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in Journal of the American Veterinary Medical Association

Abstract

Objective—To investigate bacterial culture practices in veterinary clinics, with an emphasis on laboratory biosafety and on quality of laboratory practices.

Design—Survey-based prospective study.

Sample Population—166 veterinarians.

Procedures—Veterinarians were recruited through the Veterinary Information Network (an Internet-based network restricted to veterinary personnel). All Network-registered veterinarians were eligible to participate. A standardized questionnaire regarding bacterial culture practices in veterinary clinics was completed electronically by study participants.

Results—720 veterinarians completed the survey; 166 (23%) indicated that bacterial culture was performed in his or her clinic. Clinic practices ranged from preliminary aerobic bacterial culture only with submission of isolates to a diagnostic laboratory for further testing (93/160 [58%]) to bacterial culture, identification, and antimicrobial susceptibility testing (19/160 [12%]). Most commonly, urine samples were cultured (151/162 [93%] clinics). Several prob-lematic practices were identified regarding quality and quality control, including inadequate facilities, equipment, supervision, interpretation of data, and culture methods. Biosafety infractions were also common, including inadequate laboratory location, lack of biosafety protocols, and dangerous disposal practices. Ninety-four percent of respondents stated that continuing education regarding culture practices and laboratory safety would be useful.

Conclusions and Clinical Relevance—Data confirmed that bacterial culture was commonly performed in clinics, but that major deficiencies in laboratory methods were widespread. These could result in negative effects on testing quality and increased risk of laboratory-acquired infections among clinic personnel. Veterinary practices in which bacterial cultures are performed must ensure that adequate equipment, facilities, personnel, and training are provided to enable accurate and safe sample testing.

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in Journal of the American Veterinary Medical Association

Summary

Despite the high incidence of distal respiratory tract infection of undetermined cause on farms, to our knowledge, the microbiologic effects of conventional antimicrobial treatment for this condition have not been studied. We evaluated the possible pathogenic role of bacterial isolates from the distal airways of foals with clinical respiratory tract disease, by correlating changes in their numbers (increase or decrease) with clinical, endoscopic, and pulmonary cytologic signs of disease resolution during treatment with antimicrobial drugs. We also determined qualitative changes in in vitro antimicrobial susceptibility of bacterial isolates after 7 days of treatment and relapse rate of foals. Significant (P < 0.05) decrease in the numbers of an isolate in the airways was considered strong evidence of a pathogenic role in this disease syndrome. Foals with endoscopically confirmed distal respiratory tract infection (drti; n = 65) were selected at random for treatment (n = 56) or nontreatment (n = 9), and bronchial lavage specimens were cultured and evaluated cytologically before and after 7 days of treatment with trimethoprim-sulfamethoxazole (tms) and a β-lactam drug (penicillin, ampicillin, or sulbactam-ampicillin), the standard treatment in all foals. The effect of treatment was to abruptly reduce the clinical (nasal discharge, cough, adventitious lung sounds) and cytologic signs of airway infection. Severity of disease in nontreated foals, however, did not change or did worsen over time. Reduction in the frequency and numbers of Streptococcus zooepidemicus isolated during treatment supported a causal role for this organism in the clinical syndrome observed. On the other hand, the frequency of non-Str zooepidemicus isolates (eg, Staphylococcus epidermidis, Streptomyces spp, α-hemolytic streptococci) actually increased during treatment, compatible with a commensal or competitive role for these organisms. Significantly (P < 0.001) more pretreatment isolates were susceptible in vitro to either tms or β-lactam drugs than to β-lactam drugs alone; more posttreatment isolates were susceptible to either tms or β-lactam than to either drug alone. These data indicate that there may be some benefit to combined use of tms plus β-lactam drugs in foals with drti. Mean ± sem relapse rate was 31 ± 6% (range 0 to 57%); risk factors (clinical signs of disease, laboratory variables) for relapse could not be identified. In conclusion, treatment resulted in significant (P < 0.001) reduction in airway inflammation in foals with clinical drti. The high reinfection rate indicates that a predisposing factor, possibly age-related immunodeficiency, may predispose foals to illness and persists after treatment.

