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Diagnosis and treatment of a multidrug-resistant Escherichia coli in a wild eastern box turtle (Terrapene carolina carolina)

Abstract:

An adult male eastern box turtle presented to the Turtle Rescue Team at North Carolina State University with clinical signs of an upper respiratory tract infection. After unsuccessful treatment with broad spectrum antibiotics, multidrug-resistant Escherichia coli was cultured from the infection that was resistant to commonly used antimicrobial agents. Based on the culture and susceptibility testing, 10 mg/kg of meropenem was administered intramuscularly every 24 hours for seven days. Meropenem plasma concentrations were measured to ensure that an optimum antibiotic dose was administered. Following treatment with meropenem, clinical signs ceased and subsequent culture reports were negative. Meropenem plasma concentrations identified a short half-life (4.17 hours) necessitating once-daily dosing to maintain effective concentrations. Because multiple doses were delivered from a single administration vial, the strength of reconstituted vials of meropenem during storage in the refrigerator was tested. The meropenem concentration was maintained above 90 per cent for 48 hours.