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Antibiotics (Basel, Switzerland)2021; 10(2); 155; doi: 10.3390/antibiotics10020155

Third Generation Cephalosporin Resistant Enterobacterales Infections in Hospitalized Horses and Donkeys: A Case-Case-Control Analysis.

Abstract: In human medicine, infections caused by third-generation cephalosporin-resistant (3GCRE) are associated with detrimental outcomes. In veterinary medicine, controlled epidemiological analyses are lacking. A matched case-case-control investigation (1:1:1 ratio) was conducted in a large veterinary hospital (2017-2019). In total, 29 infected horses and donkeys were matched to 29 animals with third-generation cephalosporin-susceptible (3GCSE) infections, and 29 uninfected controls (overall = 87). Despite multiple significant associations per bivariable analyses, the only independent predictor for 3GCRE infection was recent exposure to antibiotics (adjusted odds ratio (aOR) = 104, < 0.001), but this was also an independent predictor for 3GCSE infection (aOR = 22, < 0.001), though the correlation with 3GCRE was significantly stronger (aOR = 9.3, = 0.04). In separated multivariable outcome models, 3GCRE infections were independently associated with reduced clinical cure rates (aOR = 6.84, = 0.003) and with 90 days mortality (aOR = 3.6, = 0.003). spp. were the most common 3GCRE (36%), and was the major β-lactamase (79%). Polyclonality and multiple sequence types were evident among all (e.g., , , ). The study substantiates the significance of 3GCRE infections in equine medicine, and their independent detrimental impact on cure rates and mortality. Multiple genera, subtypes, clones and mechanisms of resistance are prevalent among horses and donkeys with 3GCRE infections.
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Publication Date: 2021-02-04 PubMed ID: 33557061PubMed Central: PMC7913880DOI: 10.3390/antibiotics10020155Google Scholar: Lookup
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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 focuses on investigating the impact of Third-generation cephalosporin-resistant infections in horses and donkeys hospitalized in a large veterinary hospital, highlighting the significant role of antibiotic exposure in these infections and emphasizing the negative effects on cure rates and mortality.

Research Context and Objective

  • The research carried out was in response to the lack of controlled epidemiological analyses in veterinary medicine about infections caused by third-generation cephalosporin-resistant (3GCRE) bacteria.
  • The objective of the study was to investigate the risk factors associated with 3GCRE infections in hospitalized horses and donkeys, and assess their impact on clinical outcomes, such as cure rates and mortality.

Research Methodology

  • A matched case-case-control investigation with a 1:1:1 ratio was carried out. This involved studying a group of 29 infected animals, 29 animals with third-generation cephalosporin-susceptible infections, and 29 uninfected controls, totaling 87.
  • Several statistical methods were used to find associations and predictors for the 3GCRE and 3GCSE infections.

Key Findings

  • The study found that the primary independent predictor for both 3GCRE and 3GCSE infection was recent exposure to antibiotics.
  • However, this correlation was significantly stronger in 3GCRE infections, with an adjusted odds ratio of 104, implying that animals with recent antibiotic exposure were more likely to develop 3GCRE infections.
  • The study also identified an independent association between 3GCRE infections and reduced clinical cure rates, as well as 90-day mortality rates.

Identified Bacterial Species and Resistance Mechanism

  • The most commonly identified 3GCRE bacteria were from the Enterobacterales species, making up 36% of the cases. These bacteria were found to generate the most substantial β-lactamase, which is an enzyme that contributes to antimicrobial resistance, accounting for 79% of the sample.
  • The research also revealed a high degree of genetic diversity in the bacteria, indicating multiple bacterial subtypes, clones and mechanisms of resistance.

Significance and Conclusion

  • The research substantiates the significance of 3GCRE infections in equine medicine due to their detrimental impact on cure rates and mortality.
  • It also highlights the importance of judicious antibiotic usage, considering the identified link between recent antibiotic exposure and 3GCRE infections.
  • Additionally, it provides evidence of multiple bacterial genera, subtypes, clones, and resistance mechanisms prevalent among horses and donkeys with 3GCRE infections.

Cite This Article

APA
Shnaiderman-Torban A, Marchaim D, Navon-Venezia S, Lubrani O, Paitan Y, Arielly H, Steinman A. (2021). Third Generation Cephalosporin Resistant Enterobacterales Infections in Hospitalized Horses and Donkeys: A Case-Case-Control Analysis. Antibiotics (Basel), 10(2), 155. https://doi.org/10.3390/antibiotics10020155

Publication

Antibiotics (Basel, Switzerland)
ISSN: 2079-6382
NlmUniqueID: 101637404
Country: Switzerland
Language: English
Volume: 10
Issue: 2
PII: 155

Researcher Affiliations

Shnaiderman-Torban, Anat
  • Koret School of Veterinary Medicine (KSVM), The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 7610001, Israel.
Marchaim, Dror
  • Unit of Infection Control, Shamir (Assaf Harofeh) Medical Center, Zerifin, Beer Yaakov 70300, Israel.
  • Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel.
Navon-Venezia, Shiri
  • Department of Molecular Biology, Faculty of Natural Science, Ariel University, Ariel 40700, Israel.
  • The Miriam and Sheldon Adelson School of Medicine, Ariel University, Ariel 40700, Israel.
Lubrani, Ori
  • Koret School of Veterinary Medicine (KSVM), The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 7610001, Israel.
Paitan, Yossi
  • Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
  • Clinical Microbiology Lab, Meir Medical Center, Kfar Saba 4428164, Israel.
Arielly, Haya
  • Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
Steinman, Amir
  • Koret School of Veterinary Medicine (KSVM), The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 7610001, Israel.

Conflict of Interest Statement

The authors declare no conflict of interest.

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Citations

This article has been cited 3 times.
  1. Puvača N. Optimization of Veterinary Antimicrobial Treatment in Companion and Food Animals.. Antibiotics (Basel) 2022 Aug 22;11(8).
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  2. Thomson K, Eskola K, Eklund M, Suominen K, Määttä M, Junnila J, Nykäsenoja S, Niinistö K, Grönthal T, Rantala M. Characterisation of and risk factors for extended-spectrum β-lactamase producing Enterobacterales (ESBL-E) in an equine hospital with a special reference to an outbreak caused by Klebsiella pneumoniae ST307:CTX-M-1.. Acta Vet Scand 2022 Feb 9;64(1):4.
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  3. Nocera FP, D'Eletto E, Ambrosio M, Fiorito F, Pagnini U, De Martino L. Occurrence and Antimicrobial Susceptibility Profiles of Streptococcus equi subsp. zooepidemicus Strains Isolated from Mares with Fertility Problems.. Antibiotics (Basel) 2021 Dec 27;11(1).
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