Pneumonia in horses is a respiratory condition characterized by inflammation of the lungs, often caused by bacterial, viral, or fungal infections. It can affect horses of all ages, though young and immunocompromised animals are more susceptible. Clinical signs of pneumonia in horses may include coughing, nasal discharge, fever, and labored breathing. Diagnosis typically involves a combination of clinical examination, imaging techniques such as radiography or ultrasonography, and laboratory tests including blood work and microbial cultures. Treatment strategies vary depending on the underlying cause and may involve antimicrobial therapy, supportive care, and environmental management. This page compiles peer-reviewed research studies and scholarly articles that explore the etiology, pathophysiology, diagnosis, and treatment of pneumonia in equine populations.
Vernaccini M, de Marchi L, Bindi F, Meucci V, Sala G, Cingottini D, Sgorbini M.Antibiotics are essential in veterinary medicine, enhancing animal health and welfare. However, widespread use contributes to resistance, increasing the risk of treatment failure and the transmission to humans. Objective: Analyze antibiotic prescribing practices in an equine internal medicine unit, focusing on factors influencing use, particularly Highest Priority Critically Important Antimicrobials (HPCIAs). Methods: 1315 adult equids, including horses, donkeys and mules, presented for different diseases to the Veterinary Teaching Hospital (VTH) of the University of Pisa from 2011 to 2023. Re...
Sayre KC, Flores-Ahlschwede P, Wethington AB, Kahn SK, Bray JM, Volding DM, Ahlschwede S, Bordin AI, Cohen ND, Welsh TH.Transfusion of Rhodococcus equi hyperimmune plasma (REHIP) to neonatal foals is done to reduce the incidence of rhodococcal pneumonia. Objective: To determine effects in newborn foals of REHIP transfusion on serum cortisol concentrations; the association of serum cortisol concentrations with serum globulin concentration and anti-rhodococcal immunoglobulin activity; and cumulative incidence of rhodococcal pneumonia. Methods: Serum samples were collected from 356 newborn foals from 13 New York farms immediately before and after transfusion of 1 L or 2 L of REHIP. Serum samples were assayed for c...
Calero IM, McKenzie EC, Johns JL.This report describes the diagnosis and successful management of a yearling filly with Coombs-positive anemia, thrombocytopenia, and fungal pneumonia. Diagnostic procedures, including thoracic ultrasonography and radiography, respiratory pathogen PCR testing, and evaluation of tracheal wash and bronchoalveolar lavage samples established multi-pathogen lower respiratory tract infection including a fungal agent. Orally administered voriconazole was a key component of treatment in this case to successfully eliminate fungal infection, alongside therapies for managing hematologic disease. This case...
Berghaus LJ, Venner M, Helbig H, Hildebrandt D, Hart K.Rhodococcus equi causes pneumonia in young foals, but disease susceptibility and severity vary. Cortisol and vitamin D modulate immune responses and cytokine production during bacterial infection, and altered concentrations are associated with sepsis in neonatal foals. We hypothesised an age and disease effect on circulating steroid hormone concentrations in foals, and that differences in cytokines and steroid hormone concentrations would predict disease severity in pneumonic foals. Objective: To investigate circulating concentrations of various cytokines, cortisol and vitamin D as predictors ...
Hildebrandt D, Venner M, Hart KA, Berghaus L.Early and specific diagnosis of bronchopneumonia in foals is important to prevent severe disease. In human medicine, C-reactive protein (CRP) and interleukin-6 (IL-6) are important diagnostic and prognostic biomarkers in neonatal pneumonia in other species. Evaluation of these markers in foals with naturally occurring respiratory diseases is lacking. Objective: To determine if CRP and IL-6 were useful predictors of respiratory disease in foals from birth to weaning. Methods: Prospective cohort study. Methods: Periodic blood samples from 200 initially healthy foals were collected from birth to ...
Rossi HS, Mykkänen AK, Teppo AM, Junnila JJT, Hyytiäinen HK.Pneumonia is a common condition in young, hospitalized foals, causing accumulation of inflammatory secretions to the airways. In humans, respiratory physiotherapy is commonly used as a supplementary treatment for pneumonia with varying results regarding its efficacy, but the efficacy in foals has not been assessed to date. Objective: This study aimed to evaluate the safety and efficacy of respiratory physiotherapy as a supplementary therapy method for young foals with pneumonia. Methods: A total of 44 foals with pneumonia aged under a month were used. The prospective intervention group receivi...
