Risk factors for nosocomial Salmonella infection among hospitalized horses.

OBJECTIVE: To identify risk factors for nosocomial Salmonella infections among hospitalized horses. DESIGN: Longitudinal study. ANIMALS: 1,583 horses hospitalized in an intensive care unit between January 1992 and June 1996. PROCEDURE: Survivor functions were used to estimate time to shedding salmonellae for various Salmonella serotypes. Survival analysis was then used to determine how variables associated with patient management, environmental conditions, hospital conditions, and other disease processes affected the risk of nosocomial Salmonella infection. RESULTS: 78 horses shed Salmonella organisms: 35 shed Salmonella krefeld, 26 shed S typhimurium, and 17 shed other Salmonella serotypes. Mean time from admission to shedding was significantly longer for horses shedding S krefeld or S typhimurium than for horses shedding other Salmonella serotypes. Therefore, infection with S krefeld or S typhimurium was considered nosocomial. Seven variables were found to be significantly associated with risk of nosocomial Salmonella infection: mean number of horses in the hospital shedding S krefeld during the 4 days prior to and the day of admission, mean number of horses shedding S typhimurium during this period, a diagnosis of large colon impaction, withholding feed, number of days fed bran mash, duration of treatment with potassium penicillin G, and mean daily ambient temperature. CLINICAL IMPLICATIONS: Results suggest that risk of nosocomial Salmonella infections is greater for horses with large colon impactions. In addition to implementing hospital protocols that minimize cross contamination between patients, strategies to reduce the risk of nosocomial Salmonella infection should include minimizing use of potassium penicillin G and regulation of environmental temperature in the hospital.     

Risk factors for fecal shedding of Salmonella from horses in a veterinary teaching hospital

Identification of risk factors for horses shedding Salmonella in their feces helps identify patients at-risk of infection and protect the overall population through heightened biosecurity. Fecal samples from 230 hospitalized horses were cultured for Salmonella spp. Historical data were collected on 21 putative risk factors and assessed for association with the risk of a horse being culture positive using forwards stepwise logistic regression. Salmonella was isolated from 13 horses—most commonly from either the first (n=5) or second (n=4) sample collected. Only presenting complaint (confounded by age, breed and gender) was significantly (P≤0.05) associated with positive Salmonella-culture results. Analysis of residuals showed that the model was robust, but individual risk-factor estimates were changed by removal of outliers. Overall, presenting complaint (for example, lower-respiratory-tract disease) was the most important indicator of culture status.     

Risk factors for fecal shedding of Salmonella in 91 US dairy herds in 1996

In 1996, data on management practices used on US dairy operations were collected and analyzed for association with fecal shedding of Salmonella by dairy cows. A total of 4299 fecal samples from 91 herds was cultured for Salmonella isolation. Herd-size (adjusted odds ratios (OR) = 5.8, 95% CI 1.1, 31.3), region (OR = 5.7, CI 1.4, 23.5), use of flush water systems (OR = 3.5, CI 0.9, 14.7), and feeding brewers' products to lactating cows (OR = 3.4, CI 0.9, 12.9) were identified as the most important predictive risk factors. The population attributable risks (PARs) for herd-size, region, flush water system, and feeding brewers' products to lactating cows were 0.76, 0.46, 0.37, and 0.42, respectively. The estimated PAR for all four risk factors combined was 0.95. The effects of these factors need to be more-closely evaluated in more-controlled studies, in order to develop intervention programs that reduce Salmonella shedding.     

Risk factors for salmonellosis in hospitalized horses

A case-control study to identify risk factors associated with isolation of Salmonella was accomplished, using data from records of horses hospitalized in the period July 1971 through June 1982. Horses in which nasogastric tubes were passed were at 2.9 times greater risk of having Salmonella isolated, compared with horses that did not undergo this procedure. Horses treated with antibiotics parenterally were at 6.4 times greater risk, and those treated with antibiotics orally and parenterally were at 40.4 times greater risk of developing salmonellosis, compared with horses not receiving such treatment. Horses admitted because of colic were 4.2 times as likely to have Salmonella isolated as those admitted for other reasons. Breed, age, and type of surgery did not appear to be risk factors. The risk factors identified and the magnitude of their association with Salmonella isolation were similar to those observed in a preceding study.     

Diarrhea associated with sand in the gastrointestinal tract of horses

Four horses with diarrhea had radiographic evidence of large quantities of sand in the gastrointestinal tract. Initially, none of the horses had sufficient fecal sand quantity to suggest sand enteropathy. Diarrhea resolved in all horses within 2 days of oral administration of psyllium hydrophilic mucilloid. Historically, all 4 horses had lost weight or had difficulty maintaining weight. After treatment was administered, the horses either gained weight or were easier to maintain in good condition.     

