Abstract
Pathogens frequently associated with multi-drug resistant (MDR) phenotypes, including extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-E) and Acinetobacter baumannii isolated from horses admitted to horse clinics, pose a risk for animal patients and personnel in horse clinics. To estimate current rates of colonization, a total of 341 equine patients were screened for carriage of zoonotic indicator pathogens at hospital admission. Horses showing clinical signs associated with colic (n = 233) or open wounds (n = 108) were selected for microbiological examination of nostril swabs, faecal samples and wound swabs taken from the open wound group. The results showed alarming carriage rates of Gram-negative MDR pathogens in equine patients: 10.7% (34 of 318) of validated faecal specimens were positive for ESBL-E (94%: ESBL-producing Escherichia coli), with recorded rates of 10.5% for the colic and 11% for the open wound group. 92.7% of the ESBL-producing E. coli were phenotypically resistant to three or more classes of antimicrobials. A. baumannii was rarely detected (0.9%), and all faecal samples investigated were negative for Salmonella, both directly and after two enrichment steps. Screening results for the equine nostril swabs showed detection rates for ESBL-E of 3.4% among colic patients and 0.9% in the open wound group, with an average rate of 2.6% (9/340) for both indications. For all 41 ESBL-producing E. coli isolated, a broad heterogeneity was revealed using pulsed-field gel electrophoresis (PFGE) patterns and whole genome sequencing (WGS) -analysis. However, a predominance of sequence type complex (STC)10 and STC1250 was observed, including several novel STs. The most common genes associated with ESBL-production were identified as blaCTX-M-1 (31/41; 75.6%) and blaSHV-12 (24.4%).The results of this study reveal a disturbingly large fraction of multi-drug resistant and ESBL-producing E. coli among equine patients, posing a clear threat to established hygiene management systems and work-place safety of veterinary staff in horse clinics.
Highlights
Multi-drug resistant (MDR) pathogens, especially extended-spectrum beta-lactamase (ESBL)producing Enterobacteriaceae, have frequently been reported as a cause of severe infections in horses, which has become an issue of increasing importance in veterinary infection control and biosafety in equine clinical settings [1,2,3,4,5,6]
The results of this study reveal a disturbingly large fraction of multi-drug resistant and ESBL-producing E. coli among equine patients, posing a clear threat to established hygiene management systems and work-place safety of veterinary staff in horse clinics
We provide evidence for the current, critical hygiene challenges faced by horse clinics, most notably mirrored by the detection rate of 10.7% of enteral colonization with ESBL-E, including 10.1% ESBL-producing E. coli for horses admitted for two frequent reasons, wound infection and signs of colic
Summary
Multi-drug resistant (MDR) pathogens, especially extended-spectrum beta-lactamase (ESBL)producing Enterobacteriaceae, have frequently been reported as a cause of severe infections in horses, which has become an issue of increasing importance in veterinary infection control and biosafety in equine clinical settings [1,2,3,4,5,6]. Precise information on the local endemic load and epidemiology of MDR carried by patients entering a hospital is crucial for infection control policies [7]. Such data can be used for the targeted development of prevention strategies to protect the horse from exogenous as well as endogenous infection sources [3]. Severe infections with Gram-negative bacteria in hospitalized horses have generally been reported in association with Salmonella infections [8,9,10] and ESBL-producing Enterobacteriaceae [3, 11]. ESBL-producing Enterobacteriaceae, Salmonella and A. baumannii were selected as indicator pathogens to estimate the influx of Gram-negative MDR strains
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