FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Emerging infectious diseases2021; 27(2); 529-537; doi: 10.3201/eid2702.203030

Spread of Multidrug-Resistant Rhodococcus equi, United States.

Abstract: Multidrug resistance has been detected in the animal and zoonotic human pathogen Rhodococcus equi after mass macrolide/rifampin antibioprophylaxis in endemically affected equine farms in the United States. Multidrug-resistant (MDR) R. equi emerged upon acquisition of pRERm46, a conjugative plasmid conferring resistance to macrolides, lincosamides, streptogramins, and, as we describe, tetracycline. Phylogenomic analyses indicate that the increasing prevalence of MDR R. equi since it was first documented in 2002 is caused by a clone, R. equi 2287, attributable to coselection of pRErm46 with a chromosomal rpoB mutation driven by macrolide/rifampin therapy. pRErm46 spillover to other R. equi genotypes has given rise to a novel MDR clone, G2016, associated with a distinct rpoB mutation. Our findings illustrate that overuse of antimicrobial prophylaxis in animals can generate MDR pathogens with zoonotic potential. MDR R. equi and pRErm46-mediated resistance are currently disseminating in the United States and are likely to spread internationally through horse movements.
Get Full Text
Publication Date: 2021-01-27 PubMed ID: 33496218PubMed Central: PMC7853588DOI: 10.3201/eid2702.203030Google 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
  • Research Support
  • Non-U.S. Gov't

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 suggests that overuse of antibiotics in farms in the United States has resulted in the spread of a multidrug-resistant pathogen, Rhodococcus equi, which could potentially cross over from animals to humans. This pathogen can resist multiple types of antibiotics due to a unique mutation, and its prevalence has been steadily increasing since 2002 due to continued overuse of antimicrobial drugs for animals.

Multidrug Resistance in Rhodococcus equi

  • The study explores the spread of a pathogen, Rhodococcus equi, that is capable of resisting multiple drugs. This pathogen affects both animals and humans and is of significant concern due to its multidrug-resistant properties.
  • This multidrug-resistant (MDR) strain of R. equi has evolved because of the overuse of macrolide/rifampin (types of antibiotics) in farms that have a high chance of disease prevalence.

Unique Mutation in R. equi

  • The multidrug resistance in R. equi is attributed to a specific mutation of pRERm46, a conjugative plasmid that is capable of resisting multiple classes of drugs, including macrolides, lincosamides, streptogramins, and tetracycline.
  • The research further identified a unique clone, R. equi 2287, which is proliferating due to the forced evolution by overuse of macrolide/rifampin therapy in animals.

Zoonotic Potential of MDR R. equi

  • The researchers caution that the multidrug-resistant R. equi has a high zoonotic potential, meaning it can be transferred from animals to humans.
  • The excessive use of antimicrobial drugs in animals is a driving factor in the emergence and spread of such multidrug-resistant pathogens. This is a significant public health concern as it could lead to harder-to-treat infections in humans.

Spread and Future Implications

  • The study concludes that MDR R. equi is currently spreading in the United States. Furthermore, it is likely to spread internationally through the movement of horses, as this pathogen commonly affects equine species and the environments in which they inhabit.
  • The study underscores the importance of cautious use of antimicrobial drugs in animals to prevent the emergence and spread of zoonotic, multidrug-resistant pathogens.

Cite This Article

APA
Álvarez-Narváez S, Giguère S, Cohen N, Slovis N, Vázquez-Boland JA. (2021). Spread of Multidrug-Resistant Rhodococcus equi, United States. Emerg Infect Dis, 27(2), 529-537. https://doi.org/10.3201/eid2702.203030

Publication

Emerging infectious diseases
ISSN: 1080-6059
NlmUniqueID: 9508155
Country: United States
Language: English
Volume: 27
Issue: 2
Pages: 529-537

Researcher Affiliations

Álvarez-Narváez, Sonsiray
    Giguère, Steeve
      Cohen, Noah
        Slovis, Nathan
          Vázquez-Boland, José A

            MeSH Terms

            • Actinomycetales Infections / drug therapy
            • Actinomycetales Infections / epidemiology
            • Actinomycetales Infections / veterinary
            • Animals
            • Anti-Bacterial Agents / pharmacology
            • Anti-Bacterial Agents / therapeutic use
            • Drug Resistance, Bacterial
            • Horse Diseases / epidemiology
            • Horses
            • Macrolides / pharmacology
            • Rhodococcus
            • Rhodococcus equi / genetics
            • United States / epidemiology

