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      New Insights on Leptospira Infections in a Canine Population from North Sardinia, Italy: A Sero-Epidemiological Study

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          Abstract

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          Leptospirosis is a widespread zoonosis caused by pathogenic spirochaetes of the genus Leptospira. Pathogenic leptospires live in the kidneys of different mammalian species and are excreted in the environment with the urine. The infection of humans is mainly caused by direct contact with infected animals or indirectly by contact with a contaminated environment. The aim of this study was to perform a sero-epidemiological survey to assess the presence of antibodies against Leptospira serovars in a representative sample of kennel and owned dogs from a selected area of Sardinia Island. In addition, kidney homogenates from rodents collected from the same study area were also analyzed by culture-based and real-time PCR-based testing methods. Higher antibody titers were observed against Leptospira Icterohaemmorrhagiae, which is believed to be responsible for the majority of severe cases of leptospirosis in humans. The detection of pathogenic Leptospira serotypes in dogs from northern Sardinia may represent a potential risk of infection for humans and contribute to the spread of the bacteria in the environment. Public health strategies to control possible Leptospira outbreaks should be implemented to prevent the disease from becoming a major medical and veterinary problem in this region.

          Abstract

          Leptospirosis is a widespread zoonosis recognized as a re-emerging infectious disease in a wide variety of animal species, including humans and dogs. No data exist regarding the presence of Leptospira species in the canine population of Sardinia Island. This study reports the first sero-survey for leptospirosis in kennel and owned dogs from six areas of the north of Sardinia. Sera from 1296 dogs were tested by microscopic agglutination test (MAT) specific for nine different serovars that are known to be well widespread in the Mediterranean environment. Moreover, kidney homogenates from rodents collected from the study area were also analyzed by LipL32 real-time PCR and multi-locus sequence type (MLST) on the basis of the analysis of seven concatenated loci. A total of 13% of the examined sera (95%CI: 11–15) tested positive for one or more serovars of Leptospira MAT detected; antibodies for serogroup Icterohaemorrhagiae (57%; 95%CI: 49–65) were the most common, followed by serovars Bratislava (22%; 95%CI: 16–28), Canicola (14%; 95%CI: 9–19), and Grippotyphosa (7%; 95%CI: 3–11). MLST analyses on isolates from rodents identified L. interrogans and L. borgpetersenii genomospecies. Different serovars belonging to pathogenic Leptospira serogroups are circulating in dogs from the island. Moreover, data obtained from rodents, indicated that rodents likely act as reservoir of spirochetes. Further sero-epidemiological studies are needed in order to obtain data from other collection sites in Sardinia and to increase the information on Leptospira species circulating in this area.

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          Most cited references53

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          Leptospirosis: a zoonotic disease of global importance

          In the past decade, leptospirosis has emerged as a globally important infectious disease. It occurs in urban environments of industrialised and developing countries, as well as in rural regions worldwide. Mortality remains significant, related both to delays in diagnosis due to lack of infrastructure and adequate clinical suspicion, and to other poorly understood reasons that may include inherent pathogenicity of some leptospiral strains or genetically determined host immunopathological responses. Pulmonary haemorrhage is recognised increasingly as a major, often lethal, manifestation of leptospirosis, the pathogenesis of which remains unclear. The completion of the genome sequence of Leptospira interrogans serovar lai, and other continuing leptospiral genome sequencing projects, promise to guide future work on the disease. Mainstays of treatment are still tetracyclines and beta-lactam/cephalosporins. No vaccine is available. Prevention is largely dependent on sanitation measures that may be difficult to implement, especially in developing countries.
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            Leptospirosis in humans.

