بررسی بیماری پاستورلوز و عفونت تنفسی ناشی از پاستورلامولتوسیدا و پاستورلاهمولایتیکا در گوسفند و بز (Pasteurellosis in sheep and goat)

نویسنده: دکتر فیلیپ آر اسکات دانشکده دامپزشکی دانشگاه ادینبورگ

ترجمه و تالیف دکتر احمد روغنی – دامپزشک

 

برونکوپنومونی ناشی از Pasteurella multocida یا pasteurella haemolytica گوسفندان و بزها را در هر سنی در سراسر جهان تحت تأثیر قرار می دهد. به خصوص در حیوانات جوان پس از، از شیر گرفتن می تواند ویرانگر باشد. این بیماری یکی از مهمترین علل بیماری و مرگ و میر در بره ها و بزغاله ها می باشد، به خصوص در آنهایی که آغوز کافی دریافت نکرده و یا در آنها ایمنی ناشی از مصرف آغوز به هر دلیلی کاهش یافته باشد. تحقیقات نشان داده است که این بیماری بیشتر اوقات در حیواناتی اتفاق می افتد که تحت استرس هایی مانند: حمل و نقل، از شیر گرفتن، تغییر رژیم غذایی و یا تماس غیر ایمن با حیوانات بیمار و یا حیوانات تازه وارد به مزرعه قرار گرفته باشند. پاستورلاها میتوانند باعث ایجاد سپتی سمی در بره های ۹-۴ ماهه شوند (پاستورلوز سیستمیک). بیماری پاستورلوز عمدتا با علایم تنفسی در حیوان ظاهر شده و یکی از مهمترین علتهای سرفه و تنگی نفس در گوسفند و بز می باشد. این بیماری در بین دامداران به نامهای مختلف مانند: بیماری زهره شش یا که بادی نیز شناخته می شود.

علت شناسی بیماری پاستورلوز:

  1. multocida و p.haemolytica فلور دستگاه تنفسی فوقانی هستند که می توانند به تنهایی یا همراه با سایر ارگانیسمها باعث ایجاد پنومونی شوند. پاستورلاها عمدتا بعنوان عوامل بیماریزای فرصت طلب شناخته می شوند که میتوانند به تنهایی و یا همراه با سایر عوامل بیماریزای تنفسی دیگر مانند: پاراآنفلوانزا نوع ۳، آدنو ویروس ها و به ویژه مایکوپلاسماها (عامل بیماری آگالاکسی یا باد شیر) حیوان را مستعد ابتلا به عفونت ریه و نومومیا و ذات الریه منتشر نمایند.

پاتوژنز و بیماریزایی پاستورلا:

به نظر می رسد استرس یکی از عوامل مهم در میزان بیماریزایی پاستورلاها به شمار می رود به گونه ای که استرس به پاستورلاها و سایر عوامل بیماریزا یاکتریایی و ویروسی اجازه می دهد تا در بدن میزبان تکثیر یافته و مکانیسم های طبیعی دفاع فیزیکی را مختل کنند. استرس با افزایش سطح کورتیزول در خون در واقع باعث کاهش مکانیسمهای دفاعی بدن و به نوعی سرکوب سیستم ایمنی شده و حمله به بافت ریه و ایجاد ذات الریه را برای ارگانیسمهای مهاجم تسهیل می نماید. بعنوان مثال در گوساله ها، عملکرد ماکروفاژهای آلوئولار پس از ذات الریه ویروسی مختل شده که این منجر به کاهش پاکسازی و جمع آوری عوامل بیماریزای باکتریایی استنشاق شده در ریه شده و به آنها اجازه می دهد تا در قسمتهای مختلف ریه تکثیر شوند. این افزایش عوامل بیماریزا در ریه باعث هجوم گسترده نوتروفیل ها، به بافت آسیب دیده می شود، در اثر فعل و انفعالات ایجاد شده و درگیری نوتروفیل ها با باکتریها در بافت، همزمان با از بین رفتن و لیز شدن این نوتروفیل ها، آنزیم هایی از آنها آزاد می شوند که باعث آسیب بیشتر به بافت ریه می شوند. این مکانیسم ممکن است مشابه سازه پنومونی Pasteurella در گوسفند و بز باشد.

