Consensus Statements of the American College of Veterinary Internal Medicine (ACVIM) provide the veterinary community with up-to-date information on the pathophysiology, diagnosis, and treatment of clinically important animal diseases. The ACVIM Board of Regents oversees selection of relevant topics, identification of panel members with the expertise to draft the statements, and other aspects of assuring the integrity of the process. The statements are derived from evidence-based medicine whenever possible and the panel offers interpretive comments when such evidence is inadequate or contradictory. A draft is prepared by the panel, followed by solicitation of input by the ACVIM membership which may be incorporated into the statement. It is then submitted to the Journal of Veterinary Internal Medicine, where it is edited prior to publication. The authors are solely responsible for the content of the statements. This report offers a consensus opinion on the diagnosis, epidemiology, treatment, and control of the primary enteropathogenic bacteria in dogs and cats, with an emphasis on Clostridium difficile, Clostridium perfringens, Campylobacter spp., Salmonella spp., and Escherichia coli associated with granulomatous colitis in Boxers. Veterinarians are challenged when attempting to diagnose animals with suspected bacterial-associated diarrhea because well-scrutinized practice guidelines that provide objective recommendations for implementing fecal testing are lacking. This problem is compounded by similar isolation rates for putative bacterial enteropathogens in animals with and without diarrhea, and by the lack of consensus among veterinary diagnostic laboratories as to which diagnostic assays should be utilized. Most bacterial enteropathogens are associated with self-limiting diarrhea, and injudicious administration of antimicrobials could be more harmful than beneficial. Salmonella and Campylobacter are well-documented zoonoses, but antimicrobial administration is not routinely advocated in uncomplicated cases and supportive therapy is recommended. Basic practices of isolation, use of appropriate protective equipment, and proper cleaning and disinfection are the mainstays of control. Handwashing with soap and water is preferred over use of alcohol-based hand sanitizers because spores of C. difficile and C. perfringens are alcohol-resistant, but susceptible to bleach (1:10 to 1:20 dilution of regular household bleach) and accelerated hydrogen peroxide. The implementation of practice guidelines in combination with the integration of validated molecular-based testing and conventional testing is pivotal if we are to optimize the identification and management of enteropathogenic bacteria in dogs and cats. Enteropathogenic Bacteria in Dogs and

Background: Systemic aspergillosis is a serious disease of dogs for which the clinical characteristics are poorly described. Objective: To describe the clinical and diagnostic imaging characteristics of dogs with systemic aspergillosis. Animals: Thirty dogs with systemic aspergillosis. Methods: Retrospective case review. Medical records were reviewed for signalment, clinical features, and results of clinicopathologic testing and diagnostic imaging. Diagnosis was confirmed by culture of Aspergillus terreus (n 5 13), Aspergillus deflectus (n 5 11), or other Aspergillus spp. (n 5 6).Results: Compared with the background hospital population, German Shepherd dogs and female dogs were overrepresented (odds ratio [OR] 43, 95% confidence interval [CI] 20-91, P o .0001, and OR 2.9, 95% CI 1.2-6.7, P 5 .02), respectively, with 20 of the 30 dogs being German Shepherd dogs and 77% (23 of 30) of the dogs being female. The median age was 4.5 years (range 2-8 years). Anemia, leukocytosis, hyperglobulinemia, azotemia, hypercalcemia, and hypoalbuminemia were present in 8, 21, 12, 9, 8, and 6 dogs, respectively. Diskospondylitis, osteomyelitis and thoracic lymphadenomegaly were present in 16, 10, and 5 dogs, respectively. Sonographic findings were enlarged hypoechoic lymph nodes (n 5 12), mottled and irregular kidneys with or without masses (n 5 12), pyelectasia, and an aggregate of echogenic material in the renal pelvis (n 5 9). Thirteen dogs were treated with antifungal drugs, with survival times ranging from 0 to 25 months after diagnosis.Conclusions and Clinical Importance: Systemic aspergillosis typically involves young to middle-age female German Shepherd dogs, and there are characteristic abdominal ultrasound findings with the disease process. Infection with A. deflectus was as common as A. terreus, and in rare cases, long-term survival was associated with antifungal therapy.

