pyoderma

脓皮病
  • 文章类型: Journal Article
    背景:棘皮脱落的角质形成细胞(棘皮脱落细胞[AC])的细胞学检测有助于识别犬天疱疮(cPF),但AC也发生在浅表脓皮病(SP)中,主要的鉴别诊断。
    目的:比较cPF和SP的细胞形态学特征,并建立区分cPF和SP的细胞学诊断标准。
    方法:有PF和SP的40和51只客户拥有的狗,分别。
    方法:来自cPF(64)的印象涂片,脓疱病(40)和剥脱浅层脓皮病(ESP)(17)样品用罗曼诺夫斯基染色剂染色,随机化,盲化,由两名研究者独立评估.将整个样品筛选(×500或×1000放大)为圆形(AC1),船(AC2)和筏板AC,嗜酸性粒细胞和细菌。计算了观察员之间的协议。
    结果:在PF中,AC1和AC2的10个最高×500场的平均数明显高于SP(p<0.0001;Kruskal-Wallis检验)。漂流和嗜酸性粒细胞在PF中比SP中更常见(p<0.0001;卡方检验),而细菌在PF中很少见(5%;p<0.0001;卡方检验)。有经验和新手研究者之间的观察结果高度相关。ROC分析确定了五个AC1/×500放大倍数的视野作为预测PF诊断的合适临界值。这个临界值是由另外两名调查人员测试的,他们确定了84%-100%的敏感度,诊断cPF的特异性为95%-97%,准确性为95%-96%。
    结论:基于标准的印模涂片细胞学评价可为临床诊断提供有力依据。cPF和SP的棘皮松解细胞形态不同,经验可以提高细胞学分化的准确性。
    BACKGROUND: Cytological detection of acantholytic keratinocytes (acantholytic cells [AC]) helps to identify canine pemphigus foliaceus (cPF) yet AC also occurs in superficial pyoderma (SP), the main differential diagnosis.
    OBJECTIVE: To compare selected cytomorphological features of cPF and SP and to establish cytological diagnostic criteria that could differentiate cPF from SP.
    METHODS: 40 and 51 client-owned dogs with PF and SP, respectively.
    METHODS: Impression smears from cPF (64), impetigo (40) and exfoliative superficial pyoderma (ESP) (17) samples were stained with Romanowsky stain, randomised, blinded and evaluated by two investigators independently. The entire sample was screened (×500 or ×1000 magnification) for round (AC1), boat (AC2) and raft AC, eosinophils and bacteria. Interobserver agreements were calculated.
    RESULTS: The average number of the 10 highest ×500 fields for AC1 and AC2 was significantly higher in PF than SP (p < 0.0001; Kruskal-Wallis test). Rafts and eosinophils were more common in PF than SP (p < 0.0001; chi-square test), while bacteria were rare in PF (5%; p < 0.0001; chi-square test). Observations between the experienced and novice investigators were highly correlated. An ROC analysis identified five AC1/×500-magnification field as a suitable cut-off value for predicting PF diagnosis. This cut-off value was tested by two additional investigators, who identified sensitivity of 84%-100%, specificity of 95%-97% and accuracy of 95%-96% for the diagnosis of cPF.
    CONCLUSIONS: Criterion-based impression smear cytological evaluation can provide strong evidence to support the clinical diagnosis. Acantholytic cell morphology varies in cPF and SP, and experience can improve accuracy in cytological differentiation.
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  • 文章类型: Journal Article
    假中间葡萄球菌是狗共生葡萄球菌种群中的一种。虽然它通常在健康的伴侣狗身上携带,但它也是与一系列皮肤相关的机会病原体,耳朵,伤口和其他感染。虽然适应了狗,它不仅限于他们,我们已经审查了它的宿主范围,包括越来越多的人类定植和感染报告。尽管它与宠物狗有联系,假中介在动物中广泛发现,覆盖伴侣,牲畜和自由生活的鸟类和哺乳动物。人类感染,通常在免疫受损的个体中,越来越被认可,部分原因是诊断的改善。定殖,感染,和抗菌素耐药性,包括常见的多药耐药性,在假中介链球菌分离株中,这是一个重要的健康挑战。
    Staphylococcus pseudintermedius is one species in the commensal staphylococcal population in dogs. While it is commonly carried on healthy companion dogs it is also an opportunistic pathogen associated with a range of skin, ear, wound and other infections. While adapted to dogs, it is not restricted to them, and we have reviewed its host range, including increasing reports of human colonisation and infections. Despite its association with pet dogs, S. pseudintermedius is found widely in animals, covering companion, livestock and free-living species of birds and mammals. Human infections, typically in immunocompromised individuals, are increasingly being recognised, in part due to improved diagnosis. Colonisation, infection, and antimicrobial resistance, including frequent multidrug resistance, among S. pseudintermedius isolates represent important One Health challenges.
