Bacteremia in equine neonatal diarrhea: a retrospective study (1990-2007).
Authors: Hollis A R, Wilkins P A, Palmer J E, Boston R C
Journal: Journal of veterinary internal medicine
Summary
# Bacteremia in Equine Neonatal Diarrhoea: Editorial Summary Neonatal diarrhoea in foals frequently accompanies bacteraemia, yet the relationship between these conditions and their clinical significance had not been systematically investigated prior to this retrospective analysis. Hollis and colleagues reviewed admission blood culture results from 133 foals under 30 days of age presenting with diarrhoea between 1990 and 2007, examining isolate patterns, passive transfer status, and survival outcomes. Half the cohort (66 foals, 50%) were bacteraemic at admission with 75 isolates recovered; Enterococcus spp. dominated at 29% of isolates, followed by Pantoea agglomerans (17%), with a roughly even split between Gram-negative and Gram-positive organisms overall. Surprisingly, bacteraemia status at admission did not correlate with immunoglobulin G concentration, nor did it predict survival to discharge—a finding that challenges assumptions about the severity of bacteraemia in this clinical context. For practitioners, these findings underscore that bacteraemia is an expected feature of neonatal diarrhoea rather than an ominous prognostic indicator, and suggest that antimicrobial selection should reflect the likely polymicrobial aetiology and organism prevalence identified here, rather than being driven by bacteraemia presence alone.
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Practical Takeaways
- •Bacteremia is common in foals presenting with diarrhea (50%), so broad-spectrum antimicrobial coverage should be considered early in management
- •Enterococcus and Pantoea agglomerans are the predominant organisms; antimicrobial selection should reflect the prevalence of both Gram-positive and Gram-negative bacteria
- •Presence or absence of bacteremia does not predict survival outcomes, so clinical management decisions should not be based solely on blood culture results
Key Findings
- •50% (66/133) of neonatal foals with diarrhea were bacteremic at admission with 75 total isolates
- •Enterococcus spp. was the most common isolate (29%), followed by Pantoea agglomerans (17%)
- •57% of isolates were Gram-negative organisms and 43% were Gram-positive organisms, excluding coryneform bacteria
- •Blood culture status was not associated with survival to hospital discharge