Free access
in American Journal of Veterinary Research

Abstract

Objective—To determine whether purified equine immunoglobulin specific for Rhodococcus equi virulence- associated proteins A and C (VapA and VapC) can confer passive protection against R equi-induced pneumonia in foals.

Animals—Twenty-eight 3-week-old mixed-breed pony foals.

Procedure—7 foals received IV injections of equine hyperimmune plasma (HIP) against whole-cell R equi, and 7 received purified equine immunoglobulin specific for VapA and VapC 1 day prior to intrabronchial infection with R equi strain 103+. Eleven foals were not treated prior to infection, and 3 control foals were neither treated nor infected. Heart rate, respiratory rate, and rectal temperature were recorded twice daily, and serum fibrinogen concentration and WBC count were determined every other day following infection. Foals were euthanatized 14 days following infection, and lung lesions and concentration of R equiin lungs were assessed.

Results—The onset of clinical signs of pneumonia was significantly delayed in the HIP- and immunoglobulin-treated groups, compared with the untreated infected group. Moreover, pulmonary lesions were less severe in the treated groups, and significantly fewer R equi organisms were cultured from the lungs of treated foals.

Conclusions and Clinical Relevance—Degree of protection against R equi-induced pneumonia provided by purified immunoglobulin specific for VapA and VapC was similar to that provided by commercially available HIP. Results not only suggest that immunoglobulin is the primary component of HIP that confers protection against R equi-induced pneumonia in foals but also indicate that antibodies against R equi VapA and VapC are protective. (Am J Vet Res 2001;62:1307–1313)

Full access
in American Journal of Veterinary Research

Summary

Respiratory tract infections are prevalent in foals, yet the frequency with which the distal airways are affected in clinical episodes of respiratory tract disease has not been evaluated to our knowledge. The objective of the study was to determine the incidence of distal respiratory tract infection (drti) in foals on a sample of Thoroughbred breeding farms (n = 10) in Ontario. In a pilot study, clinical criteria commonly used to select foals for antimicrobial treatment (detection of abnormal lung sounds, plus nasal discharge, cough, fever, tachypnea, and/or lethargy) were found to segregate foals with and without endoscopically confirmed drti. Mucopurulent exudate and bronchial erythema were observed more frequently (P < 0.005), bronchial lavage total cell count and neutrophil concentration were significantly (P < 0.005) higher, and intracellular cocci were recovered significantly (P < 0.01) more often from bronchial lavage samples of affected foals (n = 8) than of controls (n = 8). These clinical criteria were used to identify cases in a cohort of Thoroughbred foals (n = 219) from May 1 to October 30, 1991. Case morbidity adjusted for clustering was 82 ± 5% (95% confidence limits, 72 to 92%). Most (74%) episodes of clinical drti were detected in July and August, and equal numbers were detected before (53%) and after (47%) weaning of foals. Of 178 cases, 66 (48%) were selected at random for endoscopy and bronchial lavage. Grade-II pharyngeal lymphoid hyperplasia was observed commonly (60% of foals); auditory tube diverticulum (guttural pouch) discharge was observed in 18 of 86 (21%) foals, and guttural pouch infection was confirmed in 6 of 7 foals examined endoscopically. Endoscopically confirmed drti, defined as visual detection of bronchial exudate with microscopic detection of intracellular cocci and markedly high neutrophil count in bronchial lavage samples, was confirmed in 75 of 86 (87%) cases tested. These data indicate that drti might be reliably diagnosed by auscultation during a simple rebreathing exercise. The syndrome of drti was extremely common in Thoroughbred foals, characterized by marked inflammation of visible airways and cytologic evidence of bacterial infection. Risk factors for clinical (undifferentiated) drti were not identified in this study.

