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Equine veterinary journal2021; 54(2); 390-414; doi: 10.1111/evj.13437

Antimicrobial resistance in clinical bacterial isolates from horses in the UK.

Abstract: Surveillance of antimicrobial resistance (AMR) in horses is important to aid empirical treatment decisions and highlight emerging AMR threats. Objective: To describe the AMR patterns of common groups of bacteria from clinical submissions from horses in the UK during 2018, and to determine how this varies by sample site and type of submitting veterinary practice. Methods: Prospective observational study. Methods: All data on bacterial culture and subsequent antimicrobial susceptibility testing (AST) collected in 2018 from six large equine diagnostic laboratories were included. Resistance patterns were analysed including resistance to 1 or 2 antimicrobial classes, multidrug resistance (MDR), extensively drug resistant (XDR), resistance to highest priority critically important antimicrobials and isolates where there was no readily available treatment for adult horses in the UK. Submitting practices were classified according to whether they treated referral cases or not (first opinion). Comparisons between proportions and resistance for each bacterial group and sample site was performed using Chi-squared (or Fisher's exact test). Results: A total of 6,018 bacterial isolates from 4,038 diagnostic submissions were included from respiratory (n = 1555), urogenital (n = 1,010), skin/hair/wound/abscess (n = 753), surgical site infection (SSI) /catheter-related-infection (CRI) /orthopaedic infections (n = 347) and unknown/'other' submissions (n = 373). There were 2,711 Gram-negative isolates and 3,307 Gram-positive isolates. Prevalence of MDR for E. coli was 31.7%, Staphylococcus spp. 25.3% and > 25% for the majority of bacterial isolates from SSI/CRI/orthopaedic submissions. For Enterococcus spp. there was no readily available treatment for adult horses in the UK in 30.2% of positive submissions. MDR was significantly higher from referral hospital than first opinion submissions for the majority of pathogens (except Actinobacillus spp. and Pasteurella spp. and β-haemolytic Streptococcus spp.). Conclusions: Since culture and susceptibility results are not systematic analyses based on harmonised methods, selection bias could impact the findings. Conclusions: Ongoing surveillance is essential to understand emerging patterns of resistance. MDR is high in SSI/CRI/orthopaedic infections, which is important for hospital biosecurity and guiding treatment decisions. Harmonisation of diagnostic procedures and interpretation of results amongst veterinary laboratories will improve AMR surveillance and data comparison among laboratories.
© 2021 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2021-05-04 PubMed ID: 33566383DOI: 10.1111/evj.13437Google Scholar: Lookup
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  • Journal Article
  • Observational Study
  • Veterinary

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research explores the patterns of antimicrobial resistance (AMR) in horses in the UK, with a specific focus on 2018 data. It identifies the prevalence of resistance in different bacterial groups and investigates how this differs depending on the sample site and the type of veterinary practice involved.

Research Methodology

  • The research was a prospective observational study collecting data from six large equine diagnostic laboratories.
  • The data included all information on bacterial culture and subsequent antimicrobial susceptibility testing (AST).
  • Resistance patterns were analysed, looking for resistance to one or two antimicrobial classes, multi-drug resistance (MDR), and extensive drug resistance (XDR). They also examined resistance to the highest priority critically important antimicrobials and cases where no readily available treatment existed for adult horses in the UK.
  • The study classified submitting veterinary practices depending on whether they treated referral cases or not (first opinion).
  • Chi-squared or Fisher’s exact test was used to perform comparisons between proportions and resistance for each bacterial group and sample site.

Results of the Study

  • A total of 6,018 bacterial isolates were included from 4,038 diagnostic submissions. The submissions came from a variety of medical sites such as respiratory, urogenital, skin, hair, wound, abscess, surgical site infection (SSI) and catheter-related infection (CRI) among others.
  • The bacterial isolates were divided into 2,711 Gram-negative isolates and 3,307 Gram-positive isolates.
  • Multi-drug resistance (MDR) was observed in 31.7% of E. coli isolates, 25.3% of Staphylococcus spp., and over 25% of bacterial isolates from SSI/CRI/orthopaedic submissions.
  • In 30.2% cases of Enterococcus spp., no readily available treatment existed for adult horses in the UK.
  • The rate of MDR was significantly higher in samples from referral hospitals than first opinion submissions for most pathogens, with the exception of Actinobacillus spp., Pasteurella spp. and β-haemolytic Streptococcus spp..

Conclusions of the Study

  • The study notes that as the culture and susceptibility results are not systematic analyses based on harmonised methods, selection bias could impact the findings.
  • Continuous surveillance is essential to understand emerging patterns of resistance.
  • High levels of MDR were observed in SSI/CRI/orthopaedic infections which are crucial for hospital biosecurity and guiding treatment decisions.
  • The research suggests harmonisation of diagnostic procedures and interpretation of results among veterinary laboratories could enhance AMR surveillance and data comparison among laboratories.

Cite This Article

APA
Isgren CM, Williams NJ, Fletcher OD, Timofte D, Newton RJ, Maddox TW, Clegg PD, Pinchbeck GL. (2021). Antimicrobial resistance in clinical bacterial isolates from horses in the UK. Equine Vet J, 54(2), 390-414. https://doi.org/10.1111/evj.13437

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 54
Issue: 2
Pages: 390-414

Researcher Affiliations

Isgren, Cajsa M
  • Department of Equine Clinical Science, Institute of Infection, Veterinary and Ecological Sciences, Faculty of Health & Life Sciences, University of Liverpool, Neston, UK.
Williams, Nicola J
  • Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, Faculty of Health & Life Sciences, University of Liverpool, Neston, UK.
Fletcher, Owen D
  • Department of Equine Clinical Science, Institute of Infection, Veterinary and Ecological Sciences, Faculty of Health & Life Sciences, University of Liverpool, Neston, UK.
Timofte, Dorina
  • Department of Veterinary Anatomy, Physiology & Pathology, Institute of Infection, Veterinary and Ecological Sciences, Faculty of Health & Life Sciences, University of Liverpool, Neston, UK.
Newton, Richard J
  • Animal Health Trust, Suffolk, UK.
Maddox, Thomas W
  • Department of Musculoskeletal & Ageing Science, Institute of Life Course & Medical Sciences, Faculty of Health & Life Sciences, University of Liverpool, Neston, Cheshire, UK.
Clegg, Peter D
  • Department of Musculoskeletal & Ageing Science, Institute of Life Course & Medical Sciences, Faculty of Health & Life Sciences, University of Liverpool, Neston, Cheshire, UK.
Pinchbeck, Gina L
  • Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, Faculty of Health & Life Sciences, University of Liverpool, Neston, UK.

MeSH Terms

  • Animals
  • Anti-Bacterial Agents / pharmacology
  • Drug Resistance, Bacterial
  • Drug Resistance, Multiple, Bacterial
  • Escherichia coli
  • Horse Diseases / drug therapy
  • Horse Diseases / epidemiology
  • Horses
  • Microbial Sensitivity Tests / veterinary
  • Surgical Wound Infection / veterinary
  • United Kingdom / epidemiology

Grant Funding

  • G2015 / The Horse Trust
  • Wellcome Trust

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Citations

This article has been cited 12 times.
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