Baptiste KE, Kyvsgaard NC, Ahmed MO, Damborg P, Dowling PM.Rifampin is an enigma among antimicrobials. Blood and tissue compartment concentrations are a "moving target" along the treatment course due to the complex pharmacodynamic interactions within the body. Rifampin concomitant therapies are for the prevention and treatment of Rhodococcus equi infection in foals, for nearly 40 years. The necessity of rifampin concomitant therapies is based on beliefs that both antimicrobials (e.g., rifampin plus macrolide) penetrate into pulmonary abscesses and intracellular compartments above R. equi minimum inhibitory concentrations (MICs), as well as better ef...
Legere RM, Ott JA, Poveda C, Vanover D, Borba KER, Yeon Joo J, Martin CL, da Silveira BP, Bray JM, Landrock K, Wright GA, Blazier JC, Hillhouse AE....Inhalation of Rhodococcus equi causes severe pneumonia in humans and animals worldwide, most commonly affecting horse foals. The standard for preventing R. equi pneumonia in foals is transfusion of hyperimmune plasma, which is expensive and carries the risk of adverse effects. Our goal was to passively immunize foals against R. equi by nebulizing mRNA encoding an equine monoclonal antibody (mAb) against the virulence-associated protein A (VapA) directly into the lungs. VapA-specific memory B cells from an immunized horse were used to identify and select the sequence for an equine immunoglobuli...
da Silveira BP, Kahn SK, Legere RM, Bray JM, Cole-Pfeiffer HM, Golding MC, Cohen ND, Bordin AI.Using a horse foal model, we show that enteral immunization of newborn foals with Rhodococcus equi overcomes neonatal vaccination challenges by reprogramming innate immune responses, inducing R. equi-specific adaptive humoral and cell-mediated immune responses and protecting foals against experimental pneumonia challenge. Foals were immunized twice via gavage of R. equi (immunized group) or saline (control group) at ages 1 and 3 days. At age 28 days, all foals were challenged intrabronchially with R. equi. Post-challenge, all 5 immunized foals remained healthy, whereas 67% (4/6) of control foa...
Golen GS, Erganiş O, Balevi A. is an important bacterial pathogen and causes severe chronic granulomatous pneumonia in foals below 6 months of age. It has also become an opportunistic and emerging pathogen in immunocompromised humans. Vaccination is the most cost-effective strategy for controlling and preventing this infection. Although several potential virulence genes and candidate immunogens have been identified over the years, no effective vaccine is currently available to prevent disease in horses. Recently, bacterial vector vaccines have been shown to be promising for In this study, the gene of was cloned into P...
Rivera Maza S, Bishop RC, Austin SM, Foreman JH, Wilkins PA.Meconium impaction/retention is a significant cause of colic in foals. Historically, limitations of both medical and surgical treatment are noted. Outcomes of meconium impaction/retention have not recently been reported. Unassigned: To describe case characteristics and outcomes in foals with meconium impaction/retention. Unassigned: Retrospective, single referral hospital. Unassigned: Medical records from 2006 to 2024 were searched for foals ≤3 days old with a history of straining to defecate, abdominal distention, colic, weakness and/or tail flagging. Signalment, presenting complaint, treat...
Hepworth-Warren KL, Love K.Bacterial pneumonia is a common disease in adult horses, but there are no guidelines for practitioners regarding risk factors, diagnosis, and management of the disease. The objectives of this study were to describe how a group of equine veterinarians diagnose and treat bacterial pneumonia in adult horses. A 22-question survey was distributed via multiple platforms to equine veterinarians asking questions regarding the frequency with which they identified specific clinical findings and used certain diagnostic modalities, and the approach to antimicrobial and adjunct therapy. Three hundred nine ...
Rossi HS, Hyytiäinen HK, Junnila JJT, Rajamäki MM, Mykkänen AK.Pneumonia is a common condition in ailing neonatal foals, and it remains an important cause of morbidity and mortality in this veterinary patient group. Factors affecting the survival of young foals with pneumonia have not been thoroughly investigated. The aim of this study was to explore the potential prognostic factors associated with survival of these foals. Fifty foals under one month of age with pneumonia were included in this retrospective clinical study. The foals were divided into groups based on survival (survived to discharge or died/euthanised during hospitalisation). Multiple clini...
