tetracycline and Clostridium-Infections

Topics: Cholestyramine Resin; Clindamycin; Clostridium Infections; Enterocolitis, Pseudomembranous; Gastrointestinal Diseases; Humans; Ischemia; Lincomycin; Metals; Staphylococcal Infections; Tetracycline; Vancomycin

Topics: Abortion, Septic; Anticoagulants; Bacterial Infections; Bacteroides Infections; Chloramphenicol; Clindamycin; Clostridium Infections; Cross Infection; Drug Resistance, Microbial; Female; Genital Diseases, Female; Humans; Lincomycin; Pelvic Inflammatory Disease; Pregnancy; Pregnancy Complications, Infectious; Tetracycline; Thrombophlebitis

Topics: Acinetobacter Infections; Anti-Bacterial Agents; Antifungal Agents; Clostridium Infections; Corynebacterium; Drug Synergism; Enteritis; Erythromycin; Escherichia coli Infections; Female; Humans; Infections; Mycobacterium Infections; Mycoses; Neomycin; Penicillins; Respiratory Tract Infections; Staphylococcal Infections; Streptococcal Infections; Streptomycin; Tetracycline; Vaginitis

Clostridioides difficile is a bacterium that causes antibiotic-associated infectious diarrhea and pseudomembranous enterocolitis. The impact of C. difficile infection (CDI) in China has gained significant attention in recent years. However, little epidemiological data are available from Chongqing, a city located in Southwest China. This study aimed to investigate the epidemiological pattern of CDI and explore the drug resistance of C. difficile isolates in Chongqing.. A case-control study was conducted to investigate the clinical infection characteristics and susceptibility factors of C. difficile. The features of the C. difficile isolates were evaluated by testing for toxin genes and using multi-locus sequence typing (MLST). The susceptibility of strains to nine antibiotics was determined using agar dilution technique.. Out of 2084 diarrhea patients, 90 were tested positive for the isolation of toxigenic C. difficile strains, resulting in a CDI prevalence rate of 4.32%. Tetracycline, cephalosporins, hepatobiliary disease, and gastrointestinal disorders were identified as independent risk factors for CDI incidence. The 90 strains were classified into 21 sequence types (ST), with ST3 being the most frequent (n = 25, 27.78%), followed by ST2 (n = 10, 11.11%) and ST37 (n = 9, 10%). Three different toxin types were identified: 69 (76.67%) were A. The strains identified in Chongqing, Southwest China, exhibited high genetic diversity. Enhance full awareness of high-risk patients with HA-CDI infection, particularly those with gastrointestinal and hepatocellular diseases, and emphasize caution in the use of tetracycline and capecitabine. These findings suggest that a potential epidemic of CDI may occur in the future, emphasizing the need for timely monitoring.

Topics: Anti-Bacterial Agents; Case-Control Studies; China; Clostridioides; Clostridioides difficile; Clostridium Infections; Diarrhea; Humans; Microbial Sensitivity Tests; Multilocus Sequence Typing; Tertiary Care Centers; Tetracycline; Tigecycline

The purpose of this study was to determine the prevalence and antimicrobial resistance of Clostridium perfringens from sheep (intensive husbandry) in Gansu and Tibetan sheep (extensive husbandry) in Qinghai, China.. 400 fecal samples (sheep, n = 320, Tibetan sheep, n = 80) were collected from Gansu and Qinghai for C. perfringens isolation. Toxin genes were detected by PCR, antimicrobial susceptibility testing was carried out by broth microdilution method, and whole genome was sequenced using Illumina HiSeq.. 83 strains of C. perfringens (sheep, n = 47; Tibetan sheep, n = 36) were isolated from the samples. 44.5% (37/83) of the isolates were positive for cpb2, while 34.9% (29/83) of the isolates were positive for cna. 95.2% isolates were resistant to sulfonamides, followed by tetracycline (22.9%), ampicillin (14.5%), penicillin (10.8%), doxycycline (4.8%), and amoxicillin (1.2%). The isolates from same source shared similar allelic profile and closer genetic relationship. A total of 14 toxin genes and 11 antimicrobial resistance genes were detected among the sequenced isolates, and 10 sequenced C. perfringens isolates carried multiple (n ≥ 3) antimicrobial-resistance genes. Moreover, oxazolidinone-resistant gene optrA was detected in one isolate from Tibetan sheep, which co-harbored tetA(P), aac(6')-aph(2″), ant(6)-Ib, erm(Q), fexA, tet(44), erm(A) and erm(B).. C. perfringens from sheep and Tibetan sheep shared different prevalence rates and antimicrobial-resistance, and the isolates from same source shared closer genetic relationship.