Free access
in American Journal of Veterinary Research

Summary

Enterotoxemia was induced in 4 lambs and 4 goat kids by continuous intraduodenal infusion of a whole culture of Clostridium perfringens type D. Clinical signs, hematologic values, biochemical alterations, and postmortem lesions in the lambs and goat kids were compared. The 4 lambs and 4 goat kids died within 25 hours of beginning the infusions. Lesions were not observed in the gastrointestinal tract of the 4 lambs; however, severe hemorrhagic enterocolitis was found in the 4 goat kids. This difference between the lambs and goat kids in the lesions caused by experimentally induced enterotoxemia may explain the discrepancies reported between sheep and goats in clinical signs, response to treatment, and efficacy of vaccination observed in naturally induced enterotoxemia in the 2 species.

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in American Journal of Veterinary Research

SUMMARY

A double-blind randomized clinical trial was undertaken to determine the value of parenterally administered Streptococcus equi M-protein vaccine in foals during an epizootic of strangles. Weaned mixed-breed foals (n = 664) housed on 2 adjacent feed-lots (A and B) arrived over a 5-day period, 2 weeks before primary vaccination. Foals in lot B (n = 114) were randomly administered vaccine (n = 59) or saline solution (placebo; n = 55) on 3 occasions at biweekly intervals. Foals in lot A (n = 450) were given 1 dose of vaccine (n = 225) or placebo. The following clinical observations were scored blindly by a single observer for all foals in lot B and for 120 (randomly sampled) foals in lot A on a single day, 2 (lot B) and 6 (lot A) weeks after final vaccination: cervical lymphadenopathy, type of bilateral nasal discharge, and palpable swelling at injection site(s). Bacteriologic culture of nasal swab specimens or lymph node aspirates from selected foals with clinical disease yielded Sequi. Cervical lymphadenopathy was observed in 17 of 59 (29%) vaccinates and 39 of 55 (71%) nonvaccinated controls in lot B and in 32 of 60 (53%) vaccinates and 29 of 60 (48%) controls in lot A. Contingency χ2analysis confirmed significantly lower cervical lymphadenopathy rate (χ2= 18.5; P < 0.001) and prevalence of mucopurulent nasal discharge (χ2= 11.4; P < 0.01) for vaccinates in lot B only. Swelling(s) at the vaccine injection site were palpated in 44% of lot B and 29% of lot A vaccinates vs < 2% of placebo controls. In the face of intense natural exposure, foals inoculated 3 times with M-protein vaccine were less than half as likely to have clinical signs of strangles as were nonvaccinated horses.

Free access
in American Journal of Veterinary Research

Abstract

Objective—To determine whether duration of hospitalization in the intensive care unit (ICU) of a veterinary teaching hospital was associated with prevalence of antimicrobial resistance among rectal Escherichia coli isolates from dogs, whether antimicrobial treatment was associated with prevalence of antimicrobial resistance, and whether there were associations among antimicrobial drugs to which isolates were resistant.

Design—Prospective observational study.

Animals—116 dogs hospitalized in an ICU for ≥ 3 days.

Procedures—Rectal swab specimens were obtained every 3 days and submitted for bacterial culture for E coli. Isolates were tested for susceptibility to 12 antimicrobial agents by means of disk diffusion.

Results—For each additional day that a dog was hospitalized in the ICU, the odds of being colonized with an E coli isolate resistant to 1 or more of the 12 antimicrobials tested increased by a factor of 1.5, independent of antimicrobial treatment. Dogs that were treated with enrofloxacin were 25.6 times as likely to be colonized by a quinolone-resistant E coli strain as were dogs that did not receive any antimicrobials. Significant correlations were found for resistance to agents in the extended-spectrum cephalosporin group and the quinolone group.

Conclusions and Clinical Relevance—Results suggested that the proportion of rectal E coli isolates obtained from dogs housed for ≥ 3 days in a veterinary teaching hospital ICU that were resistant to antimicrobial agents increased as the duration of hospitalization in the ICU increased. Thus, ICU hospitalization time should be as short as possible to prevent development of antimicrobial resistance among rectal E coli isolates.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine the frequency of urinary tract infections (UTIs) in dogs with indwelling urinary catheters in an intensive care unit (ICU) and the frequency of multi–drug-resistant (MDR) Escherichia coli UTIs in those dogs.