Background: Documentation of lower respiratory tract infection has relied on microbiologic and cytologic findings in airway fluid, but there is no gold standard for making a definitive diagnosis.Objective: To report cytologic and microbiologic findings in dogs diagnosed with lower respiratory tract infection through evaluation by bronchoscopy and bronchoalveolar lavage.Animals: A total of 105 dogs with spontaneous respiratory disease. Methods: Retrospective case review of all dogs identified through the electronic medical record database that had bronchoscopy with bronchoalveolar lavage performed between 2001 and 2011. Results of bronchoalveolar lavage cytology and microbiology were evaluated in 510 dogs, and 105 cases with septic, suppurative inflammation or bacterial growth from cultures were examined further.Results: Bacteria were isolated from 89/105 aerobic cultures, 18/104 anaerobic cultures, and 30/99 Mycoplasma spp. cultures. The most common isolate was Mycoplasma spp. followed by Pasteurella sp., Bordetella sp, Enterobacteriaceae, and anaerobes. A single bacterial species was cultured from 44/99 dogs (44%) and multiple bacterial species were isolated from 55/99 dogs (56%). Suppurative inflammation with intracellular bacteria was identified cytologically in 78 of 105 dogs (74%). In 27 dogs that lacked cytologic evidence of sepsis, mixed (n = 18) and neutrophilic (n = 9) inflammation was reported, and Mycoplasma spp. (13/27) or Bordetella spp. (7/27) were most commonly isolated. Most aerobic bacteria were susceptible to routinely used antimicrobial drugs.Conclusions and Clinical Importance: Confirmation of lower respiratory tract infection in dogs is challenging and organisms can be isolated from dogs in which bacteria are not detected on cytologic examination.

We use a meta‐analysis of density dependence in reef fishes to evaluate how ecologists approach detection, inference, and estimation. We compared two groups of studies: those that detected effects of density on survival and those that did not. Distinctions between these groups have spawned heated debate about the processes that affect fish dynamics. Per capita effects of density were similar between the two groups, although total effects (and hence ambient density) were greater in studies that detected density effects. The majority of the variation in effects of density was not resolved by the classification of studies based on the authors' conclusions. These results suggest (1) that standard inferences based on null hypothesis tests may miss important sources of variation in effects and give rise to unnecessary debate; and (2) that estimation of effect sizes and model parameters (including their uncertainty) is a powerful alternative to detection of ecological processes.

Eleven laboratories collaborated to determine the periodic prevalence of Salmonella in a population of dogs and cats in the United States visiting veterinary clinics. Fecal samples (2,965) solicited from 11 geographically dispersed veterinary testing laboratories were collected in 36 states between January 2012 and April 2014 and tested using a harmonized method. The overall study prevalence of Salmonella in cats (3 of 542) was <1%. The prevalence in dogs (60 of 2,422) was 2.5%. Diarrhea was present in only 55% of positive dogs; however, 3.8% of the all diarrheic dogs were positive, compared with 1.8% of the nondiarrheic dogs. Salmonella-positive dogs were significantly more likely to have consumed raw food (P = 0.01), to have consumed probiotics (P = 0.002), or to have been given antibiotics (P = 0.01). Rural dogs were also more likely to be Salmonella positive than urban (P = 0.002) or suburban (P = 0.001) dogs. In the 67 isolates, 27 unique serovars were identified, with three dogs having two serovars present. Antimicrobial susceptibility testing of 66 isolates revealed that only four of the isolates were resistant to one or more antibiotics. Additional characterization of the 66 isolates was done using pulsed-field gel electrophoresis and whole-genome sequencing (WGS). Sequence data compared well to resistance phenotypic data and were submitted to the National Center for Biotechnology Information (NCBI). This study suggests an overall decline in prevalence of Salmonella-positive dogs and cats over the last decades and identifies consumption of raw food as a major risk factor for Salmonella infection. Of note is that almost half of the Salmonella-positive animals were clinically nondiarrheic.

Rhodococcus equi causes severe pyogranulomatous pneumonia in foals. This facultative intracellular pathogen produces similar lesions in immunocompromised humans, particularly in AIDS patients. Virulent strains of R. equi bear a large plasmid that is required for intracellular survival within macrophages and for virulence in foals and mice. Only two plasmid-encoded proteins have been described previously; a 15-to 17-kDa surface protein designated virulence-associated protein A (VapA) and an antigenically related 20-kDa protein (herein designated VapB). These two proteins are not expressed by the same R. equi isolate. We describe here the substantial similarity between VapA and VapB. Moreover, we identify three additional genes carried on the virulence plasmid, The nocardioform actinomycete, Rhodococcus equi, is an important pulmonary pathogen in foals and in human patients with AIDS. This gram-positive bacterium is a facultative intracellular pathogen that persists and multiplies within macrophages. Intracellular survival is considered to be necessary for the development of disease, which is characterized by severe and sometimes fatal pneumonia in both humans and foals (5,17).Clinical isolates of R. equi contain a large plasmid ranging in size from 80 to 90 kb in equine or 30 to 100 kb in human AIDS isolates (25,30). The large plasmid is essential for virulence in mice and foals and for intracellular survival in murine and equine macrophages (9). Plasmid curing by repeated passage during in vitro culture at 37°C eliminates the virulent phenotype (9, 27). These findings indicate that the plasmid encodes proteins that are necessary for virulence.Only two proteins encoded by R. equi virulence plasmids have been described to date. Equine isolates express a 15-to 17-kDa protein (VapA) that appears as a characteristic broad band in sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) gels (20,26,29). Human R. equi isolates from AIDS patients generally express either VapA or an antigenically related 20-kDa protein (25). The 20-kDa protein is expressed by isolates from pigs as well as humans. No R. equi isolate has been shown to express both VapA and the 20-kDa protein. However, antigenic cross-reactivity between VapA and the 20-kDa protein has been demonstrated using immunoblots and serum from infected foals (25). The similarity of VapA and the 20-kDa plasmid-encoded proteins raises the possibility that the two proteins have analogous functions in different strains of R. equi.VapA and the 20-kDa protein are located on the bacterial surface, and expression is reported to be thermally and pH regulated (22,24). Specifically, VapA and the 20-kDa protein can be detected when R. equi is cultured at 38°C but not when cultured at 30°C, and expression at 38°C is observed only if the pH of the medium is decreased below 8 (22). These characteristics suggest that expression is upregulated in the mammalian host and intracellularly where VapA or the 20-kDa protein would play a role in the pathogenesis of rhodococcal p...

