FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Journal of veterinary internal medicine2015; 30(1); 314-321; doi: 10.1111/jvim.13653

Pneumonia Caused by Klebsiella spp. in 46 Horses.

Abstract: Klebsiella spp. are implicated as a common cause of bacterial pneumonia in horses, but few reports describe clinical presentation and disease progression. Objective: To describe the signalment, clinicopathologic data, radiographic and ultrasonographic findings, antimicrobial susceptibility, outcome, and pathologic lesions associated with Klebsiella spp. pneumonia in horses. Methods: Forty-six horses from which Klebsiella spp. was isolated from the lower respiratory tract. Methods: Retrospective study. Medical records from 1993 to 2013 at the William R. Pritchard Veterinary Medical Teaching Hospital, University of California, Davis were reviewed. Exact logistic regression was performed to determine if any variables were associated with survival to hospital discharge. Results: Survival in horses <1 year old was 73%. Overall survival in adults was 63%. For adults in which Klebsiella pneumoniae was the primary isolate, survival was 52%. Mechanical ventilation preceded development of pneumonia in 11 horses. Complications occurred in 25/46 horses, with thrombophlebitis and laminitis occurring most frequently. Multi-drug resistance was found in 47% of bacterial isolates. Variables that significantly impacted survival included hemorrhagic nasal discharge, laminitis, and thoracic radiographs with a sharp demarcation between marked caudal pulmonary alveolar infiltration and more normal-appearing caudodorsal lung. Conclusions: Klebsiella spp. should be considered as a differential diagnosis for horses presenting with hemorrhagic pneumonia and for horses developing pneumonia after mechanical ventilation. Multi-drug resistance is common. Prognosis for survival generally is fair, but is guarded for adult horses in which K. pneumoniae is isolated as the primary organism.
Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
Get Full Text
Publication Date: 2015-10-23 PubMed ID: 26492860PubMed Central: PMC4913652DOI: 10.1111/jvim.13653Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • 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 research paper analyzes the characteristics, manifestations, treatment, and progression of bacterial pneumonia caused by Klebsiella spp. in horses. The study evaluates 46 cases over a two-decade period, providing rich insight into the symptoms, treatment responses, and outcomes associated with this disease in horses, including a surprisingly high rate of multi-drug resistance.

Introduction and Methodology

  • This study aims to unveil the specificities of pneumonia caused by Klebsiella spp. in horses, especially since it is a common cause, but is widely underreported.
  • It provides a retrospective analysis of 46 horses diagnosed with Klebsiella pneumonia from 1993 to 2013 at the University of California’s William R. Pritchard Veterinary Medical Teaching Hospital.
  • The researchers utilized various data sources, such as medical records, radiographs, ultrasonographic findings, and clinicopathologic analyses, to identify patterns and correlations related to this disease.
  • An exact logistic regression was performed to ascertain if any variable could predict a horse’s survival chances after being discharged from the hospital.

Results and Findings

  • The survival rate among horses younger than one year old was 73%, while in adult horses, it was about 63%.
  • In cases where Klebsiella pneumoniae was the only pathogen, the survival rate fell further to 52% in adult horses.
  • A significant number (11 out of 46) of horses developed pneumonia after undergoing mechanical ventilation.
  • Approximately half of the studied cases experienced complications, with thrombophlebitis and laminitis being the most prevalent.
  • It is noteworthy that 47% of the bacterial isolates exhibited multi-drug resistance, suggesting a significant treatment challenge.
  • Factors such as hemorrhagic nasal discharge, laminitis, and sharply demarcated images on thoracic radiographs significantly impacted the survival chances of the horses.

Conclusions

  • The study concluded that Klebsiella spp. should be regarded as a potential cause when diagnosing horses with hemorrhagic pneumonia or those that develop pneumonia post-mechanical ventilation.
  • Indeed, this pathogen’s common multi-drug resistance warrants specific attention to ensure appropriate treatment protocols.
  • The general prognosis for horses surviving this form of pneumonia is fair, but guarded in adult cases where K. pneumoniae is the only detected organism.

Cite This Article

APA
Estell KE, Young A, Kozikowski T, Swain EA, Byrne BA, Reilly CM, Kass PH, Aleman M. (2015). Pneumonia Caused by Klebsiella spp. in 46 Horses. J Vet Intern Med, 30(1), 314-321. https://doi.org/10.1111/jvim.13653

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 30
Issue: 1
Pages: 314-321

Researcher Affiliations

Estell, K E
  • William R. Pritchard Veterinary Medical Teaching Hospital, University of California, Davis, CA.
Young, A
  • William R. Pritchard Veterinary Medical Teaching Hospital, University of California, Davis, CA.
Kozikowski, T
  • William R. Pritchard Veterinary Medical Teaching Hospital, University of California, Davis, CA.
Swain, E A
  • William R. Pritchard Veterinary Medical Teaching Hospital, University of California, Davis, CA.
Byrne, B A
  • Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, CA.
Reilly, C M
  • Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, CA.
Kass, P H
  • Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA.
Aleman, M
  • Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA.

