Umbilical infections in foals: microbiological investigation and management.
Authors: Rampacci E, Passamonti F, Bottinelli M, Stefanetti V, Cercone M, Nannarone S, Gialletti R, Beccati F, Coletti M, Pepe M
Journal: The Veterinary record
Summary
Umbilical infections remain a significant clinical challenge in neonatal foals, yet evidence-based treatment protocols remain limited. Rampacci and colleagues examined 40 foals aged 1–30 days presenting with suspected omphalitis, using ultrasound imaging, umbilical swabs for bacterial culture, and blood cultures from febrile foals to characterise the microbiology and antimicrobial susceptibility profiles of causative organisms. Enterobacteria and Gram-positive cocci dominated the infection landscape (occurring in 95% of foals), whilst less common pathogens including *Serratia marcescens*, *Pantoea agglomerans* and *Trueperella pyogenes* were also isolated; notably, 11 foals developed bacteraemia. Omphalectomy was necessary in 77.5% of cases, particularly those with vascular involvement, systemic signs or clinical deterioration despite targeted antimicrobial therapy, though medical management alone proved successful in the remaining foals when guided by susceptibility testing. These findings underscore the importance of combining ultrasonographic assessment with bacterial culture and susceptibility data to individualise treatment decisions, helping practitioners distinguish cases amenable to antimicrobial therapy from those requiring surgical intervention—a distinction with significant welfare and economic implications for neonatal foal survival.
Read the full abstract on PubMed
Practical Takeaways
- •Umbilical infection is extremely common in neonatal foals; ultrasound examination combined with bacteriological sampling should be standard practice for foals showing signs of illness within the first month of life
- •Culture and antibiotic susceptibility testing should guide antimicrobial selection, as this approach was successful in all medically-treated foals
- •Omphalectomy should be strongly considered when fever, umbilical vein involvement, or joint disease is present despite antibiotic therapy, or when clinical decline occurs
Key Findings
- •Bacterial omphalitis was observed in 95% of the 40 foals studied (aged 1-30 days)
- •Bacterial septicaemia was diagnosed in 11 cases (27.5% of foals)
- •Enterobacteria and coccoid Gram-positive bacteria were the most frequently isolated pathogens
- •Omphalectomy was performed in 77.5% of foals; antibiotic therapy alone was successful in all foals that received only medical treatment