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Simple Summary: Gram negative organisms are frequently isolated from Caretta caretta and may contribute to the dissemination of antimicrobial resistance. In this study, commensal bacteria isolated from oral and cloacal samples of 98 healthy C. caretta were compared to clinical isolates isolated from the wounds of 102 injured animals, in order to investigate the presence of antimicrobial resistance bacteria in free-living loggerheads from the Adriatic Sea. A total of 410 bacteria were cultured and differences were noted in the isolated genera, as some of them were isolated only in healthy animals, while others were isolated only from injured animals. When tested for susceptibility to antimicrobials, clinical isolates showed highly significant differences in the antimicrobial resistance rates vs. commensal isolates for all the drugs tested, except for doxycycline. The detection of high antimicrobial resistance rates in loggerhead sea turtles is of clinical and microbiological significance since it impacts both the choice of a proper antibiotic therapy and the implementation of conservation programs. Gram negative organisms are frequently isolated from Caretta caretta turtles, which can act as reservoir species for resistant microorganisms in the aquatic environment. C. caretta, which have no history of treatment with antimicrobials, are useful sentinel species for resistant microbes. In this culture-based study, commensal bacteria isolated from oral and cloacal samples of 98 healthy C. caretta were compared to clinical isolates from the wounds of 102 injured animals, in order to investigate the presence of AMR bacteria in free-living loggerheads from the Adriatic Sea. A total of 410 isolates were cultured. Escherichia coli and genera such as Serratia, Moraxella, Kluyvera, Salmonella were isolated only in healthy animals, while Acinetobacter, Enterobacter, Klebsiella and Morganella were isolated only from the wounds of the injured animals. When tested for susceptibility to ampicillin, amoxicillin + clavulanic acid, ceftazidime, cefuroxime, gentamicin, doxycycline, ciprofloxacin and enrofloxacin, the clinical isolates showed highly significant differences in AMR rates vs. commensal isolates for all the drugs tested, except for doxycycline. The detection of high AMR rates in loggerheads is of clinical and microbiological significance since it impacts both the choice of a proper antibiotic therapy and the implementation of conservation programs. [ABSTRACT FROM AUTHOR]

Simple Summary: Evaluation of the respiratory system is a critical aspect of sea turtle medicine due to their peculiar anatomy. The location of the lungs under the carapace makes them vulnerable to wounds involving the carapace, which are frequent and significant complications of vessel strike injuries. Open lung wounds result in aspiration, loss of buoyancy control, and secondary infection. In sea turtles, pulmonary diseases can originate from many causes. Increased marine pollution is reflected in the increasing occurrence of sea turtles with entanglement injuries around the neck or flippers, caused by plastic waste, ghost nets, fishing lines, etc. These injuries may directly damage the upper airway or create life-threatening secondary infections. The object of the study was to describe clinical signs, radiographic, endoscopic and computed tomography examinations, and cytological and microbiological findings useful to obtaining an accurate diagnosis of pulmonary diseases in sea turtles. Moreover, we describe the treatment carried out on the basis of antimicrobial susceptibility testing to avoid unnecessary treatments and antibiotic-resistance phenomenon. Data were collected from 14 turtles. Radiographic signs of pulmonary pathology were seen in all cases. Four sea turtles underwent advanced diagnostic investigations so as to better characterize the pulmonary pattern. The bronchoalveolar lavage allowed us to withdraw fluid from the lower airways and to perform cytological and bacteriological examinations on all 14 subjects. The study suggests how it may be useful to implement diagnostic procedures in order to obtain an accurate and early diagnosis, to prevent unnecessary therapy, and to contain antibiotic-resistance phenomena. The aim of this study was to describe the clinical signs, radiographic, endoscopic and CT findings, cytological and microbiological findings and treatments of pulmonary diseases in sea turtles, in order to obtain an accurate diagnosis that avoids unnecessary therapy and antibiotic-resistance phenomena. In total, 14 loggerheads (Caretta caretta), with clinical and/or radiographic findings of pulmonary pathology, were assessed through various combinations of clinical, radiological, CT, endoscopic examination and bronchoalveolar lavage, which recovered fluid for cytologic and microbiologic analysis. In all cases, radiographic examination led to a diagnosis of pulmonary disorders—4 unilateral and 10 bilateral. All bacteria cultured were identified as Gram-negative. Antibiotic resistance was greater than 70% for all beta-lactams tested. In addition, all bacterial strains were 100% resistant to colistin sulfate and tetracycline. Specific antibiotic therapies were formulated for seven sea turtles using Enrofloxacin, and for four sea turtles using ceftazidime. In two turtles, antibiotic therapy was not included due to the presence of antibiotic resistance against all the antibiotics evaluated. In both cases, the coupage technique and environmental management allowed the resolution of the lung disease without antibiotics. All 14 sea turtles were released back into the sea. Radiographic examination must be considered the gold standard for screening sea turtles that show respiratory signs or abnormal buoyancy. Susceptibility testing with antimicrobials allowed appropriate therapy, including the reduction of antibiotic-resistance. [ABSTRACT FROM AUTHOR]