            References

            This article includes 33 references
            1. Prescott JF. Rhodococcus equi: an animal and human pathogen.. Clin Microbiol Rev 1991 Jan;4(1):20-34.
              doi: 10.1128/CMR.4.1.20pmc: PMC358176pubmed: 2004346google scholar: lookup
            2. Vázquez-Boland JA, Giguère S, Hapeshi A, MacArthur I, Anastasi E, Valero-Rello A. Rhodococcus equi: the many facets of a pathogenic actinomycete.. Vet Microbiol 2013 Nov 29;167(1-2):9-33.
              doi: 10.1016/j.vetmic.2013.06.016pubmed: 23993705google scholar: lookup
            3. Yamshchikov AV, Schuetz A, Lyon GM. Rhodococcus equi infection.. Lancet Infect Dis 2010 May;10(5):350-9.
              doi: 10.1016/S1473-3099(10)70068-2pubmed: 20417417google scholar: lookup
            4. MacArthur I, Anastasi E, Alvarez S, Scortti M, Vázquez-Boland JA. Comparative Genomics of Rhodococcus equi Virulence Plasmids Indicates Host-Driven Evolution of the vap Pathogenicity Island.. Genome Biol Evol 2017 May 1;9(5):1241-1247.
              doi: 10.1093/gbe/evx057pmc: PMC5434932pubmed: 28369330google scholar: lookup
            5. Ocampo-Sosa AA, Lewis DA, Navas J, Quigley F, Callejo R, Scortti M, Leadon DP, Fogarty U, Vazquez-Boland JA. Molecular epidemiology of Rhodococcus equi based on traA, vapA, and vapB virulence plasmid markers.. J Infect Dis 2007 Sep 1;196(5):763-9.
              doi: 10.1086/519688pubmed: 17674320google scholar: lookup
            6. Vázquez-Boland JA, Meijer WG. The pathogenic actinobacterium Rhodococcus equi: what's in a name?. Mol Microbiol 2019 Jul;112(1):1-15.
              doi: 10.1111/mmi.14267pmc: PMC6852188pubmed: 31099908google scholar: lookup
            7. Muscatello G, Leadon DP, Klayt M, Ocampo-Sosa A, Lewis DA, Fogarty U, Buckley T, Gilkerson JR, Meijer WG, Vazquez-Boland JA. Rhodococcus equi infection in foals: the science of 'rattles'.. Equine Vet J 2007 Sep;39(5):470-8.
              doi: 10.2746/042516407X209217pubmed: 17910275google scholar: lookup
            8. Giguère S. Treatment of Infections Caused by Rhodococcus equi.. Vet Clin North Am Equine Pract 2017 Apr;33(1):67-85.
              doi: 10.1016/j.cveq.2016.11.002pubmed: 28161038google scholar: lookup
            9. Giguère S, Cohen ND, Chaffin MK, Slovis NM, Hondalus MK, Hines SA, Prescott JF. Diagnosis, treatment, control, and prevention of infections caused by Rhodococcus equi in foals.. J Vet Intern Med 2011 Nov-Dec;25(6):1209-20.
              doi: 10.1111/j.1939-1676.2011.00835.xpubmed: 22092608google scholar: lookup
            10. Burton AJ, Giguère S, Sturgill TL, Berghaus LJ, Slovis NM, Whitman JL, Levering C, Kuskie KR, Cohen ND. Macrolide- and rifampin-resistant Rhodococcus equi on a horse breeding farm, Kentucky, USA.. Emerg Infect Dis 2013 Feb;19(2):282-5.
              doi: 10.3201/eid1902.121210pmc: PMC3559061pubmed: 23347878google scholar: lookup
            11. Giguère S, Lee E, Williams E, Cohen ND, Chaffin MK, Halbert N, Martens RJ, Franklin RP, Clark CC, Slovis NM. Determination of the prevalence of antimicrobial resistance to macrolide antimicrobials or rifampin in Rhodococcus equi isolates and treatment outcome in foals infected with antimicrobial-resistant isolates of R equi.. J Am Vet Med Assoc 2010 Jul 1;237(1):74-81.
              doi: 10.2460/javma.237.1.74pubmed: 20590498google scholar: lookup
            12. Huber L, Giguère S, Slovis NM, Carter CN, Barr BS, Cohen ND, Elam J, Erol E, Locke SJ, Phillips ED, Smith JL. Emergence of Resistance to Macrolides and Rifampin in Clinical Isolates of Rhodococcus equi from Foals in Central Kentucky, 1995 to 2017.. Antimicrob Agents Chemother 2019 Jan;63(1).
