Atların alt solunum yolu hastalıklarında trakeal aspirasyon örneklerinin bakteriyolojik ve sitolojik muayene bulgularının klinik ve hematolojik bulgularla ilişkilendirilerek değerlendirilmesi
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Date
2012
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Uludağ Üniversitesi
Abstract
Bu çalışmada, alt solunum yolları hastalığı bulunan atlarda trakeal aspirasyon örneklerinin sitolojik ve bakteriyolojik muayenelerinin, hematolojik ve klinik muayene bulguları ile ilişkilendirilmesi amaçlanmıştır.Çalışmada; her iki cinsiyetten, farklı yaş ve ırklarda (İngiliz ve Arap ırkı), klinik olarak hastalık belirtisi gösteren toplam 50 adet at kullanıldı. Atların klinik muayenelerini takiben, endoskopik muayene eşliğinde trakeal aspirasyon tekniği ile alınan örneklerin sitolojik ve bakteriyolojik muayeneleri yapıldı. Trakeal aspirasyon dışında atlardan kan alınarak hematolojik bulguları değerlendirildi.Anamnez, klinik bulgular ve endoskopik muayeneler temelinde klinik skorlandırma yapılarak, klinik skoru 5 ve üzeri olan vakalar değerlendirmeye alındı. Endoskopi eşliğinde uygulanan trakeal aspirasyon tekniğiyle alınan örneklerden froti hazırlanarak Wright-Giemsa ile boyandı. Sitolojik muayenede, bakteri izole edilen örnekler ile izole edilmeyen örnekler karşılaştırdı.Klinik skorlandırma sonuçlarına göre en az klinik skor 6, en fazla ise 26 olarak belirlendi. Değerlendirmenin sonucunda 6-10 arasında 15, 11-15 arası 24, 16-20 arası ise 11 at tespit edildi. Alt solunum yolları hastalığı olan atlardan yapılan hematolojik bulgularda 1 vakada lökositoz tablosu, 7 adet vakada band nötrofil düzeyinde hafif artış, 4 adet vakada ise monositoz tablosu olduğu belirlendi. Trakeal örneklerin sitolojik muayenelerine göre etken üreyen vakalarda etken üremeyen vaklara göre nötrofil, makrofaj (p<0,001) ve lenfosit hücrelerinin (p<0,05) yüzdelik oranları arasında istatistiki olarak önem bulundu.Alınan aspirasyon sıvısından yapılan bakteriyolojik muayene sonucunda 50 atın 36 'sinde Streptococcus equi subsp zooepidemicus (14), Staphylococcus lentus (4), Staphylococcus sp (1), Staphylococcus equarum (1), Staphylococcus sciuri (1), Staphylococcus vitilus (1), Staphylococcus saprophyticus (1), Staphylococcus gallinarum (1), Staphylococcus haemolyticus (2), Shewanella putrefaciens (1), Stenotrophomonas maltophilia (1), Escherichia coli (8) etkenleri çoğunlukta olmak üzere toplamda 51 adet aerobik/fakültatif gram (+) kok ve gram (-) basil grubunda bakteri üremesi tespit edildi. Etken izolasyonlarına göre antibiyogram değerlendirilmeleri yapıldı. Streptococcus equi subsp zooepidemicus izole edilen örneklerde ampisillin, Staphylococcus lentus ve diğer Staphylococcus etkenlerine karşı polimiksin B ve rifampisin ve Gram (-) basil grubunda yer alan E.coli'nin ise florfenikole duyarlılığın daha fazla olduğu belirlendi.Sunulan çalışmada bakteri izole edilen trakeal örneklerin sitolojik değerlendirmelerinde, bakteri izole edilmeyenlere göre belirlenen fark, tanı aşamasında sitolojik değerlendirmenin önemini vurgulamaktadır. Hematolojik parametrelerde belirgin bir anormalitenin belirlenmemesi hemogram bulgularının; özellikle atların solunum sistemi problemlerinin başlangıç safhasında, anamnez, klinik ve endoskopik muayene eşliğinde değerlendirilmesi gerekliliğini düşündürmektedir. Sonuç olarak atların alt solunum yolları hastalıklarında, özellikle endoskopi eşliğinde yapılan trakeal aspirasyon tekniğinin gerek sitolojik değerlendirme, gerekse etken identifikasyonu açısından kullanışlı olduğu kanısına varıldı.