Design—Prospective study.

Animals—All dogs in the ICU with an indwelling urinary catheter from January 2003 through December 2003.

Procedures—Urine samples and rectal swab specimens were collected at admission and every 3 days until discharge from the hospital. Escherichia coli isolates from urine samples and rectal swab specimens and those from dogs that were temporally or spatially associated with dogs with MDR E coli UTIs underwent antimicrobial susceptibility testing. Pulsed-field gel electrophoresis was performed on MDR isolates from urine and rectal swab specimens.

Results—Urinary catheters were placed in 137 dogs. Twenty-six UTIs were diagnosed, 15 on the day of admission and 11 after 3 or more days of catheterization. Of 12 dogs with E coli UTIs, 6 were infected at admission and 6 acquired the infection in the ICU. Two MDR E coli UTIs were detected, 1 of which was acquired in the ICU. One MDR E coli urinary isolate had an electrophoresis pattern similar to that of rectal isolates from the same dog. Urinary E coli isolates were most frequently resistant to ampicillin and cephalothin.

Conclusions and Clinical Relevance—The ICU-acquired MDR E coli UTI likely originated from the dog's intestinal flora during hospitalization. Dogs that have been referred from a community practice may have MDR E coli UTIs at the time of admission.

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in Journal of the American Veterinary Medical Association

Summary

Undifferentiated distal respiratory tract disease (nasal discharge, cough, pneumonia) in foals (1 to 8 months old) is a burdensome economic problem on breeding farms; yet, the infective agents associated with these episodes have not been well described. Possible causes of these episodes of illness were investigated by culturing specimens of proximal and distal airways of clinically diseased foals (n = 101), prior to any treatment, for aerobic and anaerobic bacteria and viruses (rhinoviruses, equine arteritis virus, equine herpesvirus subtype 1 [ehv-1], influenza virus, and adenovirus). Pairs of sera (n = 47) were examined for antibodies to influenza A virus, equine subtypes 1 and 2, ehv-1, and adenovirus antigens, and sera obtained from foals during acute infection were examined for antibodies (by agar gel immunodiffusion [agid]) to equi factor antigens of Rhodococcus equi. Viruses were not isolated from the proximal (swab) or distal (bronchial lavage) airway specimens in foals, and only 2 of 47 randomly selected foals seroconverted to ehv-1. Serotiters to the other viruses were low and frequently decreasing between samples, which was compatible with maternally derived antibody. Streptococcus zooepidemicus was the predominant isolate from bronchial lavage specimens (88/101 cases), accompanied by α-hemolytic streptococci (8 cases), Bordetella bronchiseptica (13 cases), Staphylococcus epidermidis (9 cases), and other organisms in lesser frequency. Only Str zooepidemicus was recovered significantly (P < 0.05) more often in cases than in controls. The agid test was found useful to detect foals with presumed exposure to R equi, but positive tests results did not correspond well with bacterial culture results; positive agid results were recorded in 34% of culturenegative foals. However, foals from which R equi was isolated were distinctive from the other foals on the basis of fever (> 39 C), lack of nasal discharge, blood neutrophilia, and decreased percentage of neutrophils in bronchial lavage fluid samples. Isolation of Str zooepidemicus was significantly (P < 0.01) associated with increasing neutrophil percentage in bronchial lavage fluid. In conclusion, the pathogenic roles of Str zooepidemicus and R equi were established in this group of foals with distal respiratory tract infections by use of clinical, endoscopic, hematologic, and cytologic methods. There was no evidence of a viral cause for these infections, indicating that manifestations of distal respiratory tract infection are attributable to bacterial infection causing inflammation of the airways. Further studies are warranted to pursue more-sensitive methods for detection of viral antigen or antibody in undifferentiated distal respiratory tract disease episodes in foals.

Free access
in American Journal of Veterinary Research