Effective treatment and decolonization of a dog infected with carbapenemase (VIM-2)-producing Pseudomonas aeruginosa using probiotic and photodynamic therapies

Author(s)

Sellera, Fabio P. ^[1] ; Fernandes, Miriam R. ^[2] ; Sabino, Caetano P. ^{[2, 3]} ; de Freitas, Laura M. ^[4] ; da Silva, Luciano C. B. A. ^[5] ; Pogliani, Fabio C. ^[1] ; Ribeiro, Martha S. ^[6] ; Hamblin, Michael R. ^{[7, 8]} ; Lincopan, Nilton ^{[9, 2]}

Affiliation

^[1] Univ Sao Paulo, Sch Vet Med & Anim Sci, Dept Internal Med, Av Prof Orlando M Paiva 87, BR-05508270 Sao Paulo, SP - Brazil

^[2] Univ Sao Paulo, Fac Pharmaceut Sci, Dept Clin Anal, Av Prof Orlando M Paiva 580, BR-05508000 Sao Paulo, SP - Brazil

^[3] BioLambda, Cient & Comercial, LTDA R Prof Teotonio Monteiro Barros Filho 532, BR-LTDA R P Sao Paulo, SP - Brazil

^[4] Sao Paulo State Univ UNESP, Fac Pharmaceut Sci, Dept Clin Anal, R Expedicionarios Brasil 1621, BR-14801902 Araraquara, SP - Brazil

^[5] Univ Sao Paulo, Sch Vet Med & Anim Sci, Dept Surg, Av Prof Orlando M Paiva 87, BR-05508270 Sao Paulo, SP - Brazil

^[6] IPEN CNEN, Ctr Lasers & Applicat, Av Prof Lineu Prestes 2242, BR-05508000 Sao Paulo, SP - Brazil

^[7] Massachusetts Gen Hosp, Wellman Ctr Photomed, 40 Blossom St, Boston, MA 02114 - USA

^[8] Harvard Med Sch, 25 Shattuck St, Boston, MA 02115 - USA

^[9] Univ Sao Paulo, Inst Biomed Sci, Dept Microbiol, Av Prof Lineu Prestes 1374, BR-05508900 Sao Paulo, SP - Brazil

• Document type: Journal article
• Source: VETERINARY DERMATOLOGY; v. 30, n. 2, p. 170+, APR 2019.
• Web of Science Citations: 1

Abstract

Background Carbapenem-resistant bacterial infections are a critical problem in veterinary medicine with limited treatment options. Objective To describe effective probiotic and photodynamic therapy of a dog with gut colonization and ear infection caused by a hospital-associated lineage of carbapenemase (VIM-2)-producing Pseudomonas aeruginosa. Animals A 5-year-old Lhasa apso dog presented with otitis externa. Methods and materials Unilateral otitis externa caused by carbapenem-resistant P. aeruginosa was treated with antimicrobial photodynamic therapy (aPDT) using methylene blue as photosensitizer {[}wavelength 660 nm, fluence 140 J/cm(2), 8 J and 80 s per point (six equidistant points), 100 mW, spot size 0.028 cm(2) and fluence rate 3.5 W/cm(2)]. The isolated bacterial strain also was tested for susceptibility to in vitro aPDT where the survival fraction was quantified by colony forming unit counts after exposure to increasing light doses. For decolonization, probiotic supplements were orally administered (once daily) for 14 days. Effectiveness of probiotics and photodynamic therapy was evaluated by clinical and microbiological culture assays. Results Complete resolution of clinical signs was achieved by Day 7 after aPDT. Samples collected immediately and after seven and 14 days following aPDT were negative for VIM-2-producing P. aeruginosa. Oral and rectal swabs collected on days 7, 14 and 21 after probiotic therapy, confirmed effective gastrointestinal decolonization. Conclusions and clinical importance Combined use of aPDT and probiotics could be a promising therapeutic strategy for treatment of superficial infections produced by carbapenem-resistant bacteria, while avoiding recurrent infection due to intestinal bacterial carriage of these multidrug-resistant pathogens. (AU)

• FAPESP's process: 14/24581-5 - Evaluation of the role of photodynamic therapy combined with antimicrobial peptides against bacterial resistance
• Grantee: Laura Marise de Freitas
• Support Opportunities: Scholarships in Brazil - Doctorate
• FAPESP's process: 16/08593-9 - Pan-Resistome of beta-lactamase (KPC-2, CTX-M-8, CTX-M-15)-producing Klebsiella pneumoniae and Escherichia coli isolates endemic in Brazil
• Grantee: Nilton Erbet Lincopan Huenuman
• Support Opportunities: Regular Research Grants
• FAPESP's process: 15/13527-2 - Ancestral relationship, pan-resistoma plasmid of Escherichia coli producing b-lactamases of extended spectrum (CTX-M) and of plasmid curing methods
• Grantee: Miriam Rodriguez Fernandes
• Support Opportunities: Scholarships in Brazil - Doctorate