Identification of predictors of salmonella shedding in adult horses presented for acute colic

Background

Colic has been associated with shedding of Salmonella. Horses with salmonellosis typically develop diarrhea, fever, and leukopenia. Overlooking additional predictors may result in failure to detect shedding horses and increase environmental contamination.

Objectives

Evaluate associations between signalment and clinicopathologic data during early hospitalization and Salmonella shedding in horses treated for acute colic.

Animals

Horses with acute colic admitted to a referral hospital. A total of 59 horses shedding Salmonella compared to 108 Salmonella‐negative horses.

Methods

Retrospective case‐control study evaluating patient and Salmonella culture data. Associations between variables and Salmonella shedding were identified using logistic regression. Two multivariable models were developed pertaining to (1) information available within 24 hours of admission and (2) clinical findings that developed later during hospitalization.

Results

Variables retained for multivariable model 1 indicated that Warmbloods and Arabians had increased odds for shedding Salmonella, as did horses requiring surgery (OR, 2.52; 95% CI, 1.10–5.75) or having more severe gastrointestinal disease (OR, 2.59; 95% CI, 1.08–6.20). Retained variables for model 2 demonstrated that horses that were treated surgically (OR, 1.60; 95% CI, 0.70–3.62), developed fever >103°F (OR, 2.70; 95% CI, 0.92–7.87), had abnormal leukocyte count (OR, 1.38; 95% CI, 0.61–3.09), or became inappetent and lethargic (OR, 16.69; 95% CI, 4.08–68.24) had increased odds for shedding Salmonella.

Conclusions and Clinical Importance

In horses with acute colic that present without signs of diarrhea, fever, or leukopenia, additional predictors associated with shedding Salmonella could be used to more promptly identify horses likely to shed organisms .     

Risk factors associated with fecal Salmonella shedding among hospitalized horses with signs of gastrointestinal tract disease

OBJECTIVE: To estimate prevalence of and identify risk factors for fecal Salmonella shedding among hospitalized horses with signs of gastrointestinal tract disease. DESIGN: Cross-sectional study. ANIMALS: 465 hospitalized horses with gastrointestinal tract disease. PROCEDURE: Horses were classified as positive or negative for fecal Salmonella shedding during hospitalization by means of standard aerobic bacteriologic methods. The relationship between investigated exposure factors and fecal Salmonella shedding was examined by means of logistic regression. RESULTS: The overall prevalence of fecal Salmonella shedding was 13%. Salmonella serotype Newport was the most commonly isolated serotype (12/60 [20%]), followed by Anatum (8/60 [13%]), Java (13%), and Saint-paul (13%). Foals with gastrointestinal tract disease were 3.27 times as likely to be shedding Salmonella organisms as were adult horses with gastrointestinal tract disease. Adult horses that had been treated with antimicrobial drugs prior to hospitalization were 3.09 times as likely to be shedding Salmonella organisms as were adult horses that had not been treated with antimicrobial drugs prior to hospitalization. Adult horses that underwent abdominal surgery were 2.09 times as likely to be shedding Salmonella organisms as were adult horses that did not undergo abdominal surgery. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that a history of exposure to antimicrobial drugs prior to hospitalization and abdominal surgery during hospitalization were associated with Salmonella shedding in adult horses with gastrointestinal tract disease. Foals with gastrointestinal tract disease were more likely to shed Salmonella organisms than were adult horses with gastrointestinal tract disease.     

Pilot Study Investigating Fecal Shedding of Salmonella spp. by Horses Used in Competition

This pilot study was performed to determine the need for future investigation of the effect of transportation, environmental changes, and athletic competition on fecal shedding of Salmonella spp. in sport horses. Fecal samples were collected once daily from 20 healthy horses that were competing in National Collegiate Athletic Association equestrian event that occurred over a 3-day period. The horses were divided into four groups with five horses per group. The groups were divided based on travel distance. Fresh fecal samples were collected daily and cultured for Salmonella spp., through bacterial culture, for a minimum of 3 days for three groups that traveled to compete and for 15 days for a group that was housed at the competition location. All fecal samples were negative for Salmonella spp. Although this was a pilot study with a small sample size and limited collection days, the results of this study question the effects of the stress of transportation, new environment, and athletic activity on fecal shedding of Salmonella spp. in horses. A larger study, however, is needed to further investigate these findings.     

Factors associated with Salmonella shedding among equine colic patients at a veterinary teaching hospital