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  • 文章类型: Journal Article
    假中间葡萄球菌是狗脓皮病的最常见原因。我们验证了基于比色环介导等温扩增(LAMP)的即时护理(PoC)测试,用于快速鉴定假中介杆菌,并对一线抗生素进行敏感性测试,以全身治疗犬脓皮病,即,lincosamides,第一代头孢菌素和克拉维酸阿莫西林。将新设计的靶向临床相关抗性基因的LAMP引物与先前验证的靶向spsL的引物组合用于物种鉴定。经过110个临床分离株的实验室验证,我们使用常规培养和药敏试验作为参考标准,对101份临床标本进行了检测.PoC测试的平均操作和周转时间为30和90分钟,分别。当在实验室的细菌培养物或临床标本上进行时,该测定法显示出物种鉴定和敏感性测试的敏感性和特异性接近100%。然而,当临床工作人员在现场进行时,PoC测试产生的结果不太准确(物种鉴定的灵敏度为92%,特异性为64%,对β-内酰胺的敏感性为67%,特异性为96%,lincosamide敏感性为83%,特异性为71%)。这些结果表明,PoC测试应适应用户友好的技术,以促进临床人员对结果的执行和解释。如果开发得当,该测试将使兽医能够快速获得抗菌药物选择的信息,限制治疗失败的风险,并促进小动物兽医皮肤病学抗菌药物使用指南的遵守。
    Staphylococcus pseudintermedius is the most common cause of pyoderma in dogs. We validated a point-of-care (PoC) test based on colorimetric loop-mediated isothermal amplification (LAMP) for rapid S. pseudintermedius identification and susceptibility testing for first line antimicrobials for systemic treatment of canine pyoderma, i.e., lincosamides, first generation cephalosporins and amoxicillin clavulanate. Newly designed LAMP primers targeting clinically relevant resistance genes were combined with a previously validated set of primers targeting spsL for species identification. After laboratory validation on 110 clinical isolates, we assessed the performance of the test on 101 clinical specimens using routine culture and susceptibility testing as a reference standard. The average hands-on and turnaround times for the PoC test were 30 and 90 min, respectively. The assay showed sensitivity and specificity near 100% for both species identification and susceptibility testing when performed on bacterial cultures or clinical specimens in the laboratory. However, the PoC test yielded less accurate results when performed on-site by clinical staff (92% sensitivity and 64% specificity for species identification, 67% sensitivity and 96% specificity for β-lactam susceptibility, and 83% sensitivity and 71% specificity for lincosamide susceptibility). These results indicate that the PoC test should be adapted to a user-friendly technology to facilitate performance and interpretation of results by clinical staff. If properly developed, the test would allow veterinarians to gain rapid information on antimicrobial choice, limiting the risk of treatment failure and facilitating adherence to antimicrobial use guidelines in small animal veterinary dermatology.
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  • 文章类型: Case Reports
    背景:植物性脓皮病(PV)是一种病因不明的罕见中性粒细胞性皮肤病。目前,没有PV的治疗指南。全身性类固醇通常用作一线治疗,但在停药或逐渐减少时复发是常见的。材料和方法:我们测试了200mg/d剂量的多西环素治疗耐药性PV的功效。结果:治疗4周后,我们发现PV的临床表现有了显着改善。结论:我们的病例证明了强力霉素作为全身性类固醇保护剂在治疗PV中的潜在用途。
    Background: Pyoderma vegetans (PV) is a rare neutrophilic dermatosis of unknown etiology. Currently, there are no treatment guidelines for PV. Systemic steroids are often used as first-line therapy, but recurrence upon discontinuation or tapering is common.Materials and methods: We tested the efficacy of doxycycline at a dose of 200 mg/d to treat resistant PV.Results: After 4 weeks of treatment we noticed a significant improvement in the clinical appearance of PV.Conclusions: Our case demonstrates the potential utility of doxycycline as a systemic steroid-sparing agent in the treatment of PV.