Egli P, Boone L, Huber L, Higgins C, Gaonkar PP, Arrington J, Naskou MC, Peroni J, Gordon J, Lascola KM.Platelet lysate (PL) demonstrates antimicrobial and anti-inflammatory properties offering potential for treatment of bacterial pneumonia in horses. It remains unknown whether nebulization is suitable for PL administration in horses. This pilot study characterized particle size and flow rate of pooled equine PL (single preparation) nebulized using an equine-specific nebulizer (Flexivent®). Unassigned: Protein composition and antimicrobial activity were compared before and after nebulization. Protein composition was evaluated according to growth factor, antimicrobial peptide and cytokine concen...
da Silveira BP, Cohen ND, Lawhon SD, Watson RO, Bordin AI.Rhodococcus equi causes pyogranulomatous pneumonia in foals and immunocompromised people. Despite decades of research efforts, no vaccine is available against this common cause of disease and death in foals. The purpose of this narrative review is to summarise the current understanding of interactions between R. equi and the host innate immune system, to describe features of the immune response that are associated with resistance or susceptibility to R. equi infection, and help guide strategies for developing novel approaches for preventing R. equi infections. Virulence of R. equi in foals has...
Lee J, Mordoh S, Mirza M, Carossino M, Del Piero F.An 18-y-old American Saddlebred mare was admitted with fever and acute onset of neurologic signs including grade 3 of 5 ataxia, difficulty in prehension, and dull mentation. Because of financial restraints, desired testing could not be performed; the horse's condition declined despite supportive treatment, and euthanasia was elected. Postmortem examination revealed petechiae and ecchymoses in the meninges and neuroparenchyma of the encephalon. Blast-like neoplastic round cells were identified within the vasculature and areas of hemorrhage in the neuroparenchyma, the intestinal submucosa, and o...
Woodrow JS, Palmisano M, Kulp J, Hopster K.Complications from general anesthesia, including pneumonia and decreased wound healing, are influenced by changes in immune cell function secondary to sedatives and anesthetics. It was hypothesized that immune cell function would be depressed in the early postanesthetic period. The objective was to investigate airway immune cell function before and after a general anesthetic episode in an equine in vivo model using ex vivo cell stimulations with lipopolysaccharide (LPS) for assessment of immune function. Methods: Prospective experimental study. Methods: Six healthy, adult, institution-owned ...
Deniz Ö, Ekinci G, Onmaz AC, Derelli FM, Fazio F, Aragona F, Hoven RVD.Rhodococcus equi (R. equi), a gram-positive facultative intracellular pathogen, is a common cause of pneumonia in foals and represents a major cause of disease and death. The aim of the present study was to investigate the time-depended changes in White Blood Cells (WBC), basophils (Baso), neutrophils (Neu), lymphocytes (Lymf), monocytes (Mon), eosinophils (Eos), platelet (PLT) counts, fibrinogen (Fbg) concentration, interferon (IFN-α, IFN-γ) and interleukins (IL-2 and IL-10) in foals with clinical R. equi pneumonia. The main treatment was with azithromycin-rifampicin for 14 days. Blood was ...
Sun J, Xu X, Gao S, Pan Q, Liu Z, Huang Y, Lian Y.Prevotella heparinolytica is a Gram-negative bacterium that is commonly found in the oral, intestinal, and urinary tracts. It has been extensively studied in lower respiratory tract infections in horses, which has heparinolytic activity and can secrete heparinase and further induces virulence factors in cells and causes disease. However, no such cases have been reported in humans. Methods: A 58-year-old male patient from China presented to the respiratory clinic in Suzhou with a productive cough producing white sputum for 20 days and fever for 3 days. Prior to this visit, a chest computed to...
Melo UP, Ferreira C, Barreto SWM.Respiratory diseases considerably affect equine athletes, being the second most common cause of poor performance. Among these diseases, fungal pneumonia in horses, caused specifically by Aspergillus spp., is relatively rare but potentially fatal. Fungal pneumonia typically affects horses exposed to fungal elements due to environmental factors, immunosuppression, or previous debilitating illnesses. Treatment is complex, with minimal success due to late diagnosis and serious concomitant underlying diseases. The choice of medication depends on the site of infection, the fungal species involved, a...
