Caring, competency, compassion and always learning
Incidence. Rising rapidly.
Staphylococcus pseudintermedius. Coagulase positive. Coagulase-negative in heavy growth, pathogenic. Occasional S. aureus. Biochemical vs genetic ID.
Mechanisms of resistance
Concept of MIC vs MUP . What does sensitivity mean?
Heterogeneity of resistance
First line antibiotics
Second-line antibiotics. Not to be used without culture
Third line antibiotics. Never to be used unless first line and second line exhausted.
Duration of treatment
Causes of antibiotic failure
Topical treatment. Absolute essential. No animal repeat no animal should have antibiotics dispensed for a skin infection unless it is accompanied by topical treatment.
Sometimes topical is enough. Surface pyoderma hotspots. Some cases of superficial pyoderma. Allowing client pick up after 3 to 5 days.
First line topical treatment
Second line topical therapy
Reduced susceptibility to chlorhexidine in staphylococci: is it increasing and does it matter?
Carolyne Horner, Damien Mawer, Mark Wilcox
Journal of Antimicrobial Chemotherapy, Volume 67, Issue 11, November 2012, Pages 2547-2559, https://doi.org/10.1093/jac/dks284
As well as a broad range of activity, a key potential advantage of chlorhexidine, especially when used as a skin disinfectant, is its 'residual activity
In staphylococci, chlorhexidine resistance is often defined as an MIC ≥4 mg/L,
The presence of organic matter, biofilms and biocide residues at sublethal concentrations are additional factors that need to be taken into account when comparing the in vitro and in vivo susceptibility of biocides.
The concept of heterogeneous resistance to chlorhexidine, defined as the presence of subpopulations of staphylococci that can survive at in-use concentrations of the agent, is a plausible one
Staphylococci have the capacity to efflux lipophilic cations, such as quaternary ammonium compounds, intercalating dyes, diamidines and biguanidine compounds, including chlorhexidine.
Genetic linkage between the qacA/B genes and β-lactamase resistance has been reported; an association that has been noted in both S. aureus and coagulase-negative staphylococci
Specific incidence in humans still not clear because of clonal variations, geographic differences and testing method variations. Incidence is rising.
How to culture
Must go to a laboratory that is prepared to test for third line antibiotics.
When to culture?
Policies that need to be developed
Decontamination of clippers and rooms. Handwashing and protocols.
Decontamination after clinical cure? … value?
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