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  • 文章类型: Journal Article
    血液系统恶性肿瘤的皮肤表现既代表了治疗医师的临床挑战,也代表了促进个体肿瘤知识的病理生理学模型。的确,越来越多的证据支持与特定临床特征相关的复发性分子缺陷的概念,最好的例子是VEXAS。本文将对血液学家和皮肤科医生潜在感兴趣的嗜中性和嗜酸性皮肤病进行审查。包括角膜下脓疱皮肤病型IgA天疱疮,嗜中性内分泌汗腺炎,Sweet\'s综合征以及皮肤骨髓增生异常和VEXAS,坏疽性脓皮病,嗜酸性粒细胞环形红斑,血液系统恶性肿瘤的嗜酸性皮肤病,Wells综合征和皮肤受累于嗜酸性粒细胞增多综合征。讨论了每个人可能的管理方法,强调需要治疗的潜在条件,以实现皮肤水平的缓解方案。
    Cutaneous manifestations of hematologic malignancy represent both a clinical challenge for the treating physician and a pathophysiological model for advancing the knowledge on individual neoplasms. Indeed, a growing body of evidence supports the concept of recurrent molecular defects associating with specific clinical features, as best exemplified by VEXAS. Herein neutrophilic and eosinophilic dermatoses of potential interest for both hematologists and dermatologists will be reviewed, including subcorneal pustular dermatosis-type IgA pemphigus, neutrophilic eccrine hidradenitis, Sweet\'s syndrome as well as myelodysplasia cutis and VEXAS, pyoderma gangrenosum, eosinophilic annular erythema, eosinophilic dermatosis of hematological malignancy, Wells syndrome and cutaneous involvement in hypereosinophilic syndromes. Possible management approaches are discussed for each, emphasizing scenarios that require treatment of the underlying condition to achieve remission at the skin level.
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  • 文章类型: Journal Article
    凝固葡萄球菌(SC)属于一组凝固酶阳性葡萄球菌,偶尔从脓皮病犬的皮肤病变中分离出来。我们最近发现赤藓糖醇,一种糖醇,抑制SC菌株JCM7470的生长。这项研究调查了赤藓糖醇对JCM7470生长抑制的分子机制,并确定赤藓糖醇是否抑制从脓皮病犬皮肤分离的SC的生长。在赤藓糖醇存在下对JCM7470基因表达的综合分析显示,赤藓糖醇上调glcB和ptsG基因的表达,两者都编码磷酸转移酶系统(PTS)葡糖苷和葡萄糖特异性通透酶C,B,和A域(EIICBA),分别,与糖吸收有关。此外,赤藓糖醇抑制了从犬脓皮病皮肤病变中分离出的所有27种SC菌株的体外生长,其中mecA基因阳性13株,mecA基因阴性14株。最后,添加葡萄糖可恢复赤藓糖醇对SC临床分离株的生长抑制作用.总之,我们发现赤藓糖醇促进PTS基因表达并抑制脓皮病犬SC临床分离株的体外生长。葡萄糖对赤藓糖醇诱导的生长抑制的恢复表明,葡萄糖饥饿可能有助于SC的生长抑制。
    Staphylococcus coagulans (SC) belongs to a group of coagulase-positive staphylococci occasionally isolated from the skin lesions of dogs with pyoderma. We recently revealed that erythritol, a sugar alcohol, inhibited the growth of SC strain JCM7470. This study investigated the molecular mechanisms involved in this growth inhibition of JCM7470 by erythritol, and determine whether erythritol inhibits the growth of SC isolated from the skin of dogs with pyoderma. Comprehensive analysis of the gene expression of JCM7470 in the presence of erythritol revealed that erythritol upregulated the expression of glcB and ptsG genes, both of which encode phosphotransferase system (PTS) glucoside- and glucose-specific permease C, B, and A domains (EIICBA), respectively, associated with sugar uptake. Moreover, erythritol suppressed in vitro growth of all 27 SC strains isolated from the skin lesions of canine pyoderma, including 13 mecA gene-positive and 14 mecA gene-negative strains. Finally, the growth inhibition of the SC clinical isolates by erythritol was restored by the addition of glucose. In summary, we revealed that erythritol promotes PTS gene expression and suppresses the in vitro growth of SC clinical isolates from dogs with pyoderma. Restoration of the erythritol-induced growth inhibition by glucose suggested that glucose starvation may contribute to the growth inhibition of SC.
