| Feline lower urinary tract disease(FLUTD)is one of the common feline diseases in veterinary clinic.FLUTD are mainly included feline idiopathic cystitis(FIC),urinary tract infection(UTI),urolithiasis(UL),urinary crystallization(UC)and bladder cancer(BC)and other types of disease.Hypouricemia,urinary frequency and urgency,dysuria,stranguria and others are common symptoms.With the development of economic and society,pet cats are increasingly favored by the masses.The incidence of FLUTD increased year by year,and scholars have been divergent on its incidence.Presently,there have been few systemic studies on the FLUTD in China,and it still has some scientific problems such as unknown risk factors,substandard diagnosis and treatment process,unclear genetic and drug resistance characteristics of major pathogens.In this study,a total of 157 confirmed FLUTD cases were collected from January to December 2021 at 4 animal hospitals in Wuhan.FLUTD case retrospectively analysis,pathogen exploration and drug resistance analysis of major pathogens has been conducted.The main findings are listed as below:1.Retrospective evaluation of FLUTD casesRetrospective analysis of cases was performed that the incidence of FLUTD in Wuhan was 1.15%,the mortality was 0.64%,the initial incidence was 42.68%,the recurrence was 57.32%,and the recurrence rate at one year was 7.64%.5 types of FLUTD diseases and 12 clinical symptoms were included.Among them,the incidence of lower urinary tract crystallization was 48.86%,idiopathic cystitis 27.84%,lower urinary tract urolithiasis 11.93%,lower urinary tract infection 9.09%,lower urinary tract damage 1.70%.88.54%of FLUTD cases were confirmed as had only 1 disease type.In clinical symptoms,the incidence of urinary frequency and urgency was 68.59%,the hypouricemia was 64.74%,86.63%cases have≥2 clinical symptoms.In clinical examination,abdominal ultrasound was used in 96.8%cases,in these cases,49%were suspected bladder crystallization,44%were idiopathic cystitis,and 12.5%were bladder urolithiasis.In risk factors,FLUTD was not related to breed(p=0.079),animal source(p=0.460),and type of drinking water(p=0.639),but found to be significantly associated with age(p<0.001),water intake(p<0.001),and activity(p<0.001),cat-to-pot ratio(p<0.001),and body condition score(p<0.001).Laboratory examinations found that in the blood test,54.26%cases had increasing amount of red blood cells,and61.62%cases had abnormal creatinine indicators;in the urine specimens,76.92%were cloudy urine,75.61%contained magnesium ammonium phosphate crystal,and 80.76%cases had only one crystal type,94.10%cases had occult blood.2.Pathogen evaluation of FLUTD urine specimensA total of 78 specimens were collected in this study,3(3.85%)specimens were collected by bladder massage,63(80.77%)were collected by catheterization,and 12(15.38%)were collected by bladder puncture.17(21.79%)specimens had bacterial content≥10~3 CFU/m L.19 species of 281 pathogen were isolated from urine specimens,encompassing 11 species of gram-negative bacilli,Escherichia coli,Citrobacter,Stenotrophomonas,Pseudomonas,Escherichia fergusonii,Klebsiella,Proteus mirabilis,Acinetobacter,Morganella,Pasteurella and Fibrobacter;3 species of gram-positive bacilli,Bacillus,Corynebacterium and Lactobacillus;5 species of gram-positive cocci,including Staphylococcus,Enterococcus faecium,Enterococcus faecalis,Enterococcus and Streptococcus.Among them,there were multiple species of bacteria genus,such as 8 species of Staphylococcus sp.,17 species of Bacillus sp.,5species of Pseudomonas sp.,2 species of Acinetobacter sp.,2 species of Stenotrophomonas sp.,and 2 species of Pasteur sp.,2 species of Bacillus sp.and 2species of Streptococcus species.Escherichia coli was the dominant microbiota of gram-negative bacilli in FLUTD urine specimens,and Staphylococcus was the dominant microbiota of gram-positive cocci.According to the NJ method to construct the evolutionary tree of Escherichia coli and Staphylococcus,Escherichia coli can be divided into 7 groups,and Staphylococcus can be divided into 8 groups.In addition,93.8%of lower urinary tract infection cases were accompanied by magnesium ammonium phosphate crystals.3.Drug resistance inquiry of dominant pathogens with FLUTD urine specimens The dominant microbiota of FLUTD urine specimens were Escherichia coli(55strains)and Staphylococcus(32 strains).In drug resistance,72.73%of Escherichia coli were resistant to Ampicillin,Cefaclor and Co-trimoxazole,63.64%were resistant to Gentamicin,both 54.55%were resistant to Cefoxitin and Cefazolin.85.45%of Escherichia coli were sensitive to Nitrofurantoin,and 74.55%were sensitive to Fosfomycin.Among the 32 Staphylococcus strains,93.75%were resistant to Co-trimoxazole which belonged to sulfa drug,and 84.38%were resistant to Clindamycin.62.50%of Staphylococci were sensitive to Nitrofurantoin,and 53.13%were sensitive to Levofloxacin.In the detection of drug resistance genes,the detection rates of gyr A and gry B in Escherichia coli were the highest,89.09%and 92.73%respectively,followed by the drug resistance gene aph A1,with a detection rate of 80.00%.The detection rate of drug resistance gene bla OXA was the lowest,only 3.63%.The resistance gene gyr B was detected in 81.25%of all Escherichia coli resistant to fluoroquinolones.In Staphylococcus,the tetracycline drug resistance gene tet K and theβ-lactam drug resistance gene bla Z had the highest detection rate with 71.88%,while the fluoroquinolone drug resistance gene gyr A could not be detected.The resistance gene gyr A was not detected in all fluoroquinolone-resistant Staphylococci.In conclusion,most of the FLUTD cases are recurrent cases in Wuhan,and the common disease type was lower urinary tract crystallization,followed by feline idiopathic cystitis.The common clinical symptoms are urinary frequency,urgency and hypouricemia.Lower activity,larger cat-to-pot ratio,and lower water intake were all risk factors for inducing FLUTD.Overly obese,cats aged 7 months to 6 years are more likely to develop FLUTD.Magnesium ammonium phosphate crystals accounted for the largest proportion in urine specimens,and Escherichia coli and Staphylococcus were the main pathogens of infection.In addition,each bacteria presence specimens contained magnesium ammonium phosphate crystals.Most E.coli were resistant toβ-lactams and Sulfonamides.Most Staphylococci were resistant to Clindamycin and Co-trimoxazole.This study analyzed FLUTD from multiple angles,provided suggestions for pet owners to feed cats scientifically,provided a reference process for pet doctors to accurately diagnose and treat FLUTD,provided a theoretical basis for reducing and avoiding the generation and spread of drug-resistant pathogens,and laid a foundation for exploring the mechanism of FLUTD. |
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