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Topic:Streptococcus

Streptococcus spp. are a genus of bacteria that can affect horses, leading to various infections and health conditions. These bacteria are known for causing respiratory and systemic diseases, including strangles, which is primarily caused by Streptococcus equi subsp. equi. Streptococcal infections in horses can result in symptoms such as fever, nasal discharge, and lymph node abscessation. The transmission typically occurs through direct contact with infected animals or contaminated environments. Diagnosis often involves bacterial culture or PCR testing. This page compiles peer-reviewed research studies and scholarly articles that explore the epidemiology, pathogenesis, diagnosis, and treatment of Streptococcus infections in equine populations.
Vaccination with a live multi-gene deletion strain protects horses against virulent challenge with Streptococcus equi.
Vaccine    January 15, 2015   Volume 33, Issue 9 1160-1167 doi: 10.1016/j.vaccine.2015.01.019
Robinson C, Heather Z, Slater J, Potts N, Steward KF, Maskell DJ, Fontaine MC, Lee JJ, Smith K, Waller AS.Strangles, caused by Streptococcus equi subspecies equi (S. equi) is one of the most frequently diagnosed infectious diseases of horses and there remains a significant need to develop new preventative vaccines. We generated a live vaccine strain of S. equi containing deletions in six genes: sagA, hasA, aroB, pyrC, seM and recA, which was administered to nine Welsh mountain ponies via the intramuscular route. Four vaccinated ponies developed adverse reactions following the first vaccination from which the live vaccine strain was isolated. Two of these ponies were withdrawn from the study and se...
Alpha-fetoprotein is present in the fetal fluids and is increased in plasma of mares with experimentally induced ascending placentitis.
Animal reproduction science    January 9, 2015   Volume 154 48-55 doi: 10.1016/j.anireprosci.2014.12.019
Canisso IF, Ball BA, Scoggin KE, Squires EL, Williams NM, Troedsson MH.The objectives of this study were to: (i) determine alpha-fetoprotein (AFP) concentrations in fetal fluids (FF), and (ii) compare plasma concentrations of AFP in mares with placentitis (n=17) and gestationally age-matched control mares (n=17). Fetal fluid sampling (FFS, n=7/group) was performed at 0, 5 and 12 days post inoculation (DPI) or until abortion. Plasma was harvested daily for 12 days or until abortion. Placentitis was induced via intracervical inoculation of Streptococcus equi ssp. zooepidemicus. Proteins present in the FF were resolved by 1D-SDS-PAGE, and immunoblotting was used to ...
Mastitis in a neonatal filly.
The Canadian veterinary journal = La revue veterinaire canadienne    January 8, 2015   Volume 56, Issue 1 63-65 
Gilday R, Lewis D, Lohmann KL.Neonatal mastitis is a rare occurrence in the horse. This report documents a case of mastitis caused by an organism within the Streptococcus dysgalactiae group in a 1-week-old Paint filly. Un cas de mastite chez une pouliche nouveau-née. La mastite est une maladie rare chez les pouliches nouveau-nées. Ce rapport documente un cas de la mastite causé par un organisme du groupe Streptococcus dysgalactiae qui se présente dans une pouliche Paint á l’âge de sept jours et discute la litérature pertinente au sujet de la mastite des nouveau-nés.(Traduit par les auteurs).
New perspectives for the diagnosis, control, treatment, and prevention of strangles in horses.
The Veterinary clinics of North America. Equine practice    October 6, 2014   Volume 30, Issue 3 591-607 doi: 10.1016/j.cveq.2014.08.007
Waller AS.Strangles, characterized by abscessation of the lymph nodes of the head and neck, is the most frequently diagnosed infectious disease of horses worldwide. The persistence of the causative agent, Streptococcus equi, in a proportion of convalescent horses plays a critical role in the recurrence and spread of disease. Recent research has led to the development of effective diagnostic tests that assist the eradication of S equi from local horse populations. This article describes how these advances have been made and provides advice to assist the resolution and prevention of outbreaks. New perspec...
Physiopathologic mechanisms involved in mare endometrosis.