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  • 文章类型: Journal Article
    细菌培养和敏感性广泛用于兽医学中,以确定引起感染的特定细菌以及帮助选择适当的抗菌药物。先前的研究显示了不同的结果与培养和易感性取决于所使用的实验室和方法。从患有浅表脓皮病的狗获得样品以制备均匀的细菌溶液。来自该溶液的样品采集是随机的,并提交给四个兽医实验室用于微生物鉴定和灵敏度。实验室在鉴定葡萄球菌属物种方面达成了一致。以及实验室之间对同一葡萄球菌的公平协议。在鉴定耐甲氧西林葡萄球菌属方面取得了很好的一致性。此外,在所有四个实验室中测试的所有抗菌药物上都注意到良好到非常好的一致性。在本研究中,实验室之间观察到样品处理的周转时间不同。总的来说,本研究的实验室结果存在轻度变异性.
    Bacterial culture and susceptibility are widely used in veterinary medicine to determine the specific bacteria causing infection as well as aid in appropriate antimicrobial selection. Previous studies have shown variable results with culture and susceptibility depending on the laboratory and methodology used. Samples from dogs with superficial pyoderma were obtained to make a homogeneous solution of bacteria. Sample acquisition from this solution was randomized and submitted to four veterinary laboratories for microbial identification and sensitivity. There was fair agreement among the laboratories in identification of a Staphylococcus spp. as well as fair agreement among the laboratories on the same Staphylococcus sp. Very good agreement was noted on identification of methicillin-resistant Staphylococcus spp. Additionally, good to very good agreement was noted on all antimicrobials that were tested across all four laboratories. A difference in turnaround time for sample processing was observed between the laboratories in the present study. Overall, there was mild variability among the laboratory results in this study.
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  • 文章类型: Journal Article
    赤藓糖醇(ERT)和L-抗坏血酸-2-磷酸酯(APS)是抑菌,但它们对葡萄球菌皮肤感染的影响尚不清楚。我们旨在确定ERT与APS联合是否会抑制通常从狗脓皮病皮肤病变中分离出的葡萄球菌的生长。我们调查了ERT和APS对假中介葡萄球菌生长的个体和联合作用,S.Schleiferi,和金黄色葡萄球菌使用体外浊度测定。用5%ERT和0.1%APS局部治疗10只浅表脓皮病犬的皮肤病变28天,然后使用16SrRNA扩增子测序和定量实时PCR(qPCR)分析擦拭的皮肤样品。结果表明,无论携带mecA基因,ERT都能抑制假中介杆菌的生长,APS增加了ERT对假中介链球菌的抑制作用,S.Schleiferi,和金黄色葡萄球菌在体外。此外,联合ERT和APS在属水平上降低了葡萄球菌在犬皮肤病变上的患病率.该组合略微增加了微生物群的α-多样性,但不影响微生物群的β-多样性。qPCR结果表明,该组合显着降低了皮肤病变中的假中间链球菌和S.schleiferi。EPS联合APS的局部给药可以防止葡萄球菌在哺乳动物皮肤表面的定植。这项研究的结果可能为全身性抗生素提供一种替代方法,用于治疗哺乳动物皮肤表面的浅层脓皮病。
    Erythritol (ERT) and L-ascorbyl-2-phosphate (APS) are bacteriostatic, but their effects on staphylococcal skin infections remain unknown. We aimed to determine whether ERT combined with APS inhibits the growth of staphylococci that are commonly isolated from pyoderma skin lesions in dogs. We investigated the individual and combined effects of ERT and APS on the growth of Staphylococcus pseudintermedius, S. schleiferi, and S. aureus using turbidity assays in vitro. Skin lesions from 10 dogs with superficial pyoderma were topically treated with 5% ERT and 0.1% APS for 28 days, and swabbed skin samples were then analyzed using 16S rRNA amplicon sequencing and quantitative real-time PCR (qPCR). Results showed that ERT inhibited S. pseudintermedius growth regardless of harboring the mecA gene, and APS increased the inhibitory effects of ERT against S. pseudintermedius, S. schleiferi, and S. aureus in vitro. Moreover, combined ERT and APS decreased the prevalence of staphylococci on canine skin lesions at the genus level. The combination slightly increased the α-diversity but did not affect the β-diversity of the microbiota. The qPCR results revealed that the combination significantly decreased S. pseudintermedius and S. schleiferi in skin lesions. Topical administration of EPS combined with APS can prevent staphylococcal colonization on the surface of mammalian skin. The results of this study may provide an alternative to systemic antibiotics for treating superficial pyoderma on mammalian skin surfaces.
