Antimicrobial photodynamic therapy for infectious stomatitis in snakes: Clinical views and microbiological findings

Publication date: December 2017
Source:Photodiagnosis and Photodynamic Therapy, Volume 20
Author(s): Kathleen Fernandes Grego, Marcelo Pires Nogueira de Carvalho, Marcos Paulo Vieira Cunha, Terezinha Knöbl, Fabio Celidonio Pogliani, José Luiz Catão-Dias, Sávio Stefanini Sant'Anna, Martha Simões Ribeiro, Fábio Parra Sellera
BackgroundAntimicrobial photodynamic therapy (APDT) has been broadly investigated as an alternative to treat localized infections, without leading to the selection of resistant microorganisms. Infectious stomatitis is a multifactorial disease frequently reported in captive snakes characterized by infection of the oral mucosa and surrounding tissues. In this study, we investigated methylene blue (MB)-mediated APDT to treat infectious stomatitis in snakes and verified the resistance phenotype and genotype before and after APDT.MethodsThree Boid snakes presented petechiae, edema and caseous material in their oral cavities. MB (0.01%) was applied on the lesions and after 5min they were irradiated using a red laser (λ=660nm), fluence of 280J/cm², 8J and 80s per point, 100mW, spot size 0.028cm² and fluence rate of 3.5W/cm². APDT was repeated once a week during 3 months. Samples of the lesions were collected to identify bacteria and antibiotic resistance profiles. To analyze the clonality of bacterial isolates before and after APDT, isolates were subjected to ERIC PCR analysis.ResultsSnakes presented clinical improvement such as reduction of inflammatory signs and caseous material. Pseudomonas aeruginosa and Escherichia coli were present in all snakes; Klebsiella pneumoniae and Morganella morganii were also identified in some animals. We also observed that the oral microbiota was completely replaced following APDT. However, K. pneumoniae isolates before and after APDT were a single clone with 100% of genetic similarity that lost resistance phenotype for seven antibiotics of four classes.ConclusionsThese results show that APDT can be used to treat infectious stomatitis in snakes.



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