              doi: 10.1128/AAC.01714-18pmc: PMC6325176pubmed: 30373803google scholar: lookup
            13. Anastasi E, Giguère S, Berghaus LJ, Hondalus MK, Willingham-Lane JM, MacArthur I, Cohen ND, Roberts MC, Vazquez-Boland JA. Novel transferable erm(46) determinant responsible for emerging macrolide resistance in Rhodococcus equi.. J Antimicrob Chemother 2015 Dec;70(12):3184-90.
              pubmed: 26377866doi: 10.1093/jac/dkv279google scholar: lookup
            14. Erol E, Locke S, Saied A, Cruz Penn MJ, Smith J, Fortner J, Carter C. Antimicrobial susceptibility patterns of Rhodococcus equi from necropsied foals with rhodococcosis.. Vet Microbiol 2020 Mar;242:108568.
              doi: 10.1016/j.vetmic.2019.108568pubmed: 32122582google scholar: lookup
            15. Álvarez-Narváez S, Giguère S, Anastasi E, Hearn J, Scortti M, Vázquez-Boland JA. Clonal Confinement of a Highly Mobile Resistance Element Driven by Combination Therapy in Rhodococcus equi.. mBio 2019 Oct 15;10(5).
              doi: 10.1128/mBio.02260-19pmc: PMC6794481pubmed: 31615959google scholar: lookup
            16. Berghaus LJ, Giguère S, Guldbech K, Warner E, Ugorji U, Berghaus RD. Comparison of Etest, disk diffusion, and broth macrodilution for in vitro susceptibility testing of Rhodococcus equi.. J Clin Microbiol 2015 Jan;53(1):314-8.
              doi: 10.1128/JCM.02673-14pmc: PMC4290945pubmed: 25378571google scholar: lookup
            17. Koren S, Walenz BP, Berlin K, Miller JR, Bergman NH, Phillippy AM. Canu: scalable and accurate long-read assembly via adaptive k-mer weighting and repeat separation.. Genome Res 2017 May;27(5):722-736.
              doi: 10.1101/gr.215087.116pmc: PMC5411767pubmed: 28298431google scholar: lookup
            18. Treangen TJ, Ondov BD, Koren S, Phillippy AM. The Harvest suite for rapid core-genome alignment and visualization of thousands of intraspecific microbial genomes.. Genome Biol 2014;15(11):524.
              doi: 10.1186/s13059-014-0524-xpmc: PMC4262987pubmed: 25410596google scholar: lookup
            19. Price MN, Dehal PS, Arkin AP. FastTree 2--approximately maximum-likelihood trees for large alignments.. PLoS One 2010 Mar 10;5(3):e9490.
              doi: 10.1371/journal.pone.0009490pmc: PMC2835736pubmed: 20224823google scholar: lookup
            20. Anastasi E, MacArthur I, Scortti M, Alvarez S, Giguère S, Vázquez-Boland JA. Pangenome and Phylogenomic Analysis of the Pathogenic Actinobacterium Rhodococcus equi.. Genome Biol Evol 2016 Oct 23;8(10):3140-3148.
              doi: 10.1093/gbe/evw222pmc: PMC5174736pubmed: 27638249google scholar: lookup
            21. Cohen ND, Smith KE, Ficht TA, Takai S, Libal MC, West BR, DelRosario LS, Becu T, Leadon DP, Buckley T, Chaffin MK, Martens RJ. Epidemiologic study of results of pulsed-field gel electrophoresis of isolates of Rhodococcus equi obtained from horses and horse farms.. Am J Vet Res 2003 Feb;64(2):153-61.
              doi: 10.2460/ajvr.2003.64.153pubmed: 12602583google scholar: lookup
            22. Morton AC, Begg AP, Anderson GA, Takai S, Lämmler C, Browning GF. Epidemiology of Rhodococcus equi strains on Thoroughbred horse farms.. Appl Environ Microbiol 2001 May;67(5):2167-75.
              doi: 10.1128/AEM.67.5.2167-2175.2001pmc: PMC92851pubmed: 11319096google scholar: lookup
            23. Tauch A, Götker S, Pühler A, Kalinowski J, Thierbach G. The 27.8-kb R-plasmid pTET3 from Corynebacterium glutamicum encodes the aminoglycoside adenyltransferase gene cassette aadA9 and the regulated tetracycline efflux system Tet 33 flanked by active copies of the widespread insertion sequence IS6100.. Plasmid 2002 Sep;48(2):117-29.
              doi: 10.1016/S0147-619X(02)00120-8pubmed: 12383729google scholar: lookup