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  • 文章类型: Journal Article
    狗通常无症状地携带耐甲氧西林葡萄球菌。这些细菌通常与诸如犬脓皮病和耳炎的病症有关。狗与人之间的紧密互动可以促进抗性菌株的交换,特别是耐甲氧西林假中间葡萄球菌(MRSP)。这代表了一个公共卫生问题,由于这些菌株,除了偶尔引起人类感染,还可以作为在人类医学中更重要的菌株的抗性和毒力基因的来源,如金黄色葡萄球菌。此外,MRSP菌株通常具有多重耐药性,最终影响了感染的治疗。这项研究旨在评估假中介葡萄球菌在狗及其主人之间的潜在传播。我们检查了从脓皮病和中耳炎病例中收集的一百个犬样本,以检测葡萄球菌的存在。同时,我们对所有狗主人进行了评估。使用MALDI-TOFMS和靶向nuc基因的PCR鉴定葡萄球菌菌株。还通过使用PCR检测mecA基因进行甲氧西林抗性筛选。在采样的狗中,64载着假中介。9人被确定为MRSP。在六个例子中,狗和它们的主人展示了假中介。这些样本进行了基因组测序,并筛选了抗菌素抗性基因,SCCmec打字,MLST表征,和单核苷酸多态性(SNP)分析。系统发育分析结果显示,在三个案例中,狗和主人有密切相关的分离株,表明种间传播。其中2例涉及MRSP和1例MSSP。此外,在两个MRSP病例中,检测到相同的SCCmec类型(V型)。此外,在涉及犬和主人的3例病例中,序列类型一致(MSSPST2277,MRSPST2282和ST2286).这些发现强烈表明了一个传播事件。由于假中间葡萄球菌主要是从犬类样本中分离出来的,狗可能是潜在的来源,这似乎是合理的。在其余三个案例中,尽管在两个样本中发现了相同的物种,它们有明显的系统发育差异。
    Dogs often carry methicillin-resistant Staphylococci asymptomatically. These bacteria are frequently linked to conditions such as canine pyoderma and otitis. Close interaction between dogs and humans can facilitate the exchange of resistant strains, particularly Methicillin-resistant Staphylococcus pseudintermedius (MRSP). This represents a public health issue, since these strains, in addition to occasionally causing infections in humans, can also serve as a source of resistance and virulence genes for strains of greater importance in human medicine, such as Staphylococcus aureus. Furthermore, MRSP strains are often multidrug resistant, which ends up compromising the treatment of infections. This study aimed to assess the potential transmission of Staphylococcus pseudintermedius among dogs and their owners. We examined a total of one hundred canine samples collected from cases of pyoderma and otitis to detect the presence of staphylococci. Simultaneously, we conducted evaluations on all dog owners. Staphylococci strains were identified using MALDI-TOF MS and PCR targeting the nuc gene. Methicillin resistance screening was also performed by detecting the mecA gene using PCR. Among the sampled dogs, 64 carried S. pseudintermedius. Nine were identified as MRSP. In six instances, dogs and their owners exhibited S. pseudintermedius. These samples underwent genome sequencing and were screened for antimicrobial resistance genes, SCCmec typing, MLST characterization, and Single Nucleotide Polymorphisms (SNP) analyses. The results of the phylogenetic analysis revealed that in three cases, dogs and owners had closely related isolates, suggesting interspecies transmission. Two of these cases involved MRSP and one MSSP. Moreover, in the two MRSP cases, the same SCCmec type (type V) was detected. Additionally, the sequence type was consistent across all three cases involving dogs and owners (MSSP ST2277, MRSP ST2282, and ST2286). These findings strongly indicate a transmission event. Since Staphylococcus pseudintermedius is primarily isolated from canine samples, it is plausible that dogs may have acted as a potential source. In the remaining three cases, despite identifying the same species in both samples, they had notable phylogenetic differences.
