Epidemiologic analysis of nosocomial Salmonella infections in hospitalized horses

Ekiri, Abel B.; MacKay, Robert J.; Gaskin, Jack M.; Freeman, David E.; House, Amanda M.; Giguère, Steeve; Troedsson, Mats R.; Schuman, Crystal D.; Chamier, Maria M. von; Henry, Katherine M.; Hernández, Jorge A.

doi:10.2460/javma.234.1.108

Cited by 47 publications

(67 citation statements)

References 19 publications

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“…Antimicrobial therapy has been identified as a risk factor for the development of colitis and salmonellosis in the horse. In addition, horses undergoing colic surgery are at increased risk for shedding Salmonella . Evaluation of antimicrobial use in horses undergoing colic surgery and degree of adherence to accepted guidelines is warranted in this population of animals.…”

Section: Suggested Guidelines For Antimicrobial Prophylaxis In Patienmentioning

confidence: 99%

Antimicrobial Use in Horses Undergoing Colic Surgery

Schaer

Linton

Aceto

2012

Veterinary Internal Medicne

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Background: Recommendations for antimicrobial prophylaxis for surgery are well-described in human medicine, but information is limited for veterinary practice.Objective: To characterize antimicrobial use in horses undergoing emergency colic surgery. Animals: A total of 761 horses undergoing emergency colic surgery (2001)(2002)(2003)(2004)(2005)(2006)(2007). Methods: Retrospective case review. Antimicrobial dose and timing, surgical description, and duration of treatment were collected from medical records. Associations between antimicrobial use and the occurrence of fever, incisional inflammation or infection, catheter-associated complications, or Salmonella shedding during hospitalization were analyzed using rank-sum methods and logistic regression.Results: A total of 511 (67.2%) horses received an inappropriate amount of drug preoperatively. Median time from preoperative dose to incision was 70 (IQR 55-90) minutes; median total surgery time was 110 (IQR 80-160) minutes. Seventy-three horses were euthanized under anesthesia because of poor prognosis. Of 688 horses, 438 should have been redosed intraoperatively based on the duration of surgery. Only 8 (1.8%) horses were redosed correctly. Horses remained on perioperative antimicrobials a median of 3 (IQR 2-4.5) days. Antimicrobial therapy was reinstituted in 193 (28.9%) horses, and median days of total treatment were 3.8 (IQR 2-6). Signs that led to reinstituting therapy were fever (OR 3.13, P = .001) and incisional inflammation/infection (OR 2.95, P = .001). Horses in which treatment was reinstituted had 2.3 greater odds of shedding Salmonella (P = .003). Increased surgical time was associated with longer duration of antimicrobial therapy (OR 1.02, P = .001).Conclusions and Clinical Relevance: Despite published recommendations regarding antimicrobial prophylaxis, compliance is poor; improvement might reduce postoperative complications.

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Section: Suggested Guidelines For Antimicrobial Prophylaxis In Patienmentioning

confidence: 99%

Antimicrobial Use in Horses Undergoing Colic Surgery

Schaer

Linton

Aceto

2012

Veterinary Internal Medicne

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“…In all cases, this panel included culture for Salmonella spp. by selective enrichment in selenite cystine broth, 14 detection of viruses by electron microscopy and rotavirus ELISA, a detection of C. difficile toxin A and B by ELISA, b anaerobic culture for C. perfringens, detection of Cryptosporidium spp. by modified acid-fast stain, c and detection of gastrointestinal parasite ova by flotation.…”

Section: Animalsmentioning

confidence: 99%

Infectious Agents Detected in the Feces of Diarrheic Foals: A Retrospective Study of 233 Cases (2003–2008)

