TY - JOUR
T1 - Infections caused by extended-spectrum beta-lactamase-producing Enterobacterales in hospitalized neonatal foals
T2 - Can colonization predict infection?
AU - Shnaiderman-Torban, Anat
AU - Meltzer, Lilac
AU - Zilberman-Daniels, Tal
AU - Navon-Venezia, Shiri
AU - Cohen, Adar
AU - Sutton, Gila Abells
AU - Blum, Shlomo E.
AU - Amit, Sharon
AU - Steinman, Amir
N1 - Publisher Copyright:
© 2025 The Author(s). Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
PY - 2025/3/1
Y1 - 2025/3/1
N2 - Background: Infections with extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-PE) contribute to morbidity and mortality in human neonates. In foals, data are scarce. Objectives: Determine the association between ESBL-PE gastrointestinal colonization on hospital admission and infections in hospitalized neonates. Animals: Sixty-seven foals. Methods: Prospective study of foals admitted to a veterinary hospital. Foals were screened for ESBL-PE colonization and for infections. Risk factors and clinical outcomes were analyzed. Results: Seventy-six percent of foals suffered from at least 1 bacterial infection (n = 51/67). Sixty-three non-ESBL bacterial species and 19 ESBL-PE species were isolated. Twenty foals (29.85%) had at least 1 hospital-acquired infection (HAI) and 30 foals (44.8%) suffered from multidrug resistant infections. The prevalence rates of ESBL-PE gastrointestinal colonization on admission and clinical ESBL HAIs were 47.8% (n = 32/67, 41 isolates) and 19.40% (n = 13/67, 19 isolates), respectively. On multivariable analysis, ESBL-PE HAIs were associated with colonization on admission (P =.03, odds ratio [OR] = 4.60). In an outcome analysis, ESBL-PE infection and HAIs were associated with surgery (ESBL-PE infection: P =.04, OR = 4.70; HAI: P =.004, OR = 6.4) and HAI also was associated with increased duration of hospitalization (P <.001, OR = 9.13). The major colonizing and infecting bacterial species were Escherichia coli and Klebsiella spp. Concordant ESBL-PE species were recovered from rectal screening and clinical samples in 7.46% (n = 5/67) of foals. Conclusions and Clinical Importance: On-admission ESBL-PE rectal colonization was associated with ESBL-PE HAI in neonatal foals. The ESBL-PE infections were associated with surgery during hospitalization. These findings emphasize the importance of optimal infection control and treatment of clinical infections in equine neonatal intensive care units.
AB - Background: Infections with extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-PE) contribute to morbidity and mortality in human neonates. In foals, data are scarce. Objectives: Determine the association between ESBL-PE gastrointestinal colonization on hospital admission and infections in hospitalized neonates. Animals: Sixty-seven foals. Methods: Prospective study of foals admitted to a veterinary hospital. Foals were screened for ESBL-PE colonization and for infections. Risk factors and clinical outcomes were analyzed. Results: Seventy-six percent of foals suffered from at least 1 bacterial infection (n = 51/67). Sixty-three non-ESBL bacterial species and 19 ESBL-PE species were isolated. Twenty foals (29.85%) had at least 1 hospital-acquired infection (HAI) and 30 foals (44.8%) suffered from multidrug resistant infections. The prevalence rates of ESBL-PE gastrointestinal colonization on admission and clinical ESBL HAIs were 47.8% (n = 32/67, 41 isolates) and 19.40% (n = 13/67, 19 isolates), respectively. On multivariable analysis, ESBL-PE HAIs were associated with colonization on admission (P =.03, odds ratio [OR] = 4.60). In an outcome analysis, ESBL-PE infection and HAIs were associated with surgery (ESBL-PE infection: P =.04, OR = 4.70; HAI: P =.004, OR = 6.4) and HAI also was associated with increased duration of hospitalization (P <.001, OR = 9.13). The major colonizing and infecting bacterial species were Escherichia coli and Klebsiella spp. Concordant ESBL-PE species were recovered from rectal screening and clinical samples in 7.46% (n = 5/67) of foals. Conclusions and Clinical Importance: On-admission ESBL-PE rectal colonization was associated with ESBL-PE HAI in neonatal foals. The ESBL-PE infections were associated with surgery during hospitalization. These findings emphasize the importance of optimal infection control and treatment of clinical infections in equine neonatal intensive care units.
KW - antimicrobial resistance
KW - beta-lactamase
KW - equine
UR - http://www.scopus.com/inward/record.url?scp=85219135241&partnerID=8YFLogxK
U2 - 10.1111/jvim.17299
DO - 10.1111/jvim.17299
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C2 - 39980458
AN - SCOPUS:85219135241
SN - 0891-6640
VL - 39
JO - Journal of Veterinary Internal Medicine
JF - Journal of Veterinary Internal Medicine
IS - 2
M1 - e17299
ER -