Factors associated with the risk of positive blood culture in neonatal foals presented to a referral center (2000-2014).
Authors: Furr Martin, McKenzie Harold
Journal: Journal of veterinary internal medicine
Summary
# Editorial Summary Bloodstream infections represent a significant clinical challenge in neonatal foals, yet few studies have systematically examined which presentation findings reliably indicate infection risk. Furr and McKenzie conducted a retrospective case-control analysis of 429 foals under 14 days old presenting to a referral centre between 2000 and 2014, comparing 143 culture-positive cases against 286 controls to identify independent risk factors through multivariable logistic regression. Umbilical disease emerged as a particularly strong predictor (adjusted OR 11.01), whilst hypoglycaemia elevated risk substantially (adjusted OR 13.51), but the combination of umbilical involvement with low haematocrit proved most striking, conferring an odds ratio exceeding 999. Notably, commonly suspected risk factors including prematurity, hypothermia, failure of passive transfer, and maternal uterine infection showed no statistically significant association with bacteraemia. For practitioners managing neonatal foals, these findings provide an evidence-based framework for rapidly stratifying infection risk at initial assessment, enabling more targeted diagnostic and therapeutic decisions whilst avoiding unnecessary antimicrobial exposure in lower-risk animals.
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Practical Takeaways
- •Screen neonatal foals presenting with umbilical disease and/or hypoglycemia as high-priority candidates for blood culture and early antimicrobial therapy, as these foals have markedly elevated BSI risk
- •The combination of umbilical disease and anemia (low hematocrit) should raise particular concern for bacteremia; consider aggressive intervention in these cases
- •While other conditions (prematurity, hypothermia, diarrhea) are clinically important in neonatal foals, they are not independently predictive of bloodstream infection status
Key Findings
- •Umbilical disease increased BSI risk 11-fold (adjusted OR 11.01, P=0.02) in neonatal foals
- •Hypoglycemia increased BSI risk 13.5-fold (adjusted OR 13.51, P=0.03)
- •Combined umbilical disease and low hematocrit had extremely elevated risk (OR >999.99, P=0.04)
- •Prematurity, hypothermia, abdominal disease, diarrhea, failure of passive transfer, and maternal uterine infection were not significant risk factors for BSI