MeSH Terms

  • Animals
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Drug Resistance, Multiple, Bacterial
  • Horse Diseases / microbiology
  • Horses
  • Klebsiella / drug effects
  • Klebsiella / isolation & purification
  • Klebsiella Infections / microbiology
  • Klebsiella Infections / pathology
  • Klebsiella Infections / veterinary
  • Pneumonia, Bacterial / microbiology
  • Pneumonia, Bacterial / prevention & control
  • Pneumonia, Bacterial / veterinary
  • Retrospective Studies

References

This article includes 30 references
  1. Ainsworth DM, Cheetham J. Disorders of the lower respiratory tract. In: Reed SM, Bayly WM, Sellon DC, eds. Equine Internal Medicine, 3rd ed St. Louis, MO: Saunders; 2010:325.
  2. Giguere S. Disorders of the lung: Bacterial pneumonia and pleuropneumonia. In: Smith BP, ed. Large Animal Internal Medicine, 5th ed St. Louis, MO: Elsevier; 2015:471.
  3. Magid JH. Pneumonia and pleuritis in a mare.. Vet Clin North Am Equine Pract 2006 Apr;22(1):247-54.
    pubmed: 16627121doi: 10.1016/j.cveq.2005.12.002google scholar: lookup
  4. Wilkins PA. Lower respiratory problems of the neonate.. Vet Clin North Am Equine Pract 2003 Apr;19(1):19-33, v.
    pubmed: 12747659doi: 10.1016/s0749-0739(02)00064-0google scholar: lookup
  5. Hoffman AM, Viel L, Prescott JF, Rosendal S, Thorsen J. Association of microbiologic flora with clinical, endoscopic, and pulmonary cytologic findings in foals with distal respiratory tract infection.. Am J Vet Res 1993 Oct;54(10):1615-22.
    pubmed: 8250386
  6. Pusterla N, Jones ME, Mohr FC, Higgins JK, Mapes S, Jang SS, Samitz EM, Byrne BA. Fatal pulmonary hemorrhage associated with RTX toxin producing Actinobacillus equuli subspecies haemolyticus infection in an adult horse.. J Vet Diagn Invest 2008 Jan;20(1):118-21.
    pubmed: 18182526doi: 10.1177/104063870802000127google scholar: lookup
  7. DebRoy C, Roberts E, Jayarao BM, Brooks JW. Bronchopneumonia associated with extraintestinal pathogenic Escherichia coli in a horse.. J Vet Diagn Invest 2008 Sep;20(5):661-4.
    pubmed: 18776106doi: 10.1177/104063870802000524google scholar: lookup
  8. Platt H, Atherton JG, Orskov I. Klebsiella and Enterobacter organisms isolated from horses.. J Hyg (Lond) 1976 Dec;77(3):401-8.
    pmc: PMC2129811pubmed: 794407doi: 10.1017/s0022172400055789google scholar: lookup
  9. Sandiumenge A, Rello J. Ventilator-associated pneumonia caused by ESKAPE organisms: cause, clinical features, and management.. Curr Opin Pulm Med 2012 May;18(3):187-93.
    pubmed: 22366995doi: 10.1097/mcp.0b013e328351f974google scholar: lookup
  10. Peleg AY, Hooper DC. Hospital-acquired infections due to gram-negative bacteria.. N Engl J Med 2010 May 13;362(19):1804-13.
    pmc: PMC3107499pubmed: 20463340doi: 10.1056/nejmra0904124google scholar: lookup
  11. Racklyeft DJ, Love DN. Bacterial infection of the lower respiratory tract in 34 horses.. Aust Vet J 2000 Aug;78(8):549-59.
    pubmed: 10979512doi: 10.1111/j.1751-0813.2000.tb11901.xgoogle scholar: lookup
  12. Wilkins PA. Lower airway diseases of the adult horse.. Vet Clin North Am Equine Pract 2003 Apr;19(1):101-21, vii.
    pubmed: 12747664doi: 10.1016/s0749-0739(02)00069-xgoogle scholar: lookup
  13. Sweeney CR, Holcombe SJ, Barningham SC, Beech J. Aerobic and anaerobic bacterial isolates from horses with pneumonia or pleuropneumonia and antimicrobial susceptibility patterns of the aerobes.. J Am Vet Med Assoc 1991 Mar 1;198(5):839-42.
    pubmed: 2026535
  14. Sweeney CR, Divers TJ, Benson CE. Anaerobic bacteria in 21 horses with pleuropneumonia.. J Am Vet Med Assoc 1985 Oct 1;187(7):721-4.
    pubmed: 4055490
  15. CLSI. Performance Standards for Antimicrobial Disk and Dilution Susceptibility Tests for Bacteria Isolated from Animals; Second Information Supplement. CLSI document VET01‐S2. Wayne, PA: Clinical and Laboratory Standards Institute; 2013.
