title: Renal infarction and immune-mediated glomerulonephritis in sheep (Ovis aries) chronically implanted with indwelling catheters.
abstract: Microbial infections are common sequelae in humans and animals implanted with long-term intravascular catheters. Understanding the pathophysiology of infectious morbidity is critical to improving quality of care in catheterized subjects. Here, we describe findings in 6 clinically healthy, male sheep implanted with indwelling aortic or cardiac catheters for 6 to 10 mo. We isolated multiple bacterial species including Serratia spp., Enterobacter agglomerans, Eschericia coli, Klebsiella oxytoca, and K. pneumoniae in aerobic cultures from catheter tips. Although sheep were clinically asymptomatic, 1 or both kidneys from all animals contained wedge-shaped infarcts of varying size and number. Microscopic examination revealed (a) marked fibrosis with mild inflammatory cell infiltrate consistent with chronic foreign body reaction around catheters; (b) moderate to severe, diffuse, subacute to chronic membranoproliferative glomerulonephritis and mild, multifocal chronic interstitial nephritis; and (c) mesangial immune-complex deposition as demonstrated by direct immunofluorescence technique. The finding of bacterial colonization of catheters together with chronic glomerulonephritis and immune-complex deposits in kidneys in clinically asymptomatic sheep underscores the need for close microbiologic monitoring of catheter implants and assessment of kidney function in animals instrumented for long-term vascular access.
authors.affiliation: Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA.ranga@mit.edu
authors.forename: Varada P
authors.initials: VP
authors.lastname: Rao
authors.forename: Theofilos
authors.initials: T
authors.lastname: Poutahidis
authors.forename: Robert P
authors.initials: RP
authors.lastname: Marini
authors.forename: Hilda
authors.initials: H
authors.lastname: Holcombe
authors.forename: Arlin B
authors.initials: AB
authors.lastname: Rogers
authors.forename: James G
authors.initials: JG
authors.lastname: Fox
mesh_terms: D000818:Animals; D001424:Bacterial Infections / Q000209:etiology / Q000473:pathology / Q000662:veterinary*; D002404:Catheterization; D002408:Catheters, Indwelling / Q000382:microbiology / Q000662:veterinary*; D004755:Enterobacteriaceae / Q000166:cytology / Q000302:isolation & purification; D005921:Glomerulonephritis / Q000209:etiology / Q000276:immunology / Q000662:veterinary*; D007238:Infarction / Q000209:etiology / Q000662:veterinary*; D007668:Kidney / Q000098:blood supply* / Q000473:pathology; D008297:Male; D012756:Sheep; D012757:Sheep Diseases / Q000209:etiology* / Q000276:immunology / Q000382:microbiology