Reproduction in domestic animals = Zuchthygiene    October 4, 2014   Volume 49 Suppl 4 82-87 doi: 10.1111/rda.12397
Rebordão MR, Galvão A, Szóstek A, Amaral A, Mateus L, Skarzynski DJ, Ferreira-Dias G.Endometrosis is a degenerative chronic process, characterized by paramount fibrosis development in mare endometrium. This condition is one of the major causes of subfertility/infertility in mares. As in other organs, fibrosis might be a pathologic sequel of many chronic inflammatory diseases. However, aetiology and physiopathologic mechanisms involved in endometrial fibrosis are still controversial. This review presents new hypotheses based on our newest data. As the first line of innate immune defence, systemic neutrophils arrive in the uterus at mating or in the presence of pathogens. A nove...
Diagnostic double-guarded low-volume uterine lavage in mares.
Theriogenology    September 17, 2014   Volume 83, Issue 2 222-227 doi: 10.1016/j.theriogenology.2014.09.008
Christoffersen M, Brandis L, Samuelsson J, Bojesen AM, Troedsson MH, Petersen MR.Endometritis constitutes a major problem in the management of broodmares; hence, diagnostic tests with a high sensitivity and specificity are highly appreciated. The aim of this study was to compare the results from endometrial, cytologic, and bacteriologic examinations obtained by a newly developed, double-guarded, flushing technique versus standard diagnostic tests, the double-guarded swab and biopsy. The described double-guarded flush technique requires the use of a disposable uterine flushing tube, a sanitary sleeve, a sterile steel speculum, and a 250 mL fluid bag. Endometrial biopsies, s...
Pulmonary pharmacokinetics of desfuroylceftiofur acetamide after nebulisation or intramuscular administration of ceftiofur sodium to weanling foals.
Equine veterinary journal    September 5, 2014   Volume 47, Issue 4 473-477 doi: 10.1111/evj.12316
Fultz L, Giguère S, Berghaus LJ, Grover GS, Merritt DA.Administration of ceftiofur sodium via nebulisation has been recommended for the treatment of bronchopneumonia in horses, despite the lack of pharmacokinetic and safety data. Objective: To compare concentrations of desfuroylceftiofur acetamide (DCA) in plasma and pulmonary epithelial lining fluid (PELF) of foals after nebulisation or i.m. administration of ceftiofur sodium and to determine if nebulisation of ceftiofur sodium induces airway inflammation. Methods: Randomised experimental study. Methods: Six weanling foals received ceftiofur sodium (2.2 mg/kg bwt daily for 5 doses) by the i.m. ...
Neutrophil extracellular traps formation by bacteria causing endometritis in the mare.
Journal of reproductive immunology    August 27, 2014   Volume 106 41-49 doi: 10.1016/j.jri.2014.08.003
Rebordão MR, Carneiro C, Alexandre-Pires G, Brito P, Pereira C, Nunes T, Galvão A, Leitão A, Vilela C, Ferreira-Dias G.Besides the classical functions, neutrophils (PMNs) are able to release DNA in response to infectious stimuli, forming neutrophil extracellular traps (NETs) and killing pathogens. The pathogenesis of endometritis in the mare is not completely understood. The aim was to evaluate the in vitro capacity of equine PMNs to secrete NETs by chemical activation, or stimulated with Streptococcus equi subspecies zooepidemicus (Szoo), Escherichia coli (Ecoli) or Staphylococcus capitis (Scap) strains obtained from mares with endometritis. Ex vivo endometrial mucus from mares with bacterial endometritis wer...
Efficacy of a Parapoxvirus ovis-based immunomodulator against equine herpesvirus type 1 and Streptococcus equi equi infections in horses.
Veterinary microbiology    July 27, 2014   Volume 173, Issue 3-4 232-240 doi: 10.1016/j.vetmic.2014.07.015
Ons E, Van Brussel L, Lane S, King V, Cullinane A, Kenna R, Lyons P, Hammond TA, Salt J, Raue R.The efficacy of Zylexis®, an immunomodulator in horses based on inactivated Parapoxvirus ovis (iPPVO), was assessed using an equine herpesvirus type 1 (EHV-1) challenge model in the presence of a natural infection with Streptococcus equi equi (S. equi). Eleven horses were treated with iPPVO and twelve were kept as controls. Six horses were challenged with EHV-1 and commingled with the horses on study. Animals were dosed on Days -2, 0 (just before commingling) and Day 7. On Day 11 significantly less nasal discharge, enlarged lymph nodes, EHV-1 shedding and lower rectal temperatures were observ...