Topics: Animals; Anti-Bacterial Agents; Clostridium Infections; Clostridium perfringens; Prevalence; Sheep; Tetracycline

This cross sectional study was designed to investigate the molecular detection of C. perfringens toxins (alpha, epsilon, iota) and antibiotics resistance genes, as well as sequencing of their toxin genes.. Different wound swabs were taken from 140 patients. PCR was applied for detection of clostridial toxins; alpha toxin (cpa) gene, epsilon toxin (etx) gene, and iota toxin (iap) gene. Metronidazole nim gene, tetracycline resistance genes; (tetQ, tetM, tetB, and tetW) and clindamycin resistance genes erm (A,B), were used for genotypic detection of antibiotic resistance.. Out of 140 clinical samples collected, 7 isolates were detected using specific primer 16S-23S intergenic rRNA spacer gene of C. perfringens. Results showed presence of alpha toxin (cpa) genes in all clostridial isolates, Epsilon toxin (etx) genes in 2/7(28.4%), and iota toxin (iap) genes in 2/7 (28.4%). Results of antibiotic resistance genes showed that all isolates were not able to produce nim, tet W and Q, tet B, erm (A), erm (B) genes except for tetM. Gene sequence analysis for cpa gene showed that there were 3 mutations in the sample of this gene, the results of etx gene when had been sent 2 samples from this gene. The first sample showed that there was one mutation and the results of iap gene showed that there were no mutation in 2 samples of the iap gene. The samples had been showed identical 100%.. The DNA sequence analysis of bacterial genome revealed several important feature including that may allow to confirm new the presence of toxin and to identify new or mutant toxins that may be missed by diagnostic PCR specifically target toxin encoding genes.

Topics: Anti-Bacterial Agents; Clindamycin; Clostridium Infections; Clostridium perfringens; Cross-Sectional Studies; Drug Resistance, Bacterial; Genes, Bacterial; Hospitals; Humans; Iraq; Metronidazole; Polymerase Chain Reaction; Sequence Analysis, DNA; Tetracycline

Many of the disease-causing toxins of the pathogenic bacterium Clostridium perfringens are harboured on large, highly stable, conjugative plasmids. Previous work has established the requirement of a ParMRC-like partitioning system for plasmid maintenance, but little is known about other mechanisms used to ensure stable plasmid inheritance. The archetypal 47 kb Tcp plasmid, pCW3, encodes a gene, resP, whose putative product has sequence similarity to members of the serine recombinase family of site-specific recombinases. ResP is therefore likely to function to resolve plasmid multimers. Sequence analysis identified that resP genes are present on all C. perfringens plasmid families, suggesting a conserved function in these plasmids. To assess the requirement of resP for the stability of pCW3, deletion mutants were constructed. Deletion of resP from pCW3 resulted in a marked instability phenotype that was rescued upon complementation with the wild-type resP gene. Complementation with resP genes from two different C. perfringens plasmids demonstrated that only closely related resP genes can complement the mutation on pCW3. The function of ResP in vivo was examined using an Escherichia coli model system, which determined that two directly repeated res sites were required for the resolution of DNA and that ResP could resolve multimeric plasmid forms into monomeric units. Based on these findings we concluded that ResP could catalyse the resolution of plasmid multimers and was required for the maintenance of Tcp plasmids within C. perfringens. Overall, the results of this study have significant implications for our understanding of the maintenance of toxin-encoding plasmids within C. perfringens.