            24. Chopra I, Roberts M. Tetracycline antibiotics: mode of action, applications, molecular biology, and epidemiology of bacterial resistance.. Microbiol Mol Biol Rev 2001 Jun;65(2):232-60 ; second page, table of contents.
              doi: 10.1128/MMBR.65.2.232-260.2001pmc: PMC99026pubmed: 11381101google scholar: lookup
            25. Targant H, Doublet B, Aarestrup FM, Cloeckaert A, Madec JY. IS6100-mediated genetic rearrangement within the complex class 1 integron In104 of the Salmonella genomic island 1.. J Antimicrob Chemother 2010 Jul;65(7):1543-5.
              doi: 10.1093/jac/dkq163pubmed: 20483981google scholar: lookup
            26. Partridge SR, Recchia GD, Stokes HW, Hall RM. Family of class 1 integrons related to In4 from Tn1696.. Antimicrob Agents Chemother 2001 Nov;45(11):3014-20.
              doi: 10.1128/AAC.45.11.3014-3020.2001pmc: PMC90776pubmed: 11600350google scholar: lookup
            27. Huber L, Giguère S, Cohen ND, Slovis NM, Hanafi A, Schuckert A, Berghaus L, Greiter M, Hart KA. Prevalence and risk factors associated with emergence of Rhodococcus equi resistance to macrolides and rifampicin in horse-breeding farms in Kentucky, USA.. Vet Microbiol 2019 Aug;235:243-247.
              doi: 10.1016/j.vetmic.2019.07.010pubmed: 31383308google scholar: lookup
            28. Álvarez-Narváez S, Berghaus LJ, Morris ERA, Willingham-Lane JM, Slovis NM, Giguere S, Cohen ND. A Common Practice of Widespread Antimicrobial Use in Horse Production Promotes Multi-Drug Resistance.. Sci Rep 2020 Jan 22;10(1):911.
              doi: 10.1038/s41598-020-57479-9pmc: PMC6976650pubmed: 31969575google scholar: lookup
            29. Kilby ER. The demographics of the US equine population. In: Salem DJ, Rowan AN, editors. The state of the animals. Washington (DC): Human Society Press; 2007. p. 175–205.
            30. Womble A, Giguère S, Lee EA. Pharmacokinetics of oral doxycycline and concentrations in body fluids and bronchoalveolar cells of foals.. J Vet Pharmacol Ther 2007 Jun;30(3):187-93.
              doi: 10.1111/j.1365-2885.2007.00857.xpubmed: 17472649google scholar: lookup
            31. Collignon PJ, Conly JM, Andremont A, McEwen SA, Aidara-Kane A, Agerso Y, Andremont A, Collignon P, Conly J, Dang Ninh T, Donado-Godoy P, Fedorka-Cray P, Fernandez H, Galas M, Irwin R, Karp B, Matar G, McDermott P, McEwen S, Mitema E, Reid-Smith R, Scott HM, Singh R, DeWaal CS, Stelling J, Toleman M, Watanabe H, Woo GJ. World Health Organization Ranking of Antimicrobials According to Their Importance in Human Medicine: A Critical Step for Developing Risk Management Strategies to Control Antimicrobial Resistance From Food Animal Production.. Clin Infect Dis 2016 Oct 15;63(8):1087-1093.
              doi: 10.1093/cid/ciw475pubmed: 27439526google scholar: lookup
            32. Álvarez-Narváez S, Giguère S, Berghaus LJ, Dailey C, Vázquez-Boland JA. Horizontal Spread of Rhodococcus equi Macrolide Resistance Plasmid pRErm46 across Environmental Actinobacteria.. Appl Environ Microbiol 2020 Apr 17;86(9).
              doi: 10.1128/AEM.00108-20pmc: PMC7170479pubmed: 32169935google scholar: lookup
            33. Letek M, González P, Macarthur I, Rodríguez H, Freeman TC, Valero-Rello A, Blanco M, Buckley T, Cherevach I, Fahey R, Hapeshi A, Holdstock J, Leadon D, Navas J, Ocampo A, Quail MA, Sanders M, Scortti MM, Prescott JF, Fogarty U, Meijer WG, Parkhill J, Bentley SD, Vázquez-Boland JA. The genome of a pathogenic rhodococcus: cooptive virulence underpinned by key gene acquisitions.. PLoS Genet 2010 Sep 30;6(9):e1001145.
              doi: 10.1371/journal.pgen.1001145pmc: PMC2947987pubmed: 20941392google scholar: lookup