The Antiphagocytic Activity of SeM of Streptococcus equi Requires Capsule.
Journal of equine science    June 25, 2014   Volume 25, Issue 2 53-56 doi: 10.1294/jes.25.53
Timoney JF, Suther P, Velineni S, Artiushin SC.Resistance to phagocytosis is a crucial virulence property of Streptococcus equi (Streptococcus equi subsp. equi; Se), the cause of equine strangles. The contribution and interdependence of capsule and SeM to killing in equine blood and neutrophils were investigated in naturally occurring strains of Se. Strains CF32, SF463 were capsule and SeM positive, strains Lex90, Lex93 were capsule negative and SeM positive and strains Se19, Se1-8 were capsule positive and SeM deficient. Phagocytosis and killing of Se19, Se1-8, Lex90 and Lex93 in equine blood and by neutrophils suspended in serum were sig...
Serum amyloid A and haptoglobin concentrations are increased in plasma of mares with ascending placentitis in the absence of changes in peripheral leukocyte counts or fibrinogen concentration.
American journal of reproductive immunology (New York, N.Y. : 1989)    June 11, 2014   Volume 72, Issue 4 376-385 doi: 10.1111/aji.12278
Canisso IF, Ball BA, Cray C, Williams NM, Scoggin KE, Davolli GM, Squires EL, Troedsson MH.Currently, placentitis, an important cause of late pregnancy loss in mares, is diagnosed by clinical signs and ultrasonography. Acute phase proteins (APP) are mainly produced and secreted by the liver in response to acute inflammatory stimuli. We hypothesized that APP are increased in mares with placentitis. Methods: Concentrations of serum amyloid A (SAA), haptoglobin (Hp), fibrinogen (Fb), and white blood cell counts (WBC) were determined in plasma of mares with experimentally induced placentitis and gestationally age-matched control mares. Placentitis was induced via intracervical inoculati...
Capsular hyaluronic acid of equine isolates of Streptococcus zooepidemicus is upregulated at temperatures below 35°C.
Equine veterinary journal    June 11, 2014   Volume 47, Issue 3 333-338 doi: 10.1111/evj.12272
Velineni S, Timoney JF.Streptococcus zooepidemicus causes opportunist respiratory and other infections in the horse. Capsule expression is highly variable and known to affect resistance to phagocytosis. Most clinical isolates producing small, dry colonies at 37°C produce mucoid colonies at temperatures below 35°C. Objective: The aim was to understand the molecular basis of increased capsule expression by equine isolates of S. zooepidemicus at temperatures lower than 35°C. Methods: Cross-sectional observational study. Methods: Capsule production by groups of equine S. zooepidemicus strains was determined at 23, ...
Development of a loop-mediated isothermal amplification method for detecting Streptococcus equi subsp. zooepidemicus and analysis of its use with three simple methods of extracting DNA from equine respiratory tract specimens.
The Journal of veterinary medical science    May 28, 2014   Volume 76, Issue 9 1271-1275 doi: 10.1292/jvms.14-0140
Kinoshita Y, Niwa H, Katayama Y.Streptococcus equi subsp. zooepidemicus (S. zooepidemicus) is a dominant pathogenic bacterium in equine pneumonia. We developed a specific loop-mediated isothermal amplification (LAMP) method, which targets the gene encoding sorbitol-6-phosphate 2-dehydrogenase (sorD), for detecting S. zooepidemicus and examined the clinical efficacies of its use in combination with each of 3 DNA extraction methods easily used by veterinary practitioners, namely the Loopamp PURE DNA Extraction Kit, InstaGene Matrix and a conventional boiling method. The LAMP method plus the Loopamp PURE DNA Extraction Kit gave...
Inhibition of fructan-fermenting equine faecal bacteria and Streptococcus bovis by hops (Humulus lupulus L.) β-acid.
Journal of applied microbiology    May 14, 2014   Volume 117, Issue 2 329-339 doi: 10.1111/jam.12532
Harlow BE, Lawrence LM, Kagan IA, Flythe MD.The goals of this study were to determine if β-acid from hops (Humulus lupulus L.) could be used to control fructan fermentation by equine hindgut micro-organisms, and to verify the antimicrobial mode of action on Streptococcus bovis, which has been implicated in fructan fermentation, hindgut acidosis and pasture-associated laminitis (PAL) in the horse. Results: Suspensions of uncultivated equine faecal micro-organisms produced fermentation acids when inulin (model fructan) was the substrate, but β-acid (i.e. lupulone) concentrations ≥9 ppm inhibited lactate production and mitigated the d...