Topics: Clostridium Infections; Clostridium perfringens; Conjugation, Genetic; DNA, Bacterial; Genes, Bacterial; Humans; Plasmids; Tetracycline

NetF-producing type A

Topics: Animals; Anti-Bacterial Agents; beta-Lactams; Canada; Clostridium Infections; Clostridium perfringens; DNA, Bacterial; Dogs; Horses; Multilocus Sequence Typing; Switzerland; Tetracycline; Tetracycline Resistance; United States

The increasing clinical importance of human infections (frequently severe) caused by

Topics: Animal Husbandry; Animals; Anti-Bacterial Agents; Clostridioides difficile; Clostridium Infections; Evolution, Molecular; Genotype; Molecular Epidemiology; Polymerase Chain Reaction; Ribotyping; Selection, Genetic; Swine; Swine Diseases; Tetracycline

Clostridium difficile is a major nosocomial pathogen in humans with an increasing incidence in the community. The "one-health" approach of research is needed to investigate possible reservoirs of C. difficile and route of its transmission. The objective of this study is to investigate the occurrence of C. difficile in pigs in the Czech Republic with characterisation of the isolates to determine their genetic relatedness to C. difficile isolates from European and Asian pigs. A total of 198 pig faeces samples from 23 farms were investigated and of those 57 samples (55 piglets, 2 sows) from 11 farms were confirmed as C. difficile positive. The majority of C. difficile isolates belonged to the sequence type 11 and clade 5. The predominant ribotypes were 078 (n = 23), 078-variant (n = 5), 033 (n = 10) followed by RTs 150 (n = 7), 011 (n = 5), 045 (n = 4), 126, 014, 002 (n = 1, each). All isolates were susceptible to metronidazole, vancomycin and tetracycline. Isolates of RTs 150 and 078-variant were moxifloxacin resistant (MIC≥32 mg/L) and carried the amino acid substitution Thr82Ile in the GyrA. A multi-locus variable number tandem-repeats analysis (MLVA) revealed a clonal relatedness of isolates within individual farms and in C. difficile RT078 isolates between two Czech farms. Czech C. difficile RT078 isolates clustered with German C. difficile RT078 isolates and Czech C. difficile 078-variant isolates clustered with C. difficile RT078 isolates from Japan and Taiwan. This study found an emergence of C. difficile RT078 in Czech piglets that was related genetically to C. difficile RT078 isolates from Germany, Japan and Taiwan.

Topics: Amino Acid Substitution; Animals; Anti-Bacterial Agents; Clostridioides difficile; Clostridium Infections; Czech Republic; DNA Gyrase; Germany; Japan; Metronidazole; Microbial Sensitivity Tests; Moxifloxacin; Multilocus Sequence Typing; Ribotyping; Swine; Taiwan; Tetracycline; Vancomycin

Clostridium septicum is a highly pathogenic microbe that causes gas gangrene in humans, and is the principal cause of spontaneous gas gangrene in patients with gastrointestinal maladies, including adenocarcinoma of the colon. Despite modern approaches to manage C. septicum infection, morbidity and mortality remain high (>60%). At present, no objective in-vivo data exist supporting the current antibiotic treatment recommendations for C. septicum infection. Utilizing an established murine model of clostridial myonecrosis, this study investigated the efficacy of standard antibiotics for anaerobic Gram-positive soft tissue infections (penicillin, clindamycin, tetracycline and vancomycin) in treating C. septicum gas gangrene. Following intramuscular challenge with 1 × 10

Topics: Animals; Anti-Bacterial Agents; Clindamycin; Clostridium Infections; Clostridium septicum; Drug Administration Schedule; Female; Humans; Injections, Intramuscular; Injections, Intraperitoneal; Mice; Microbial Sensitivity Tests; Muscle, Skeletal; Penicillins; Soft Tissue Infections; Survival Analysis; Tetracycline; Vancomycin

