Enterococcus infections in foals. (June 2019)

• Record Type: Journal Article
• Authors: Willis, A.T.; Magdesian, K.G.; Byrne, B.A.; Edman, J.M.
• Is Part Of: Veterinary journal. Volume 248(2019)
• Page Start: 42
• Page End: 47
• Publication Date: 2019-06
• Subjects: Faecium -- Foal -- Enterococci -- Multidrug resistant -- Urogenital; Veterinary medicine -- Periodicals; 636
• DOI: 10.1016/j.tvjl.2019.04.005
• Languages: English
• ISSNs: 1090-0233

Abstract

Highlights: This study compared foals with enterococcal infections with foals with sepsis of another bacterial etiology. Sites of origin, antimicrobial susceptibility, and survival outcome to discharge were evaluated. Enterococcus was more frequently cultured from the lower urinary tract and umbilicus in foals than were other bacteria. Almost half (48%) of Enterococcus isolates had a multiple antimicrobial resistance index ≥30%; 46% had a multidrug resistance index ≥30%. Foals with enterococcal isolates were less likely to survive to discharge than were control foals. Abstract: Enterococci have been increasing in prevalence in foal sepsis over the past three decades. There are no published studies in the peer-reviewed literature documenting common sites of infection, antimicrobial susceptibility, or outcome specifically associated with enterococcal infections in foals. Our objectives were to evaluate the sites of origin, antimicrobial susceptibility, and survival outcome to discharge in foals with enterococcal infections compared with foals with sepsis of another bacterial etiology. Seventy-five foals 0–30 days of age with cultures positive for Enterococcus and 170 control foals 0–30 days of age with cultures positive for other bacteria were included. Enterococcus was 2.67 times (95% confidence interval [CI], 1.49–4.80; P = 0.0012) more likely to be isolated from the lower urogenital tract of foals than were other bacteria. Enterococci were less likely to be isolated from blood cultures than other bacteria, with an odds ratio (OR) of 0.17 (95% CI 0.09−0.35; P < 0.0001). For Enterococcus isolates, 48% ( n = 29/61) had a multiple antimicrobial resistance (MAR) index of ≥30% and 46% ( n = 28/61) had a multiple drug resistance (MDR) index of ≥30%. Foals with enterococcal infections were less likely to survive to discharge (49.9% vs. 63.5%; P = 0.03). Enterococcus is commonly isolated from the lower urogenital tract of foals, is often multidrug resistant, and foals with enterococcal infections were less likely to survive. Multidrug resistance is common among enterococcal isolates, and therefore antimicrobial susceptibility testing of cultured isolates is warranted.