Equine respiratory disease: a causal role for Streptococcus zooepidemicus.
Veterinary journal (London, England : 1997)    April 30, 2014   Volume 201, Issue 1 3-4 doi: 10.1016/j.tvjl.2014.04.013
Waller AS.No abstract available
PCR based differentiation between Streptococcus dysgalactiae subsp. equisimilis strains isolated from humans and horses.
Comparative immunology, microbiology and infectious diseases    April 26, 2014   Volume 37, Issue 3 169-172 doi: 10.1016/j.cimid.2014.04.001
Preziuso S, Pinho MD, Attili AR, Melo-Cristino J, Acke E, Midwinter AC, Cuteri V, Ramirez M.Streptococcus dysgalactiae subsp. equisimilis (SDSE) can be severely pathogenic in humans and is increasingly isolated from horses with respiratory, reproductive or other diseases, although it is often considered a commensal bacterium. Here a PCR protocol is described for identifying SDSE recovered from humans. A multiplex PCR targeting the 16S rRNA and the streptokinase precursor gene has been optimized for differentiating between SDSE strains isolated from humans and those isolated from horses. Previously, the sequence of the streptokinase precursor gene of SDSE recovered from horses has bee...
Immunology of infective preterm delivery in the mare.
Equine veterinary journal    March 21, 2014   Volume 46, Issue 6 661-668 doi: 10.1111/evj.12243
Lyle SK.Placentitis is reported to be the cause of 9.8-33.5% of abortions, stillbirths and perinatal losses in horses. Bacterial infections are responsible for 53% of placentitis cases with Streptococcus equi ssp. zooepidemicus being isolated in 28% of these cases. Clinically, mares may have a vaginal discharge, show udder development, lactate prenatally and deliver a premature or dead foal. Major aspects of the pathogenesis of infectious preterm delivery that may require more effective therapeutic targeting are myometrial contraction, immunological aspects of preterm delivery, and the effects of proi...
Characterization of a mucoid clone of Streptococcus zooepidemicus from an epizootic of equine respiratory disease in New Caledonia.
Veterinary journal (London, England : 1997)    February 1, 2014   Volume 200, Issue 1 82-87 doi: 10.1016/j.tvjl.2014.01.014
Velineni S, Desoutter D, Perchec AM, Timoney JF.Streptococcus equi subspecies zooepidemicus (Sz) is a tonsillar and mucosal commensal of healthy horses with the potential to cause opportunistic infections of the distal respiratory tract stressed by virus infection, transportation, training or high temperature. The invasive clone varies from horse to horse with little evidence of lateral transmission in the group. Tonsillar isolates are non-mucoid although primary isolates from opportunist lower respiratory tract infections may initially be mucoid. In this study, a novel stably mucoid Sz (SzNC) from a clonal epizootic of respiratory disease ...
Removal of bacteria from stallion semen by colloid centrifugation.
Animal reproduction science    January 17, 2014   Volume 145, Issue 1-2 47-53 doi: 10.1016/j.anireprosci.2014.01.005
Morrell JM, Klein C, Lundeheim N, Erol E, Troedsson MH.Bacteria (environmental contaminants and occasionally potential pathogens) are found in most stallion ejaculates and may negatively affect sperm quality during storage. Since the use of antibiotics can lead to the development of resistance, an alternative means of microbial control is desirable. The removal of bacteria from stallion semen using Single Layer Centrifugation through Androcoll-E was investigated. Known doses of cultured bacteria were added to freshly collected ejaculates (15mL aliquots) before processing by Single Layer Centrifugation. The resulting sperm pellets and controls (not...
Endometrial tissue and blood plasma concentration of ceftiofur and metabolites following intramuscular administration of ceftiofur crystalline free acid to mares.