Berghaus LJ, Cathcart J, Berghaus RD, Ryan C, Toribio RE, Hart KA.Rhodococcus equi (R. equi), a pneumonia-causing intracellular bacterium, results in significant morbidity and mortality in young foals, while healthy adult horses rarely develop disease. Survival and replication within alveolar macrophages (AMφ) are the hallmarks of R. equi's pathogenicity. The vitamin D receptor (VDR) and its ligand, the active vitamin D metabolite 1,25(OH)2D, are important in immune responses to intracellular bacteria. The vitamin D/VDR pathway regulates the downstream production of cytokines in infected human AMφ. The immunomodulatory role of the vitamin D/VDR pathway in ...
Laclaire AL, Manguin E, Tanquerel L.Effects of general anesthesia with controlled ventilation on the respiratory system have had limited evaluation in horses. A prospective observational study was performed with eleven client-owned horses undergoing elective surgery. Physical examination, auscultation with a rebreathing bag, complete blood cell count, lung ultrasound imaging, tracheal endoscopy imaging and transendoscopic tracheal wash were conducted before and 24 hours after anesthesia. Lung ultrasound imaging was also repeated just after recovery. A significant increase in blood neutrophil count between pre- and post-anesthesi...
İncili CA, Eröksüz Y, Otlu B, Kara E, Tanrıverdi ES, Timurkan MÖ, Kalender H, Eröksüz H.Moellerella wisconsensis is a Gram-negative, facultative anaerobic bacillus of Entero-bacteriaceae family, and it is an uncommon pathogen in domestic animals. To date, five cases were reported including two dogs, two cattle, and a goat. Streptococcus equisimilis is the second common bacterial agent after the S. equi subsp. zooepidemicus in equine pneumonia cases. The present report describes the isolation of M. wisconses from lungs and spleen of a 10-year-old Arabian horse (May 08, 2022) at post-mortem examination being co-infected with S. equisimilis. Clinical and pathological findings includ...
Rakowska A, Czopowicz M, Bereznowski A, Witkowski L.Rhodococcus equi is a widely recognized bacterium responsible for pneumonia in preweaned foals. On endemic farms, foals with a subclinical course of the disease usually outnumber those presenting clinical signs. The disease is typically chronic and mainly manifests as fever and dyspnoea. Currently, field diagnosis is often based on lung ultrasound (LUS); however, both diagnostic and therapeutic approaches vary among practitioners and considerably change over time. This longitudinal, prospective study was designed to describe the appearance and progression of rhodococcal pulmonary lesions durin...
Tsuzuki N, Maruko T, Takeyama A, Ikeda H, Mizuguchi Y.Forty-five foals with Rhodococcus equi infection and pneumonia symptoms were classified into a surviving group and a dead group. Using serum samples, the oxidative stress index (OSI) was determined at the first visit and the follow-up visit. The OSI of the surviving group was significantly lower at the follow-up than that at the first visit. No significant difference was observed between the OSI of the dead group at the first and follow-up visits. In the surviving group, treatment at the first visit mitigated inflammation and reduced OSI. However, in the dead group, poor response to the treatm...
Bohlman T, Waddell H, Schumaker B.The occurrence of zoonotic infections following an animal exposure continues to be an important consideration for all patients, especially those within agricultural communities. Streptococcus equi subspecies equi (S. equi subsp. equi) is a bacteria known to cause a common infection called 'Strangles' in horses. This article highlights a new case of pneumonia and bacteremia in a patient caused by S. equi subsp. equi following strangles exposure in a horse. Rarely has there been reported horse to human transmission of subsp. equi. Methods: A 70-year-old woman attended a rural emergency departmen...
Hepworth-Warren KL, Estell K, Cowles B, Amodie D, Crisman M.Serum amyloid A (SAA) is a major acute phase protein in horses which could be a useful tool for assessing clinical response to treatment of bacterial pneumonia in adult horses.
Bergmann R, Schroedl W, Müller U, Baums CG.Streptococcus equi subsp. zooepidemicus (SEZ) is a major equine pathogen that causes pneumonia, abortion, and polyarthritis. It can also cause invasive infections in humans. SEZ expresses the M-like protein SzM, which recruits host proteins such as fibrinogen to the bacterial surface. Equine SEZ strain C2, which binds only comparably low amounts of human fibrinogen in comparison to human SEZ strain C33, was previously shown to proliferate in equine and human blood. As the expression of SzM_C2 was necessary for survival in blood, this study investigated the working hypothesis that SzM_C2 inhibi...