Clostridium difficile is the main cause of antibiotic associated diarrhea. In the past decade, the number of C. difficile patients has increased dramatically, coinciding with the emergence of two PCR ribotypes 027 and 078. PCR ribotype 078 is also frequently found during C. difficile outbreaks in pigfarms. Previously, the genome of the PCR ribotype 078 strain M120, a human isolate, was described to contain a unique insert of 100 kilobases.. Analysis of this insert revealed over 90 open reading frames, encoding proteins originating from transposons, phages and plasmids. The insert was shown to be a transposon (Tn6164), as evidenced by the presence of an excised and circularised molecule, containing the ligated 5'and 3'ends of the insert. Transfer of the element could not be shown through filter-mating experiments. Whole genome sequencing of PCR ribotype 078 strain 31618, isolated from a diarrheic piglet, showed that Tn6164 was not present in this strain. To test the prevalence of Tn6164, a collection of 231 Clostridium difficile PCR ribotype 078 isolates from human (n = 173) and porcine (n = 58) origin was tested for the presence of this element by PCR. The transposon was present in 9 human, tetracycline resistant isolates, originating from various countries in Europe, and none of the pig strains. Nine other strains, also tetracycline resistant human isolates, contained half of the transposon, suggesting multiple insertion steps yielding the full Tn6164. Other PCR ribotypes (n = 66) were all negative for the presence of the transposon. Multi locus variable tandem repeat analysis revealed genetic relatedness among transposon containing isolates. Although the element contained several potential antibiotic resistance genes, it did not yield a readily distinguishable phenotype.. Tn6164 is a newly described transposon, occurring sporadically in C. difficile PCR ribotype 078 strains. Although no transfer of the element could be shown, we hypothesize that the element could serve as a reservoir of antibiotic resistance genes for other bacteria. Further research is needed to investigate the transfer capabilities of the element and to substantiate the possible role of Tn6164 as a source of antibiotic resistance genes for other gut pathogens.

Topics: Animals; Anti-Bacterial Agents; Clostridioides difficile; Clostridium Infections; Diarrhea; DNA Transposable Elements; DNA, Bacterial; Genomic Islands; Humans; Open Reading Frames; Polymorphism, Genetic; Ribotyping; Swine; Tetracycline; Tetracycline Resistance

Multidrug resistance and antibiotic resistance mechanisms were investigated in 316 Clostridium difficile clinical isolates collected during the first European surveillance on C. difficile in 2005.. MICs of eight different antibiotics were determined using Etest. Reserpine- and carbonyl cyanide m-chlorophenylhydrazone-sensitive efflux was tested using the agar dilution method. Molecular analysis of the resistance mechanisms was performed using PCR assays, PCR mapping and sequencing.. One hundred and forty-eight C. difficile strains were resistant to at least one antibiotic and 82 (55%) were multidrug resistant. In particular, 48% of these isolates were resistant to erythromycin, clindamycin, moxifloxacin and rifampicin. New genetic elements or determinants conferring resistance to erythromycin/clindamycin or tetracycline were identified. Even if most multiresistant strains carried an erm(B) gene, quite a few were erm(B) negative. In-depth analysis of the underlying mechanism in these isolates was carried out, including analysis of 23S rDNA and the ribosomal proteins L4 and L22. Interestingly, resistance to rifampicin was observed in multidrug-resistant strains in association with resistance to fluoroquinolones. Mutations in the rpo(B) and gyrA genes were identified as the cause of resistance to these antibiotics, respectively.. Characterization of multidrug-resistant C. difficile clinical isolates shows that antibiotic resistance is changing, involving new determinants and mechanisms and providing this pathogen with potential advantages over the co-resident gut flora. The present paper provides, for the first time, a comprehensive picture of the different characteristics of multidrug-resistant C. difficile strains in Europe in 2005 and represents an important source of data for future comparative European studies.

Topics: Anti-Bacterial Agents; Aza Compounds; Clindamycin; Clostridioides difficile; Clostridium Infections; DNA Transposable Elements; DNA, Ribosomal; Drug Resistance, Multiple, Bacterial; Erythromycin; Europe; Fluoroquinolones; Humans; Methyltransferases; Microbial Sensitivity Tests; Molecular Sequence Data; Moxifloxacin; Quinolines; Ribosomal Proteins; Rifampin; RNA, Ribosomal, 23S; Tetracycline

Clostridium difficile and Clostridium perfringens are anaerobic, Gram-positive bacilli that are common causes of enteritis and enterotoxemias in both domestic animals and humans. Both organisms have been associated with acute and chronic large and small bowel diarrhea, and acute hemorrhagic diarrheal syndrome in the dog. The objective of this study was to determine the in vitro antimicrobial susceptibilities of canine C. difficile and C. perfringens isolates in an effort to optimize antimicrobial therapy for dogs with clostridial-associated diarrhea. The minimum inhibitory concentrations (MIC) of antibiotics recommended for treating C. difficile (metronidazole, vancomycin) and C. perfringens-associated diarrhea in the dog (ampicillin, erythromycin, metronidazole, tetracycline, tylosin) were determined for 70 canine fecal C. difficile isolates and 131 C. perfringens isolates. All C. difficile isolates tested had an MIC of or=256 microg/ml for both erythromycin and tylosin. A third C. perfringens isolate had an MIC of 32 microg/ml for metronidazole. Based on the results of this study, ampicillin, erythromycin, metronidazole, and tylosin appear to be effective antibiotics for the treatment of C. perfringens-associated diarrhea, although resistant strains do exist. However, because there is limited information regarding breakpoints for veterinary anaerobes, and because intestinal concentrations are not known, in vitro results should be interpreted with caution.

