Comparison of clinical, microbiologic, and clinicopathologic findings in horses positive and negative for Clostridium difficile infection

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Abstract

Objective - To compare clinical, microbiologic, and clinicopathologic findings among horses infected with Clostridium difficile that had toxin A in their feces, horses with evidence of C difficile infection that were negative for toxin A in their feces, and horses with diarrhea that were negative for C difficile infection. Design - Cross-sectional study. Animals - 292 horses and foals with diarrhea. Procedures - Feces were submitted for microbial culture and tested for the C difficile antigen glutamate dehydrogenase and for toxin A with a commercial ELISA. Results - Horses with toxin A in their feces had higher band neutrophil count, rectal temperature, hospitalization time prior to the onset of diarrhea, and total hospitalization time than did horses without evidence of C difficile infection, and 32 of the 33 (97%) horses with toxin A in their feces had received antimicrobials prior to the onset of diarrhea. Horses with toxin A in their feces had a significantly higher mortality rate than did horses negative for toxin A in their feces. Sensitivity and specificity of the ELISA for detection of C difficile antigen were 93% and 88%, when assay results were compared with results of microbial culture following direct plating, and 66% and 93%, when assay results were compared with results of microbial culture following broth enrichment. Conclusions and Clinical Relevance - Results provided some evidence that horses positive for toxin A had more severe clinical disease than did horses with evidence of C difficile infection that were negative for toxin A and horses with diarrhea without evidence of C difficile infection.

Original languageEnglish (US)
Pages (from-to)777-784
Number of pages8
JournalJournal of the American Veterinary Medical Association
Volume234
Issue number6
DOIs
StatePublished - Mar 15 2009

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Clostridium Infections
Clostridium difficile
Horses
horses
Feces
toxins
infection
feces
Diarrhea
diarrhea
Infection
Hospitalization
Enzyme-Linked Immunosorbent Assay
Horse Diseases
enzyme-linked immunosorbent assay
Antigens
Glutamate Dehydrogenase
antigens
glutamate dehydrogenase
assays

ASJC Scopus subject areas

  • veterinary(all)

Cite this

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title = "Comparison of clinical, microbiologic, and clinicopathologic findings in horses positive and negative for Clostridium difficile infection",
abstract = "Objective - To compare clinical, microbiologic, and clinicopathologic findings among horses infected with Clostridium difficile that had toxin A in their feces, horses with evidence of C difficile infection that were negative for toxin A in their feces, and horses with diarrhea that were negative for C difficile infection. Design - Cross-sectional study. Animals - 292 horses and foals with diarrhea. Procedures - Feces were submitted for microbial culture and tested for the C difficile antigen glutamate dehydrogenase and for toxin A with a commercial ELISA. Results - Horses with toxin A in their feces had higher band neutrophil count, rectal temperature, hospitalization time prior to the onset of diarrhea, and total hospitalization time than did horses without evidence of C difficile infection, and 32 of the 33 (97{\%}) horses with toxin A in their feces had received antimicrobials prior to the onset of diarrhea. Horses with toxin A in their feces had a significantly higher mortality rate than did horses negative for toxin A in their feces. Sensitivity and specificity of the ELISA for detection of C difficile antigen were 93{\%} and 88{\%}, when assay results were compared with results of microbial culture following direct plating, and 66{\%} and 93{\%}, when assay results were compared with results of microbial culture following broth enrichment. Conclusions and Clinical Relevance - Results provided some evidence that horses positive for toxin A had more severe clinical disease than did horses with evidence of C difficile infection that were negative for toxin A and horses with diarrhea without evidence of C difficile infection.",
author = "Rebecca Ruby and Magdesian, {K G} and Kass, {Philip H}",
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N2 - Objective - To compare clinical, microbiologic, and clinicopathologic findings among horses infected with Clostridium difficile that had toxin A in their feces, horses with evidence of C difficile infection that were negative for toxin A in their feces, and horses with diarrhea that were negative for C difficile infection. Design - Cross-sectional study. Animals - 292 horses and foals with diarrhea. Procedures - Feces were submitted for microbial culture and tested for the C difficile antigen glutamate dehydrogenase and for toxin A with a commercial ELISA. Results - Horses with toxin A in their feces had higher band neutrophil count, rectal temperature, hospitalization time prior to the onset of diarrhea, and total hospitalization time than did horses without evidence of C difficile infection, and 32 of the 33 (97%) horses with toxin A in their feces had received antimicrobials prior to the onset of diarrhea. Horses with toxin A in their feces had a significantly higher mortality rate than did horses negative for toxin A in their feces. Sensitivity and specificity of the ELISA for detection of C difficile antigen were 93% and 88%, when assay results were compared with results of microbial culture following direct plating, and 66% and 93%, when assay results were compared with results of microbial culture following broth enrichment. Conclusions and Clinical Relevance - Results provided some evidence that horses positive for toxin A had more severe clinical disease than did horses with evidence of C difficile infection that were negative for toxin A and horses with diarrhea without evidence of C difficile infection.

AB - Objective - To compare clinical, microbiologic, and clinicopathologic findings among horses infected with Clostridium difficile that had toxin A in their feces, horses with evidence of C difficile infection that were negative for toxin A in their feces, and horses with diarrhea that were negative for C difficile infection. Design - Cross-sectional study. Animals - 292 horses and foals with diarrhea. Procedures - Feces were submitted for microbial culture and tested for the C difficile antigen glutamate dehydrogenase and for toxin A with a commercial ELISA. Results - Horses with toxin A in their feces had higher band neutrophil count, rectal temperature, hospitalization time prior to the onset of diarrhea, and total hospitalization time than did horses without evidence of C difficile infection, and 32 of the 33 (97%) horses with toxin A in their feces had received antimicrobials prior to the onset of diarrhea. Horses with toxin A in their feces had a significantly higher mortality rate than did horses negative for toxin A in their feces. Sensitivity and specificity of the ELISA for detection of C difficile antigen were 93% and 88%, when assay results were compared with results of microbial culture following direct plating, and 66% and 93%, when assay results were compared with results of microbial culture following broth enrichment. Conclusions and Clinical Relevance - Results provided some evidence that horses positive for toxin A had more severe clinical disease than did horses with evidence of C difficile infection that were negative for toxin A and horses with diarrhea without evidence of C difficile infection.

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