Zúñiga MP, Badillo E, Abalos P, Valencia ED, Marín P, Escudero E, Galecio JS.Rhodococcus equi is responsible for foal pneumonia worldwide, with a significant economic impact on the production and breeding of horses. In Chile, the first case was reported in 2000, and since then, its incidence has been increasing. Distinctive characteristics of R. equi as an intracellular pathogen in macrophages, emergence of virulence plasmids encoding surface lipoprotein antigens, and appearance of antibiotic resistance against macrolides and rifampicin have significantly complicated the treatment of R. equi pneumonia in foals. Therefore, in vitro susceptibility studies of first-line a...
Higgins C, Huber L.Rhodococcus equi, a gram-positive facultative intracellular pathogen and a soil saprophyte, is one of the most common causes of pneumonia in young foals. It poses a threat to the economy in endemic horse-breeding farms and to animal welfare annually. Many farms use thoracic ultrasonographic screening and antimicrobial treatment of subclinically affected foals as a preventive measure against severe R. equi infections. The wide use antimicrobials to treat subclinically affected foals has contributed to the emergence of multidrug resistant (MDR)-R. equi in both clinical isolates from sick foals a...
Lykkesfeldt J, Svendsen O.Important infectious diseases in farm animals, such as pneumonia and enteritis, are thought to be associated with the so-called oxidative stress, i.e. a chemical phenomenon involving an imbalance in the redox status of the individual animal. The specifics of oxidative stress and how it may result in disease or be prevented are complex questions with no simple answers. However, the considerable literature on the subject suggests that many researchers consider oxidative stress-related mechanisms to be important early events in disease development. A particularly intriguing aspect is that, at lea...
Prescott JF.Recent isolations of Rhodococcus equi from cavitatory pulmonary disease in patients with AIDS have aroused interest among medical microbiologists in this unusual organism. Earlier isolations from humans had also been in immunosuppressed patients following hemolymphatic tumors or renal transplantation. This organism has been recognized for many years as a cause of a serious pyogranulomatous pneumonia of young foals and is occasionally isolated from granulomatous lesions in several other species, in some cases following immunosuppression. The last decade has seen many advances in understanding o...
Witte W, Strommenger B, Stanek C, Cuny C.Methicillin-resistant Staphylococcus aureus of clonal lineage ST398 that exhibits related spa types and contains SCCmec elements of types IVa or V has been isolated from colonized and infected humans and companion animals (e.g., dog, pig, horse) in Germany and Austria. Of particular concern is the association of these cases with cases of nosocomial ventilator-associated pneumonia.
Hondalus MK, Mosser DM.Rhodococcus equi is a facultative intracellular bacterium of macrophages that can cause serious pneumonia in both young horses and immunocompromised people. Essential to understanding rhodococcus pathogenesis is a quantitative documentation of the intracellular events that follow macrophage phagocytosis of the organism. By using a bacterial immunofluorescence staining assay, we verified the intracellular survival and replicative potential of R. equi in both murine peritoneal macrophages and equine alveolar macrophages in vitro. Following an initial lag period of 6 to 12 h, the intracellular nu...
Giguère S, Cohen ND, Chaffin MK, Hines SA, Hondalus MK, Prescott JF, Slovis NM.Pneumonia is a major cause of disease and death in foals. Rhodococcus equi, a gram-positive facultative intracellular pathogen, is a common cause of pneumonia in foals. This article reviews the clinical manifestations of infection caused by R. equi in foals and summarizes current knowledge regarding mechanisms of virulence of, and immunity to, R. equi. A complementary consensus statement providing recommendations for the diagnosis, treatment, control, and prevention of infections caused by R. equi in foals can be found in the same issue of the Journal.
Giguère S, Cohen ND, Chaffin MK, Slovis NM, Hondalus MK, Hines SA, Prescott JF.Rhodococcus equi, a gram-positive facultative intracellular pathogen, is one of the most common causes of pneumonia in foals. Although R. equi can be cultured from the environment of virtually all horse farms, the clinical disease in foals is endemic at some farms, sporadic at others, and unrecognized at many. On farms where the disease is endemic, costs associated with morbidity and mortality attributable to R. equi may be very high. The purpose of this consensus statement is to provide recommendations regarding the diagnosis, treatment, control, and prevention of infections caused by R. equi...