            Leptospirosis is a widespread and potentially fatal zoonosis that is endemic in many tropical regions and causes large epidemics after heavy rainfall and flooding. Infection results from direct or indirect exposure to infected reservoir host animals that carry the pathogen in their renal tubules and shed pathogenic leptospires in their urine. Although many wild and domestic animals can serve as reservoir hosts, the brown rat (Rattus norvegicus) is the most important source of human infections. Individuals living in urban slum environments characterized by inadequate sanitation and poor housing are at high risk of rat exposure and leptospirosis. The global burden of leptospirosis is expected to rise with demographic shifts that favor increases in the number of urban poor in tropical regions subject to worsening storms and urban flooding due to climate change. Data emerging from prospective surveillance studies suggest that most human leptospiral infections in endemic areas are mild or asymptomatic. Development of more severe outcomes likely depends on three factors: epidemiological conditions, host susceptibility, and pathogen virulence (Fig. 1). Mortality increases with age, particularly in patients older than 60 years of age. High levels of bacteremia are associated with poor clinical outcomes and, based on animal model and in vitro studies, are related in part to poor recognition of leptospiral LPS by human TLR4. Patients with severe leptospirosis experience a cytokine storm characterized by high levels of IL-6, TNF-alpha, and IL-10. Patients with the HLA DQ6 allele are at higher risk of disease, suggesting a role for lymphocyte stimulation by a leptospiral superantigen. Leptospirosis typically presents as a nonspecific, acute febrile illness characterized by fever, myalgia, and headache and may be confused with other entities such as influenza and dengue fever. Newer diagnostic methods facilitate early diagnosis and antibiotic treatment. Patients progressing to multisystem organ failure have widespread hematogenous dissemination of pathogens. Nonoliguric (high output) renal dysfunction should be supported with fluids and electrolytes. When oliguric renal failure occurs, prompt initiation of dialysis can be life saving. Elevated bilirubin levels are due to hepatocellular damage and disruption of intercellular junctions between hepatocytes, resulting in leaking of bilirubin out of bile caniliculi. Hemorrhagic complications are common and are associated with coagulation abnormalities. Severe pulmonary hemorrhage syndrome due to extensive alveolar hemorrhage has a fatality rate of >50 %. Readers are referred to earlier, excellent summaries related to this subject (Adler and de la Peña-Moctezuma 2010; Bharti et al. 2003; Hartskeerl et al. 2011; Ko et al. 2009; Levett 2001; McBride et al. 2005).
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              European consensus statement on leptospirosis in dogs and cats.

              Leptospirosis is a zoonotic disease with a worldwide distribution affecting most mammalian species. Clinical leptospirosis is common in dogs but appears to be rare in cats. Both dogs and cats, however, can shed leptospires in the urine. This is problematic as it can lead to exposure of humans. The control of leptospirosis, therefore, is important not only from an animal but also from a public health perspective. The aim of this consensus statement is to raise awareness of leptospirosis and to outline the current knowledge on the epidemiology, clinical features, diagnostic tools, prevention and treatment measures relevant to canine and feline leptospirosis in Europe.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Biology (Basel)
                Biology (Basel)
                biology
                Biology
                MDPI
                2079-7737
                07 June 2021
                June 2021
                : 10
                : 6
                : 507
                Affiliations
                [1 ]Istituto Zooprofilattico Sperimentale della Sardegna, Department of Animal Health, Laboratory of Seroimmunology, 07100 Sassari, Italy; nicoletta.ponti@ 123456izs-sardegna.it (M.N.P.); bruna.palmas@ 123456izs-sardegna.it (B.P.); pierangela.pintore@ 123456izs-sardegna.it (P.P.); aureliana.pedditzi@ 123456izs-sardegna.it (A.P.); valentina.chisu@ 123456izs-sardegna.it (V.C.)
                [2 ]Azienda Socio Sanitaria Locale, Azienda Tutela Salute, 09047 Cagliari, Italy; ang.piras@ 123456atssardegna.it
                Author notes
                [* ]Correspondence: ivana.piredda@ 123456izs-sardegna.it ; Tel.: +39-079-289-2329
                Author information
                https://orcid.org/0000-0002-2878-4682
                Article
                biology-10-00507
                10.3390/biology10060507
                8226461
                34200298
                8ad00571-6412-4643-abbe-8f546c60d019
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/).

                History
                : 19 May 2021
                : 05 June 2021
                Categories
                Article

                leptospira,dogs,rats,seroprevalence,canine,mat,mlst,vaccines,zoonosis
                leptospira, dogs, rats, seroprevalence, canine, mat, mlst, vaccines, zoonosis

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