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Epidemiologic analysis of nosocomial Salmonella infections in hospitalized horses

Abel B. Ekiri DVM, MS1, Robert J. MacKay DVM, PhD, DACVIM2, Jack M. Gaskin DVM, PhD3, David E. Freeman DVM, PhD, DACVS4, Amanda M. House DVM, DACVIM5, Steeve Giguère DVM, PhD, DACVIM6, Mats R. Troedsson DVM, PhD, DACT7, Crystal D. Schuman BS8, Maria M. von Chamier BS9, Katherine M. Henry BHS10, and Jorge A. Hernandez DVM, MPVM, PhD11
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  • 1 Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0136.
  • | 2 Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0136.
  • | 3 Department of Infectious Diseases and Pathology, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0136.
  • | 4 Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0136.
  • | 5 Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0136.
  • | 6 Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0136.
  • | 7 Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0136.
  • | 8 Department of Infectious Diseases and Pathology, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0136.
  • | 9 Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0136.
  • | 10 Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0136.
  • | 11 Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0136.

Abstract

Objective—To examine the relationship between abdominal surgery and nosocomial Salmonella infections and the relationship between high caseload in combination with abdominal surgery and nosocomial Salmonella infections in hospitalized horses with signs of gastrointestinal tract disease.

Animals—140 horses.

Design—Case-control study.

Procedures—To accomplish the first objective, 1 to 4 control horses were matched with each nosocomial case horse on the basis of admission date of a primary case horse. The frequency of abdominal surgery and other investigated exposure factors were compared between nosocomial case horses and control horses. For the second objective, 4 control horses were matched with each nosocomial case horse on the basis of year of admission. The frequency of high caseload (≥ 26 inpatients), abdominal surgery, and other factors was compared between nosocomial case horses and control horses.

Results—The odds of nosocomial Salmonella infection were 8 times as high (odds ratio = 8.2; 95% confidence interval = 1.11, 60.24) in horses that underwent abdominal surgery, compared with the odds for horses that did not undergo surgery. High caseload alone or in combination with abdominal surgery was not associated with increased risk of nosocomial Salmonella infection.

Conclusions and Clinical Relevance—Abdominal surgery was identified as a risk factor for nosocomial Salmonella infections in horses. Horses that undergo abdominal surgery require enhanced infection control and preventative care. Risk of nosocomial Salmonella infections may be reduced by implementation of biosecurity measures (such as the use of plastic boots, gloves, and footbaths) immediately after surgery.

Abstract

Objective—To examine the relationship between abdominal surgery and nosocomial Salmonella infections and the relationship between high caseload in combination with abdominal surgery and nosocomial Salmonella infections in hospitalized horses with signs of gastrointestinal tract disease.

Animals—140 horses.

Design—Case-control study.

Procedures—To accomplish the first objective, 1 to 4 control horses were matched with each nosocomial case horse on the basis of admission date of a primary case horse. The frequency of abdominal surgery and other investigated exposure factors were compared between nosocomial case horses and control horses. For the second objective, 4 control horses were matched with each nosocomial case horse on the basis of year of admission. The frequency of high caseload (≥ 26 inpatients), abdominal surgery, and other factors was compared between nosocomial case horses and control horses.

Results—The odds of nosocomial Salmonella infection were 8 times as high (odds ratio = 8.2; 95% confidence interval = 1.11, 60.24) in horses that underwent abdominal surgery, compared with the odds for horses that did not undergo surgery. High caseload alone or in combination with abdominal surgery was not associated with increased risk of nosocomial Salmonella infection.

Conclusions and Clinical Relevance—Abdominal surgery was identified as a risk factor for nosocomial Salmonella infections in horses. Horses that undergo abdominal surgery require enhanced infection control and preventative care. Risk of nosocomial Salmonella infections may be reduced by implementation of biosecurity measures (such as the use of plastic boots, gloves, and footbaths) immediately after surgery.

Contributor Notes

The authors thank Iva Addison, Samuel Smith, and Jude Kaufmann for technical assistance.

Address correspondence to Dr. Hernandez.