A NEVER ENDING STORY MASTITIS
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1 A NEVER ENDING STORY MASTITIS
2 DIAGNOSTIČNE PREISKAVE CITOLOŠKE METODE: Mikroskopsko štetje levkocitov v razmazu mleka(prescott- Breed) Preizkus z mastitis reagensom npr. California mastitis test Elektronsko štetje celic v mleku (Fossomatic) MERJENJE ELEKTRIČNE PREVODNOSTI MLEKA BAKTERIOLOŠKA PREISKAVA MLEKA ANTIBIOGRAM
3 DOLOČITEV ŠTEVILA CELIC V MLEKU Mikroskopska metoda California mastitis test Merjenje električne prevodnosti mleka Elektronsko štetje celic
4 Število celic v mleku iz zdrave vimenske četrti je praviloma pod mejo 100x10 3 /ml. Med vrstami levkocitov v zdravi žlezi prevladujejo makrofagi v okuženi pa nevtrofilni granulociti.
5 SPREMINJANJE ŠSC IN IZLOČANJA BAKTERIJ Z MLEKOM V PRIMERU OKUŽBE S S.AUREUSOM Dan vzorčenja Bakterije/ml ŠSC (x 1000/ml) > >
6 BAKTERIOLOŠKA PREISKAVA
7 POMEMBNEJŠI BAKTERIJSKI POVZROČITELJI MASTITISA STREPTOCOCCUS (agalactiae, dysgalactiae,uberis) STAPHYLOCOCCUS (aureus) BACILARNI POVZROČITELJI (E.coli, Pseudomonas aeruginosa,klebsiella pneumoniae) OSTALI POVZROČITELJI MIKOPLAZME PLESNI KVASOVKE
8 CANDIDA ALBICANS
9 INTRAMAMARNA APLIKACIJA ANTIBIOTIKA
10 ANTIBIOGRAM Difuzijska metoda
11 Dilucijska metoda Antibiotic assay by tube dilution, permitting detection of the minimum inhibitory concentration (MIC). A series of increasing concentrations of antibiotic is prepared in the culture medium. Each tube is inoculated, and incubation is allowed to proceed. Growth (turbidity) occurs in those tubes with antibiotic concentrations below the MIC
12 E test
13 β - lactamase testing
14 INCIDENCE OF MASTITIS PATHOGENS IN SLOVENIA Subclinical mastitis (n=10817) (n=12514) (n=9834) (n=11159) Streptococcus agalactiae % 1,1 0,8 0,2 0,4 Streptococcus spp. % 39,6 40,9 47,1 53,2 Staphylococcus aureus % 48,2 45,7 42,6 31,8 Yeast, fungi % 7, ,3 11,5 Other % 3,9 4,8 3,8 3,1
15 MRSA THE SUPERBUG Methicillin resistant Staphylococcus aureus VRSA THE HYPERBUG Vancomycin resistant Staphylococcus aureus Tracking Antibiotic Resistance in Staphylococcus aureus
16 COWS SHEEP Antibiotik S I R S I R % % % % % % Sensitivity of S. aureus strains isolated from milk samples Penicillin Ampicillin Amoxicil. + clav. acid Cloxacillin Oxacillin Kanamyc Cows n = 1238 Sheep n = 740 Cephalex
17 Breast infection 1 Breast infection 2 Normal breast
18 PRAKTIČNA VREDNOST BAKTERIOLOŠKE PREISKAVE IN ANTIBIOGRAMA ZDRAVLJENJE: Diagnostika mastitisa; Da/ne, katera vimenska četrt? Determinacija povzročiteljev vnetja Dokaz občutljivosti/rezistence povzročiteljev na posamezne antibiotike
19 SANACIJA/PREVENTIVA: Vir (rezervoar) patogenih mikroorganizmov Način širjenja patogenih mikroorganizmov v čredi in dejavniki, ki pri tem sodelujejo Način okužbe mlečne žleze
20 OB MOLŽI: Streptococcus agalactiae, Staphylococcus aureus ZDRAVO VIME OKUŽENO VIME POŠKODBE V ČASU MED MOLŽAMI OB MOLŽI OKOLJE IZTREBKI VDOR ZRAKA V MOLZNO ENOTO KRPE ZA ČIŠČENJE ROKE NASTILJ ZEMLJA VODA MED MOLŽAMI: drugi streptokoki, E. coli, Ps. aeruginosa
21 BAJKE IN POVESTI O ZDRAVLJENJU MASTITISA NA SLOVENSKEM
22 BIOTECHNOLOGY
23
24
25 imunosupresija Subkliničen potek --- Kliničen potek ZDRAVJE BOLEZEN
26 ZDRAVLJENJE MASTITISA ZDRAVLJENJE KLINIČNI MASTITIS SUBKLINIČNI MASTITIS KLINIČNA OZDRAVITEV BAKTERIOLOŠKA OZDRAVITEV BAKTERIOLOŠKA OZDRAVITEV
27 POTEK ZDRAVLJENJA PODATKI Anamneza Rezultati predhodnih preiskav Rezultati kliničnega pregleda Rezultat bakteriološke preiskave Rezultat antibiograma
