Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in Hospitalized Neonatal Foals: Prevalence, Risk Factors for Shedding and Association with Infection.
Authors: Shnaiderman-Torban Anat, Paitan Yossi, Arielly Haia, Kondratyeva Kira, Tirosh-Levy Sharon, Abells-Sutton Gila, Navon-Venezia Shiri, Steinman Amir
Journal: Animals : an open access journal from MDPI
Summary
Extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) represent a growing antimicrobial resistance concern in equine medicine, yet their epidemiology in hospitalised neonatal foals remained poorly characterised until this Israeli investigation. Researchers conducted rectal sampling from 55 mare–foal pairs on admission and day 3 of hospitalisation, identifying ESBL-producing isolates through culture enrichment and antibiotic susceptibility testing, with molecular characterisation via multilocus sequence typing. Shedding prevalence was alarmingly high, escalating from 33% in foals and 16% in mares on admission to 85% and 58% respectively by day 3 of hospitalisation; crucially, foal shedding correlated independently with umbilical infection on presentation (P = 0.016) and ampicillin treatment during stay (P = 0.011), rather than reflecting maternal carriage status. *Escherichia coli* dominated the isolates, with bacterial diversity increasing during hospitalisation, and four foals developed clinical ESBL-E infections including umbilical and wound contamination. These findings demand urgent attention to infection control protocols and judicious antimicrobial prescribing in neonatal foal units, as the high acquisition and shedding rates suggest nosocomial transmission risk and potential reservoirs for resistance dissemination among hospitalised populations.
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Practical Takeaways
- •Neonatal foals in hospital settings carry a high and rapidly increasing burden of antibiotic-resistant bacteria; strict infection control measures are critical to prevent transmission and clinical disease
- •Umbilical infections at admission and ampicillin use during hospitalization are key risk factors for ESBL-E shedding in foals—consider alternative antimicrobials when possible and ensure meticulous umbilical care in newborns
- •Resistance rates in hospitalized foals are alarming and should prompt veterinarians to use selective culture and susceptibility testing to guide therapy rather than empirical broad-spectrum antibiotics
Key Findings
- •ESBL-E shedding in neonatal foals increased from 33% on admission to 85% during hospitalization, compared to 16% to 58% in mares
- •Foal shedding was associated with umbilical infection on admission (P = 0.016) and ampicillin treatment during hospitalization (P = 0.011)
- •Escherichia coli was the most common ESBL-E identified, with increased species diversity during hospitalization
- •Four foals developed clinical infections with ESBL-E strains including umbilical and wound infections