Efficacy of Electrolysed Saline Water Against Multidrug-Resistant Staphylococcus pseudintermedius in a Canine Postoperative Pin Tract Infection: An in-situ Study With In Vitro and Clinical Validation

Öz

This study evaluated the antimicrobial efficacy of electrolysed saline water (pH 8.5) against Staphylococcus pseudintermedius isolated purely from a pin tract infection in a dog following orthopaedic surgery. The main material of the study was a 4-month-old female stray dog. An old antebrachium fracture was identified in the right foreleg and pinhole infection and fistula were detected 17 days after osteosynthesis. After the swab sample was taken from the wound, the pin was removed and the wound was irrigated with electrolyzed saline.The isolate obtained from the wound exhibited multidrug resistance to penicillin, trimethoprim-sulfamethoxazole, and tetracycline but remained susceptible to oxacillin, enrofloxacin, and vancomycin. Macro dilution testing revealed a log₁₀ reduction of 4.4 in S. pseudintermedius viability upon exposure to electrolysed water. Clinical application involving daily systemic ceftriaxone and topical irrigation with electrolysed water demonstrated synergistic effects, resolving the infection within one week. Follow-up examination confirmed complete wound closure, cessation of discharge, and no bacterial growth in swab cultures. These findings suggest that electrolysed water is an effective adjunct therapy for biofilm-associated surgical site infections, offering advantages in antimicrobial stewardship and zoonotic risk mitigation.

Anahtar Kelimeler

• Antimicrobial resistance
• biofilm
• electrolysed water
• S. pseudintermedius
• veterinary surgery

Destekleyen Kurum

This study was not supported by any institution.

Etik Beyan

Under de Article (8) k of Turkey’s transposed legislation (Reg. 28914) implementing Directive 2010/63/EU, clinical veterinary practices performed exclusively for patient care are exempt from ethical evaluation. An informed consent form was obtained from the animal owner.

Bir Köpekte Postoperatif Pin Yolu Enfeksiyonunda Çoklu İlaç Dirençli Staphylococcus pseudintermedius'a Karşı Elektrolize Tuzlu Suyun Etkinliği: In Vitro ve Klinik Validasyon ile Desteklenen İn-Situ Araştırma

Öz

Bu çalışmada, ortopedik cerrahi sonrası bir köpekte pin deliği enfeksiyonundan saf olarak izole edilen Staphylococcus pseudintermedius'a karşı elektrolize tuzlu suyun (pH 8.5) antimikrobiyal etkinliği değerlendirilmiştir. Çalışmanın ana materyalini 4 aylık dişi bir sokak köpeği oluşturdu. Sağ ön bacakta eski bir antebrachium kırığı belirlendi ve osteosentezden sonraki 17. günde pin deliği enfeksiyonu ve fistül tespit edildi. Yaradan alınan swap örneği sonrası pin çıkartılarak elektrolize tuzlu su ile yaranın irrigasyonu yapıldı. Yaradan elde edilen izolat penisilin, trimetoprim-sülfametoksazol ve tetrasikline çoklu ilaç direnci gösterirken, oksasilin, enrofloksasin ve vankomisine duyarlılık göstermiştir. Elektrolize suyun makrodilüsyon testi ile antmikrobiyal aktivitesi ölçüldüğünde S.pseudintermedius için minimum inhibitör konsantrasyon değerinin log10 redüksiyonunun 4,4 olduğunu ortaya koymuştur. Günlük topikal elektrolize su irrigasyonu ve sistemik seftriakson ile klinik uygulamada, enfeksiyonu bir hafta içinde engelleyerek sinerjik etkiler gösterdiği ortaya konulmuştur. Bir hafta sonraki kontrolde yaranın tamamen kapandığı akıntının kesildiği ve swap ile alınan örnekte Staphylococcus pseudintermedius’un üremediği görülmüştür. Bu bulgular, elektrolize suyun biyofilm ilişkili cerrahi alan enfeksiyonları için etkili bir yardımcı tedavi olduğunu, antimikrobiyal yönetim ve zoonotik risk azaltmada avantajlar sunduğunu göstermektedir. çeşit olmuştur.

Anahtar Kelimeler

• Antimikrobiyal direnç
• biyofilm
• elektrolize su
• S. pseudintermedius
• veteriner cerrahi

Destekleyen Kurum

Bu çalışma herhangi bir kurum tarafından desteklenmemiştir.

Etik Beyan

Türkiye'nin 2010/63/AB Direktifini uygulayan aktarılmış mevzuatının (Yönetmelik 28914) (8) k maddesi uyarınca, yalnızca hasta bakımı için gerçekleştirilen klinik veterinerlik uygulamaları etik değerlendirmeden muaftır. Hayvan sahibinden bilgilendirilmiş onam formu alındı.