28 AKUTNI MASTITIS PRIČETEK ZDRAVLJENJA KRONIČNI MASTITIS
29 MASTITIS STAPHYLOCOCCUS AUREUS OVCA
30 MIKROABSCESI V ŽLEZNEM TKIVU Mastitis apostematosa BAKTERIJA V NOTRANJOSTI CELICE
31 DEJAVNIKI POVEZANI Z OZDRAVITVIJO MASTITISA POVZROČENEGA S STAPHYLOCOCCUS AUREUS + STAROST ŽIVALI 1., 2. LAKTACIJA ŠTEVILO OKUŽENIH ČETRTI / KRAVO NIZKO ŠSC OB ZAČETKU ZDRAVLJENJA LAKTACIJSKO OBDOBJE > 150 DNI p.t. OBČUTLJIVOST NA PENICILIN PODALJŠAN ČAS ZDRAVLJENJA KRAVA A: 4. laktacija, ŠSC 2000 x 10 3, < 100 dni p.t., 1,2% bakt. ozdravitev KRAVA B: 1. laktacija ŠSC < 500 x 10 3, 220 dni p.t., 61% bakt. ozdravitev
32 The course of the SCC in milk during a S. aureus infection SCCx Time (months)
33 IZBIRA ZDRAVILA
34 FARMAKOLOŠKI UČINKI GLUKOKORTIKOIDOV GLUKONEOGENEZA ZAVIRAJO FORMIRANJE LIMFOIDNEGA TKIVA IN ZORENJE LIMFOCITOV INHIBICIJA VNETNIH PROCESOV
35 Three types of action of antimicrobial agents. At the time indicated by the arrow, a growthinhibitory concentration was added to the exponentially growing culture. Note the relationships between viable and total cell counts
36 NAČIN DELOVANJA POSAMEZNIH ANTIBIOTIKOV NA BAKTERIJSKO CELICO BAKTERICIDNO BAKTERIOSTATIČNO PENICILINI PENICILIN G KLOKSACILIN AMPICILIN AMOKSICILIN MAKROLIDI TILOZIN ERITROMICIN SPIRAMICIN OLEANDOMICIN CEFALOSPORINI TETRACIKLINI
37 BAKTERICIDNO BAKTERIOSTATIČNO AMINOGLIKOZIDI STREPTOMICIN KANAMICIN FRAMICETIN GENTAMICIN PIRANOZIDI LINKOMICIN KLINDAMICIN KLORAMFENIKOL OSTALI ANTIBIOTIKI RIFAMPICIN
38 OBČUTLJIVOST ISTOVRSTNIH BAKTERIJ NA DOLOČEN ANTIBIOTIK BAKTERIJE ZELO OBČUTLJIVE OBČUTLJIVE MANJ OBČUTLJIVE
39 ALEXANDER FLEMING THE GREATEST POSSIBILITY OF EVIL IN SELF-MEDICATION IS THE USE OF TOO SMALL DOSES SO THAT INSTEAD OF CLEARING UP INFECTION, THE MICROBES ARE EDUCATED TO RESIST PENICILLIN AND A HOST OF PENICILLIN-FAST ORGANISMS IS BREAD OUT WHICH CAN BE PASSED TO OTHER INDIVIDUALS AND FROM THEM TO OTHERS UNTIL THEY REACH SOMEONE WHO GETS A SEPTICEMIA OR A PNEUMONIA WHICH PENICILLIN CANNOT SAVE. INTERVIEW BY THE NY TIMES 1945
40 LIFE MAGAZINE, 1944
41 ENDOCARDITIS - VALVULITIS Penicilin v odmerku 12 to 18 mil. U/24 h, polsintetični penicilini, cefalosporini antimikrobna terapija najmanj 6 tednov % ozdravitev do 85% TERAPIJA MASTITIS - CHRONICA Signifikantno manjši odmerki antibiotika Povprečno 10 x krat krajši čas zdravljenja % ozdravitev??? POVZROČITELJI: Streptococci, Enterococci, Staphylococcus aureus, coagulase-negative staphylococci
42 ZDRAVLJENJE OB PRESUŠITVI Manjša mlečnost Večja obrambna sposobnost mlečne žleze Večja koncentracija antibiotika v žarišču okužbe Manjša količina zavrženega mleka Odpade problem reziduov v mleku Možnost razvoja kroničnih oblik mastitisa Prenos okužbe na ostale živali v čredi
43 ANTIBIOTIK V MLEČNI ŽLEZI STAPHYLOCOCCUS AUREUS
44
45 ŠIRJENJE MIKROORGANIZMOV V HLEVSKEM OKOLJU
46 ODPRAVLJANJE OBSTOJEČIH OKUŽB M A S T I T I S ZDRAVLJENJE IZLOČEVANJE MOLZNI STROJ MOLŽA RAZMERE V HLEVU PREHRANA PREPREČEVANJE NOVIH OKUŽB
47 PROGRAM SANACIJE Ocena kmetije, hleva, molzišča,prehrane,načina reje itd. Klinični pregled živali s poudarkom na mlečni žlezi Analiza razpoložljivih rezultatov in zbiranje novih podatkov Spremljanje poteka molže Pregled molznega stroja Odkrivanje okuženih krav Sanacijski in preventivni ukrepi, glede na vrsto povzročiteljev, ki prevladujejo v določeničredi Ocenjevanje uspeha sanacije
48
49 RESULTS OF BACTERIOLOGICAL EXAMINATIONS
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