The aim of this study was to associate tracheal aspiration samples cytologic and bacteriologic examinations with the hematologic and clinical examinations of horses with respiratory diseases.In the study 50 horses showing clinical respiratory disease signs, at different age, breed (English and Arabic) and sex were included. After the clinical examination, samples were taken by endoscopy with tracheal aspiration technic, which were cytologically and bacteriologically examined. Beside the tracheal aspiration, heamatologic examinations were performed.A clinical score was defined based on anemnesis, clinical signs and endoscopic investigations. Cases with a clinical score of 5 and >5 were included. Blood smears were prepared of the samples taken with tracheal aspiration technic by endoscopy and were stained with Wright-Giemsa stain. Samples with bacterial isolations were cytologically compared with the samples without bacterial isolation.According to the clinical score results, the minimum clinical score was 6 and the maximum clinical score was defined as 26. After the assessment 15 horses with a score of 6-10, 24 horses with a score of 11-16 and 21 horses with a score of 16-20 were established. Depending on the heamatological results of horses with lower respiratory tract diseases; 1 case with leukocytosis, 7 with a mild increase of band neutrophils and 4 with a mild monocytosis were detected. In the comparison of cytologic examination of tracheal samples with bacterial agents and without bacterial agents statistical differences in the percentage of neutrophils, macrophages (p<0,001) and lymphocytes (p<0,05) were defined.According to the bacteriologic examination results of the tracheal aspiration samples in 50 horses following agents were mainly detected: Streptococcus equi subsp zooepidemicus (14), Staphylococcus lentus (4), Staphylococcus sp (2), Staphylococcus equarum (1), Staphylococcus sciuri (1), Staphylococcus vitilus (1), Staphylococcus saprophyticus (1), Staphylococcus gallinarum (1), Staphylococcus haemolyticus (2), Shewanella putrefaciens (1), Stenotrophomonas maltophilia (1), Escherichia coli (8). Totally 51 aerobic/facultative gram (+) and gram (-) bacils were isolated. All these was followed by an antibiogram investigation. In samples isolated Streptococcus equi subsp zooepidemicus a sensitivity against ampicylline, in samples with Staphylococcus lentus and other Staphylococcus agents were sensitive to polymycsine B and rifampicine and the gram (-) bacil E.coli was detected to be more sensitive to florfenicol.In the study the importance of the cytological examination is shown in the comparisaon of the samples with and without bacterial agents. There was no significant changes in hematological examinations especially in the first phase of respiratory diseases in horses. These show us to interpretate hemotologic results according to anamnese, clinical and endoscopic examinations. In conclusion, the tracheal aspirate technic is useful for cytological and bacteriological examination in horses with lower respiratory tract diseases.
The aim of this study was to associate tracheal aspiration samples cytologic and bacteriologic examinations with the hematologic and clinical examinations of horses with respiratory diseases.In the study 50 horses showing clinical respiratory disease signs, at different age, breed (English and Arabic) and sex were included. After the clinical examination, samples were taken by endoscopy with tracheal aspiration technic, which were cytologically and bacteriologically examined. Beside the tracheal aspiration, heamatologic examinations were performed.A clinical score was defined based on anemnesis, clinical signs and endoscopic investigations. Cases with a clinical score of 5 and >5 were included. Blood smears were prepared of the samples taken with tracheal aspiration technic by endoscopy and were stained with Wright-Giemsa stain. Samples with bacterial isolations were cytologically compared with the samples without bacterial isolation.According to the clinical score results, the minimum clinical score was 6 and the maximum clinical score was defined as 26. After the assessment 15 horses with a score of 6-10, 24 horses with a score of 11-16 and 21 horses with a score of 16-20 were established. Depending on the heamatological results of horses with lower respiratory tract diseases; 1 case with leukocytosis, 7 with a mild increase of band neutrophils and 4 with a mild monocytosis were detected. In the comparison of cytologic examination of tracheal samples with bacterial agents and without bacterial agents statistical differences in the percentage of neutrophils, macrophages (p<0,001) and lymphocytes (p<0,05) were defined.According to the bacteriologic examination results of the tracheal aspiration samples in 50 horses following agents were mainly detected: Streptococcus equi subsp zooepidemicus (14), Staphylococcus lentus (4), Staphylococcus sp (2), Staphylococcus equarum (1), Staphylococcus sciuri (1), Staphylococcus vitilus (1), Staphylococcus saprophyticus (1), Staphylococcus gallinarum (1), Staphylococcus haemolyticus (2), Shewanella putrefaciens (1), Stenotrophomonas maltophilia (1), Escherichia coli (8). Totally 51 aerobic/facultative gram (+) and gram (-) bacils were isolated. All these was followed by an antibiogram investigation. In samples isolated Streptococcus equi subsp zooepidemicus a sensitivity against ampicylline, in samples with Staphylococcus lentus and other Staphylococcus agents were sensitive to polymycsine B and rifampicine and the gram (-) bacil E.coli was detected to be more sensitive to florfenicol.In the study the importance of the cytological examination is shown in the comparisaon of the samples with and without bacterial agents. There was no significant changes in hematological examinations especially in the first phase of respiratory diseases in horses. These show us to interpretate hemotologic results according to anamnese, clinical and endoscopic examinations. In conclusion, the tracheal aspirate technic is useful for cytological and bacteriological examination in horses with lower respiratory tract diseases.
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Keywords
Alt solunum yolları hastalığı, Sitolojik muayene, Bakteriyolojik muayene, Trakeal aspirasyon, At, Lower respiratory tract disease, Cytological examination, Bacteriological examination, Tracheal aspiration, Horse
Citation
Kasap, S. (2012). Atların alt solunum yolu hastalıklarında trakeal aspirasyon örneklerinin bakteriyolojik ve sitolojik muayene bulgularının klinik ve hematolojik bulgularla ilişkilendirilerek değerlendirilmesi. Yayınlanmamış doktora tezi. Uludağ Üniversitesi Sağlık Bilimleri Enstitüsü.