Differences in isolation rate and antimicrobial susceptibility of bacteria isolated from foals with sepsis at admission and after ≥48 hours of hospitalization

Mathijs J.P. Theelen, W. David Wilson, Barbara A. Byrne, Judy M. Edman, Philip H. Kass, Lapo Mughini-Gras, K. Gary Magdesian

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Antimicrobial treatment protocols for foals with sepsis that do not improve clinically often are adjusted based on bacteriological and antimicrobial susceptibility testing results from samples collected at hospital admission. Objectives: To evaluate whether hospitalization for ≥48 hours affects bacteriological and antimicrobial susceptibility testing results. Animals: Two-hundred sixty-seven foals <30 days of age admitted to a neonatal intensive care unit and diagnosed with sepsis. Methods: Medical records were reviewed retrospectively to identify foals with sepsis and positive bacteriological cultures. Results from samples collected at hospital admission were compared to those collected ≥48 hours after admission. Logistic regression for clustered data and exact logistic regression were used for statistical analysis. Results: Three-hundred fifty-three unique bacterial isolates were obtained from 231 foals at hospital admission and 92 unique bacterial isolates were obtained from 57 foals after ≥48 hours of hospitalization. Relative isolation frequency after ≥48 hours of hospitalization increased for Acinetobacter spp., 0.6% versus 3.3% (odds ratio [OR], 7.63; 95% confidence interval [CI], 1.28-45.45); Enterococcus spp., 4.8% versus 19.6% (OR, 5.37; 95% CI, 2.64-10.90); Klebsiella spp., 5.1% versus 10.9% (OR, 2.27; 95% CI, 1.05-4.89); Pseudomonas spp., 3.0% versus 7.6% (OR, 3.49; 95% CI, 3.49-240.50); and Serratia spp., 3.0% versus 5.4% (OR, 20.23; 95% CI, 2.20-186.14). Bacteria isolated after ≥48 hours of hospitalization were less susceptible to all tested antimicrobial drugs, except for imipenem. Conclusions and Clinical Importance: Decreased antimicrobial susceptibility of bacteria isolated after ≥48 hours of hospitalization provides a rationale for repeated bacteriological culture and susceptibility testing in hospitalized foals with sepsis.

Original languageEnglish (US)
JournalJournal of Veterinary Internal Medicine
DOIs
StateAccepted/In press - Jan 1 2020

Keywords

  • amikacin
  • ampicillin
  • antimicrobial resistance
  • ceftiofur
  • chloramphenicol
  • enrofloxacin
  • gentamicin
  • healthcare-associated infections
  • horse
  • hospital-acquired infections
  • imipenem
  • neonate
  • nosocomial infections
  • penicillin
  • tetracycline
  • trimethoprim/sulfamethoxazole

ASJC Scopus subject areas

  • veterinary(all)

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