitches (78.6%). In canine cases with paired samples (n = 34), agreement between uterine and vaginal bacterial agents was observed in 18 cases (52.9%), whereas 16 cases (47.1%) showed discordant isolates; in queens (n = 11), uterine and vaginal isolates agreed in 7 cases (63.6%) and were discordant in 4 cases (36.4%). Antimicrobial susceptibility patterns were generally favorable, with most isolates remaining susceptible to cefovecin, amoxicillin–clavulanate, gentamicin and cephalosporins, in accordance with recent reports on small-animal pathogens. These findings indicate that vaginal cultures can provide useful but incomplete information about uterine infection, underscoring the importance of uterine sampling whenever feasible and highlighting opportunities to optimize empirical antimicrobial therapy and promote responsible antibiotic use in the management of pyometra.
ABSTRACT: Pyometra in bitches and queens is a common and potentially life-threatening uterine infection and a major indication for antibiotic use in companion animals. This study aimed to characterize the vaginal and uterine microbiota of females with pyometra and to assess whether vaginal cultures can reliably guide empirical antimicrobial therapy. A retrospective, observational, cross-sectional study was conducted at a university veterinary hospital, including 39 intact females (27 dogs, 69.2%; 12 cats, 30.8%), from which paired vaginal and uterine swabs were collected for aerobic culture, 16S rRNA gene sequencing, and disk diffusion susceptibility testing. Escherichia coli was the most frequently isolated bacterial species across both species and sampling sites, particularly in uterine samples from bitches (78.6%). In canine cases with paired samples (n = 34), agreement between uterine and vaginal bacterial agents was observed in 18 cases (52.9%), whereas 16 cases (47.1%) showed discordant isolates; in queens (n = 11), uterine and vaginal isolates agreed in 7 cases (63.6%) and were discordant in 4 cases (36.4%). Antimicrobial susceptibility patterns were generally favorable, with most isolates remaining susceptible to cefovecin, amoxicillin–clavulanate, gentamicin and cephalosporins, in accordance with recent reports on small-animal pathogens. These findings indicate that vaginal cultures can provide useful but incomplete information about uterine infection, underscoring the importance of uterine sampling whenever feasible and highlighting opportunities to optimize empirical antimicrobial therapy and promote responsible antibiotic use in the management of pyometra.
Descrição
Palavras-chave
Piómetra Microbiota vaginal Microbiota uterina Infeção Multirresistência Antibióticos Pyometra Vaginal microbiota Uterine microbiota Infection Multidrug resistance Antibiotics
Contexto Educativo
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Licença CC
Sem licença CC