Topics: Ampicillin; Animals; Anti-Bacterial Agents; Clostridioides difficile; Clostridium Infections; Clostridium perfringens; Diarrhea; Dog Diseases; Dogs; Erythromycin; Metronidazole; Microbial Sensitivity Tests; Tetracycline; Tylosin

The aim of this study was to test the hypothesis that all conjugative R-plasmids of Clostridium perfringens are closely related to the previously characterized tetracycline resistance plasmid, pCW3. Fourteen conjugative R-plasmids derived from 11 C. perfringens strains isolated in Australia, the United States, France, Belgium, and Japan were analyzed. Eleven of the plasmids encoded tetracycline resistance while three carried both tetracycline and chloramphenicol resistance. Each of these plasmids was compared, by restriction analysis, to the reference plasmid, pCW3. Seven of the tetracycline resistance plasmids had EcoRI, XbaI, and ClaI restriction profiles that were identical to those of the corresponding pCW3 digests. The seven remaining R-plasmids were different from pCW3. Comparison of partial restriction maps of these plasmids with a complete map of pCW3 indicated that they contained at least 17 kb of DNA that also was present in pCW3. Hybridization analysis confirmed that these plasmids shared substantial homology with pCW3. The three tetracycline and chloramphenicol resistance plasmids frequently lost a 6-kb chloramphenicol resistance segment during conjugation. Cloning experiments showed that the chloramphenicol resistance determinant was expressed in Escherichia coli and that the chloramphenicol resistance gene of one of these plasmids, pIP401, was contained within a 1.5-kb region of the 6-kb deletion segment. Hybridization analysis indicated that the deletion segment of pIP401 was related to those of the other two chloramphenicol resistance plasmids. During the course of this study, conjugative R-plasmids which appear to be identical to pCW3 or closely related to pCW3 were identified from C. perfringens strains from human, animal and environmental sources in five countries. It is concluded that C. perfringens strains in humans and animals throughout the world have overlapping gene pools and that all the conjugative C. perfringens R-plasmids examined probably evolved from a pCW3-like element.

Topics: Animal Diseases; Animals; Animals, Domestic; Australia; Belgium; Chloramphenicol; Clostridium Infections; Clostridium perfringens; DNA Restriction Enzymes; DNA, Bacterial; Drug Resistance, Microbial; France; Humans; Japan; Nucleic Acid Hybridization; R Factors; Tetracycline; United States

Tetracyclines were implicated in the 1950s in induction of protracted diarrhea and pseudomembranous colitis. Because the pathogenetic mechanism of these illnesses has been questioned recently, we studied tetracycline in hamster models of antibiotic-associated colitis. Orogastric administration of tetracycline caused diarrhea and death, with evidence of hemorrhagic typhlitis. Filtrates of cecal contents were toxic when inoculated into normal hamsters and cell culture monolayers, and toxicity was neutralized with Clostridium sordellii antitoxin. Tetracycline-resistant C. difficile was cultured from stools of these hamsters, but Staphylococcus aureus was not isolated. The value of tetracycline for treatment or prevention of clindamycin-induced colitis in hamsters was also studied, and it was found that daily orogastric administration of tetracycline was poorly protective against clindamycin-induced colitis.

Topics: Animals; Bacterial Toxins; Clindamycin; Clostridium Infections; Cricetinae; Enterocolitis, Pseudomembranous; Feces; Male; Mesocricetus; Tetracycline

A case of Clostridium welchii septicaemia following acute cholecystitis is described. The onset was acute and a rapidly fatal outcome ensued. Radiological findings were negative. An approach to the antibiotic treatment and general management is discussed.