  16. Seltzer KL, Byars TD. Prognosis for return to racing after recovery from infectious pleuropneumonia in thoroughbred racehorses: 70 cases (1984-1989).. J Am Vet Med Assoc 1996 Apr 15;208(8):1300-1.
    pubmed: 8635976
  17. Bedenice D, Heuwieser W, Brawer R, Solano M, Rand W, Paradis MR. Clinical and prognostic significance of radiographic pattern, distribution, and severity of thoracic radiographic changes in neonatal foals.. J Vet Intern Med 2003 Nov-Dec;17(6):876-86.
    pubmed: 14658726doi: 10.1111/j.1939-1676.2003.tb02528.xgoogle scholar: lookup
  18. Smith BP. Pleuritis and pleural effusion in the horse: a study of 37 cases.. J Am Vet Med Assoc 1977 Jan 15;170(2):208-11.
    pubmed: 576221
  19. Ko WC, Paterson DL, Sagnimeni AJ, Hansen DS, Von Gottberg A, Mohapatra S, Casellas JM, Goossens H, Mulazimoglu L, Trenholme G, Klugman KP, McCormack JG, Yu VL. Community-acquired Klebsiella pneumoniae bacteremia: global differences in clinical patterns.. Emerg Infect Dis 2002 Feb;8(2):160-6.
    pmc: PMC2732457pubmed: 11897067doi: 10.3201/eid0802.010025google scholar: lookup
  20. Wang E, Ouellet N, Simard M, Fillion I, Bergeron Y, Beauchamp D, Bergeron MG. Pulmonary and systemic host response to Streptococcus pneumoniae and Klebsiella pneumoniae bacteremia in normal and immunosuppressed mice.. Infect Immun 2001 Sep;69(9):5294-304.
    pmc: PMC98638pubmed: 11500398doi: 10.1128/iai.69.9.5294-5304.2001google scholar: lookup
  21. Carr EA, Carlson GP, Wilson WD, Read DH. Acute hemorrhagic pulmonary infarction and necrotizing pneumonia in horses: 21 cases (1967-1993).. J Am Vet Med Assoc 1997 Jun 15;210(12):1774-8.
    pubmed: 9187729
  22. Divers TJ. Prevention and treatment of thrombosis, phlebitis, and laminitis in horses with gastrointestinal diseases.. Vet Clin North Am Equine Pract 2003 Dec;19(3):779-90.
    pubmed: 14740769doi: 10.1016/j.cveq.2003.08.002google scholar: lookup
  23. Lankveld DP, Ensink JM, van Dijk P, Klein WR. Factors influencing the occurrence of thrombophlebitis after post-surgical long-term intravenous catheterization of colic horses: a study of 38 cases.. J Vet Med A Physiol Pathol Clin Med 2001 Nov;48(9):545-52.
    pubmed: 11765811doi: 10.1046/j.1439-0442.2001.00383.xgoogle scholar: lookup
  24. Dabareiner RM, White NA. Large colon impaction in horses: 147 cases (1985-1991).. J Am Vet Med Assoc 1995 Mar 1;206(5):679-85.
    pubmed: 7744691
  25. Hlastala MP, Bernard SL, Erickson HH, Fedde MR, Gaughan EM, McMurphy R, Emery MJ, Polissar N, Glenny RW. Pulmonary blood flow distribution in standing horses is not dominated by gravity.. J Appl Physiol (1985) 1996 Sep;81(3):1051-61.
    pubmed: 8889734doi: 10.1152/jappl.1996.81.3.1051google scholar: lookup
  26. Stewart JH, Young IH, Rose RJ, Costas L, Barko AM. The distribution of ventilation-perfusion ratios in the lungs of newborn foals.. J Dev Physiol 1987 Aug;9(4):309-24.
    pubmed: 2821098
  27. Broberg CA, Palacios M, Miller VL. Klebsiella: a long way to go towards understanding this enigmatic jet-setter.. F1000Prime Rep 2014;6:64.
    pmc: PMC4126530pubmed: 25165563doi: 10.12703/p6-64google scholar: lookup
  28. Liang C, Xing B, Yang X, Fu Y, Feng Y, Zhang Y. Molecular epidemiology of aminoglycosides resistance on Klebsiella pneumonia in a hospital in China.. Int J Clin Exp Med 2015;8(1):1381-5.
    pmc: PMC4358596pubmed: 25785141
  29. Tzouvelekis LS, Markogiannakis A, Psichogiou M, Tassios PT, Daikos GL. Carbapenemases in Klebsiella pneumoniae and other Enterobacteriaceae: an evolving crisis of global dimensions.. Clin Microbiol Rev 2012 Oct;25(4):682-707.
    pmc: PMC3485753pubmed: 23034326doi: 10.1128/cmr.05035-11google scholar: lookup
  30. Davis JL, Salmon JH, Papich MG. Pharmacokinetics and tissue distribution of doxycycline after oral administration of single and multiple doses in horses.. Am J Vet Res 2006 Feb;67(2):310-6.
    pubmed: 16454638doi: 10.2460/ajvr.67.2.310google scholar: lookup

