Consecutive antibiotic treatment with doxycycline and marbofloxacin clears bacteremia in Mycoplasma haemofelis-infected cats

•Mycoplasma haemofelis is the most pathogenic feline hemoplasma species.•Effective complete elimination of M. haemofelis was achieved for the first time in blood and tissues of infected cats.•No reactivation of bacteremia was noted after immunosuppression using high-doses of methylprednisolone aceta...

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Bibliographic Details
Published in:Veterinary microbiology 2018-04, Vol.217, p.112-120
Main Authors: Novacco, Marilisa, Sugiarto, Sarah, Willi, Barbara, Baumann, Julia, Spiri, Andrea M., Oestmann, Angelina, Riond, Barbara, Boretti, Felicitas S., Naegeli, Hanspeter, Hofmann-Lehmann, Regina
Format: Article
Language:English
Subjects:
Activation
Animal diseases
Animals
Anti-Bacterial Agents - administration & dosage
Anti-Bacterial Agents - therapeutic use
Antibiotic treatment
Antibiotics
Antibodies, Bacterial - blood
Bacteremia
Bacteremia - drug therapy
Bacteremia - microbiology
Bacteremia - veterinary
Bacteria
Bacterial Load - drug effects
Bacterial Load - veterinary
Blood
Bone marrow
Cat Diseases - drug therapy
Cat Diseases - microbiology
Cats
Clearance of bacteremia
DNA, Bacterial
Doxycycline
Doxycycline - administration & dosage
Doxycycline - therapeutic use
Fluoroquinolones - administration & dosage
Fluoroquinolones - therapeutic use
Hemolytic anemia
Hemotropic mycoplasmas
Immunosuppression
Methylprednisolone - administration & dosage
Mycoplasma - drug effects
Mycoplasma - genetics
Mycoplasma - pathogenicity
Mycoplasma haemofelis
Mycoplasma Infections - drug therapy
Mycoplasma Infections - microbiology
Mycoplasma Infections - veterinary
Organs
Pathogens
Real-Time Polymerase Chain Reaction
Treatment Outcome
Veterinary medicine
Zoonotic potential
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Summary:•Mycoplasma haemofelis is the most pathogenic feline hemoplasma species.•Effective complete elimination of M. haemofelis was achieved for the first time in blood and tissues of infected cats.•No reactivation of bacteremia was noted after immunosuppression using high-doses of methylprednisolone acetate.•We recommend doxycycline treatment (5 mg/kg bid orally ≤ 28 days) for clearance of M. haemofelis and monitoring bacterial loads by real-time PCR.•If bacteremia persists or reoccurs and clearance is needed, treatment should be switched to marbofloxacin (2 mg/kg sid orally for 14 days). Mycoplasma haemofelis is the most pathogenic feline hemoplasma species and a causative agent of infectious hemolytic anemia in cats. Current treatment protocols are effective in reducing M. haemofelis blood loads and clinical signs but consistent bacteremia clearance is rarely achieved. The aim of this study was to develop an antibiotic treatment protocol capable of clearing M. haemofelis bacteremia. Doxycycline and marbofloxacin treatment protocols were evaluated in chronically M. haemofelis infected cats in two pre-experiments and a controlled treatment study (main experiment) using five treated and four untreated cats. The blood bacterial loads in the main experiment were monitored weekly by real-time PCR for 203 days. Cats were treated with doxycycline (5 mg/kg bid orally) for 28 days. Cats that remained M. haemofelis PCR-positive or became positive again (all 5 cats in the main experiment) were switched to marbofloxacin treatment (2 mg/kg sid orally) for 14 days; then, all cats were PCR-negative. Immunosuppression after the antibiotic treatment did not lead to reactivation of bacteremia. Fine needle aspirates of different organs and bone marrow collected before and after immunosuppression were PCR-negative. Overall, 5 cats cleared bacteremia with doxycycline alone (showing lower bacterial loads at the treatment start), while 10 cats needed to be switched to marbofloxacin. Based on our results, we recommend doxycycline treatment (10 mg/kg up to 28 days) for clearance of M. haemofelis infection and monitoring bacterial loads by real-time PCR. Only if bacteremia persists or reoccurs, antibiotic treatment should be switched to marbofloxacin (2 mg/kg sid for 14 days).
ISSN:0378-1135
1873-2542
DOI:10.1016/j.vetmic.2018.03.006