Prevalence and antimicrobial susceptibility of bacterial isolates from horses with synovial sepsis: A cross-sectional study of 95 cases.
Abstract: Bacterial culture and antimicrobial susceptibility testing of septic synovial samples allows instigation of targeted antimicrobial therapy; however, bacterial culture takes more than 24 h and has low sensitivity. This study aimed to identify the most frequently cultured bacteria and their antimicrobial susceptibility profile from septic synovial samples in our referral equine hospital, to allow recommendations regarding appropriate initial antimicrobial therapy prior to culture results. Hospital records for all horses with synovial sepsis and a synovial sample submitted to the microbiology laboratory between 2004 and 2013 were retrieved (n= 379 samples). One horse had positive cultures from more than one synovial structure, and two horses had positive cultures obtained from repeat samples. Overall, 114 bacterial isolates were obtained. Gram-positive bacteria were isolated in 75% of cases, of which 22% were haemolytic Staphylococcus spp., and 52% were Staphylococcus aureus including two multidrug-resistant isolates. Gram-negative bacteria were isolated from 25% of cases. Anaerobic Clostridium spp. was isolated in 3% of cases. Of the first line antimicrobials, oxytetracycline and doxycycline were effective against 70-100% of the Gram-positive bacteria and 20-100% of the Gram-negative organisms, whilst trimethoprim-sulphamethoxazole and gentamicin efficacy ranged between 50% and 88% for both Gram-positive and Gram-negative bacteria. Of the equine protected antimicrobials, ceftiofur was effective against 70-90% of all bacterial isolates whilst 80% of isolates were susceptible to enrofloxacin. These results indicate that tetracyclines, trimethoprim-sulphamethoxazole or gentamicin may be suitable first-line antimicrobials for treatment of synovial sepsis cases while awaiting laboratory results, findings which support current recommendations for antimicrobial stewardship in equine medicine.
Copyright © 2016 Elsevier Ltd. All rights reserved.
Publication Date: 2016-07-16 PubMed ID: 27687937DOI: 10.1016/j.tvjl.2016.07.004Google Scholar: Lookup
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- Journal Article
Summary
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This study investigated the most common bacteria found in horse joint infections and how effectively these bacteria respond to different antibiotics. The report helps guide the initial choice of antibiotics, before specific bacteria are identified.
Research Methodology
- The study was based on reviewing medical records from a veterinary hospital for horses presenting with synovial sepsis (joint infection) between 2004 and 2013.
- Samples taken from the infected joints were cultured in a lab to identify the bacteria causing the infection.
- Antimicrobial susceptibility tests were then conducted to determine the effectiveness of antibiotics against the specific bacterial strains.
Findings
- The research identified 114 bacterial strains from 379 samples. The samples came from different horses and sometimes there were multiple samples from the same horse.
- The majority of infections, 75%, were caused by gram-positive bacteria. The most common species were Haemolytic Staphylococci (22% of gram-positive cases) and Staphylococcus aureus (52%, including two multidrug-resistant strains).
- Gram-negative bacteria were found in 25% of infections. In 3% of cases, anaerobic bacteria, Clostridium spp., were identified.
- The first choice antibiotics tested included oxytetracycline, doxycycline, trimethoprim-sulphamethoxazole, and gentamicin. Their effectiveness varied considerably, ranging from 20-100% against different bacteria.
- Tetracyclines (more precisely, oxytetracycline and doxycycline) had a broad spectrum of effectiveness, being active against most Gram-positive (70-100%) and some Gram-negative bacteria (20-100%).
- Trimethoprim-sulphamethoxazole and gentamicin had similar spectrums of activity, showing efficacy in 50-88% of cases, against both types of bacteria.
Conclusions
- The researchers concluded that tetracyclines, trimethoprim-sulphamethoxazole or gentamicin could be suitable initial choices for treatment of horse joint infections while awaiting lab results.
- The results provide evidence-based guidance to use targeted therapies in accordance with antimicrobial stewardship practices – an approach that promotes using antibiotics which are known to be effective against specific types of bacteria.