OBJECTIVE: To evaluate factors potentially associated with fecal Salmonella shedding among equine patients hospitalized for colic at a veterinary teaching hospital and to determine the effects of probiotic treatment on fecal Salmonella shedding and clinical signs. DESIGN: Longitudinal study and controlled trial. ANIMALS: 246 equine colic patients. PROCEDURE: History and medical information were obtained from patient records. Fecal and environmental samples were submitted for aerobic bacterial culture for Salmonella enterica. Fifty-one patients were treated with a commercially available probiotic; 46 were treated with a placebo. Logistic regression was used to evaluate data. RESULTS: Salmonella organisms were detected in feces from 23 (9%) patients at least once during hospitalization. Patients were more likely to shed Salmonella organisms if diarrhea was evident < or = 6 hours after hospitalization and duration of hospitalization exceeded 8 days (odds ratio [OR], 20.3), laminitis developed during hospitalization (OR, 12.0), results of nasogastric intubation were abnormal (OR, 4.9), leukopenia was evident < or =6 hours after hospitalization (OR, 4.6), or travel time to the teaching hospital exceeded 1 hour (OR, 3.5). Horses treated with the probiotic did not differ from control horses in regard to likelihood of fecal Salmonella shedding (OR, 1.5) or prevalence of clinical signs. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that certain risk factors are associated with fecal shedding of S enterica among equine patients hospitalized at a veterinary teaching hospital because of colic and that pathogen monitoring in patients and the hospital environment and use of barrier nursing precautions for equine colic patients are beneficial.     

The Incidence of Aeromonas Species in the Feces of Nondiarrheic Horses

Aeromonas species have been isolated from the feces of diarrheic adult horses and foals. However, Aeromonas species have also been isolated from the feces of approximately 5% of clinically normal adult horses outside the United States. The objectives of this study were to determine whether Aeromonas species can be shed in the feces of nondiarrheic adult horses and identify any effects of season of year, transportation, and hospitalization on possible fecal shedding of Aeromonas species. Feces were cultured for Aeromonas and Salmonella species from 138 nondiarrheic adult horses examined in the hospital and by field services for complaints other than gastrointestinal disease. Fecal Aeromonas and Salmonella species were isolated from 6.5% and 2.2% of nondiarrheic horses, respectively. All Aeromonas isolates were identified as A caviae. There were no apparent effects on time of year, hospitalization, or transport on isolation of Aeromonas species from feces. Isolation of Aeromonas species from diarrheic horses in the absence of other possible enteric pathogens indicates intestinal disease as a result of Aeromonas infection, but Aeromonas species can also occur as copathogens with Salmonella infections.     

Evaluation of a PCR to detect Salmonella in fecal samples of horses admitted to a veterinary teaching hospital.

The diagnostic accuracy of a PCR used to identify horses shedding Salmonella spp. in their feces during hospitalization was estimated, relative to bacterial culture of serially collected fecal samples, using longitudinal data. Five or more fecal samples were collected from each of 116 horses admitted as inpatients, for reasons other than gastrointestinal disease, between July 26, 2001 and October 25, 2002. All 873 fecal samples collected were tested with a PCR based on oligonucleotide primers defining a highly conserved segment of the histidine transport operon gene of Salmonella typhimurium, and each sample was cultured for Salmonella spp. One or more samples from 87 (75%) horses were PCR positive, and Salmonella was cultured from 1 or more samples from 11 (9.5%) horses. All culture-positive horses had at least 1 PCR-positive result, whereas only 29 (28%) culture-negative horses were PCR negative on all fecal samples tested. The PCR was most specific, relative to bacterial culture of serially collected fecal samples, when used to test samples from Quarterhorse or breeds other than Thoroughbred or Standardbred, or from clinical (vs. healthy, accompanying horses) cases. Overall, the PCR had the greatest agreement (70%), compared with bacterial culture of serially collected fecal samples, using a cutoff of 2 or more positive PCR test results to define a Salmonella-positive horse. The reasons why some fecal samples, from which Salmonella organisms cannot be isolated, are PCR positive need to be determined before the PCR can be incorporated into Salmonella surveillance programs for hospitalized equine populations.     

Absence of equid herpesvirus-1 reactivation and viremia in hospitalized critically ill horses

Background: Equid herpesvirus‐1 (EHV‐1) reactivation and shedding can occur in latently infected, asymptomatic animals. Risk factors for reactivation include stress and illness. The risk of asymptomatic shedding in hospitalized, critically ill horses with acute abdominal disease is unknown. This information is important to assess the need for additional biosecurity protocols to prevent spread of EHV‐1 in hospitalized critically ill horses with acute abdominal disorders. Objectives: To determine the frequency of reactivation and nasal shedding of EHV‐1 in hospitalized critically ill horses. Animals: One hundred twenty‐four client‐owned horses admitted to the Veterinary Teaching Hospital with acute abdominal disorders were included in the study. Methods: Cross‐sectional study examining the risk of reactivation of EHV‐1 in horses admitted with acute, severe, gastrointestinal disease. Whole blood and nasal secretions were collected throughout hospitalization. In addition, mandibular lymph nodes were collected from 9 study horses and 26 other Michigan horses. All samples were tested for the presence of EHV‐1 nucleic acid by real‐time PCR assays targeting the glycoprotein B gene and the polymerase (ORF 30) gene. Results: One hundred and twenty‐four horses met the inclusion criteria. None of the samples were positive for EHV‐1 DNA. Conclusion and Clinical Importance: These results suggest that nasal shedding and viremia of EHV‐1 in hospitalized critically ill horses with acute abdominal disorder is extremely rare. Implementation of additional biosecurity protocols to limit aerosol spread of EHV‐1 among horses with acute abdominal disease and other hospitalized horses is not necessary.     