Kaynakça

1. Awosile, B. B., McClure, J. T., Saab, M. E., & Heider, L. C. (2018). Antimicrobial resistance in bacteria isolated from cats and dogs from the Atlantic Provinces, Canada from 1994-2013. The Canadian veterinary journal, 59(8), 885– 893.
2. Bannoehr, J., & Guardabassi, L. (2012). Staphylococcus pseudintermedius in the dog: Taxonomy, diagnostics, ecology, epidemiology and pathogenicity. Veterinary Dermatology, 23(4), 253. https://doi.org/10.1111/j.1365- 3164.2012.01046.x
3. Brook, I., & Frazier, E. H. (1990). Aerobic and anaerobic bacteriology of wounds and cutaneous abscesses. Archives of surgery (Chicago, Ill. : 1960), 125(11), 1445–1451. https://doi.org/10.1001/archsurg.1990.01410230039007
4. Chrobak-Chmiel, D., Golke, A., Dembele, K., Ćwiek, K., Kizerwetter-Świda, M., Rzewuska, M., & Binek, M. (2018). Staphylococcus pseudintermedius, both commensal and pathogen. Medycyna Weterynaryjna, 74(1), 6042-2018. https://doi.org/10.21521/mw.6042
5. Daeschlein G. (2013). Antimicrobial and antiseptic strategies in wound management. International wound journal, 10 Suppl 1, 9–14. https://doi.org/10.1111/iwj.12175
6. Espinel-Rupérez, J., Martín-Ríos, M. D., Salazar, V., Baquero-Artigao, M. R., & Ortiz-Díez, G. (2019). Incidence of surgical site infection in dogs undergoing soft tissue surgery: risk factors and economic impact. Veterinary record open, 6(1), e000233. https://doi.org/10.1136/vetreco-2017-000233
7. Ferran, A.. A., Liu, J., Toutain, P. L., & Bousquet-Mélou, A. (2016). Comparison of the In vitro Activity of Five Antimicrobial Drugs against Staphylococcus pseudintermedius and Staphylococcus aureus Biofilms. Frontiers in microbiology, 7, 1187. https://doi.org/10.3389/fmicb.2016.01187
8. Gulaydin A, Gulaydin O, Akgul MB (2024): Isolation of aerobic bacteria from surgical site infections following orthopaedic operations in cats and dogs. Vet Med-Czech 69, 243–253.

9. Hansson, C., Hoborn, J., Möller, A., & Swanbeck, G. (1995). The microbial flora in venous leg ulcers without clinical signs of infection. Repeated culture using a validated standardised microbiological technique. Acta dermato- venereologica, 75(1), 24–30. https://doi.org/10.2340/00015555752430
10. Hirsch, T., Jacobsen, F., Rittig, A., Goertz, O., Niederbichler, A., Steinau, H. U., Seipp, H. M., & Steinstraesser, L. (2009). Vergleichende In-vitro-Studie zur Zytotoxizität klinisch eingesetzter Antiseptika [A comparative in vitro study of cell toxicity of clinically used antiseptics]. Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete, 60(12), 984–991. https://doi.org/10.1007/s00105-009-1842-x
11. Ishihara, M., Murakami, K., Fukuda, K., Nakamura, S., Kuwabara, M., Hattori, H., Fujita, M., Kiyosawa, T., & Yokoe, H. (2017). Stability of Weakly Acidic Hypochlorous Acid Solution with Microbicidal Activity. Biocontrol science, 22(4), 223–227. https://doi.org/10.4265/bio.22.223
12. Khatoon, Z., McTiernan, C. D., Suuronen, E. J., Mah, T. F., & Alarcon, E. I. (2018). Bacterial biofilm formation on implantable devices and approaches to its treatment and prevention. Heliyon, 4(12), e01067. https://doi.org/10.1016/j.heliyon.2018.e01067
13. Kramer, A., Dissemond, J., Kim, S., Willy, C., Mayer, D., Papke, R., Tuchmann, F., & Assadian, O. (2018). Consensus on Wound Antisepsis: Update 2018. Skin pharmacology and physiology, 31(1), 28–58. https://doi.org/10.1159/000481545
14. Kubota, A., Goda, T., Tsuru, T., Yonekura, T., Yagi, M., Kawahara, H., Yoneda, A., Tazuke, Y., Tani, G., Ishii, T., Umeda, S., & Hirano, K. (2015). Efficacy and safety of strong acid electrolyzed water for peritoneal lavage to prevent surgical site infection in patients with perforated appendicitis. Surgery today, 45(7), 876–879. https://doi.org/10.1007/s00595-014-1050-x
15. Müller, G., & Kramer, A. (2008). Biocompatibility index of antiseptic agents by parallel assessment of antimicrobial activity and cellular cytotoxicity. The Journal of antimicrobial chemotherapy, 61(6), 1281–1287. https://doi.org/10.1093/jac/dkn125
16. Priyantha MAR. (2020). Review of Staphylococcus pseudintermedius infection in dogs and humans. S.L.Vet. J 67(1-2):1-9. https:doi.org/10.4038/slvj.v67i1-2.51
17. Sakarya, S., Gunay, N., Karakulak, M., Ozturk, B., & Ertugrul, B. (2014). Hypochlorous Acid: an ideal wound care agent with powerful microbicidal, antibiofilm, and wound healing potency. Wounds: a compendium of clinical research and practice, 26(12), 342–350.
18. Turk, R., Singh, A., & Weese, J. S. (2015). Prospective surgical site infection surveillance in dogs. Veterinary surgery : VS, 44(1), 2–8. https://doi.org/10.1111/j.1532-950X.2014.12267.x
19. Välkki, K. J., Thomson, K. H., Grönthal, T. S. C., Junnila, J. J. T., Rantala, M. H. J., Laitinen-Vapaavuori, O. M., & Mölsä, S. H. (2020). Antimicrobial prophylaxis is considered sufficient to preserve an acceptable surgical site infection rate in clean orthopaedic and neurosurgeries in dogs. Acta veterinaria Scandinavica, 62(1), 53. https://doi.org/10.1186/s13028-020-00545-z
20. Walther, B., Hermes, J., Cuny, C., Wieler, L. H., Vincze, S., Abou Elnaga, Y., Stamm, I., Kopp, P. A., Kohn, B., Witte, W., Jansen, A., Conraths, F. J., Semmler, T., Eckmanns, T., & Lübke-Becker, A. (2012). Sharing more than friendship-- nasal colonization with coagulase-positive staphylococci (CPS) and co-habitation aspects of dogs and their owners. PloS one, 7(4), e35197. https://doi.org/10.1371/journal.pone.0035197