Equine veterinary journal    December 6, 2013   Volume 46, Issue 5 606-610 doi: 10.1111/evj.12192
Scofield D, Black J, Wittenburg L, Gustafson D, Ferris R, Hatzel J, Traub-Dargatz J, McCue P.Systemic administration of ceftiofur crystalline free acid (CCFA) may be a potential treatment for infectious endometritis caused by Streptococcus equi ssp. zooepidemicus (S.  zooepidemicus) and other susceptible bacterial organisms in the mare. Objective: To determine if i.m. administration of CCFA at the label dose will exceed the minimum inhibitory concentration (MIC) of S.  zooepidemicus in the endometrium following single administration and multiple administration protocols. Methods: Experimental pharmacokinetic study. Methods: Three mares (Group 1) were administered a single i.m. dos...
Streptococcus zooepidemicus and Streptococcus equi evolution: the role of CRISPRs.
Biochemical Society transactions    November 22, 2013   Volume 41, Issue 6 1437-1443 doi: 10.1042/BST20130165
Waller AS, Robinson C.The host-restricted bacterium Streptococcus equi is the causative agent of equine strangles, the most frequently diagnosed infectious disease of horses worldwide. The disease is characterized by abscessation of the lymph nodes of the head and neck, leading to significant welfare and economic cost. S. equi is believed to have evolved from an ancestral strain of Streptococcus zooepidemicus, an opportunistic pathogen of horses and other animals. Comparison of the genome of S. equi strain 4047 with those of S. zooepidemicus identified examples of gene loss due to mutation and deletion, and gene ga...
Evidence of lateral gene transfer among strains of Streptococcus zooepidemicus in weanling horses with respiratory disease.
Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases    November 19, 2013   Volume 21 157-160 doi: 10.1016/j.meegid.2013.11.006
Velineni S, Breathnach CC, Timoney JF.Streptococcus zooepidemicus (Sz) is a tonsillar commensal of healthy horses but with potential to opportunistically invade the lower respiratory tract. Sz is genetically variable and recombinogenic based on analysis of gene sequences including szp, szm and MLST data. Although a variety of serovars of the protective SzP are commonly harbored in the tonsils of the same horse, lower respiratory infections usually involve a single clone. Nevertheless, isolation of specific clones from epizootics of respiratory disease has been recently reported in horses and dogs in N. America, Europe and Asia. In...
Purulent pericarditis and pneumonia caused by Streptococcus equi subsp. zooepidemicus.
Journal of medical microbiology    November 15, 2013   Volume 63, Issue Pt 2 313-316 doi: 10.1099/jmm.0.066290-0
Held J, Schmitz R, van der Linden M, Nührenberg T, Häcker G, Neumann FJ.Purulent pericarditis is a life-threatening disease that usually manifests following bacteraemia or through spreading from an intrathoracic focus. Only a few cases of this disease have been reported with Lancefield group C streptococci as aetiological agents, and the primary focus in these infections remains unknown. We report a case of purulent pericarditis with septic and cardiogenic shock, caused by Streptococcus equi subsp. zooepidemicus (group C) in a 51-year-old patient. The pathogen was possibly contracted through contact with horses. Most probably, it caused initially pneumonia before ...
The molecular identification of Streptococcus equi subsp. equi strains isolated within New Zealand.
New Zealand veterinary journal    October 24, 2013   Volume 62, Issue 2 63-67 doi: 10.1080/00480169.2013.841536
Patty OA, Cursons RT.To identify Streptococcus equi subsp. equi (S. equi) by PCR analysis and obtain isolates by culture, in order to investigate the strains of S. equi infecting horses within New Zealand. Methods: A diagnostic PCR, based on the amplification of the seeI gene for S. equi, was used on 168 samples submitted from horses with and without clinical signs of strangles. Samples were also processed and cultured on selective media for the isolation of β-haemolytic colonies. In addition, the hypervariable region of the seM gene of S. equi was amplified and then sequenced for strain typing purposes. Results:...
Bacteriological and Molecular Detection of Streptococcus equi subsp. equi and Streptococcus equi subsp. zooepidemicus in Equines of Northern India.
Journal of equine science    September 30, 2013   Volume 24, Issue 3 53-55 doi: 10.1294/jes.24.53
Mir IA, Kumar B, Taku A, Faridi F, Bhat MA, Baba NA, Maqbool T.Present study was undertaken to study the prevalence of β-haemolytic streptococci in equine of northern temperate region of Jammu and Kashmir, India. One hundred and forty one samples were collected in duplicate from nasopharyngeal tract of diseased (53) and apparently healthy equine (88) for isolation and direct PCR. A total of 77 isolates of streptococci were recovered from 141 samples with an overall prevalence rate of 54.60%. Out of these 77 isolates, 52 were from diseased and 25 from apparently healthy animals. Of the 77 isolates, 4 were identified as Streptococcus equi subsp. equi, 56 a...