Risk factors associated with colic in horses

Many factors have been identified as risk factors for colic in horses in several epidemiological studies. The aim of our paper was to review the results of 12 epidemiological studies, in order to assess the impact of each risk factor for colic. According to the literature, the factors that increase the risk of colic are feeding practices (type and quality of food, type and changes of feeding), the intrinsic factors of horses (sex, age and breed), management (type and changes of housing and activity), medical history (a previous colic, administration of a medical treatment) and parasite control (the presence of worms and type of deworming program). Several individual factors were incriminated as risk factors by all the studies. Nevertheless, the different studies did not always agree on the role of other risk factors. The conclusions were tightly related to several criteria in the selection of the study population, like the type of the epidemiological study, the number and the origin of horses included and the location of the study.     

Risk factors associated with renal insufficiency in horses with primary gastrointestinal disease: 26 cases (2000-2003)

OBJECTIVE: To identify factors associated with renal insufficiency in colic- or colitis-affected horses with high serum creatinine (SCr) concentrations evaluated at a referral hospital. DESIGN: Retrospective case series. ANIMALS: 167 colic- or colitis-affected horses (88 represented a random sample [hospital population], and 79 had high SCr concentration at initial evaluation [study population]). PROCEDURE: Medical records were reviewed. Data collected included signalment; physical examination, clinicopathologic, and diagnostic findings; and outcome. The study population was categorized on the basis of whether SCr concentration did (AR group; n = 53) or did not (PA group; 26) normalize within 72 hours of fluid therapy. Characteristics of the study and hospital populations were compared. RESULTS: Males and Quarter Horses were significantly overrepresented in the study population. Compared with the hospital population, study-population horses were significantly more likely to have colitis, gastric reflux, and diarrhea at initial evaluation. Initial mean SCr concentration in the PA group was significantly higher than the AR group; identification of gastric reflux, abnormal rectal examination findings, and hypochloremia were significantly associated with persistent azotemia after 72 hours of fluid therapy. Compared with the AR group, PA group horses were 3 times as likely to die or be euthanized. CONCLUSIONS AND CLINICAL RELEVANCE: In colic- or colitis-affected horses, factors associated with renal insufficiency included gastric reflux, abnormal rectal examination findings, or hypochloremia initially; prognosis for horses in which azotemia resolves within 72 hours of treatment appears to be better than for horses with persistent azotemia.     

Risk factors associated with injuries in thoroughbred horses.

A case-control study was conducted on Thoroughbred horses to identify factors associated with the risk of breakdown on racetracks. A total of 310 cases (breakdowns) were identified from the Horse Identification Department records kept by the chief examining veterinarian of New York Racing Association. For each case, two control horses were selected randomly from the Daily Racing Form Inc. records. Multiple logistic regression analysis was used to identify and quantify the risk of factors associated with breakdown, while simultaneously controlling for the effect of other putative factors. Factors associated with risk of breakdown were: track (horses raced on Saratoga racetrack were at a lesser risk of breakdown), track composition/condition (turf tracks had a lower risk compared to dirt), number of seasons in race, racing in a later race, number of starts per year, the total number of starts, season (summer had a higher risk than winter or spring) and age of the horse.     

Prevalence and factors associated with fecal shedding of Giardia spp. in domestic cats

The prevalence of cats shedding Giardia cysts (13.6%) in the present study was found to be higher than previously reported (1% to 11%) and may reflect a higher sensitivity for the diagnostic test used. The presence of Cryptosporidium spp. oocysts, coccidial oocysts, and a clinical history of chronic (>2 weeks) gastrointestinal signs were significantly associated with the presence of Giardia spp. cysts in the feces. There were no associations between the presence of Giardia spp. cysts and type of housing, acute gastrointestinal signs, vomiting, gender, source of cat (i.e., animal shelter versus private breeder), or gastrointestinal parasites other than Cryptosporidium spp. and intestinal coccidial agents.     

Risk factors for disease associated with influenza virus infections during three epidemics in horses

