The effect of different antimicrobial treatment regimens on the faecal shedding of ESBL-producing Escherichia coli in horses

Schoster, Angelika; Spijk, J N van; Damborg, Peter; Moodley, Arshnee; Kirchgaessner, Constanze; Hartnack, Sonja; Schmitt, Sarah

doi:10.1016/j.vetmic.2020.108617

Cited by 10 publications

(17 citation statements)

References 27 publications

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“…Detected rates are in general concordance with previous studies, reporting proportions from 7 to 16% (Maddox et al, 2012;Walther et al, 2018b;Schoster et al, 2020), but lower than in studies using selective enrichment (Shnaiderman-Torban et al, 2020). A very recent study by Schoster et al (2020) on hospitalized horses shedding ESBL-EC included different groups of equine patients while the duration of the PAP or anti-infective antimicrobial courses was determined individually for each patient by the veterinarian in charge. The fecal samples were collected -amongst other times-at hospital admission and 48-60 h afterward (Schoster et al, 2020).…”

Section: Isolation Rates Of Esbl-ec In Specimens Of Equine Patientssupporting

confidence: 87%

“…The fecal samples were collected -amongst other times-at hospital admission and 48-60 h afterward (Schoster et al, 2020). Interestingly, Schoster et al (2020) found no significant difference concerning the ESBL-EC shedding rates in horses receiving either a fourth-generation cephalosporin or the common P/G combination. Although neither the study design nor the study population included by that particular work are directly comparable with the present study, interesting similarities are apparent: An increase in ESBL-EC detection rates reported for samples of hospitalized horses, for instance, are clearly in line with those recorded in the present study, since they have also noted an elevation in detection rates beyond 50% within 3 days after hospital admission.…”

Section: Isolation Rates Of Esbl-ec In Specimens Of Equine Patientsmentioning

confidence: 98%

“…A very recent study by Schoster et al (2020) on hospitalized horses shedding ESBL-EC included different groups of equine patients while the duration of the PAP or anti-infective antimicrobial courses was determined individually for each patient by the veterinarian in charge. The fecal samples were collected -amongst other times-at hospital admission and 48-60 h afterward (Schoster et al, 2020). Interestingly, Schoster et al (2020) found no significant difference concerning the ESBL-EC shedding rates in horses receiving either a fourth-generation cephalosporin or the common P/G combination.…”

Section: Isolation Rates Of Esbl-ec In Specimens Of Equine Patientsmentioning

confidence: 99%

“…In recent years, reports on ESBL-EC carriage and fecal shedding in horses have increased (de Lagarde et al, 2019;Hordijk et al, 2020). Hospital stay alone, for instance, as well as antibiotic courses have only recently been identified as important risk factors for ESBL-EC colonization of equine patients (Schoster et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

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Frequency, Local Dynamics, and Genomic Characteristics of ESBL-Producing Escherichia coli Isolated From Specimens of Hospitalized Horses

et al. 2021

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Previous research identified veterinary clinics as hotspots with respect to accumulation and spread of multidrug resistant extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (EC). Therefore, promoting the prudent use of antibiotics to decrease selective pressure in that particular clinical environment is preferable to enhance biosecurity for animal patients and hospital staff. Accordingly, this study comparatively investigated the impact of two distinct perioperative antibiotic prophylaxis (PAP) regimens (short-term versus prolonged) on ESBL-EC carriage of horses subjected to colic surgery. While all horses received a combination of penicillin/gentamicin (P/G) as PAP, they were assigned to either the “single-shot group” (SSG) or the conventional “5-day group” (5DG). Fecal samples collected on arrival (t0), on the 3rd (t1) and on the 10th day after surgery (t2) were screened for ESBL-EC. All isolates were further investigated using whole genome sequences. In total, 81 of 98 horses met the inclusion criteria for this study. ESBL-EC identified in samples available at t0, t1 and t2 were 4.8% (SSG) and 9.7% (5DG), 37% (SSG) and 47.2% (5DG) as well as 55.6% (SSG) and 56.8% (5DG), respectively. Regardless of the P/G PAP regimen, horses were 9.12 times (95% CI 2.79–29.7) more likely to carry ESBL-EC at t1 compared to t0 (p < 0.001) and 15.64 times (95% CI 4.57–53.55) more likely to carry ESBL-EC at t2 compared to t0 (p < 0.001). ESBL-EC belonging to sequence type (ST) 10, ST86, ST641, and ST410 were the most prevalent lineages, with blaCTX–M–1 (60%) being the dominant ESBL gene. A close spatio-temporal relationship between isolates sharing a particular ST was revealed by genome analysis, strongly indicating local spread. Consequently, hospitalization itself has a strong impact on ESBL-EC isolation rates in horses, possibly masking differences between distinct PAP regimens. The results of this study reveal accumulation and spread of multi-drug resistant ESBL-EC among horses subjected to colic surgery with different P/G PAP regimens, challenging the local hygiene management system and work-place safety of veterinary staff. Moreover, the predominance of particular ESBL-EC lineages in clinics providing health care for horses needs further investigation.

