Active surveillance in an equine intensive care unit identifies clusters of ESKAPEE pathogens in the veterinary hospital environment.
Abstract: Healthcare-associated infections (HAIs) associated with ESKAPEE pathogens are an emerging concern in equine hospitals, especially in the intensive care unit (ICU). To gain insight into the occurrence of HAIs and to identify potential reservoirs and transmission routes of ESKAPEE pathogens in an equine ICU, a pilot study of two periods (December 2022-January 2023 and April-June 2023) was performed, where patient and environmental samples were obtained upon ICU admission and discharge. A sampling and laboratory protocol for the detection and identification of different ESKAPEE pathogens and Salmonella spp. was developed. Samples consisted of patient samples and patient-bound environmental samples, including nose and environmental swabs, feces, twitch ropes and catheter tips. Non-patient bound samples were collected from high-contact surfaces for staff members. In total, 271 patient-bound samples (n = 122 in sampling period 1 and n = 149 in sampling period 2) from 30 patients and 28 non-patient bound environmental samples were collected resulting in the isolation of 207 ESKAPEE isolates. A selection of isolates (n = 115) was sequenced to identify clusters and antimicrobial resistance genes. ESKAPEE pathogens were present in 90 % of the horses hospitalized at the ICU or their immediate environment. Different genetic clusters of MRSA, A. baumannii and E. cloacae isolates were identified over time suggesting transmission and persistence within the ICU. During both sampling periods no HAIs were observed, but the abundance of these pathogens might pose a risk for HAIs. This study shows the importance for every (veterinary) hospital to implement surveillance and to further optimize hygiene protocols.
Copyright © 2025 The Authors. Published by Elsevier B.V. All rights reserved.
Publication Date: 2025-02-20 PubMed ID: 39987813DOI: 10.1016/j.vetmic.2025.110439Google Scholar: Lookup
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- Journal Article
Summary
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The research focuses on studying the occurrence of Healthcare-Associated Infections (HAIs) caused by ESKAPEE pathogens in an equine hospital’s Intensive Care Unit (ICU) and identifying their sources and possible paths of transmission.
Research Methodology
- The pilot study involved two distinct periods: December 2022-January 2023 and April-June 2023.
- Patient samples and environmental samples were collected upon admission to and discharge from the ICU. This was to observe any pathogenic changes that might have occurred during their stay.
- The researchers developed a protocol for collecting and analyzing samples. They aimed to spot and identify various ESKAPEE pathogens, as well as Salmonella spp.
- The sample collection was comprehensive, involving both patient samples (nose swabs, fecal samples, twitch ropes, and catheter tips) and environmental samples from high-contact surfaces that staff members interacted with regularly.
Results and Findings
- A total of 271 patient-bound samples and 28 non-patient bound environmental samples were collected. The analysis led to the isolation of 207 ESKAPEE isolates.
- The team sequenced a selection of these isolates in order to identify genetic clusters and antimicrobial resistance genes. The pathogens were present in or around 90% of the hospitalized horses.
- Clusters of MRSA, A. baumannii, and E. cloacae isolates displayed changes over time, indicating transmission and persistence within the ICU environment.
- Notably, no HAIs were observed during the sampling periods. However, the researchers caution that the abundance of these pathogens still carries a risk for HAIs.
Implications and Recommendations
- The study underscores the necessity for continuous surveillance in veterinary (and other healthcare) hospitals. This can be crucial to monitor and prevent potential disease outbreaks.
- In light of the findings, optimizing hygiene protocols in the ICU and other parts of the hospital is recommended to minimize the risk of infections.
Cite This Article
APA
Sijtsema M, Stringer T, Hopman NEM, van der Graaf-van Bloois L, Duim B, van den Brom-Spierenburg A, Theelen M, Zomer A, Broens EM.
(2025).
Active surveillance in an equine intensive care unit identifies clusters of ESKAPEE pathogens in the veterinary hospital environment.
Vet Microbiol, 303, 110439.
https://doi.org/10.1016/j.vetmic.2025.110439 Publication
Researcher Affiliations
- Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, The Netherlands.
- Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, The Netherlands.
- Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, The Netherlands.
- Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, The Netherlands.
- Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, The Netherlands.
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, The Netherlands.
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, The Netherlands.
- Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, The Netherlands.
- Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, The Netherlands. Electronic address: E.M.Broens@uu.nl.
MeSH Terms
- Animals
- Horses
- Hospitals, Animal
- Intensive Care Units
- Horse Diseases / microbiology
- Horse Diseases / epidemiology
- Cross Infection / microbiology
- Cross Infection / veterinary
- Cross Infection / epidemiology
- Pilot Projects
Conflict of Interest Statement
Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Els M. Broens reports financial support was provided by Friends of Veterinary Medicine, Utrecht University. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper
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