Cite This Article
APA
Robinson CS, Timofte D, Singer ER, Rimmington L, Rubio-Martínez LM.
(2016).
Prevalence and antimicrobial susceptibility of bacterial isolates from horses with synovial sepsis: A cross-sectional study of 95 cases.
Vet J, 216, 117-121.
https://doi.org/10.1016/j.tvjl.2016.07.004 Publication
Researcher Affiliations
- School of Veterinary Science, University of Liverpool, Chester High Road, Neston, Wirral, CH64 7TE, UK.
- Microbiology Diagnostics Service, School of Veterinary Science, University of Liverpool, Chester High Road, Neston, Wirral, CH64 7TE, UK; Institute of Infection and Global Health, University of Liverpool, UK.
- School of Veterinary Science, University of Liverpool, Chester High Road, Neston, Wirral, CH64 7TE, UK.
- School of Veterinary Science, University of Liverpool, Chester High Road, Neston, Wirral, CH64 7TE, UK.
- School of Veterinary Science, University of Liverpool, Chester High Road, Neston, Wirral, CH64 7TE, UK. Electronic address: lrubio@liverpool.ac.uk.
MeSH Terms
- Animals
- Anti-Bacterial Agents / pharmacology
- Bacteria / drug effects
- Cross-Sectional Studies
- Drug Resistance, Bacterial
- England / epidemiology
- Female
- Horse Diseases / epidemiology
- Horse Diseases / microbiology
- Horses
- Male
- Microbial Sensitivity Tests / veterinary
- Prevalence
- Sepsis / epidemiology
- Sepsis / microbiology
- Sepsis / veterinary
- Synovial Membrane / microbiology
- Synovitis / epidemiology
- Synovitis / microbiology
- Synovitis / veterinary
Citations
This article has been cited 8 times.- Loppnow Z, Kersh K, Wang C, Spaethe S, Troy J. Clinical use of antimicrobial regional limb perfusion in adult horses diagnosed with synovial sepsis or penetrating synovial wounds at a single equine referral hospital in the Midwest United States-163 cases (2010-2020). Front Vet Sci 2025;12:1504486.
- Terschuur JA, Coomer RPC, McKane SA. Administration safety of medical-grade honey (MGH) in septic synovial structures in horses: 3 cases. Can J Vet Res 2023 Apr;87(2):153-156.
- Li W, Wang J, Li C, Zong Z, Zhao J, Gao H, Liu D. Achieving Ultrasensitive Chromogenic Probes for Rapid, Direct Detection of Carbapenemase-Producing Bacteria in Sputum. JACS Au 2023 Jan 23;3(1):227-238.
- Avellar HK, Lutter JD, Ganta CK, Beard W, Smith JR, Jonnalagadda N, Peloquin S, Kang Q, Ayub K. In vitro antimicrobial activity of equine platelet lysate and mesenchymal stromal cells against common clinical pathogens. Can J Vet Res 2022 Jan;86(1):59-64.
- Haralambus R, Florczyk A, Sigl E, Gültekin S, Vogl C, Brandt S, Schnierer M, Gamerith C, Jenner F. Detection of synovial sepsis in horses using enzymes as biomarkers. Equine Vet J 2022 May;54(3):513-522.
- Redpath A, Hallowell GD, Bowen IM. Use of aminoglycoside antibiotics in equine clinical practice; a questionnaire-based study of current use. Vet Med Sci 2021 Mar;7(2):279-288.
- Isgren CM, Salem SE, Singer ER, Wylie CE, Lipreri G, Graham RJTY, Bladon B, Boswell JC, Fiske-Jackson AR, Mair TS, Rubio-Martínez LM. A multi-centre cohort study investigating the outcome of synovial contamination or sepsis of the calcaneal bursae in horses treated by endoscopic lavage and debridement. Equine Vet J 2020 May;52(3):404-410.
- Robinson CS, Singer ER, Piviani M, Rubio-Martinez LM. Are serum amyloid A or D-lactate useful to diagnose synovial contamination or sepsis in horses?. Vet Rec 2017 Oct 21;181(16):425.
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