یافته های بالینی و علایم درمانگاهی در بیماری پاستورلوز:

ضایعات ریه ناشی از بیماری پاستورلوز در بز
ضایعات ریه ناشی از بیماری پاستورلوز در بز

علائم بالینی شامل افسردگی، سستی و بیقراری همراه با علایم اندوتوکسمی عمیق دیده می شود. مرگ ناگهانی ممکن است بدون مشاهده علائم بالینی رخ دهد. گوسفندان مبتلا به طور معمول از بقیه گله جدا شده و به راحتی صید و مهار می شوند. با نزدیک شدن به حیوان و یا تلاش برای گرفتن آن، ممکن است میزان تنفس های شکمی افزایش یابد.

گوسفندان مبتلا به طور معمول تب دار بوده و اندازه گیری دمای بدن آنها دمای ۴۰/۵ -۴۰ درجه سانتیگراد را نشان می دهد. غشاهای مخاطی متراکم هستند و ممکن است علایمی از کمبود آب بدن یا دهیتراتاسیون در بدن حیوان دیده شود. چشمها فرو رفته بوده و تست دهیدراتاسیون با برگشت آهسته و تاخیری پوست معولا مثبت می باشد. تعداد تنفس افزایش می یابد و اغلب به صورت شکمی می باشد. انقباضات و حرکات شکمبه کاهش یافته یا وجود ندارد. شواهدی از اسهال نیز ممکن است دیده شود. در مراحل درگیری شدید ریه، ممکن است مایع کف آلود در اطراف دهان دیده شود. آبریزش از چشمها معمولا وجود داشته و سرفه های دردناک در حیوان مشاهده می گردد. لمس زیر گلو و مسیر نای و حنجره برای حیوان بسیار دردناک بوده و اغلب منجر به ایجاد سرفه های شدید و مرطوب می گردد. بینی حیوان ممکن است کثیف بوده و ترشحات چرکی از آن آویزان باشد که معمولا در این مرحله، عامل بیماری به احتمال زیاد با سایر عوامل ثانویه به صورت کمپلکس در آمده است.

ضایعات کالبد گشایی در بیماری پاستورلوز:

معمولا خونریزی های اکیموتیک زیر جلدی روی گلو و دنده ها وجود دارد. ریه ها متورم و قرمز بنفش بوده و مجاری تنفسی حاوی کف آلوده به خون می باشد. موارد مزمن که مدتی از بیماری گذشته باشد، معمولا به پلوریزی فیبرینی منجر می شود به گونه ای که ششها در محوطه صدری به دنده ها چسبیده اند.

تشخیص بیماری پاستورلوز در گوسفند:

یکی از راههای مهم تشخیص و یا غربالگری بیماری پاستورلوز در زمان کالبد گشایی، استفاده از آزمایش تست غرق شدن بافت ریه در آب (تست ذات الریه) یا شناور شدن آن است (حالت طبیعی) می باشد، به گونه ای که یک تکه از بافت ریه را در داخل یک ظرف آب می اندازیم، در حالت طبیعی و ریه سالم، تکه بافت ریه نبایستی به زیر آب برود درحالی که در مواقع ذات الریه و درگیری شدید ریه بدلیل درگیری کیسه های هوایی در ریه این خاصیت طبیعی از بین رفته و بافت ریه در ظرف آب غرق می شود.

در موارد حاد بیماری، کشت های حاصل از سواب نای یا شستشوی نای با آب مقطر استریل و جمع آوری محتویات و یا نمونه گیری از بافت ریه و یا غدد لنفاوی آن و ارسال به آزمایشگاه برای تشخیص استفاده می شود. معاینه هیستوپاتولوژیک مفید است، خصوصاً اگر به انواع دیگر پنومونی (مثلاً پنومونی بینابینی ویروسی در گوسفندان و بزهای بزرگسال) نیز مشکوک باشید. در موارد مزمن بیماری، کشت باکتریایی ممکن است نتایج کمتری داشته باشد.