Topics: Aged; Cephaloridine; Cholecystitis; Clostridium Infections; Clostridium perfringens; Humans; Male; Sepsis; Tetracycline

Topics: Animals; Bovine Virus Diarrhea-Mucosal Disease; Cattle; Cattle Diseases; Clostridium Infections; Haemophilus Infections; Immunization; Infectious Bovine Rhinotracheitis; Paramyxoviridae Infections; Pasteurella Infections; Penicillins; Pneumonia; Respiratory Tract Infections; Stress, Physiological; Tetracycline

Topics: Actinomycetales Infections; Anaerobiosis; Anti-Bacterial Agents; Bacterial Infections; Bacteroides Infections; Cephalosporins; Chloramphenicol; Clindamycin; Clostridium Infections; Erythromycin; Fusobacterium; Humans; Lincomycin; Metronidazole; Microbial Sensitivity Tests; Oxygen; Penicillins; Rifampin; Streptococcal Infections; Tetracycline; Treponemal Infections; Vancomycin; Veillonella

Topics: Animals; Anti-Bacterial Agents; Cephaloridine; Clostridium; Clostridium Infections; Gas Gangrene; Injections, Intravenous; Lincomycin; Mice; Microbial Sensitivity Tests; Penicillin G; Tetracycline

Topics: Acidosis; Clostridium Infections; Clostridium perfringens; Endocarditis, Bacterial; Enterococcus faecalis; Heart Failure; Humans; Male; Middle Aged; Penicillin Resistance; Penicillins; Streptococcal Infections; Streptomycin; Tetracycline

Topics: Abortion, Septic; Acute Kidney Injury; Antitoxins; Chloramphenicol; Clostridium Infections; Clostridium perfringens; Exchange Transfusion, Whole Blood; Female; Heparin; Humans; Hysterectomy; Mannitol; Metaraminol; Methylprednisolone; Penicillins; Pregnancy; Streptomycin; Tetracycline

Topics: Animals; Clostridium; Clostridium Infections; Clostridium perfringens; Drug Synergism; Erythromycin; Gas Gangrene; Mice; Stimulation, Chemical; Tetracycline; Time Factors

Topics: Amputation, Surgical; Cellulitis; Clostridium; Clostridium Infections; Debridement; Diagnosis, Differential; Gas Gangrene; Humans; Injections, Intravenous; Male; Middle Aged; Penicillin G; Radiography; Tetracycline; Time Factors

Topics: Adolescent; Adult; Amputation, Surgical; Clostridium Infections; Clostridium perfringens; Extremities; Gas Gangrene; Humans; Hyperbaric Oxygenation; Leg Injuries; Methods; Middle Aged; Penicillins; Tetracycline

Topics: Animals; Anti-Bacterial Agents; Clostridium Infections; Disease Models, Animal; Drug Synergism; Escherichia coli Infections; Gas Gangrene; Liver Extracts; Penicillin G Procaine; Proteus Infections; Rats; Staphylococcal Infections; Tetracycline

Topics: Abortion, Septic; Adult; Anti-Bacterial Agents; Clostridium Infections; Curettage; Drug Synergism; Female; Gas Gangrene; Humans; Kanamycin; Penicillins; Pregnancy; Sepsis; Tetracycline

Topics: Animals; Chloramphenicol; Clostridium; Clostridium Infections; Clostridium perfringens; Depression, Chemical; Mice; Pseudomonas Infections; Tetracycline

Topics: Aged; Clostridium Infections; Clostridium perfringens; Empyema; Escherichia coli; Humans; Male; Methods; Middle Aged; Penicillin G; Pleura; Punctures; Radiography; Tetracycline

Topics: Animals; Clostridium; Clostridium Infections; Guinea Pigs; Mice; Necrosis; Rabbits; Radiation Effects; Tetracycline

Topics: Adolescent; Clostridium Infections; Clostridium perfringens; Drug Hypersensitivity; Erythromycin; Humans; Male; Penicillin G; Penicillin Resistance; Tetracycline

Topics: Animals; Clostridium Infections; Clostridium perfringens; Mice; Tetracycline

Topics: Abortion, Septic; Ampicillin; Chloramphenicol; Clostridium; Clostridium Infections; Escherichia coli Infections; Female; Humans; Injections, Intramuscular; Injections, Intravenous; Kanamycin; Klebsiella Infections; Penicillin G; Pregnancy; Streptomycin; Tetracycline

Topics: Animals; Antitoxins; Clostridium Infections; Gas Gangrene; Penicillins; Sheep; Tetracycline; Wounds, Gunshot