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Home / Equine Research Bank / J Vet Intern Med / Infections caused by extended-spectrum beta-lactamase-produc...
Journal of veterinary internal medicine2025; 39(2); e17299; doi: 10.1111/jvim.17299

Infections caused by extended-spectrum beta-lactamase-producing Enterobacterales in hospitalized neonatal foals: Can colonization predict infection?

Abstract: Infections with extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-PE) contribute to morbidity and mortality in human neonates. In foals, data are scarce. Objective: Determine the association between ESBL-PE gastrointestinal colonization on hospital admission and infections in hospitalized neonates. Methods: Sixty-seven foals. Methods: Prospective study of foals admitted to a veterinary hospital. Foals were screened for ESBL-PE colonization and for infections. Risk factors and clinical outcomes were analyzed. Results: Seventy-six percent of foals suffered from at least 1 bacterial infection (n = 51/67). Sixty-three non-ESBL bacterial species and 19 ESBL-PE species were isolated. Twenty foals (29.85%) had at least 1 hospital-acquired infection (HAI) and 30 foals (44.8%) suffered from multidrug resistant infections. The prevalence rates of ESBL-PE gastrointestinal colonization on admission and clinical ESBL HAIs were 47.8% (n = 32/67, 41 isolates) and 19.40% (n = 13/67, 19 isolates), respectively. On multivariable analysis, ESBL-PE HAIs were associated with colonization on admission (P = .03, odds ratio [OR] = 4.60). In an outcome analysis, ESBL-PE infection and HAIs were associated with surgery (ESBL-PE infection: P = .04, OR = 4.70; HAI: P = .004, OR = 6.4) and HAI also was associated with increased duration of hospitalization (P < .001, OR = 9.13). The major colonizing and infecting bacterial species were Escherichia coli and Klebsiella spp. Concordant ESBL-PE species were recovered from rectal screening and clinical samples in 7.46% (n = 5/67) of foals. Conclusions: On-admission ESBL-PE rectal colonization was associated with ESBL-PE HAI in neonatal foals. The ESBL-PE infections were associated with surgery during hospitalization. These findings emphasize the importance of optimal infection control and treatment of clinical infections in equine neonatal intensive care units.
© 2025 The Author(s). Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
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Publication Date: 2025-02-21 PubMed ID: 39980458DOI: 10.1111/jvim.17299Google Scholar: Lookup
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Summary

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The study explores the connection between gastrointestinal colonization of extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-PE) upon hospital admission and subsequent infections in hospitalised baby horses or foals. The research found that ESBL-PE gastrointestinal colonization on arrival at the hospital was significantly associated with ESBL-PE hospital-acquired infections in neonatal foals.

Study Overview and Methods

  • The study involved 67 baby horses and was conducted prospectively, meaning it followed the foals forward in time to observe outcomes.
  • Upon admission to a veterinary hospital, foals were screened for colonization of ESBL-PE in their gastrointestinal tract.
  • During the hospitalisation, the foals were also screened for infections, and both risk factors and clinical outcomes were analysed.

Results and Findings

  • Of the 67 foals, 76% suffered from at least one bacterial infection. The researchers isolated 63 non-ESBL bacterial species and 19 ESBL-PE species during the study.
  • About 30% of foals had at least one hospital-acquired infection (HAI) and nearly 45% suffered from multidrug resistant infections.
  • The prevalence of ESBL-PE gastrointestinal colonization upon hospital admission and clinical ESBL HAIs was 47.8% and 19.4% respectively.
  • The analysis, using multiple variables, revealed a strong association between ESBL-PE HAIs and the presence of ESBL-PE in the gastrointestinal tract upon hospital admission.
  • Further outcome analysis showed a connection between ESBL-PE infection and hospital-acquired infections to surgical procedures during hospitalization.
  • Additionally, an increased duration of hospitalisation was associated with ESBL infection and hospital-acquired infections.
  • The primary colonizing and infection-causing bacterial species found were Escherichia coli and Klebsiella spp., with matching ESBL-PE species discovered from rectal screening and clinical samples in about 7.46% of foals.

Conclusion

  • The study concludes that on-admission ESBL-PE rectal colonization is associated with ESBL-PE hospital-acquired infections in hospitalised baby horses.
  • The research also indicated that ESBL-PE infections were linked to surgeries foals underwent during hospitalization.
  • These findings underscore the need for optimal infection control and the importance of appropriate clinical infection treatment in equine neonatal intensive care units.

Cite This Article

APA
Shnaiderman-Torban A, Meltzer L, Zilberman-Daniels T, Navon-Venezia S, Cohen A, Sutton GA, Blum SE, Amit S, Steinman A. (2025). Infections caused by extended-spectrum beta-lactamase-producing Enterobacterales in hospitalized neonatal foals: Can colonization predict infection? J Vet Intern Med, 39(2), e17299. https://doi.org/10.1111/jvim.17299

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 39
Issue: 2
Pages: e17299

Researcher Affiliations

Shnaiderman-Torban, Anat
  • Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel.
Meltzer, Lilac
  • Chaim Sheba Medical Center, Ramat-Gan, Israel.
Zilberman-Daniels, Tal
  • Chaim Sheba Medical Center, Ramat-Gan, Israel.
Navon-Venezia, Shiri
  • Department of Molecular Biology, Faculty of Natural Sciences, Ariel University, Ariel, Israel.
  • The Miriam and Sheldon Adelson School of Medicine, Ariel University, Ariel, Israel.
Cohen, Adar
  • Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel.
Sutton, Gila Abells
  • Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel.
Blum, Shlomo E
  • Kimron Veterinary Institute, Bet Dagan, Israel.
Amit, Sharon
  • Chaim Sheba Medical Center, Ramat-Gan, Israel.
Steinman, Amir
  • Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel.

MeSH Terms

  • Animals
  • Horses
  • Horse Diseases / microbiology
  • beta-Lactamases / metabolism
  • Animals, Newborn
  • Enterobacteriaceae Infections / veterinary
  • Enterobacteriaceae Infections / microbiology
  • Enterobacteriaceae / drug effects
  • Enterobacteriaceae / isolation & purification
  • Prospective Studies
  • Male
  • Cross Infection / microbiology
  • Cross Infection / veterinary
  • Female
  • Hospitals, Animal
  • Risk Factors

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