درمان و کنترل بیماری پاستورلوز:

درمان باید براساس کشت باکتریایی و انجام تست حساسیت باکتریایی انجام گیرد، به ویژه در شیوع بیماری در گله و یا زمانی که حیوانات با ارزش درگیر هستند یا در موارد حاد یا مزمن که اقدامات درمانی اولیه با شکست روبرو شده است. آنتی بیوتیک های موثری که معمولاً برای درمان بیماری پاستورلوز توصیه شده شامل:

  •  اکسی تتراسایکلین ۱۰ درصد با دز ۱۰ میلی گرم به ازای هر کیلوگرم وزن زنده در روز به مدت سه روز
  •  اکسی تتراسیکلین ۲۰ درصد (طولانی اثر) با دز ۲۰ میلی گرم به ازای هر کیلوگرم وزن زنده یک بار (توصیه مترجم: تکرار یک هفته بعد)
  • فلورفنیکل تزریقی با دز ۲۰ میلی گرم به ازای هر کیلو وزن زنده به صورت دو تزریق با فاصله ۴۸ ساعت
  • تیلوزین ۲۰ درصد با دز ۲۰ میلی گرم به ازای هر کیلو وزن زنده یک بار در روز و به مدت ۵ روز

استفاده از داروهای ضد التهاب و خلط آور نیز برای کاهش علایم تنفسی توصیه شده است. درموارد حاد همچنین ممکن است از داروهای ضد التهاب مانند: فلونیکسین مگلومین یا کتوپروفن همراه با آنتی بیوتیک درمانی برای کنترل اندوتوکسمی و التهاب استفاده شوند.

بعد از اینکه دمای بدن به حالت طبیعی رسید، درمان باید حداقل برای ۲۴ تا ۴۸ ساعت دیگر ادامه داشته باشد.

ازداروی تیل مایکوزین و سایر آنتی بیوتیک های ماکرولید نیز می توان استفاده کرد، اما بطور قابل توجهی گرانتر از اکسی تتراسایکلین هستند.

عوامل مستعد کننده گوسفند و گاو به پاستورلوز و پنومونی:

مهمترین عوامل شامل: تهویه ناکافی، ازدحام جمعیت، جمع شدن حیوانات از مزارع مختلف همراه با شرایط تغذیه ای بد و استرس کمبود جا، تغذیه نامناسب، عدم انتقال موثر آنتی بادی از مادر به نوزاد، حمل و نقل در شرایط بد و سرمای و یا گرمای شدید و سایر استرس ها می باشد که همگی با شیوع ناگهانی پنومونی ناشی از پاستورلوز و یا همراه با سایر عوامل همراه بوده است.

کنترل و پیشگیری پاستورلوز و پنومونی ناشی از آن:

تحریک تنفسی و ایجاد سرفه های شدید در بیماری پاستورلوز

کنترل و پیشگیری پاستورلوز و پنومونی ناشی از آن عمدتا با اصلاح عوامل مستعد کننده در هر زمان عملی میباشد.

پیشگیری از پاستورلوزیس بهتر است با استفاده از واکسن های دارای پروتئین های تنظیم شده توسط آهن انجام شود. از آنجا که این پروتئین ها از نظر آنتی ژنیکی مشابه هستند، از محافظت متقابل در برابر سایر سروتیپ ها برخوردار هستند.

برنامه واکسیناسیون میشها و بزها بر علیه بیماری پاستورلوز و پنومونی:

معمولا به میش ها یک دوره اولیه تزریق در سن ۴ تا ۶ هفتگی آبستنی و به دنبال آن یک یادآور در زمان ۶-۴ هفته قبل از بره زایی انجام می شود. با این حال، این رژیم واکسیناسیون فقط تا ۵ هفته یک ایمنی غیر فعال برای بره ها فراهم می کند به همین دلیل برای حفاظت و ایجاد ایمنی طولانی تر و فعال در بره ها، از دو دوز واکسن که یکی در سن ۱۰ روزگی و دیگری ۱۵ روز بعد تجویز می شود استفاده می شود، زیرا آنتی بادی colostral در ایجاد ایمنی فعال تداخل ندارد.

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