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Home / Equine Research Bank / Vet Microbiol / Gram-negative multi-drug resistant bacteria influence surviv...
Veterinary microbiology2018; 226; 64-73; doi: 10.1016/j.vetmic.2018.10.009

Gram-negative multi-drug resistant bacteria influence survival to discharge for horses with septic synovial structures: 206 Cases (2010-2015).

Abstract: Bacterial colonization of synovial structures can cause infections that are difficult to treat. Systemic and local antimicrobials and repeated joint lavages are the mainstays of therapy. However, despite aggressive treatments, infection may persist, leading to significant tissue damage or death of the patient. In order to investigate the impact of bacterial culture and antimicrobial resistance on survival to discharge, we reviewed medical records of horses admitted to the University of Pennsylvania's large animal teaching hospital from 2010-2015. Two-hundred and six cases with a definitive diagnosis of septic synovitis and a synovial fluid sample submitted for microbiological culture were included in the study. Of these horses, 48% were culture negative and 52% were positive for any bacterial growth, of which 66% were gram-positive and 28% were gram-negative aerobic organisms with 4% anaerobic and 2% fungal organisms. Overall survival to discharge from hospital was 86%. Horses that had negative growth on culture were more likely to survive until discharge (p < 0.02). Multivariable analyses revealed that the likelihood of euthanasia was significantly associated with identification of coagulase positive Staphylococcus spp. (OR 7.66, 5.46-10.74, p < 0.0001), β-hemolytic Streptococcus spp. (OR 5.18, 3.56-7.55, p < 0.0001), Enterococcus spp. (OR 18.38, 11.45-29.52, p = 0.002), Enterobacteriaceae (OR 31.37, 22.28-44.17, p < 0.0001), Pseudomonas aeruginosa (OR 9.31, 5.30-16.34, p = 0.0004) or other gram-negative species (OR 3.51, 2.07-5.94, p = 0.001). Multi-drug resistance and gram-negative bacteria species were associated with significantly decreased survival rates (OR 119.24, 70.57-201.46, p < 0.0001). In conclusion, prognosis for survival to discharge was poor for horses that were infected with gram-negative organisms, particularly those with MDR phenotypes.
Copyright © 2018 Elsevier B.V. All rights reserved.
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Publication Date: 2018-10-13 PubMed ID: 30389045DOI: 10.1016/j.vetmic.2018.10.009Google Scholar: Lookup
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  • Journal Article

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.

This study reveals that horses suffering from septic synovitis, a joint infection, have a lower discharge survival rate when their infection is caused by multi-drug resistant gram-negative bacteria.

Research Context and Approach

  • The research focused on horses admitted to the University of Pennsylvania’s large animal teaching hospital from 2010-2015, with a definitive diagnosis of septic synovitis – an infection in the joint spaces or structures surrounding them.
  • The aim of the study was to evaluate the impact of bacterial culture and antimicrobial resistance on survival to discharge i.e., the recovery and release of the animal from hospital care.
  • Survival rates, bacterial growth, and types of bacteria were observed and recorded for each case.
  • Horses that were culture-positive (indicated presence of bacterial infection) were classified based on the type of bacterial growth, including gram-positive, gram-negative aerobic organisms, anaerobic, and fungal organisms.

Findings

  • 206 cases were included in the study, out of which almost half were culture-negative (indicating no bacteria growth).
  • The other half showed bacterial growth, with the majority being gram-positive bacteria.
  • Surprisingly, horses that showed no bacterial growth in culture had a higher likelihood to survive until discharge.
  • Through statistical analysis, specific types of bacteria strains were found to be significantly associated with the likelihood of euthanasia, indicating a worse prognosis. These strains included various species of Staphylococcus, Streptococcus, Enterococcus, Enterobacteriaceae, Pseudomonas aeruginosa, and other gram-negative species.
  • Horses infected with multi-drug resistant and gram-negative bacteria species had decreased survival rates dramatically.

Conclusion

  • The study concluded that horses suffering from septic synovitis and infected with gram-negative organisms, particularly multi-drug resistant ones, had a high risk of not surviving until their hospital discharge.
  • This finding underlines the complexity and gravity of treating infections caused by multi-drug resistant bacteria in veterinary medicine, just as it is a significant concern in human medicine.

Cite This Article

APA
Gilbertie JM, Schnabel LV, Stefanovski D, Kelly DJ, Jacob ME, Schaer TP. (2018). Gram-negative multi-drug resistant bacteria influence survival to discharge for horses with septic synovial structures: 206 Cases (2010-2015). Vet Microbiol, 226, 64-73. https://doi.org/10.1016/j.vetmic.2018.10.009

Publication

Veterinary microbiology
ISSN: 1873-2542
NlmUniqueID: 7705469
Country: Netherlands
Language: English
Volume: 226
Pages: 64-73
PII: S0378-1135(18)30824-1

Researcher Affiliations

Gilbertie, Jessica M
  • Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, 382 West Street Rd., Kennett Square, PA 19348, United States; North Carolina State University, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, 27607 Raleigh, NC, United States.
Schnabel, Lauren V
  • North Carolina State University, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, 27607 Raleigh, NC, United States.
Stefanovski, Darko
  • Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, 382 West Street Rd., Kennett Square, PA 19348, United States.
Kelly, Donna J
  • Department of Pathobiology, New Bolton Center, School of Veterinary Medicine, 382 West Street Rd., Kennett Square, PA 19348, United States.
Jacob, Megan E
  • North Carolina State University, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, 27607 Raleigh, NC, United States.
Schaer, Thomas P
  • Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, 382 West Street Rd., Kennett Square, PA 19348, United States. Electronic address: tpschaer@vet.upenn.edu.

MeSH Terms

  • Animals
  • Anti-Bacterial Agents / pharmacology
  • Arthritis, Infectious / microbiology
  • Arthritis, Infectious / veterinary
  • Drug Resistance, Multiple, Bacterial
  • Enterobacteriaceae / drug effects
  • Enterobacteriaceae Infections / mortality
  • Enterobacteriaceae Infections / veterinary
  • Gram-Negative Bacteria / drug effects
  • Gram-Negative Bacterial Infections / mortality
  • Gram-Negative Bacterial Infections / veterinary
  • Horse Diseases / microbiology
  • Horse Diseases / mortality
  • Horses
  • Hospitals, Animal
  • Microbial Sensitivity Tests
  • Patient Discharge / statistics & numerical data
  • Pseudomonas aeruginosa / drug effects
  • Staphylococcus / drug effects
  • Synovial Fluid / cytology
  • Synovial Fluid / microbiology
  • Synovitis / microbiology
  • Synovitis / veterinary

Citations

This article has been cited 11 times.
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    doi: 10.1371/journal.pone.0221012pubmed: 31415623google scholar: lookup
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