Prevalence of antimicrobial resistance in equine-associated Pseudomonas aeruginosa: a systematic review and meta-analysis.
Authors: Yang Luo, Xie Yuxin, Zhong Guangzhi, Liu Dejun, Zhu Yiping, Li Jing
Journal: BMC veterinary research
Summary
# Editorial Summary: Antimicrobial Resistance in Equine Pseudomonas aeruginosa Pseudomonas aeruginosa represents a significant opportunistic pathogen in equine medicine, yet our understanding of resistance patterns in this species remains limited. A systematic review and meta-analysis synthesising data from 10 peer-reviewed studies (encompassing 1,624 isolates) has revealed concerning trends in antimicrobial resistance, with particularly high resistance rates emerging for imipenem, amikacin, and ceftiofur—drugs commonly employed in equine respiratory and wound infections. Notable geographical variation exists, with Asian regions reporting substantially elevated resistance rates, likely reflecting differences in antimicrobial stewardship practices and regulatory frameworks. Of practical relevance, aztreonam, fosfomycin, ciprofloxacin, and ceftazidime demonstrated the most reliable efficacy across isolates, though the authors emphasise that findings are constrained by the limited evidence base and variable reporting across studies. Given these patterns of emerging resistance, equine practitioners should prioritise culture and susceptibility testing prior to treatment initiation, implement stringent infection control protocols, and engage in evidence-based antimicrobial stewardship to preserve therapeutic options for both individual patients and the broader equine population.
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Practical Takeaways
- •When treating suspected P. aeruginosa infections in equines, consider resistance patterns in your region and favor aztreonam, fosfomycin, ciprofloxacin, or ceftazidime based on culture and sensitivity results
- •Avoid routine use of imipenem, amikacin, and ceftiofur for P. aeruginosa without confirmed susceptibility, as resistance rates are rising across multiple regions
- •Implement strict antimicrobial stewardship practices in your facility, including culture-based diagnostics before treatment and avoiding broad-spectrum agents when narrower options are effective
Key Findings
- •Analysis of 1,624 P. aeruginosa isolates from 10 equine studies revealed high resistance rates to imipenem, amikacin, and ceftiofur with increasing temporal trends
- •Asia reported the highest average antimicrobial resistance rates, suggesting regional differences in antimicrobial use patterns
- •Aztreonam, fosfomycin, ciprofloxacin, and ceftazidime demonstrated the most consistent antimicrobial efficacy against equine-associated P. aeruginosa
- •Generalizability of findings is limited by only 10 eligible studies and uneven distribution of isolate testing across antimicrobial classes