Meijer WG, Prescott JF.Rhodococcus equi is an important cause of subacute or chronic abscessating bronchopneumonia of foals up to 3-5 months of age. It shares the lipid-rich cell wall envelope characteristic of the mycolata, including Mycobacterium tuberculosis, as well as the ability of pathogenic members of this group to survive within macrophages. The possession of a large virulence plasmid in isolates recovered from pneumonic foals is crucial for virulence. The plasmid contains an 27 kb pathogenicity island (PI) that encodes seven related virulence-associated proteins (Vaps), including the immunodominant surface...
Hondalus MK.Inhalation of the soil-borne organism, Rhodococcus equi, can lead to a chronic and severe pyogranulomatous pneumonia in young horses and immunocompromised people. In addition, ulcerative colitis is a common sequela to infection in foals, and dissemination from the lung to other body sites is not uncommon in either the horse or man. Although the facultative intracellular bacterium is susceptible to neutrophil-mediated killing, it is able to resist innate macrophage defenses and establish residence within the intracellular environment of that phagocyte. Definitive virulence factors of R. equi ha...
Muscatello G, Leadon DP, Klayt M, Ocampo-Sosa A, Lewis DA, Fogarty U, Buckley T, Gilkerson JR, Meijer WG, Vazquez-Boland JA.Infection with Rhodococcus (Corynebacterium) equi is a well-recognised condition in foals that represents a consistent and serious risk worldwide. The condition manifests itself primarily as one of pulmonary abscessation and bronchitis, hence the terminology of 'rattles' derived from its most obvious clinical sign, frequently terminal when first identified. This review addresses the clinical manifestation, bacteriology and pathogenesis of the condition together with recent developments providing knowledge of the organism in terms of virulence, epidemiology, transmission and immune responses. E...
van der Geize R, Grommen AW, Hessels GI, Jacobs AA, Dijkhuizen L.Rhodococcus equi causes fatal pyogranulomatous pneumonia in foals and immunocompromised animals and humans. Despite its importance, there is currently no effective vaccine against the disease. The actinobacteria R. equi and the human pathogen Mycobacterium tuberculosis are related, and both cause pulmonary diseases. Recently, we have shown that essential steps in the cholesterol catabolic pathway are involved in the pathogenicity of M. tuberculosis. Bioinformatic analysis revealed the presence of a similar cholesterol catabolic gene cluster in R. equi. Orthologs of predicted M. tuberculosis vi...
Cohen ND.A prospective study was conducted to describe the causes of and farm management factors associated with disease and death in a population of foals in Texas. Data from 2,468 foals at 167 farms were provided by veterinarians for all 12 months during 1991. Among 2,468 foals, 116 deaths were reported (4.7%). Pneumonia was the most commonly reported cause of death, followed by septicemia. When considered as a group, musculoskeletal disorders (traumatic, infectious, or deforming problems) represented the most common cause of all reported deaths. Daily risk of death was greatest during the first 7 da...
Giguère S, Lee E, Williams E, Cohen ND, Chaffin MK, Halbert N, Martens RJ, Franklin RP, Clark CC, Slovis NM.To determine the prevalence of antimicrobial resistance to macrolide antimicrobials or rifampin in Rhodococcus equi isolates and to describe treatment outcome in foals infected with antimicrobial-resistant isolates of R equi. Methods: Cross-sectional study. Methods: 38 isolates classified as resistant to macrolide antimicrobials or rifampin received from 9 veterinary diagnostic laboratories between January 1997 and December 2008. Methods: For each isolate, the minimum inhibitory concentration of macrolide antimicrobials (ie, azithromycin, erythromycin, and clarithromycin) and rifampin was dete...
Hillidge CJ.The selection of lipid-soluble antibiotics capable of intracellular penetration is considered critical for the successful treatment of Rhodococcus equi pneumonia and lung abscesses in foals. Two such antibiotics: erythromycin (25 mg kg-1, three times daily) and rifampin (5 mg kg-1 twice daily) have been used in combination for this purpose at the University of Florida since 1981. Positive evidence of R. equi was present on culture of tracheal aspirates in 57 foals, most of which exhibited radiographic evidence of extensive lung abscessation. The duration of therapy ranged from 4 to 9 weeks. Mi...
