Infections caused by multidrug-resistant bacteria in an equine hospital (2012–2015)

Multidrug-resistant (MDR) bacteria are an emerging threat in human and veterinary medicine. There are few reports about infections caused by MDR isolates in horses. The aim of this study was to provide an overview of infections caused by MDR bacteria at the Equine Hospital Zurich between 2012 and 2015. Medical records were searched for horses with confirmed MDR bacterial infection. Multidrug resistance was defined according to human guidelines specific for each pathogen. MDR isolates were most commonly isolated from post-procedural infections (53/110, 48%), followed by musculoskeletal (16/110, 15%) and soft tissue infections (16/110, 15%). Escherichia coli (32/158, 20%) and Staphylococcus aureus (25/158, 16%) were the most common isolates. High resistance rates precluded therapy with commonly used antimicrobial drugs. The overall mortality rate was 20% (22/108) but depended on the localisation of the infection. Antimicrobial treatment prior to development of infection was reported for 89% (91/102) of horses. This study showed that MDR pathogens, mainly MDR E. coli and MRSA, cause a considerable number of infections in horses. A wide range of infections was seen, however, nosocomial infections predominated. These cases are typically hospitalised, pretreated with antibiotics, and suffering from comorbidities putting them at high-risk for acquiring infections caused by MDR isolates. The mortality of such infections was generally low but depended on site of infection.     

A comparison of the pharmacodynamic effects of intravenous ketamine–xylazine with alfaxalone in mute swans (Cygnus olor) presenting at a wildlife veterinary hospital

ObjectiveTo compare effects of intravenous (IV) alfaxalone with ketamine–xylazine combination on anaesthetic induction, recovery and cardiopulmonary variables in mute swans.Study designRandomized, controlled, clinical study.AnimalsA group of 58 mute swans.MethodsSwans were given either alfaxalone (10 mg kg^–1; group A) or a combination of ketamine (12.5 mg kg^–1) and xylazine (0.28 mg kg^–1) (group KX) IV. Heart and respiratory rates, end-tidal carbon dioxide and peripheral haemoglobin oxygen saturation were recorded at 5 minute intervals during anaesthesia. Time from anaesthetic induction to intubation, from cessation of isoflurane to extubation, to lifting head, sternal recumbency and absence of head/neck ataxia were recorded. Anaesthetic and recovery quality were scored (1 = very poor; 5 = excellent). Data are presented as median (interquartile range). Significance was set at p < 0.05.ResultsIn group A, 44% (12/27) of swans required mechanical ventilation for 2–14 minutes versus 3.2% (1/31) of swans in group KX (p = 0.0002). Heart rate was higher in group A than in group KX [146 (127–168) versus 65.5 (56–78) beats minute^–1, respectively; p < 0.0001]. The isoflurane concentration required to maintain anaesthesia was higher in group A than in group KX [2.5% (2.0–3.0%) versus 1.5% (1.0–2.0%), respectively; p = 0.0001]. Time from cessation of isoflurane administration to lifting head was significantly longer in group A than in group KX [12 (9–17) versus 6 (4–7.75) minutes, respectively; p < 0.0001]. Anaesthesia quality scores were significantly better in group KX than in group A [4 (4–5) versus 4 (3–4), respectively; p = 0.0011], as were recovery scores [4 (3–5) versus 2 (2–3), respectively; p = 0.0005].Conclusions and clinical relevanceAlfaxalone is a suitable anaesthetic induction agent for use in mute swans. There is a greater incidence of postinduction apnoea and a higher incidence of agitation on recovery with alfaxalone than with ketamine–xylazine.