Sequential bacterial sampling of the midline incision in horses undergoing exploratory laparotomy.
Abstract: There is limited information about bacterial isolates that are present on the equine midline incision during and following exploratory laparotomy. Objective: To investigate the bacterial species cultured from the ventral midline pre-, intra- and post- laparotomy, whether particular bacterial isolates are associated with the development of surgical site infections (SSIs) and to report the antimicrobial resistance phenotypes of these isolates. Methods: Prospective cohort study. Methods: The ventral midline of 31 horses undergoing exploratory laparotomy was sampled for bacterial culture at set time-points pre, intra and post-operatively. Inclusion criteria were that horses must have undergone exploratory laparotomy within 90 min of the initial colic examination upon hospital admission and must not have been placed in a stable prior to surgery. SSI was defined as any purulent or serous discharge from the laparotomy incision of >24 h duration. Results: Seven horses (22.6%) developed a SSI. None of the variables tested were associated with the altered risk of SSI. The prevalence of a positive bacterial culture from the incision increased progressively over time and a variety of bacteria were isolated. A positive intra-operative culture was not a predictor of SSI; and when a SSI did occur, it was due to a different bacterial isolate. MRSA and ESBL-producers were identified in the post-operative period in one and four different horses respectively, but none of these developed a SSI. Conclusions: Sampling was limited to hospitalisation and no culture results were available for horses developing SSI following hospital discharge. Conclusions: A variety of bacterial species may be isolated from equine laparotomy incisions peri-operatively without development of SSI. SSI does not appear to be solely related to bacterial contamination of the incision peri-operatively and other mechanisms such as bacteraemia merit further investigation.
© 2018 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
Publication Date: 2018-05-17 PubMed ID: 29679416PubMed Central: PMC6585715DOI: 10.1111/evj.12958Google Scholar: Lookup
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- Journal Article
Summary
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The research investigates the types of bacteria found on the incision site of horses undergoing laparotomy surgery, the correlation of these bacteria with post-operative infections, and the antibiotic resistance of these bacterial isolates. A key finding is that an array of bacteria may be found without leading to infection, and that infection is not solely linked to onsite bacterial contamination.
Study Overview
- Researchers conducted a prospective study, sampling bacteria present at the incision site of 31 horses undergoing exploratory laparotomy, a surgical procedure in which the abdomen is opened and internal organs examined.
- Swabs were acquired before, during, and after the procedure, aiming to identify the bacterial species present and their relation to surgical site infections (SSIs).
- A stringent inclusion criterion was followed. The horses in the study must have had the surgery within 90 minutes after being examined for colic symptoms upon hospital admission and must have not been put in a stable prior to surgery.
- For this study, SSIs were classified as any instance of purulent (pus-related) or serous (clear, serum-like) discharge from the incision that lasted for more than 24 hours.
Key Findings
- Of the 31 horses involved in the study, seven (about 22.6%) developed an SSI.
- No risk factors studied showed a connection to the increased chances of SSIs.
- Positive bacterial cultures from the incision site grew over time, with different bacterial types recorded. However, having a positive intra-operative culture did not predict the occurrence of SSIs.
- When an SSI did occur, the study found that the bacteria causing it were not the ones found on the incision site during surgery.
- In the post-operative period, MRSA and ESBL-producing bacteria were detected in some horses, but these horses did not develop SSIs.
Conclusions and Limitations
- The researchers highlighted that their sampling was limited to the hospitalisation period of the horses, indicating a gap in knowledge regarding the species of bacteria possibly accumulating after the horses left the hospital.
- In conclusion, the study showed that the presence of various bacteria on the surgical incision site did not necessarily lead to SSIs.
- The study suggests that SSIs aren’t solely due to bacterial contamination of the operative area, pointing towards the potential role of other mechanisms (e.g., blood-borne infection or bacteraemia) that warrant further investigation.
Cite This Article
APA
Isgren CM, Salem SE, Townsend NB, Timofte D, Maddox TW, Archer DC.
(2018).
Sequential bacterial sampling of the midline incision in horses undergoing exploratory laparotomy.
Equine Vet J, 51(1), 38-44.
https://doi.org/10.1111/evj.12958 Publication
Researcher Affiliations
- Department of Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, Leahurst, UK.
- Department of Equine Clinical Science, Institute of Veterinary Science, University of Liverpool, Leahurst, UK.
- Department of Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, Leahurst, UK.
- Department of Surgery, Faculty of Veterinary Medicine, Zagazig University, Zakazik, Egypt.
- Three Counties Equine Hospital, Stratford Bridge, Ripple, Tewkesbury, UK.
- Institute of Veterinary Science, University of Liverpool, Leahurst, UK.
- Institute of Infection and Global Health, University of Liverpool, Leahurst, UK.
- Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool, Leahurst, UK.
- Department of Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, Leahurst, UK.
- Department of Equine Clinical Science, Institute of Veterinary Science, University of Liverpool, Leahurst, UK.
MeSH Terms
- Animals
- Bacteria / classification
- Bacteria / drug effects
- Bacteria / isolation & purification
- Bacterial Infections / epidemiology
- Bacterial Infections / microbiology
- Bacterial Infections / veterinary
- Bacterial Load / veterinary
- Bandages / veterinary
- Cohort Studies
- Drug Resistance, Bacterial
- England / epidemiology
- Horse Diseases / epidemiology
- Horse Diseases / microbiology
- Horses
- Laparotomy / veterinary
- Perioperative Period / veterinary
- Phenotype
- Prevalence
- Prospective Studies
- Surgical Wound / microbiology
- Surgical Wound / veterinary
- Surgical Wound Infection / epidemiology
- Surgical Wound Infection / microbiology
- Surgical Wound Infection / veterinary
- Surveys and Questionnaires
Grant Funding
- University of Liverpool
- Veterinary Research Project Support
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