Byrne BA, Prescott JF, Palmer GH, Takai S, Nicholson VM, Alperin DC, Hines SA.Rhodococcus equi causes severe pyogranulomatous pneumonia in foals. This facultative intracellular pathogen produces similar lesions in immunocompromised humans, particularly in AIDS patients. Virulent strains of R. equi bear a large plasmid that is required for intracellular survival within macrophages and for virulence in foals and mice. Only two plasmid-encoded proteins have been described previously; a 15- to 17-kDa surface protein designated virulence-associated protein A (VapA) and an antigenically related 20-kDa protein (herein designated VapB). These two proteins are not expressed by t...
Padalino B, Raidal SL, Knight P, Celi P, Jeffcott L, Muscatello G.This study aimed to document the effects of an eight hour journey on behavioural, clinical, haematological, environmental and respiratory parameters, and to identify possible associations between factors. Twelve horses underwent clinical examination, respiratory endoscopy with tracheal wash (TW) aspiration, and collection of venous and arterial blood before (BJ) and after the journey (AJ). TW were submitted for conventional quantitative bacteriological evaluation and genetic microbiome analyses. Behaviour was assessed in stables prior to transportation and throughout the journey. Transportatio...
Venner M, Rödiger A, Laemmer M, Giguère S.Mass antimicrobial treatment of foals with small ultrasonographic pulmonary lesions is common on farms with endemic disease caused by Rhodococcus equi. The objectives of this study were to compare the relative efficacy of three antimicrobial protocols for the treatment of pulmonary abscesses on a farm with endemic infections caused by R. equi and to determine the frequency of spontaneous resolution of subclinical pulmonary lesions. Foals with ultrasonographic evidence of pulmonary abscesses ≥ 1.0 cm in diameter (n=128) were randomly allocated to one of four equal treatment groups. Animals wi...
Ashour J, Hondalus MK.Rhodococcus equi is a facultative intracellular opportunistic pathogen of immunocompromised people and a major cause of pneumonia in young horses. An effective live attenuated vaccine would be extremely useful in the prevention of R. equi disease in horses. Toward that end, we have developed an efficient transposon mutagenesis system that makes use of a Himar1 minitransposon delivered by a conditionally replicating plasmid for construction of R. equi mutants. We show that Himar1 transposition in R. equi is random and needs no apparent consensus sequence beyond the required TA dinucleotide. The...
Hultén C, Demmers S.Differentiation between infectious and noninfectious disease and rapid initiation of accurate treatment are essential in managing diseases in the neonatal and young foal. Identification of useful inflammatory markers for these purposes is, therefore, of great importance. The aim of this study was to compare the responses of the acute phase protein serum amyloid A (SAA) with the responses of fibrinogen and total leucocyte and neutrophil counts in infectious diseases encountered in the young foal, and to assess whether SAA measurements give additional information useful in the management of thes...
Yager JA.The pathogenesis of Rhodococcus equi pneumonia in foals is reviewed. The main routes of infection are respiratory and alimentary. The latter is probably the chief route of exposure in all foals and probably leads to development of specific immunity. Susceptible foals, those whose maternal immunity wanes before generation of their own immune response, readily develop disease if exposed aerogenously to sufficient numbers of R. equi. Management and environmental circumstances have a major role to play in determining the magnitude of this challenge and, therefore, in the prevalence of the disease....
Kanaly ST, Hines SA, Palmer GH.Rhodococcus equi, a facultative intracellular bacterium, causes chronic, often fatal granulomatous pneumonia in young horses and in humans with AIDS. The inability of host alveolar macrophages to kill intracellular R. equi results in the development of granulomas and progressive loss of pulmonary parenchyma. Clearance of the organism from the lung requires functional CD4+ T cells. The purpose of this study was to identify the cytokine effector mechanisms that mediate clearance of R. equi from the lung. Mice were treated with monoclonal antibodies (MAbs) to either gamma interferon (IFN-gamma) o...
Cywes-Bentley C, Rocha JN, Bordin AI, Vinacur M, Rehman S, Zaidi TS, Meyer M, Anthony S, Lambert M, Vlock DR, Giguère S, Cohen ND, Pier GB.Immune correlates of protection against intracellular bacterial pathogens are largely thought to be cell-mediated, although a reasonable amount of data supports a role for antibody-mediated protection. To define a role for antibody-mediated immunity against an intracellular pathogen, Rhodococcus equi, that causes granulomatous pneumonia in horse foals, we devised and tested an experimental system relying solely on antibody-mediated protection against this host-specific etiologic agent. Immunity was induced by vaccinating pregnant mares 6 and 3 weeks prior to predicted parturition with a conjug...
