Molecular characterization of Clostridium difficile isolates from horses in an intensive care unit and association of disease severity with strain type.
Abstract: To determine molecular characteristics, antimicrobial susceptibility, and toxigenicity of Clostridium difficile isolates from horses in an intensive care unit and evaluate associations among severity of clinical disease with specific strains of C difficile. Methods: Prospective study. Methods: 130 horses. Methods: Feces were collected from horses admitted for acute gastrointestinal tract disease with loose feces and submitted for microbial culture and immunoassay for toxin production. Polymerase chain reaction assays were performed on isolates for toxins A and B genes and strain identification. Results: Isolates were grouped into 3 strains (A, B, and C) on the basis of molecular banding patterns. Toxins A and B gene sequences were detected in 93%, 95%, and 73% of isolates of strains A, B, and C, respectively. Results of fecal immunoassays for toxin A were positive in 40%, 63%, and 16% of horses with strains A, B, and C, respectively. Isolates in strain B were resistant to metronidazole. Horses infected with strain B were 10 times as likely to have been treated with metronidazole prior to the onset of diarrhea as horses infected with other strains. Duration from onset of diarrhea to discharge (among survivors) was longer, systemic inflammatory response syndromes were more pronounced, and mortality rate was higher in horses infected with strain B than those infected with strains A and C combined. Conclusions: Horses may be infected with a number of heterogeneous isolates of C difficile. Results indicated that toxigenicity and antimicrobial susceptibility of isolates vary and that metronidazole-resistant strains may be associated with severe disease.
Publication Date: 2006-03-02 PubMed ID: 16506942DOI: 10.2460/javma.228.5.751Google Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
- Clostridium
- Diagnosis
- Diarrhea
- Disease control
- Disease Diagnosis
- Disease Etiology
- Disease Management
- Disease Outbreaks
- Disease Prevalence
- Disease Severity
- Disease Surveillance
- Disease Transmission
- Disease Treatment
- Equine Health
- Horses
- Infection
- Infectious Disease
- Veterinary Care
- Veterinary Medicine
- Veterinary Research
- Veterinary Science
Summary
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The research investigates the molecular characteristics, antimicrobial resistance, and toxin production of Clostridium difficile bacteria in horses, emphasizing on the association between disease severity and specific strains. The study reveals that the type of C. difficile strain can significantly influence the severity of the disease, with metronidazole-resistant strains possibly linked to severe disease conditions.
Methodology
The researchers carried out a prospective study on 130 horses admitted to an intensive care unit for acute gastrointestinal disease with loose feces. The following mechanisms were employed:
- Fecal samples were taken from the horses for microbial culture to understand the bacterial make-up and for immunoassay to evaluate toxin production.
- Genomic study of the isolates was performed using polymerase chain reaction assays. This helped in identifying the presence of toxins A and B genes and also in strain identification.
Findings
Based on the molecular banding patterns, the isolates were categorized into three strains: A, B, and C. The main findings include:
- Both toxins A and B gene sequences were identified in 93% and 73% of isolates of strains A and C respectively, and in 95% of strain B isolates.
- Results of the fecal immunoassays showed that toxin A was present in 40%, 63%, and 16% of horses with strains A, B, and C, respectively.
- Strain B isolates were resistant to the antibiotic metronidazole, and horses infected with this strain were ten times more likely to have been treated with metronidazole prior to displaying signs of diarrhea than those infected with other strains.
- The study revealed that horses infected with strain B had a longer recovery period, greater systemic inflammatory response, and a higher mortality rate than those infected with strains A and C.
Conclusion
The research concludes that horses can be infected by a variety of C.difficile strains. There was significant variation in the toxigenicity and antimicrobial resistance of the isolates. Of particular concern was the strain B which showed resistance to metronidazole and seemed to be associated with severe disease. Therefore, understanding the molecular characteristics of these strains is essential for the effective treatment and management of the disease.
Cite This Article
APA
Magdesian KG, Dujowich M, Madigan JE, Hansen LM, Hirsh DC, Jang SS.
(2006).
Molecular characterization of Clostridium difficile isolates from horses in an intensive care unit and association of disease severity with strain type.
J Am Vet Med Assoc, 228(5), 751-755.
https://doi.org/10.2460/javma.228.5.751 Publication
Researcher Affiliations
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
MeSH Terms
- Animals
- Anti-Bacterial Agents / pharmacology
- Anti-Bacterial Agents / therapeutic use
- Bacterial Toxins / analysis
- Bacterial Toxins / chemistry
- Base Sequence
- Clostridioides difficile / classification
- Clostridioides difficile / drug effects
- Clostridioides difficile / isolation & purification
- Drug Resistance, Bacterial
- Enterocolitis, Pseudomembranous / drug therapy
- Enterocolitis, Pseudomembranous / microbiology
- Feces / microbiology
- Female
- Horse Diseases / drug therapy
- Horse Diseases / microbiology
- Horses
- Hospitals, Animal
- Male
- Metronidazole / pharmacology
- Metronidazole / therapeutic use
- Microbial Sensitivity Tests / veterinary
- Phylogeny
- Polymerase Chain Reaction / methods
- Polymerase Chain Reaction / veterinary
- Prospective Studies
- Severity of Illness Index
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