Abstract
Medical records of 101 blood culture‐confirmed bacteremic foals were reviewed to determine whether foals with Actinobacillus sp. bacteremia are affected at an earlier age, have more severe signs of disease, and have a worse prognosis than do foals with bacteremia of other causes. Thirty percent (30/101) of bacteremic foals had Actinobacillus sp. cultured, and these were 2 times more likely to die (crude odds ratio [ORCR] 0.8, 4; P= . 14), with a survival rate of 43% (13/30) compared to the overall survival rate of 55% (56/101). When compared to other bacteremic foals, foals with actinobacillosis were 7 times more likely to have been sick from birth (adjusted odds ratio [ORADJ 2, 26; P= .003) and 6 times more likely to have diarrhea (ORADJ 1, 22; P= .009). By bivariate analysis, foals with Actinobacillus sp. bacteremia were 5 times more likely to have a sepsis score >11 (ORCR 1, 18; P= .007), 6 times more likely to be obtunded (ORCR 2, 20; P= .005), and 3 times more likely to have pneumonia (ORCR 1, 7; P= .03). Furthermore, Actinobacillus sp. bacteremic foals were 27 times more likely to have a segmented neutrophil count <3.3 × 109 cells/L (ORadj 4, 166; P < .0001) and were 4.5 times more likely to have a band neutrophil count >0.46 × 109 cells/L (ORADJ 1, 17; P= .02) when compared to foals that had bacteremia caused by either gram‐negative enteric or gram‐positive organisms. Sepsis score was ≤ 11 in 49% (29/59) of bacteremia foals aged <13 days for which a discernible sepsis score was calculable. Results of this study should improve the diagnostic sensitivity of clinical examinations of neonatal foals, thereby facilitating treatment decisions.
Highlights
Medical records of 101 blood culture–confirmed bacteremic foals were reviewed to determine whether foals with Actinobacillus sp. bacteremia are affected at an earlier age, have more severe signs of disease, and have a worse prognosis than do foals with bacteremia of other causes
A history of seizures was present in 7% (7/ 101), diarrhea was present in 24% (24/101), and colic was present in 13% (13/101)
Foals with Actinobacillus sp. bacteremia were more likely to be ill from birth, to have diarrhea, to be recumbent at presentation, to have a sepsis score Ͼ11, to be obtunded, to have pneumonia, to have a lower segmented neutrophil count, and to have a higher band neutrophil count than other bacteremic foals
Summary
Medical records of 101 blood culture–confirmed bacteremic foals were reviewed to determine whether foals with Actinobacillus sp. bacteremia are affected at an earlier age, have more severe signs of disease, and have a worse prognosis than do foals with bacteremia of other causes. Results of this study should improve the diagnostic sensitivity of clinical examinations of neonatal foals, thereby facilitating treatment decisions It is unknown if the type of bacterial organism present in the blood of bacteremic foals influences presenting clinical signs or subsequent prognosis. Bacteremia was reported to affect foals within a few hours of birth up to 3 days of age It is associated with sudden onset of fever, prostration, and diarrhea and frequently localization of the organism to joints, kidneys, lungs, and intestine. Bacteremia succumb to infection at an earlier age, have an increased occurence of failure of transfer of passive immunity, and have a decreased survival rate.[3,5,6,17,18,19] The purpose of this retrospective study was to determine outcome and indicators of disease severity in foals with Actinobacillus sp. We hypothesized that foals with Actinobacillus sp. bacteremia succumb to infection at an earlier age, have an increased occurence of failure of transfer of passive immunity, and have a decreased survival rate.[3,5,6,17,18,19] The purpose of this retrospective study was to determine outcome and indicators of disease severity in foals with Actinobacillus sp. bacteremia, and to identify diagnostic factors that differentiate foals with actinobacillosis from foals with bacteremia caused by either enteric gramnegative or gram-positive organisms
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