Campylobacter is the leading cause of human gastroenteritis worldwide. Wild birds, including American crows, are abundant in urban, suburban, and agricultural settings and are likely zoonotic vectors of Campylobacter. Their proximity to humans and livestock increases the potential spreading of Campylobacter via crows between the environment, livestock, and humans. However, no studies have definitively demonstrated that crows are a vector for pathogenic Campylobacter. We used genomics to evaluate the zoonotic and pathogenic potential of Campylobacter from crows to other animals with 184 isolates obtained from crows, chickens, cows, sheep, goats, humans, and nonhuman primates. Whole-genome analysis uncovered two distinct clades of Campylobacter jejuni genotypes; the first contained genotypes found only in crows, while a second genotype contained "generalist" genomes that were isolated from multiple host species, including isolates implicated in human disease, primate gastroenteritis, and livestock abortion. Two major ␤-lactamase genes were observed frequently in these genomes (oxa-184, 55%, and oxa-61, 29%), where oxa-184 was associated only with crows and oxa-61 was associated with generalists. Mutations in gyrA, indicative of fluoroquinolone resistance, were observed in 14% of the isolates. Tetracycline resistance (tetO) was present in 22% of the isolates, yet it occurred in 91% of the abortion isolates. Virulence genes were distributed throughout the genomes; however, cdtC alleles recapitulated the crow-only and generalist clades. A specific cdtC allele was associated with abortion in livestock and was concomitant with tetO. These findings indicate that crows harboring a generalist C. jejuni genotype may act as a vector for the zoonotic transmission of Campylobacter. IMPORTANCEThis study examined the link between public health and the genomic variation of Campylobacter in relation to disease in humans, primates, and livestock. Use of large-scale whole-genome sequencing enabled population-level assessment to find new genes that are linked to livestock disease. With 184 Campylobacter genomes, we assessed virulence traits, antibiotic resistance susceptibility, and the potential for zoonotic transfer to observe that there is a "generalist" genotype that may move between host species. Campylobacter is a motile Gram-negative spiral bacterium that causes gastroenteritis in humans and other animals (1, 2). In livestock, Campylobacter may cause abortion in addition to gastroenteritis (3). It is one of the most common foodborne zoonotic pathogens worldwide and is often transmitted via the fecal-oral route through the consumption of contaminated food or water (1, 2). In the United States, campylobacteriosis is estimated to affect more than 1.3 million people each year, with symptoms including fever, abdominal cramping, and bloody diarrhea (1, 4, 5). Internationally, campylobacteriosis is a significant public health burden; the incidence in developed nations is estimated to be 4.4 to 9.3 per 1,000 people yearly and...

Although protected for nearly a century, California’s sea otters have been slow to recover, in part due to exposure to fecally-associated protozoal pathogens like Toxoplasma gondii and Sarcocystis neurona. However, potential impacts from exposure to fecal bacteria have not been systematically explored. Using selective media, we examined feces from live and dead sea otters from California for specific enteric bacterial pathogens (Campylobacter, Salmonella, Clostridium perfringens, C. difficile and Escherichia coli O157:H7), and pathogens endemic to the marine environment (Vibrio cholerae, V. parahaemolyticus and Plesiomonas shigelloides). We evaluated statistical associations between detection of these pathogens in otter feces and demographic or environmental risk factors for otter exposure, and found that dead otters were more likely to test positive for C. perfringens, Campylobacter and V. parahaemolyticus than were live otters. Otters from more urbanized coastlines and areas with high freshwater runoff (near outflows of rivers or streams) were more likely to test positive for one or more of these bacterial pathogens. Other risk factors for bacterial detection in otters included male gender and fecal samples collected during the rainy season when surface runoff is maximal. Similar risk factors were reported in prior studies of pathogen exposure for California otters and their invertebrate prey, suggesting that land-sea transfer and/or facilitation of pathogen survival in degraded coastal marine habitat may be impacting sea otter recovery. Because otters and humans share many of the same foods, our findings may also have implications for human health.