Draft Genome Sequence of Streptococcus equi subsp. zooepidemicus Strain S31A1, Isolated from Equine Infectious Endometritis.
Genome announcements    September 5, 2013   Volume 1, Issue 5 e00683-13 doi: 10.1128/genomeA.00683-13
da Piedade I, Skive B, Christensen H, Bojesen AM.We present the draft genome sequence of Streptococcus equi subsp. zooepidemicus S31A1, a strain isolated from equine infectious endometritis in Denmark. Comparative analyses of this genome were done with four published reference genomes: S. zooepidemicus strains MGCS10565, ATCC 35246, and H70 and S. equi subsp. equi strain 4047.
Infectious risk factors and clinical indicators for tracheal mucus in British National Hunt racehorses.
Equine veterinary journal    August 30, 2013   Volume 46, Issue 2 150-155 doi: 10.1111/evj.12109
Cardwell JM, Smith KC, Wood JL, Newton JR.Many studies of respiratory disease in racehorses have focused on a combination of increased tracheal mucus and airway neutrophilia. Examination of each component separately should provide further insight into this condition. Objective: To identify infectious risk factors for endoscopically visible tracheal mucus in National Hunt racehorses. Methods: A 2 year prospective longitudinal study. Methods: Monthly quantitative bacteriological examinations of tracheal wash samples and viral serological examinations were conducted. Risk factors for 'small amounts of mucus' (mucus score = 1/3) and 'incr...
Identification of novel immunoreactive proteins of Streptococcus zooepidemicus with potential as vaccine components.
Vaccine    July 8, 2013   Volume 31, Issue 38 4129-4135 doi: 10.1016/j.vaccine.2013.06.100
Velineni S, Timoney JF.Streptococcus zooepidemicus is an important opportunistic pathogen of the equine respiratory and reproductive tracts. A normal tonsillar and mucosal commensal, it becomes invasive under conditions of stress such as virus infection, weaning, high temperature, prolonged transportation and failure of uterine involution. The aim of this study was to evaluate the vaccine potential of several surface exposed and secreted proteins of a novel mucoid clone of SzNC78 (ST-307) from an epizootic of equine respiratory disease. Methods: An expression gene library of SzNC78 was probed with a pool of convales...
Development of a real-time PCR to detect Streptococcus equi subspecies equi.
Equine veterinary journal    June 28, 2013   Volume 46, Issue 1 56-59 doi: 10.1111/evj.12088
North SE, Wakeley PR, Mayo N, Mayers J, Sawyer J.Infection with Streptococcus equi subspecies equi (S. equi) is endemic in the UK. A proportion of horses serve as long-term carriers and act as a reservoir of infection. Detection of these persistently infected horses is difficult using standard culture techniques owing to a lack of sensitivity and overgrowth by contaminating bacteria. In addition, differentiation of this causative bacterium from the closely related S. equi zooepidemicus has made the development of reliable and accurate diagnostic tests difficult. Objective: To develop and validate a sensitive and specific real-time PCR assay ...
Transmission of Streptococcus equi subspecies zooepidemicus infection from horses to humans.
Emerging infectious diseases    June 20, 2013   Volume 19, Issue 7 1041-1048 doi: 10.3201/eid1907.121365
Pelkonen S, Lindahl SB, Suomala P, Karhukorpi J, Vuorinen S, Koivula I, Väisänen T, Pentikäinen J, Autio T, Tuuminen T.Streptococcus equi subspecies zooepidemicus (S. zooepidemicus) is a zoonotic pathogen for persons in contact with horses. In horses, S. zooepidemicus is an opportunistic pathogen, but human infections associated with S. zooepidemicus are often severe. Within 6 months in 2011, 3 unrelated cases of severe, disseminated S. zooepidemicus infection occurred in men working with horses in eastern Finland. To clarify the pathogen's epidemiology, we describe the clinical features of the infection in 3 patients and compare the S. zooepidemicus isolates from the human cases with S. zooepidemicus isolates...
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