OBJECTIVE: To identify risk factors associated with respiratory tract disease in horses during 3 epidemics caused by influenza virus infections. DESIGN: Cross-sectional and prospective longitudinal observational studies. ANIMALS: 1,163 horses stabled at a Thoroughbred racetrack. PROCEDURES: Investigations were conducted during a 3-year period. An epidemic of respiratory tract disease caused by influenza virus infections was identified in each year. Routine observations and physical examinations were used to classify horses' disease status. Data were analyzed to identify factors associated with development of disease. RESULTS: Results were quite similar among the epidemics. Concentrations of serum antibodies against influenza virus and age were strongly associated with risk of disease; young horses and those with low antibody concentrations had the highest risk of disease. Calculation of population attributable fractions suggested that respiratory tract disease would have been prevented in 25% of affected horses of all horses had high serum antibody concentrations prior to exposure. However, recent history of vaccination was not associated with reduction in disease risk. Exercise ponies had greater risk of disease than racehorses, which was likely attributable to frequent horse-to-horse contact. CONCLUSIONS AND CLINICAL RELEVANCE: Particular attention should be paid to young horses, those with low serum antibody concentrations, and horses that have frequent contact with other horses when designing and implementing control programs for respiratory tract disease caused by influenza virus infections. It appears that control programs should not rely on the efficacy of commercial vaccines to substantially reduce the risk of disease caused by influenza virus infections.     

Risk factors for enterolithiasis among horses in Texas

OBJECTIVE: To identify risk factors for enterolithiasis in horses. DESIGN: Matched case-control study. ANIMALS: 26 horses with enteroliths, 104 horses with other causes of colic that underwent surgery (52 horses, surgical control group) or were treated medically (52 horses, nonsurgical control group). PROCEDURE: Medical records were reviewed for horses with enteroliths and control horses. Information collected included signalment, anamnesis, and findings on physical examination and clinicopathologic testing at admission. Horses with enteroliths and control horses were compared by means of conditional logistic regression to identify factors associated with enterolithiasis. RESULTS: Horses that were fed alfalfa hay, spent < or = 50% of time outdoors, or were Arabian or miniature breeds had an increased risk of developing enteroliths. Horses with enteroliths were more likely to have been hyperbilirubinemic and to have had clinical signs > 12 hours prior to admission. CONCLUSIONS AND CLINICAL RELEVANCE: Breed and diet appear to influence the risk of enterolithiasis; other management factors also may influence development of enteroliths. Duration of clinical signs may be longer and signs may be less severe among horses with enteroliths, compared with horses with other causes of colic.     

Risk factors associated with development of postoperative ileus in horses.

OBJECTIVE: To determine risk factors associated with development of postoperative ileus in horses undergoing surgery for colic. DESIGN: Case-control study. ANIMALS: 69 horses that developed ileus after surgery for colic and 307 horses that did not develop postoperative ileus. PROCEDURE: Signalment, history, clinicopathologic data, treatment, lesions, and outcome were obtained from medical records. RESULTS: Variables associated with increased risk of postoperative ileus included age > 10 years, Arabian breed, PCV > or = 45%, high serum concentrations of protein and albumin, anesthesia > 2.5 hours' duration, surgery > 2 hours' duration, resection and anastomosis, and lesions in the small intestine. Enterotomy reduced the risk of postoperative ileus. After multivariate logistic regression, the final model included the variables Arabian breed, PCV > or = 45%, lesion type, duration of surgery (> 2 hours vs < or = 2 hours), and pelvic flexure enterotomy. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that by evaluating certain factors, horses at increased risk of postoperative ileus may be recognized before the condition develops. Preventative treatment and early intervention may be instituted in these horses. Shortening surgery time and performing an enterotomy may decrease the probability of horses developing postoperative ileus.     

Prevalence of fecal shedding of Salmonella spp in dairy herds

OBJECTIVE: To estimate prevalence of Salmonella spp in Ohio dairy farms and to identify potential risk factors for fecal shedding of salmonellae. DESIGN: Cross-sectional study. SAMPLE POPULATION: 105 Ohio dairy farms. PROCEDURE: Individual fecal samples from all mature cows in study herds were tested for Salmonella spp by use of standard bacteriologic culture procedures. Herds were identified as infected if at least 1 cow was shedding Salmonella spp. Information regarding herd characteristics, management practices, and health history were collected. Potential risk factors for herd-level Salmonella infection were identified. RESULTS: In 31% of the study herds (95% confidence interval, 22 to 40%), at least 1 cow was shedding Salmonella spp. Six percent of 7,776 fecal samples contained Salmonella organisms; prevalence within infected herds ranged from < 1 to 97%. Herd size, use of free stalls for lactating and nonlactating cows, and use of straw bedding in nonlactating cows were significantly associated with fecal shedding of Salmonella spp, as determined by use of univariate analysis. By use of multivariate analysis, large herds were more likely to be infected than smaller herds; however, no other factors were associated with Salmonella infection after adjustment for herd size. CONCLUSIONS AND CLINICAL RELEVANCE: Subclinical shedding of Salmonella spp is common in Ohio dairy herds, although we could not identify specific interventions that may influence the prevalence of Salmonella spp on dairy farms. It appears that large herd size and intensive management may provide an environment conducive to Salmonella shedding and chronic dairy herd infection.