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  • 文章类型: Journal Article
    化脓性链球菌(StrepA)在全球范围内造成了从浅表感染到侵袭性疾病的重大疾病负担。它每年造成超过500,000人死亡,主要在低收入和中等收入国家(LMIC)。皮肤和咽部的浅表StrepA感染可导致风湿性心脏病,LMIC中StrepA相关死亡的最大原因。StrepA也可以无症状地定植于正常皮肤和咽部(运输),潜在的感染风险增加。乳酸链球菌亚种。等路(SDSE)运输在LMIC中也很常见,并且可能与StrepA相互作用。本研究旨在调查StrepA和SDSE携带和感染流行病学,冈比亚家庭内的传播动态和自然获得性免疫。
    将进行为期一年的纵向家庭观察队列研究。将从苏库塔市区招募45户家庭,冈比亚,约450名参与者。每月都会探访住户,现有参与者将接受口咽和正常皮肤擦拭。咽炎和脓皮病的事件病例将通过主动病例报告被捕获。从疾病部位取棉签。拭子将在A组存在的情况下进行培养,C和Gβ溶血性链球菌。分离物将进行全基因组测序。每次访问,临床,社会人口和社会混合数据将被收集。将在基线和最后一次访问时收集血清。每次就诊时收集口服液和干血斑样品。测量粘膜和血清抗-StrepA抗体应答。
    本研究将报告StrepA和SDSE临床流行病学,危险因素,传输动力学,以及对携带和感染的血清学反应。详细的社会混合行为将与系统发育相关性相结合,以模拟家庭之间和家庭之间的传播程度。该研究将提供数据,以帮助实现全球战略StrepA研究目标。
    UNASSIGNED: Streptococcus pyogenes (StrepA) causes a significant burden of disease globally from superficial infections to invasive disease. It is responsible for over 500,000 deaths each year, predominantly in low- and middle-income countries (LMIC). Superficial StrepA infections of the skin and pharynx can lead to rheumatic heart disease, the largest cause of StrepA-related deaths in LMIC. StrepA can also asymptomatically colonise normal skin and the pharynx (carriage), potentially increasing infection risk. Streptococcus dysgalactiae subsp. equisimilis (SDSE) carriage is also common in LMIC and may interact with StrepA. This study aims to investigate StrepA and SDSE carriage and infection epidemiology, transmission dynamics and naturally acquired immunity within households in The Gambia.
    UNASSIGNED: A longitudinal household observational cohort study will be conducted over one year. 45 households will be recruited from the urban area of Sukuta, The Gambia, resulting in approximately 450 participants. Households will be visited monthly, and available participants will undergo oropharyngeal and normal skin swabbing. Incident cases of pharyngitis and pyoderma will be captured via active case reporting, with swabs taken from disease sites. Swabs will be cultured for the presence of group A, C and G beta-haemolytic streptococci. Isolates will undergo whole genome sequencing. At each visit, clinical, socio-demographic and social mixing data will be collected. Blood serum will be collected at baseline and final visit. Oral fluid and dried blood spot samples will be collected at each visit. Mucosal and serum anti-StrepA antibody responses will be measured.
    UNASSIGNED: This study will report StrepA and SDSE clinical epidemiology, risk factors, transmission dynamics, and serological responses to carriage and infection. Detailed social mixing behaviour will be combined with phylogenetic relatedness to model the extent of transmission occurring withing and between households. The study will provide data to help meet global strategic StrepA research goals.
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