Martens RJ, Martens JG, Fiske RA, Hietala SK.The immunoprophylactic capacity of specific immune plasma was evaluated in pony foals infected experimentally with Rhodococcus equi. Immune plasma, produced by repeated parenteral administration of viable R. equi to adult horses, was harvested and frozen. Group I (six control foals) and Group II (six principal foals) received lactated Ringers solution and immune plasma respectively at three and five days of age. R. equi were aerosolised into a caudal lung lobe of all foals at seven days of age. Clinical signs, haematological alterations, immune responses, thoracic radiographs and technetium99m...
Huber L, Giguère S, Slovis NM, Carter CN, Barr BS, Cohen ND, Elam J, Erol E, Locke SJ, Phillips ED, Smith JL.The objective of this study was to determine the prevalence of strains resistant to macrolides and rifampin over time in clinical samples from foals submitted to diagnostic laboratories in central Kentucky. We performed a retrospective observational study of all clinical samples from foals that were submitted to veterinary diagnostic laboratories in Kentucky between January 1995 and December 2017. Samples were included if the bacterium was cultured and tested for susceptibility to erythromycin or rifampin. susceptibility testing to erythromycin was available for 2,169 isolates of , while s...
Padalino B, Raidal SL, Hall E, Knight P, Celi P, Jeffcott L, Muscatello G.An online survey was conducted to determine associations between transport management and transport-related injuries and diseases in horses in Australia. The survey was composed of three sections: respondents' demographic information, transport management strategies or procedures (before, during and after transportation) and transport diseases experienced in the previous two year period. Univariate and multivariate modelling was performed exploring associations between variables (respondents' details and transport management strategies) and the following transport-related diseases as outcomes:...
Wada R, Kamada M, Anzai T, Nakanishi A, Kanemaru T, Takai S, Tsubaki S.Twelve foals, between 27 and 83 days old, were infected with 2 strains of Rhodococcus equi by intratracheal administration. Ten of the 12 foals were inoculated with 10(4)-10(10) colony forming units (cfu) of ATCC 33701 strain. The other 2 foals were inoculated with 10(9) cfu of a plasmid-cured derivative of the ATCC 33701 strain (ATCC 33701P-). All of the 10 foals challenged with the ATCC 33701 strain showed clinical signs of pulmonary disease within 5-13 days, such as gross lesions associated with acute bronchopneumonia and microscopic lesions associated with granulomatous pneumonia. The two ...
Hines SA, Stone DM, Hines MT, Alperin DC, Knowles DP, Norton LK, Hamilton MJ, Davis WC, McGuire TC.Rhodococcus equi is a gram-positive bacterium that infects alveolar macrophages and causes rhodococcal pneumonia in horses and humans. The virulence plasmid of R. equi appears to be required for both pathogenicity in the horse and the induction of protective immunity. An understanding of the mechanisms by which virulent R. equi circumvents protective host responses and by which bacteria are ultimately cleared is important for development of an effective vaccine. Six adult horses were challenged with either virulent R. equi or an avirulent, plasmid-cured derivative. By using a flow cytometric m...
Nordengrahn A, Rusvai M, Merza M, Ekström J, Morein B, Belák S.Equine herpesvirus type 2 (EHV-2), a member of the Gammaherpesvirinae subfamily, was studied in a two-phase respiratory disease complex of young foals as a predisposing factor for the secondary bacterial invasion of lungs with Rhodococcus equi (R. equi). Foals were immunized against EHV-2 on a farm where R. equi pneumonia regularly occurred during the last years. The immunizations were performed by using a subunit vaccine which selectively presents envelope glycoproteins of EHV-2 in a multimeric form of immunostimulating complexes (iscoms). The etiological role of EHV-2 was estimated by observ...
Vo AT, van Duijkeren E, Fluit AC, Gaastra W.The aim of the present study was to contribute to the knowledge on extended-spectrum beta-lactamases (ESBL's), AmpC beta-lactamases and integrons in Enterobacteriaceae isolated from horses, which is still limited. The susceptibility of 1581 clinical isolates from animals to ceftiofur was tested. Most of these isolates (n=1347) originated from horses. Seven ceftiofur-resistant equine isolates (four Escherichia coli and three Klebsiella pneumoniae) were identified and all seven were multidrug-resistant. These isolates were further studied for the presence of ESBL's, AmpC beta-lactamases and clas...
