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Journal of veterinary internal medicine2020; 34(2); 955-963; doi: 10.1111/jvim.15692

Differences in isolation rate and antimicrobial susceptibility of bacteria isolated from foals with sepsis at admission and after ≥48 hours of hospitalization.

Abstract: Antimicrobial treatment protocols for foals with sepsis that do not improve clinically often are adjusted based on bacteriological and antimicrobial susceptibility testing results from samples collected at hospital admission. Objective: To evaluate whether hospitalization for ≥48 hours affects bacteriological and antimicrobial susceptibility testing results. Methods: Two-hundred sixty-seven foals <30 days of age admitted to a neonatal intensive care unit and diagnosed with sepsis. Methods: Medical records were reviewed retrospectively to identify foals with sepsis and positive bacteriological cultures. Results from samples collected at hospital admission were compared to those collected ≥48 hours after admission. Logistic regression for clustered data and exact logistic regression were used for statistical analysis. Results: Three-hundred fifty-three unique bacterial isolates were obtained from 231 foals at hospital admission and 92 unique bacterial isolates were obtained from 57 foals after ≥48 hours of hospitalization. Relative isolation frequency after ≥48 hours of hospitalization increased for Acinetobacter spp., 0.6% versus 3.3% (odds ratio [OR], 7.63; 95% confidence interval [CI], 1.28-45.45); Enterococcus spp., 4.8% versus 19.6% (OR, 5.37; 95% CI, 2.64-10.90); Klebsiella spp., 5.1% versus 10.9% (OR, 2.27; 95% CI, 1.05-4.89); Pseudomonas spp., 3.0% versus 7.6% (OR, 3.49; 95% CI, 3.49-240.50); and Serratia spp., 3.0% versus 5.4% (OR, 20.23; 95% CI, 2.20-186.14). Bacteria isolated after ≥48 hours of hospitalization were less susceptible to all tested antimicrobial drugs, except for imipenem. Conclusions: Decreased antimicrobial susceptibility of bacteria isolated after ≥48 hours of hospitalization provides a rationale for repeated bacteriological culture and susceptibility testing in hospitalized foals with sepsis.
© 2020 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
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Publication Date: 2020-02-05 PubMed ID: 32022351PubMed Central: PMC7096636DOI: 10.1111/jvim.15692Google Scholar: Lookup
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Summary

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This research aims to examine the changes in bacteriological and antimicrobial susceptibility testing results of foals with sepsis before and after at least 48 hours of hospitalization. It finds an increased frequency of various bacterial infections and decreased susceptibility to most antimicrobial drugs over the course of hospitalization, suggesting the need for repeated testing.

Objective and Methodology

The objective of this study was to investigate if there are differences in the bacteria isolated from septic foals and their susceptibility to antimicrobial drugs at admission versus after 48 hours or more of hospitalization.

  • The study was conducted on 267 foals, all of whom were less than 30 days old and admitted to a neonatal intensive care unit (NICU) with a diagnosis of sepsis.
  • This research uses a retrospective review of medical records to identify septic foals with positive bacteriological cultures. As part of the methodology, logistic regression for clustered data and exact logistic regression were used for the statistical analysis.

Results

The results showed distinct changes in bacteriology and antimicrobial susceptibility over the course of hospitalization:

  • At the time of hospital admission, 353 unique bacterial isolates were obtained from 231 foals. After at least 48 hours of hospitalization, a total of 92 unique bacterial isolates were obtained from 57 foals.
  • There was an increased relative isolation frequency for Acinetobacter spp., Enterococcus spp., Klebsiella spp., Pseudomonas spp., and Serratia spp. after 48 hours of hospitalization.
  • Bacteria isolated after 48 hours of hospitalization were found to be less susceptible to all tested antimicrobial drugs, with the exception of Imipenem. This suggests that the bacteria became more resistant to treatment over time.

Conclusion

The decrease in susceptibility of bacteria isolated from septic foals after 48 hours of hospitalization indicates necessary adjustments to antimicrobial treatment protocols. The dramatically altered susceptibility suggests the need for repeated bacteriological culture and susceptibility testing. This can allow clinicians to adjust treatment according to changing bacterial profiles and susceptibilities, potentially improving the effectiveness of care for foals with sepsis.

Cite This Article

APA
Theelen MJP, Wilson WD, Byrne BA, Edman JM, Kass PH, Mughini-Gras L, Magdesian KG. (2020). Differences in isolation rate and antimicrobial susceptibility of bacteria isolated from foals with sepsis at admission and after ≥48 hours of hospitalization. J Vet Intern Med, 34(2), 955-963. https://doi.org/10.1111/jvim.15692

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 34
Issue: 2
Pages: 955-963

Researcher Affiliations

Theelen, Mathijs J P
  • Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
  • Department of Infectious Diseases and Immunity, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
Wilson, W David
  • Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California.
Byrne, Barbara A
  • Department of Pathology, Microbiology & Immunology, School of Veterinary Medicine, University of California, Davis, California.
Edman, Judy M
  • Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California.
Kass, Philip H
  • Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, California.
Mughini-Gras, Lapo
  • Department of Infectious Diseases and Immunity, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
  • Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
Magdesian, K Gary
  • Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California.

MeSH Terms

  • Animals
  • Animals, Newborn
  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia / drug therapy
  • Bacteremia / veterinary
  • Drug Resistance, Bacterial
  • Female
  • Horse Diseases / drug therapy
  • Horse Diseases / microbiology
  • Horses
  • Hospitalization
  • Male
  • Microbial Sensitivity Tests / veterinary
  • Records / veterinary
  • Retrospective Studies

Grant Funding

  • University of California, Davis

Conflict of Interest Statement

Authors declare no conflict of interest.

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Citations

This article has been cited 7 times.
  1. Bookbinder LC, Mani R, Carr EA. Antibiograms of field and hospital acquired equine neonatal bacterial fluid cultures in the Midwestern United States: 149 samples (2007-2018). J Vet Intern Med 2023 May-Jun;37(3):1193-1200.
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  3. Chen LT, Wesdorp E, Jager M, Siegers EW, Theelen MJP, Besselink N, Vermeulen C, Zomer AL, Broens EM, Wagenaar JA, de Ridder J. Bacterial cell-free DNA profiling reveals the co-elevation of multiple bacteria in newborn foals with suspected sepsis. iScience 2025 Dec 19;28(12):114005.
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  4. Graham AE, Colgate VA, Floyd EF. Antibiograms of Bacterial Cultures From Equine Neonates at a United Kingdom Hospital: 381 Samples (2018-2023). J Vet Intern Med 2025 Sep-Oct;39(5):e70198.
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