The One Health role of interplay between canine parvovirus and Gram-negative bacterial translocation in sepsis and multi-organ failure in dogs

Abstract

Introduction: Canine parvovirus (CPV-2) is one of the most lethal gastrointestinal viruses in dogs, characterized by hemorrhagic gastroenteritis, severe intestinal mucosal destruction, and depletion of crypt stem cells. Mortality in CPV infection is often not directly caused by the virus, but rather as a result of sepsis and multiorgan failure (MODS) following enteric Gram-negative bacterial translocation. This systematic review aimed to evaluate the role of One Health in the association between parvovirus, bacterial translocation, and sepsis in dogs.

Methods: A systematic search was conducted in PubMed, Google Scholar, and ScienceDirect for studies published between January 2018 and December 2024 following the PRISMA guidelines. Inclusion criteria were clinical and experimental studies that simultaneously examined CPV infection, endotoxin (lipopolysaccharide, LPS) in the blood, organ failure, and outcomes related to antimicrobial resistance. Of the 956 studies found, 34 studies met the inclusion criteria.

Results: Among CPV-infected dogs with sepsis, Gram-negative bacterial translocation (E. coli, Salmonella, Klebsiella) was reported in 82% of cases (descriptive summary). Intestinal barrier disruption elevated serum LPS, triggering TLR4/MYD88-mediated cytokine storm (IL-1β, IL-6, TNF-α), which was associated with ARDS, renal tubular necrosis, and myocarditis. Antimicrobial resistance to first-line antibiotics (cephalexin, enrofloxacin) was observed in 43% of isolates. However, due to heterogeneity among observational studies, these pooled percentages should be interpreted cautiously and are presented as aggregated summaries rather than definitive estimates.

Conclusion: From a One Health perspective, three levels of intervention were defined. First, animal health with widespread CPV vaccination and the use of probiotics to maintain the integrity of the intestinal barrier. Second, human health by reducing the selective pressure of antibiotics through targeted therapy based on an antibiogram. Third, environmental health is achieved by properly managing contaminated waste and feces from infected puppies, which can serve as reservoirs of antimicrobial resistance genes.