Frederick

Giguère

Sanchez

2009

Veterinary Internal Medicne

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Background: Diarrhea is common in foals but there are no studies investigating the relative prevalence of common infectious agents in a population of hospitalized diarrheic foals.Objectives: To determine the frequency of detection of infectious agents in a population of hospitalized foals with diarrhea and to determine if detection of specific pathogens is associated with age, outcome, or clinicopathologic data.Animals: Two hundred and thirty-three foals 10 months of age with diarrhea examined at a referral institution. Methods: Retrospective case series. Each foal was examined for Salmonella spp., viruses, Clostridium difficile toxins, Clostridium perfringens culture, C. perfringens enterotoxin, Cryptosporidium spp., and metazoan parasites in feces collected at admission or at the onset of diarrhea.Results: At least 1 infectious agent was detected in 122 foals (55%). Rotavirus was most frequently detected (20%) followed by C. perfringens (18%), Salmonella spp. (12%), and C. difficile (5%). Foals o 1 month of age were significantly more likely to be positive for C. perfringens (odds ratio [OR] 5 15, 95% confidence interval [CI] 5 3.5-66) or to have negative fecal diagnostic results (OR 5 3.0, 95% CI 5 1.7-5.2) than older foals. Foals 4 1 month of age were significantly more likely to have Salmonella spp. (OR 5 2.6, 95% CI 5 1.2-6.0), rotavirus (OR 5 13.3, 95% CI 5 5.3-33), and parasites (OR 5 23, 95% CI 5 3.1-185) detected compared with younger foals. Overall 191 of the 223 foals (87%) survived. The type of infectious agent identified in the feces or bacteremia was not significantly associated with survival.Conclusions and Clinical Importance: In the population studied, foals with diarrhea had a good prognosis regardless of which infectious agent was identified in the feces.

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“…Risk factors for nosocomial Salmonella infection among hospitalized horses include colic as the reason for admission (Hird et al 1984, House et al 1999, abdominal surgery (Ekiri et al 2009), parenteral antimicrobial drug administration (Hird et al 1984, House et al 1999, nasogastric intubation (Hird et al 1984), increased mean daily ambient temperature (House et al 1999), and shedding of the same Salmonella serovar by other equine patients in the days prior to admission (House et al 1999). The establishment of Salmonella transmission as nosocomial in origin requires a combination of historical, clinical, and laboratory data.…”

Section: Introductionmentioning

confidence: 99%

Salmonella entericaSerovar Oranienburg Outbreak in a Veterinary Medical Teaching Hospital with Evidence of Nosocomial and On-Farm Transmission

Cummings

Rodriguez‐Rivera

Mitchell

et al. 2014

Vector-Borne and Zoonotic Diseases

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Nosocomial salmonellosis continues to pose an important threat to veterinary medical teaching hospitals. The objectives of this study were to describe an outbreak of salmonellosis caused by Salmonella enterica serovar Oranienburg within our hospital and to highlight its unique features, which can be used to help mitigate or prevent nosocomial outbreaks in the future. We retrospectively analyzed data from patients that were fecal culture-positive for Salmonella Oranienburg between January 1, 2006, and June 1, 2011, including historical, clinical, and pulsed-field gel electrophoresis (PFGE) data. Salmonella Oranienburg was identified in 20 horses, five alpacas, and three cows during this time frame, with dates of admission spanning the period from August, 2006, through January, 2008. We consider most of these patients to have become infected through either nosocomial or on-farm transmission, as evidenced by molecular subtyping results and supportive epidemiologic data. Interpretation of PFGE results in this outbreak was challenging because of the identification of several closely related Salmonella Oranienburg subtypes. Furthermore, a high percentage of cases were fecal culture-positive for Salmonella Oranienburg within 24 h of admission. These patients initially appeared to represent new introductions of Salmonella into the hospital, but closer inspection of their medical records revealed epidemiologic links to the hospital following the index case. Cessation of this outbreak was observed following efforts to further heighten biosecurity efforts, with no known cases or positive environmental samples after January, 2008. This study demonstrates that a Salmonella-positive culture result within 24 h of admission does not exclude the hospital as the source of infection, and it underscores the important role played by veterinary medical teaching hospitals as nodes of Salmonella infection that can promote transmission outside of the hospital setting. Nosocomial salmonellosis continues to pose an important threat to veterinary medical teaching hospitals.

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Epidemiologic analysis of nosocomial Salmonella infections in hospitalized horses

Cited by 47 publications

References 19 publications

Antimicrobial Use in Horses Undergoing Colic Surgery

Antimicrobial Use in Horses Undergoing Colic Surgery

Infectious Agents Detected in the Feces of Diarrheic Foals: A Retrospective Study of 233 Cases (2003–2008)

Salmonella entericaSerovar Oranienburg Outbreak in a Veterinary Medical Teaching Hospital with Evidence of Nosocomial and On-Farm Transmission

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