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Section: Isolation Rates Of Esbl-ec In Specimens Of Equine Patientssupporting

confidence: 87%

Section: Isolation Rates Of Esbl-ec In Specimens Of Equine Patientsmentioning

confidence: 98%

Section: Isolation Rates Of Esbl-ec In Specimens Of Equine Patientsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Frequency, Local Dynamics, and Genomic Characteristics of ESBL-Producing Escherichia coli Isolated From Specimens of Hospitalized Horses

et al. 2021

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“…Shedding rates of 3GCRE by healthy horses in farms were reported worldwide, varying from 5.2% to 44% [11][12][13][14][15]. In three different studies, conducted in two different equine hospitals, shedding rates were shown to increase by 2.5-5.1-fold during hospitalization, implying that the nosocomial acquisition and spread of these resistant bacteria is common in certain veterinary facilities [11,16,17]. Moreover, there are numerous reports on various severe and invasive 3GCRE infectious syndromes among horses, e.g., skin and soft tissue infections, surgical site infections, upper respiratory tract infections, and bacteremia [18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Third Generation Cephalosporin Resistant Enterobacterales Infections in Hospitalized Horses and Donkeys: A Case–Case–Control Analysis

et al. 2021

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In human medicine, infections caused by third-generation cephalosporin-resistant Enterobacterales (3GCRE) are associated with detrimental outcomes. In veterinary medicine, controlled epidemiological analyses are lacking. A matched case–case–control investigation (1:1:1 ratio) was conducted in a large veterinary hospital (2017–2019). In total, 29 infected horses and donkeys were matched to 29 animals with third-generation cephalosporin-susceptible Enterobacterales (3GCSE) infections, and 29 uninfected controls (overall n = 87). Despite multiple significant associations per bivariable analyses, the only independent predictor for 3GCRE infection was recent exposure to antibiotics (adjusted odds ratio (aOR) = 104, p < 0.001), but this was also an independent predictor for 3GCSE infection (aOR = 22, p < 0.001), though the correlation with 3GCRE was significantly stronger (aOR = 9.3, p = 0.04). In separated multivariable outcome models, 3GCRE infections were independently associated with reduced clinical cure rates (aOR = 6.84, p = 0.003) and with 90 days mortality (aOR = 3.6, p = 0.003). Klebsiella spp. were the most common 3GCRE (36%), and blaCTX-M-1 was the major β-lactamase (79%). Polyclonality and multiple sequence types were evident among all Enterobacterales (e.g., Klebsiella pneumoniae, Escherichia coli, Enterobacter cloacae). The study substantiates the significance of 3GCRE infections in equine medicine, and their independent detrimental impact on cure rates and mortality. Multiple Enterobacterales genera, subtypes, clones and mechanisms of resistance are prevalent among horses and donkeys with 3GCRE infections.

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Does colonization with MRSA, ESBL – producing Enterobacteriaceae, and/or Acinetobacter baumannii – increase the risk for postoperative surgical site infection?

Gehlen

Klein

Merle

et al. 2023

Veterinary Medicine & Sci

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Objective: Evaluation of the role of indicator pathogens in equine surgical site infection (SSI) and other infection-promoting factors. Study design:Cross-sectional study. Animals:Horses presenting with an open injury or surgical colic during 1.5 years. Methods:A nasal swab and a faecal sample were collected from every patient upon admission. Furthermore, a wound swab was collected from wounds of injured horses.Details on the wounds and procedures were documented. Laparotomy incisions and injuries were monitored for signs suggesting infection. Results:In total, 156 horses presented because of a surgical colic (n = 48) or open injuries (n = 108). Thirteen surgical colic patients and three injured horses did not survive beyond 24 h, and four injured horses were discharged from the clinic at the day of admission. SSIs occurred in 31 (30.7%) injured horses and 11 (31.4%) horses after laparotomy. Regarding injuries, general anaesthesia increased the risk of developing a WI compared to sedation. Indicator pathogens were cultured from 29/42 SSI.In total, 10/11 infected laparotomy incisions and 19/31 injuries with SSI tested positive for multidrug-resistant pathogens (MDRPs) . Indicator pathogens were not detected at admission in any of the horses that developed incisional SSIs after laparotomy but were detected in two of the injured horses that developed SSIs. Conclusion:MDRPs were identified in almost 70% of the SSI. Less than 5% of the affected animals were colonized with the same pathogen before admission, indicating that colonization with MDR pathogens is only one of the crucial factors for the development of SSI.

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The effect of different antimicrobial treatment regimens on the faecal shedding of ESBL-producing Escherichia coli in horses

Cited by 10 publications

References 27 publications

Frequency, Local Dynamics, and Genomic Characteristics of ESBL-Producing Escherichia coli Isolated From Specimens of Hospitalized Horses

Frequency, Local Dynamics, and Genomic Characteristics of ESBL-Producing Escherichia coli Isolated From Specimens of Hospitalized Horses

Third Generation Cephalosporin Resistant Enterobacterales Infections in Hospitalized Horses and Donkeys: A Case–Case–Control Analysis

Does colonization with MRSA, ESBL – producing Enterobacteriaceae, and/or Acinetobacter baumannii – increase the risk for postoperative surgical site infection?

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