Characterization of Clostridium difficile isolates from foals with diarrhea: 28 cases (1993-1997).

This research studied the characteristics of Clostridium difficile bacteria from foals with diarrhea and identified clinical abnormalities in affected foals, finding a high survival rate and a large percentage of bacteria with toxin A and B gene sequences.

Research Methods

• A retrospective study was conducted on 28 foals with C Difficile-associated diarrhea.
• Characteristics such as toxigenicity, molecular fingerprinting, and antibiotic susceptibility were determined by reviewing the foals’ medical records for pieces of information including clinical findings and results of clinicopathologic testing.
• The researchers also noted whether the foals had previously received antimicrobials prior to the development of diarrhea and what the outcome for each foal was.

Findings

• Out of the 28 foals, 23 survived (82%).
• Gene sequences for toxin A and B were found in the bacteria isolated from 24 out of 27 foals. In one case, only the gene sequence for toxin B was found.
• An ELISA test used to detect for toxin A revealed a positive result in only 40% of the samples.
• Out of the 23 isolates tested, 43% were resistant to the antibiotic metronidazole, a medication often used to treat bacteria-related infections.
• Molecular fingerprinting was used to examine the genetic variation among the different bacteria samples. There was a significant amount of heterogeneity among the different isolates, except for those that were resistant to metronidazole.

Clinical Symptoms

• Several clinical symptoms and hematologic abnormalities indicative of inflammation were observed in the affected foals.
• Hemoglobin levels were abnormal in 16 foals and showed signs of tachypnea, a condition characterized by rapid breathing.
• Other common serum biochemical abnormalities included metabolic acidosis, hyponatremia, hypocalcemia, azotemia, hypoproteinemia, hyperglycemia, and high enzyme activities.
• Adequate passive transfer of maternal antibodies was observed in all 12 foals evaluated, which is key in providing initial immunity to the foals.

Conclusions

• This research found that a large percentage of C Difficile bacteria isolated from foals with diarrhea contain the toxin A and B gene sequences.
• It also indicated a potential resistance to metronidazole, suggesting a need for susceptibility testing before administrating the antibiotic.
• Furthermore, the extensive molecular heterogeneity among the isolates was also observed, emphasizing the need for a more personalized approach to treatment.
• Lastly, clinical and hematological findings in C Difficile infected foals were similar to those infected by other diarrheal pathogens, suggesting similar impacts on the health of the affected foals.