Citations

This article has been cited 19 times.
  1. Hepworth-Warren KL, Estell K, Cowles B, Amodie D, Crisman M. Utility of serum amyloid A in monitoring clinical response to antimicrobial treatment in horses with bacterial pneumonia. J Vet Intern Med 2023 Sep-Oct;37(5):1917-1922.
    doi: 10.1111/jvim.16818pubmed: 37522636google scholar: lookup
  2. Brandly JE, Midon M, Douglas HF, Hopster K. Flow-controlled expiration reduces positive end-expiratory pressure requirement in dorsally recumbent, anesthetized horses. Front Vet Sci 2023;10:1135452.
    doi: 10.3389/fvets.2023.1135452pubmed: 37124564google scholar: lookup
  3. Migliorisi A, Barger A, Austin S, Foreman JH, Wilkins P. Hyponatremia in horses with septic pneumopathy. J Vet Intern Med 2022 Sep;36(5):1820-1826.
    doi: 10.1111/jvim.16522pubmed: 36054644google scholar: lookup
  4. Arafa AA, Hedia RH, Dorgham SM, Ibrahim ES, Bakry MA, Abdalhamed AM, Abuelnaga ASM. Determination of extended-spectrum β-lactamase-producing Klebsiella pneumoniae isolated from horses with respiratory manifestation. Vet World 2022 Apr;15(4):827-833.
    doi: 10.14202/vetworld.2022.827-833pubmed: 35698500google scholar: lookup
  5. Venturini C, Bowring B, Partridge SR, Ben Zakour NL, Fajardo-Lubian A, Lopez Ayala A, Qin J, Totsika M, van Galen G, Norris J, Iredell J. Co-Occurrence of Multidrug Resistant Klebsiella pneumoniae Pathogenic Clones of Human Relevance in an Equine Pneumonia Case. Microbiol Spectr 2022 Jun 29;10(3):e0215821.
    doi: 10.1128/spectrum.02158-21pubmed: 35579468google scholar: lookup
  6. Rahman A, Uzal FA, Hassebroek AM, Carvallo FR. Retrospective study of pneumonia in non-racing horses in California. J Vet Diagn Invest 2022 Jul;34(4):587-593.
    doi: 10.1177/10406387221094273pubmed: 35535386google scholar: lookup
  7. Ribonnet C, Palmers K, Saegerman C, Vanderperren K, van Galen G. Perioperative lung ultrasonography in healthy horses undergoing general anesthesia for elective surgery. J Vet Intern Med 2022 May;36(3):1160-1172.
    doi: 10.1111/jvim.16408pubmed: 35322893google scholar: lookup
  8. De Koster S, Rodriguez Ruiz JP, Rajakani SG, Lammens C, Glupczynski Y, Goossens H, Xavier BB. Diversity in the Characteristics of Klebsiella pneumoniae ST101 of Human, Environmental, and Animal Origin. Front Microbiol 2022;13:838207.
    doi: 10.3389/fmicb.2022.838207pubmed: 35222344google scholar: lookup
  9. Ribeiro MG, de Morais ABC, Alves AC, Bolaños CAD, de Paula CL, Portilho FVR, de Nardi Júnior G, Lara GHB, de Souza Araújo Martins L, Moraes LS, Risseti RM, Guerra ST, Bello TS, Siqueira AK, Bertolini AB, Rodrigues CA, Paschoal NR, de Almeida BO, Listoni FJP, Sánchez LFG, Paes AC. Klebsiella-induced infections in domestic species: a case-series study in 697 animals (1997-2019). Braz J Microbiol 2022 Mar;53(1):455-464.
    doi: 10.1007/s42770-021-00667-0pubmed: 35018603google scholar: lookup
