Molecular characterization of Clostridium difficile isolates from horses in an intensive care unit and association of disease severity with strain type

K G Magdesian, Mauricio Dujowich, John E Madigan, Lori M. Hansen, Dwight C. Hirsh, Spencer S. Jang

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Objective - To determine molecular characteristics, antimicrobial susceptibility, and toxigenicity of Clostridium difficile isolates from horses in an intensive care unit and evaluate associations among severity of clinical disease with specific strains of C difficile. Design - Prospective study. Animals - 130 horses. Procedures - Feces were collected from horses admitted for acute gastrointestinal tract disease with loose feces and submitted for microbial culture and immunoassay for toxin production. Polymerase chain reaction assays were performed on isolates for toxins A and B genes and strain identification. Results - Isolates were grouped into 3 strains (A, B, and C) on the basis of molecular banding patterns. Toxins A and B gene sequences were detected in 93%, 95%, and 73% of isolates of strains A, B, and C, respectively. Results of fecal immunoassays for toxin A were positive in 40%, 63%, and 16% of horses with strains A, B, and C, respectively. Isolates in strain B were resistant to metronidazole. Horses infected with strain B were 10 times as likely to have been treated with metronidazole prior to the onset of diarrhea as horses infected with other strains. Duration from onset of diarrhea to discharge (among survivors) was longer, systemic inflammatory response syndromes were more pronounced, and mortality rate was higher in horses infected with strain B than those infected with strains A and C combined. Conclusions and Clinical Relevance - Horses may be infected with a number of heterogeneous isolates of C difficile. Results indicated that toxigenicity and antimicrobial susceptibility of isolates vary and that metronidazole-resistant strains may be associated with severe disease.

Original languageEnglish (US)
Pages (from-to)751-755
Number of pages5
JournalJournal of the American Veterinary Medical Association
Volume228
Issue number5
DOIs
StatePublished - Mar 1 2006

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Clostridium difficile
disease severity
Horses
Intensive Care Units
horses
Metronidazole
metronidazole
toxins
Immunoassay
Feces
Diarrhea
immunoassays
Systemic Inflammatory Response Syndrome
diarrhea
Gastrointestinal Diseases
anti-infective agents
feces
Genes
Survivors
Gastrointestinal Tract

ASJC Scopus subject areas

  • veterinary(all)

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Molecular characterization of Clostridium difficile isolates from horses in an intensive care unit and association of disease severity with strain type. / Magdesian, K G; Dujowich, Mauricio; Madigan, John E; Hansen, Lori M.; Hirsh, Dwight C.; Jang, Spencer S.

In: Journal of the American Veterinary Medical Association, Vol. 228, No. 5, 01.03.2006, p. 751-755.

Research output: Contribution to journalArticle

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