Does colonization with MRSA, ESBL – producing Enterobacteriaceae, and/or Acinetobacter baumannii – increase the risk for postoperative surgical site infection?
Abstract: Evaluation of the role of indicator pathogens in equine surgical site infection (SSI) and other infection-promoting factors. Cross-sectional study. Horses presenting with an open injury or surgical colic during 1.5 years. A nasal swab and a faecal sample were collected from every patient upon admission. Furthermore, a wound swab was collected from wounds of injured horses. Details on the wounds and procedures were documented. Laparotomy incisions and injuries were monitored for signs suggesting infection. In total, 156 horses presented because of a surgical colic (n = 48) or open injuries (n = 108). Thirteen surgical colic patients and three injured horses did not survive beyond 24 h, and four injured horses were discharged from the clinic at the day of admission. SSIs occurred in 31 (30.7%) injured horses and 11 (31.4%) horses after laparotomy. Regarding injuries, general anaesthesia increased the risk of developing a WI compared to sedation. Indicator pathogens were cultured from 29/42 SSI. In total, 10/11 infected laparotomy incisions and 19/31 injuries with SSI tested positive for multidrug-resistant pathogens (MDRPs) . Indicator pathogens were not detected at admission in any of the horses that developed incisional SSIs after laparotomy but were detected in two of the injured horses that developed SSIs. MDRPs were identified in almost 70% of the SSI. Less than 5% of the affected animals were colonized with the same pathogen before admission, indicating that colonization with MDR pathogens is only one of the crucial factors for the development of SSI. Colonization with MDRP seems not to predispose horses to MDR SSIs.
© 2023 The Authors. Veterinary Medicine and Science published by John Wiley & Sons Ltd.
Publication Date: 2023-01-16 PubMed ID: 36646070PubMed Central: PMC10029890DOI: 10.1002/vms3.1073Google Scholar: Lookup
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- Journal Article
Summary
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The research study investigates if colonization with certain bacteria increases the risk for postoperative surgical site infection (SSI) in horses. The findings suggest that while colonization with multidrug-resistant pathogens (MDRPs) is a factor, it is not the primary cause of SSIs in horses.
Study Design and Methodology
- This cross-sectional study involved horses with open injuries or surgical colic over a period of 1.5 years.
- Upon their admission, the researchers collected a nasal swab and a fecal sample from each horse. For horses with open wounds, additional wound swabs were taken.
- The researchers also documented details about the wounds and procedures the horses underwent.
- Both laparotomy incisions and injuries were monitored for signs of infection.
Participants and Results
- Total of 156 horses participated in the study. Of these, 48 presented surgical colic, and 108 had open injuries.
- Non-survivors within 24 hours included 13 surgical colic patients and three injured horses. Four injured horses were discharged on the same day of admission.
- The study found that SSI occurred in 31 (30.7%) injured horses and 11 (31.4%) horses post-laparotomy.
- Regarding injuries, general anesthesia increased the risk of wound infection, compared to sedation.
- At least one indicator pathogen was found in 29 of the 42 SSI cases.
Indicator Pathogens and Role of Multidrug-resistant Pathogens
- In total, 10 of the 11 infected laparotomy incisions and 19 of the 31 injuries with SSI were positive for multidrug-resistant pathogens (MDRPs).
- Interestingly, none of the horses that developed SSIs post-laparotomy had indicator pathogens detected upon admission. However, two injured horses that developed SSIs had these pathogens detected upon admission.
- Almost 70% of SSIs were found to have MDRPs. However, less than 5% of the infected animals had prior colonization with the same pathogen, suggesting that colonization with multidrug-resistant pathogens was not the primary factor for SSI development.
- This led to the conclusion that while colonization with MDRPs happens, it does not necessarily predispose horses to multidrug-resistant SSIs.
Cite This Article
APA
Gehlen H, Klein KS, Merle R, Lübke-Becker A, Stoeckle SD.
(2023).
Does colonization with MRSA, ESBL – producing Enterobacteriaceae, and/or Acinetobacter baumannii – increase the risk for postoperative surgical site infection?
Vet Med Sci, 9(2), 729-737.
https://doi.org/10.1002/vms3.1073 Publication
Researcher Affiliations
- Equine Clinic: Surgery and Radiology, Freie Universität Berlin, Berlin, Germany.
- Equine Clinic: Surgery and Radiology, Freie Universität Berlin, Berlin, Germany.
- Institute for Veterinary Epidemiology and Biostatistics, Freie Universität Berlin, Berlin, Germany.
- Institute of Microbiology and Epizootics, Freie Universität Berlin, Berlin, Germany.
- Veterinary Centre for Resistance Research (TZR), Freie Universität Berlin, Berlin, Germany.
- Equine Clinic: Surgery and Radiology, Freie Universität Berlin, Berlin, Germany.
MeSH Terms
- Horses
- Animals
- Surgical Wound Infection / epidemiology
- Surgical Wound Infection / veterinary
- Enterobacteriaceae
- Acinetobacter baumannii
- Methicillin-Resistant Staphylococcus aureus
- Colic / surgery
- Colic / veterinary
- Cross-Sectional Studies
- Horse Diseases / epidemiology
- Horse Diseases / surgery
Conflict of Interest Statement
The authors declare no conflict of interest.
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Citations
This article has been cited 3 times.- Stöckle SD, Kannapin DA, Merle R, Lübke-Becker A, Gehlen H. Comparison of a Single-Shot Antibiotic Protocol Compared to a Conventional 5-Day Antibiotic Protocol in Equine Diagnostic Laparotomy Regarding Pre- and Postoperative Colonization with Multi-Drug-Resistant Indicator Pathogens. Antibiotics (Basel) 2026 Jan 21;15(1).
- Bassiouny M, Neubauer H, Sprague LD. Gram-positive ESKAPE pathogens in Germany: A comprehensive analysis of occurrence and resistance development in animal, food, and environmental sources. One Health 2025 Jun;20:101099.
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