  10. Nielsen SS, Bicout DJ, Calistri P, Canali E, Drewe JA, Garin-Bastuji B, Gonzales Rojas JL, Gortazar Schmidt C, Herskin M, Michel V, Miranda Chueca MA, Padalino B, Pasquali P, Roberts HC, Sihvonen LH, Spoolder H, Stahl K, Velarde A, Viltrop A, Winckler C, Dewulf J, Guardabassi L, Hilbert F, Mader R, Baldinelli F, Alvarez J. Assessment of animal diseases caused by bacteria resistant to antimicrobials: Horses. EFSA J 2021 Dec;19(12):e07112.
    doi: 10.2903/j.efsa.2021.7112pubmed: 34987627google scholar: lookup
  11. Aleman MR, True A, Scalco R, Crowe CM, Costa LRR, Chigerwe M. Gentamicin-induced sensorineural auditory loss in healthy adult horses. J Vet Intern Med 2021 Sep;35(5):2486-2494.
    doi: 10.1111/jvim.16221pubmed: 34322916google scholar: lookup
  12. Darniati D, Setiyaningsih S, Agungpriyono DR, Handharyani E. First evidence of Klebsiella pneumoniae infection in Aceh cattle: Pathomorphology and antigenic distribution in the lungs. Vet World 2021 Apr;14(4):1007-1013.
    doi: 10.14202/vetworld.2021.1007-1013pubmed: 34083953google scholar: lookup
  13. Sukmawinata E, Uemura R, Sato W, Thu Htun M, Sueyoshi M. Multidrug-Resistant ESBL/AmpC-Producing Klebsiella pneumoniae Isolated from Healthy Thoroughbred Racehorses in Japan. Animals (Basel) 2020 Feb 25;10(3).
    doi: 10.3390/ani10030369pubmed: 32106501google scholar: lookup
  14. Theelen MJP, Wilson WD, Byrne BA, Edman JM, Kass PH, Mughini-Gras L, Magdesian KG. Differences in isolation rate and antimicrobial susceptibility of bacteria isolated from foals with sepsis at admission and after ≥48 hours of hospitalization. J Vet Intern Med 2020 Mar;34(2):955-963.
    doi: 10.1111/jvim.15692pubmed: 32022351google scholar: lookup
  15. Krishnan SG, Sajeev S, Sivam V, T RS, Ojha R, Shome BR, Holmes M, Sundaram T, M D R, Vinayagam S, Meesala S, Malik T, Dara PK. Identification of serotype O3b and high-risk clone ST37 of Klebsiella pneumoniae revealed by comparative genomic analysis. Front Cell Infect Microbiol 2024;14:1517125.
    doi: 10.3389/fcimb.2024.1517125pubmed: 39902187google scholar: lookup
  16. Khalefa HS, Arafa AA, Hamza D, El-Razik KAA, Ahmed Z. Emerging biofilm formation and disinfectant susceptibility of ESBL-producing Klebsiella pneumoniae. Sci Rep 2025 Jan 10;15(1):1599.
    doi: 10.1038/s41598-024-84149-xpubmed: 39794383google scholar: lookup
  17. Hepworth-Warren KL, Love K. Survey of the approach to the diagnosis and management of bacterial pneumonia in adult horses by equine veterinarians. Front Vet Sci 2024;11:1484970.
    doi: 10.3389/fvets.2024.1484970pubmed: 39764370google scholar: lookup
  18. Kabir A, Lamichhane B, Habib T, Adams A, El-Sheikh Ali H, Slovis NM, Troedsson MHT, Helmy YA. Antimicrobial Resistance in Equines: A Growing Threat to Horse Health and Beyond-A Comprehensive Review. Antibiotics (Basel) 2024 Jul 29;13(8).
    doi: 10.3390/antibiotics13080713pubmed: 39200013google scholar: lookup
  19. Hallowell KL, Hepworth-Warren KL, Dembek K. An updated description of bacterial pneumonia in adult horses and factors associated with death. J Vet Intern Med 2024 Sep-Oct;38(5):2766-2775.
    doi: 10.1111/jvim.17141pubmed: 39005215google scholar: lookup
Subscribe to our newsletter
Join 100,129 horse owners like you who receive our email updates on horse health and nutrition.