            Citations

            This article has been cited 20 times.
            1. Di Carlo P, Pipitò L, Orlando E, Bellavia S, Boncori G, Sarno C, Rodolico V, Fasciana T, Sergi C, Cascio A. Intestinal Lesions Due to Rhodococcus equi in a Patient With Advanced Retroviral Disease and Pulmonary Infection: A Case of Colonic Malakoplakia. Cureus 2023 Jul;15(7):e42248.
              doi: 10.7759/cureus.42248pubmed: 37605704google scholar: lookup
            2. Liu L, Yu W, Cai K, Ma S, Wang Y, Ma Y, Zhao H. Identification of vaccine candidates against rhodococcus equi by combining pangenome analysis with a reverse vaccinology approach. Heliyon 2023 Aug;9(8):e18623.
              doi: 10.1016/j.heliyon.2023.e18623pubmed: 37576287google scholar: lookup
            3. Swanner KD, Patel R, Nguyen TT, Patel FN, Magadia R, Rifai AO, Davenport M. A Rare Presentation of Rhodococcus Equi Bacteremia as a Result of Right Upper Arm Cellulitis: A Case Report and Literature Review. Cureus 2023 Apr;15(4):e38295.
              doi: 10.7759/cureus.38295pubmed: 37255906google scholar: lookup
            4. Val-Calvo J, Darcy J, Gibbons J, Creighton A, Egan C, Buckley T, Schmalenberger A, Fogarty U, Scortti M, Vázquez-Boland JA. International Spread of Multidrug-Resistant Rhodococcus equi. Emerg Infect Dis 2022 Sep;28(9):1899-1903.
              doi: 10.3201/eid2809.220222pubmed: 35997496google scholar: lookup
            5. Sting R, Schwabe I, Kieferle M, Münch M, Rau J. Fatal Infection in an Alpaca (Vicugna pacos) Caused by Pathogenic Rhodococcus equi. Animals (Basel) 2022 May 19;12(10).
              doi: 10.3390/ani12101303pubmed: 35625149google scholar: lookup
            6. Narváez SÁ, Fernández I, Patel NV, Sánchez S. Novel Quantitative PCR for Rhodococcus equi and Macrolide Resistance Detection in Equine Respiratory Samples. Animals (Basel) 2022 May 3;12(9).
              doi: 10.3390/ani12091172pubmed: 35565598google scholar: lookup
            7. Cohen ND, Flores-Ahlschewde P, Gonzales GM, Kahn SK, da Silveira BP, Bray JM, King EE, Blair CC, Bordin AI. Fecal concentration of Rhodococcus equi determined by quantitative polymerase chain reaction of rectal swab samples to differentiate foals with pneumonia from healthy foals. J Vet Intern Med 2022 May;36(3):1146-1151.
              doi: 10.1111/jvim.16438pubmed: 35475581google scholar: lookup
            8. Song Y, Xu X, Huang Z, Xiao Y, Yu K, Jiang M, Yin S, Zheng M, Meng H, Han Y, Wang Y, Wang D, Wei Q. Genomic Characteristics Revealed Plasmid-Mediated Pathogenicity and Ubiquitous Rifamycin Resistance of Rhodococcus equi. Front Cell Infect Microbiol 2022;12:807610.
              doi: 10.3389/fcimb.2022.807610pubmed: 35252029google scholar: lookup
            9. Nielsen SS, Bicout DJ, Calistri P, Canali E, Drewe JA, Garin-Bastuji B, Gonzales Rojas JL, Gortázar C, Herskin M, Michel V, Miranda Chueca MÁ, Padalino B, Pasquali P, Roberts HC, Spoolder H, Ståhl K, Velarde A, Viltrop A, Winckler C, Baldinelli F, Broglia A, Kohnle L, Alvarez J. Assessment of listing and categorisation of animal diseases within the framework of the Animal Health Law (Regulation (EU) No 2016/429): antimicrobial-resistant Rhodococcus equi in horses. EFSA J 2022 Feb;20(2):e07081.
              doi: 10.2903/j.efsa.2022.7081pubmed: 35136423google scholar: lookup
