Shnaiderman-Torban Anat, Meltzer Lilac, Zilberman-Daniels Tal, Navon-Venezia Shiri, Cohen Adar, Sutton Gila Abells, Blum Shlomo E, Amit Sharon, Steinman Amir
Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel.
Chaim Sheba Medical Center, Ramat-Gan, Israel.
J Vet Intern Med. 2025 Mar-Apr;39(2):e17299. doi: 10.1111/jvim.17299.
Infections with extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-PE) contribute to morbidity and mortality in human neonates. In foals, data are scarce.
Determine the association between ESBL-PE gastrointestinal colonization on hospital admission and infections in hospitalized neonates.
Sixty-seven foals.
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.
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.
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.
产超广谱β-内酰胺酶肠杆菌科细菌（ESBL-PE）感染会导致人类新生儿发病和死亡。关于幼驹的相关数据较少。
确定住院新生幼驹入院时ESBL-PE胃肠道定植与感染之间的关联。
67匹幼驹。
对一家兽医医院收治的幼驹进行前瞻性研究。对幼驹进行ESBL-PE定植和感染筛查。分析危险因素和临床结局。
76%的幼驹至少患有一种细菌感染（n = 51/67）。分离出63种非ESBL细菌和19种ESBL-PE细菌。20匹幼驹（29.85%）至少患有一种医院获得性感染（HAI），30匹幼驹（44.8%）患有多重耐药感染。入院时ESBL-PE胃肠道定植率和临床ESBL HAI发生率分别为47.8%（n = 32/67，41株）和19.40%（n = 13/67，19株）。多变量分析显示，ESBL-PE HAI与入院时的定植相关（P = 0.03，比值比[OR] = 4.60）。在结局分析中，ESBL-PE感染和HAI与手术相关（ESBL-PE感染：P = 0.04，OR = 4.70；HAI：P = 0.004，OR = 6.4），HAI还与住院时间延长相关（P < 0.001，OR = 9.13）。主要的定植和感染细菌种类为大肠杆菌和克雷伯菌属。7.46%（n = 5/67）的幼驹直肠筛查和临床样本中分离出的ESBL-PE种类一致。
新生幼驹入院时ESBL-PE直肠定植与ESBL-PE HAI相关。ESBL-PE感染与住院期间的手术相关。这些发现强调了在马属动物新生儿重症监护病房中优化感染控制和临床感染治疗的重要性。
