Equine Infectious Disease Laboratory, Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA.
Department of Pathobiology, College of Veterinary Medicine, Auburn University, Auburn, Alabama, USA.
Equine Vet J. 2022 May;54(3):481-494. doi: 10.1111/evj.13567. Epub 2022 Mar 21.
Pneumonia in foals caused by the bacterium Rhodococcus equi has a worldwide distribution and is a common cause of disease and death for foals. The purpose of this narrative review was to summarise recent developments pertaining to the epidemiology, immune responses, treatment, and prevention of rhodococcal pneumonia of foals. Screening tests have been used to implement earlier detection and treatment of foals with presumed subclinical R. equi pneumonia to reduce mortality and severity of disease. Unfortunately, this practice has been linked to the emergence of antimicrobial-resistant R. equi in North America. Correlates of protective immunity for R. equi infections of foals remain elusive, but recent evidence indicates that innate immune responses are important both for mediating killing and orchestrating adaptive immune responses. A macrolide antimicrobial in combination with rifampin remains the recommended treatment for foals with R. equi pneumonia. Great need exists to identify which antimicrobial combination is most effective for treating foals with R. equi pneumonia and to limit emergence of antimicrobial-resistant strains. In the absence of an effective vaccine against R. equi, passive immunisation remains the only commercially available method for effectively reducing the incidence of R. equi pneumonia. Because passive immunisation is expensive, labour-intensive and carries risks for foals, great need exists to develop alternative approaches for passive and active immunisation.
马驹的肺炎由马红球菌引起，这种细菌在世界范围内分布广泛，是导致马驹发病和死亡的常见原因。本综述的目的是总结与马驹马红球菌肺炎的流行病学、免疫反应、治疗和预防相关的最新进展。已经使用筛选试验来实现对疑似无症状马红球菌肺炎驹的早期检测和治疗，以降低死亡率和疾病严重程度。不幸的是，这种做法与北美出现的抗微生物药物耐药的马红球菌有关。马驹马红球菌感染的保护性免疫相关因素仍然难以捉摸，但最近的证据表明，先天免疫反应对于介导杀伤和协调适应性免疫反应都很重要。大环内酯类抗生素联合利福平仍然是治疗马红球菌肺炎驹的推荐治疗方法。非常需要确定哪种抗生素组合对治疗马红球菌肺炎驹最有效，并限制抗微生物药物耐药菌株的出现。由于缺乏针对马红球菌的有效疫苗，被动免疫仍然是唯一可用于有效降低马红球菌肺炎发病率的商业上可用方法。由于被动免疫费用高、劳动强度大且对驹有风险，因此迫切需要开发针对被动和主动免疫的替代方法。