            10. Żychska M, Witkowski L, Klementowska A, Rzewuska M, Kwiecień E, Stefańska I, Czopowicz M, Szaluś-Jordanow O, Mickiewicz M, Moroz A, Bonecka J, Kaba J. Rhodococcus equi-Occurrence in Goats and Clinical Case Report. Pathogens 2021 Sep 4;10(9).
              doi: 10.3390/pathogens10091141pubmed: 34578172google scholar: lookup
            11. Erol E, Scortti M, Fortner J, Patel M, Vázquez-Boland JA. Antimicrobial Resistance Spectrum Conferred by pRErm46 of Emerging Macrolide (Multidrug)-Resistant Rhodococcus equi. J Clin Microbiol 2021 Sep 20;59(10):e0114921.
              doi: 10.1128/JCM.01149-21pubmed: 34319806google scholar: lookup
            12. Álvarez-Narváez S, Huber L, Giguère S, Hart KA, Berghaus RD, Sanchez S, Cohen ND. Epidemiology and Molecular Basis of Multidrug Resistance in Rhodococcus equi. Microbiol Mol Biol Rev 2021 May 19;85(2).
              doi: 10.1128/MMBR.00011-21pubmed: 33853933google scholar: lookup
            13. Ghielmetti G, Stevens MJA, Schmitt S, Kittl S, Cernela N, Biggel M, Schulthess B, Keller PM, Schrenzel J, Stephan R. Multi-host distribution of Rhodococcus equi (Prescottella equi) strains and their phylogenomic clustering. BMC Microbiol 2025 Jul 21;25(1):447.
              doi: 10.1186/s12866-025-04152-8pubmed: 40691552google scholar: lookup
            14. Ribeiro NG, Silva PD, de Lima Paz PJ, Arabe Filho MF, Listoni FP, Listoni EP, Panegossi LC, Ribeiro MG. In vitro susceptibility pattern of Rhodococcus equi isolated from patients to antimicrobials recommended exclusively to humans, to domestic animals and to both. Rev Inst Med Trop Sao Paulo 2025;67:e3.
              doi: 10.1590/S1678-9946202567003pubmed: 39907395google scholar: lookup
            15. Huguet AS, Gourbeyre O, Bernand A, Philibert C, Bousquet-Melou A, Lallemand EA, Ferran AA. Comparative bactericidal activity of four macrolides alone and combined with rifampicin or doxycycline against Rhodococcus equi at concentrations achievable in foals. Front Pharmacol 2024;15:1458496.
              doi: 10.3389/fphar.2024.1458496pubmed: 39624843google scholar: lookup
            16. 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
            17. Liu L, Cai P, Gu W, Duan X, Gao S, Ma X, Ma Y, Ma S, Li G, Wang X, Cai K, Wang Y, Cai T, Zhao H. Evaluation of vaccine candidates against Rhodococcus equi in BALB/c mice infection model: cellular and humoral immune responses. BMC Microbiol 2024 Jul 8;24(1):249.
              doi: 10.1186/s12866-024-03408-zpubmed: 38977999google scholar: lookup
            18. Ranganath N, Mendoza MA, Stevens R, Kind D, Wengenack N, Shah A. Rhodococcus infection: a 10-year retrospective analysis of clinical experience and antimicrobial susceptibility profile. J Clin Microbiol 2024 Mar 13;62(3):e0153723.
              doi: 10.1128/jcm.01537-23pubmed: 38349145google scholar: lookup
            19. Alvarez Narvaez S, Sanchez S. Exploring the Accessory Genome of Multidrug-Resistant Rhodococcus equi Clone 2287. Antibiotics (Basel) 2023 Nov 17;12(11).
              doi: 10.3390/antibiotics12111631pubmed: 37998833google scholar: lookup
            20. Tsuzuki N, Maruko T, Takeyama A, Ikeda H, Mizuguchi Y. Evaluation of oxidative stress in foals with Rhodococcus equi infection-induced pneumonia for the judgment of therapeutic effect. J Vet Med Sci 2023 Dec 6;85(12):1277-1280.
              doi: 10.1292/jvms.23-0260pubmed: 37853622google scholar: lookup
            Subscribe to our newsletter
            Join 99,780 horse owners like you who receive our email updates on horse health and nutrition.