Preventive veterinary medicine2011; 100(2); 134-145; doi: 10.1016/j.prevetmed.2011.02.006

Longitudinal study of antimicrobial-resistant commensal Escherichia coli in the faeces of horses in an equine hospital.

Maddox, TW
·
Williams, NJ
·
Clegg, PD
·
O'Donnell, AJ
·
Dawson, S
·
Pinchbeck, GL

Abstract: The increasing prevalence of antimicrobial resistance in bacteria represents a considerable problem for human and veterinary medicine, causing complications in the treatment of infections. Resistance in Escherichia coli from horses has been documented in commensal and pathogenic strains, but little information exists regarding the prevalence of such bacteria in hospitalised horses or associated risk factors. A longitudinal cohort study was conducted of 103 horses admitted to a referral equine hospital for more than 48 h, with faecal samples collected on hospital admission and subsequently every two days until discharge. Horses undergoing radioactive gamma scintigraphic examination, un-weaned foals and mares with un-weaned foals were excluded. Data were collected from enrolled animals, including antimicrobial treatment history and hospitalisation details. Samples were cultured for resistant E. coli; isolates had their antimicrobial resistance profile determined. High sample prevalence for resistant E. coli was identified for all antimicrobials examined except co-amoxiclav. The prevalence of resistance was consistently lower at admission, rising to a peak 4 days post-admission. Risk factors were analysed using multilevel, multivariable modelling, which identified significant clustering of resistance outcomes within horses. For all outcomes except trimethoprim resistance, the day the sample was obtained was significant, with increased risk of resistance for samples taken on day 2 or later. Antimicrobial treatment in the previous seven days and increased total daily dosages of cotrimoxazole prescribed in the hospital in the previous 24-48 h were associated with increased risk. Location within the hospital and admission reason were significant risk factors for some resistance outcomes. High levels of multidrug-resistant E. coli (47.7% of samples) and extended spectrum β-lactamase-producing E. coli (27.3% of samples) were recovered; such bacteria could significantly complicate treatment if they were the cause of infection and may represent a risk to personnel in close contact with hospitalised horses.

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Publication Date: 2011-03-04 PubMed ID: 21377225DOI: 10.1016/j.prevetmed.2011.02.006Google Scholar: Lookup

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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.

The research article covers a thorough study on the prevalence and risk factors of antimicrobial-resistant Escherichia coli in the feces of horses in an equine hospital. The study records an alarming rise in resistance over the stay period and identifies potential risk factors for such resistance.

Study Design and Population

The researchers conducted a longitudinal cohort study, a design best suited for observing development, change, and outcomes over time.
The study population consisted of 103 horses admitted to a referral equine hospital for more than 48 hours. Hence, the study did not include horses undergoing radioactive gamma scintigraphic examination, un-weaned foals, and mares with un-weaned foals.
In order to understand the nature of antimicrobial resistance in the selected population, the team collected fecal samples from the horses upon admission and then every two days until their discharge.
Additional information such as the horses’ treatment history and hospitalization details were also recorded to aid in the analysis.

Findings of the Study

Fecal samples were cultured, and the antimicrobial resistance profile of the isolated E.coli strains were determined.
The resistance to all examined antimicrobials except co-amoxiclav was alarmingly prevalent in the samples.
The researchers noted a pattern: the resistance prevalence was lowest upon admission, but it escalated, peaking four days post-admission.

Analysis of Risk Factors

The risk factors contributing to this rise in antimicrobial resistance were scrutinized using advanced multilevel, multivariable modeling.
The study recorded significant “clustering” of resistance outcomes within individual horses.
For everything except resistance to trimethoprim, the day the sample was obtained stood out as a significant risk factor – there was a marked increase in resistance for samples taken on Day 2 or later.
The researchers also tied an increased risk of resistance to horses that had received antimicrobial treatment in the seven days prior to sampling and those that had been prescribed higher daily doses of cotrimoxazole in the preceding 24-48 hours.
The location within the hospital and the reason for admission also emerged as significant risk factors for some of the resistance outcomes.

Implications of the Findings

In terms of implications, the study found high levels of multidrug-resistant E. coli (affecting 47.7% of samples) and extended-spectrum β-lactamase-producing E. coli (in 27.3% of samples).
These strains could severely complicate treatment regimes if they were the cause of infection, and might also pose significant risks to staff members who are in close contact with the horses.

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APA

Maddox TW, Williams NJ, Clegg PD, O'Donnell AJ, Dawson S, Pinchbeck GL. (2011). Longitudinal study of antimicrobial-resistant commensal Escherichia coli in the faeces of horses in an equine hospital. Prev Vet Med, 100(2), 134-145. https://doi.org/10.1016/j.prevetmed.2011.02.006

Publication

Preventive veterinary medicine

ISSN: 1873-1716

NlmUniqueID: 8217463

Country: Netherlands

Language: English

Volume: 100

Issue: 2

Pages: 134-145

Researcher Affiliations

Maddox, Thomas W

National Centre for Zoonosis Research, School of Veterinary Sciences, Leahurst Campus, University of Liverpool, CH64 7TE, UK. Thomas.Maddox@liverpool.ac.uk

Williams, Nicola J

Clegg, Peter D

O'Donnell, Andrew J

Dawson, Susan

Pinchbeck, Gina L

MeSH Terms

Animals
Anti-Bacterial Agents / pharmacology
Drug Resistance, Multiple, Bacterial
Escherichia coli / drug effects
Escherichia coli / isolation & purification
Feces / microbiology
Female
Horse Diseases / epidemiology
Horse Diseases / microbiology
Horses
Hospitals, Animal
Male

Citations

This article has been cited 15 times.

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Isgren CM, Edwards T, Pinchbeck GL, Winward E, Adams ER, Norton P, Timofte D, Maddox TW, Clegg PD, Williams NJ. Emergence of carriage of CTX-M-15 in faecal Escherichia coli in horses at an equine hospital in the UK; increasing prevalence over a decade (2008-2017). BMC Vet Res 2019 Jul 29;15(1):268.
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