A Clinical Trial of Probiotic Administration for Prevention of Salmonella Shedding in the Postoperative Period in Horses With Colic

The purpose of this study was to evaluate the effects of probiotic administration on the prevalence of fecal shedding of Salmonella , the prevalence of postoperative diarrhea, the length of antimicrobial therapy, and the length of the hospitalization stay during the postoperative period in horses with colic. Two commercially available probiotics for horses were used in a double-blind prospective study of 200 horses undergoing surgery for colic. Probiotic or placebo was administered PO once a day for 7 days postoperatively, and fecal cultures for Salmonella were obtained daily for 10 days. After selection of 186 patients completing the treatment protocol, the results indicated that the commercial probiotic formulations had no effect on Salmonella shedding, prevalence of diarrhea, length of antimicrobial therapy, or length of hospitalization ( P > .05). Twenty percent of the horses yielded 1 or more positive fecal cultures for Salmonella; of these horses, 74% were classified as asymptomatic shed-ders. Twenty-six percent of all horses had fluid diarrhea postoperatively, with only 12% of these horses having positive fecal cultures for Salmonella , The most common isolate was Salmonella krefeld (24 of 39 isolates). Among the different gastrointestinal disorders, horses with feed and sand impactions appeared to be more prone to shed Salmonella .     

Epidemiologic study of salmonellae shedding in the feces of horses and potential risk factors for development of the infection in hospitalized horses

A study was designed to identify epidemiologic factors associated with the development and spread of salmonellae in horses in a veterinary teaching hospital, through a case-control study and a longitudinal follow-up prospective study. In the case-control study, 44 horses shedding salmonellae in feces were compared with 99 control horses not shedding salmonellae in feces; regarding breed, sex, age and initial diagnosis, none of the odds ratios for study factors was significant. The factors found to be associated with fecal shedding of salmonellae in the prospective study included diarrhea at the time of admission to the hospital, fever while hospitalized, and a change in diet while hospitalized. Horses identified to be shedding salmonellae in feces were not limited to those with clinical signs of salmonellosis; however, spread of salmonellae from a shedder without clinical signs of disease to other hospitalized horses was not identified. The most common serovars of Salmonella isolated were oranienburg and newport.     

Prevalence of Clostridium difficile in horses

Fecal samples were collected to establish the apparent prevalence of Clostridium difficile shedding in Standardbred and Thoroughbred racehorses housed at 4 racetracks and 2 breeding facilities, and in horses admitted to a referral large animal clinic. Forty-one (7.59%) of 540 racetrack horses, seven (5.83%) of 120 breeding farm horses, and four (4.88%) out of 82 horses admitted to the referral clinic were culture-positive for C. difficile. An overall fecal culture prevalence of 7.01% for C. difficile was identified in 742 fecal samples. PCR-ribotyping and toxin gene identification was performed and seventeen 17 PCR-ribotypes were identified among the 52 C. difficile isolates.     

Prevalence of Multi-Drug-Resistant Salmonella in Equids Maintained by Low Income Individuals and on Designated Equine Farms in India

We examined 872 equids (445 maintained by low-income individuals and 427 maintained on nine designated equine farms) and, using previously described methods for bacteria, isolated Salmonella from fecal samples of 59 (6.77%) animals. Of the 646 horses, 183 donkeys, and 43 mules that had feces cultured for Salmonella, 42 (6.5%), 7 (3.8%), and 10 (23.3%), respectively, were excreting Salmonella strains in feces. Six horse mares were excreting Salmonella enterica of two different serovars simultaneously. A total of 65 Salmonella enterica isolates belonged to 13 serovars, namely S. paratyphi B var Java (14), S. I. 4, 5, 12, 27: r, i: 1, 5 (11), S. Drogana (8), S. Newport (7), S. Saintpaul (5), S. Lagos (4), S. Typhimurium (5), S. Kottbus (3), S. Bovismorbificans (3), S. Dumfries (2), S. Tshiongwe (1) S. Weltevreden (monophasic) (1), and S. enterica ssp salamae (1). With Salmonella-specific polymerase chain reaction (PCR) using hisJ gene primers, 107 (12.3) fecal samples yielded a specific amplicon of 496 bp. On using PCR, prevalence of Salmonella in donkeys, horses, and mules was 4.9%, 10.8%, and 65.1%, respectively. With both methods of Salmonella detection in feces, prevalence was significantly higher in female than in male donkeys and horses. Salmonella shedding in feces was significantly higher in equids maintained by low-income people than those at designated equine farms. Almost all Salmonella isolates (63 of 65) had multiple-drug-resistance (MDR, resistance to three or more drugs). Salmonella isolates were commonly resistant to sulfamethoxazole (90.8%), tetracycline (70.8%), doxycycline (67.7%), furazolidone (66.2%), and colistin (55.4%). A few isolates had resistance to trimethoprim (3.1%), ciprofloxacin (3.1%), ceftriaxone (3.1%), ceftazidime (3.1%), cefoperazone (3.1%), chloramphenicol (4.6%), cefotaxime (6.2%), gentamicin (9.2%), ampicillin + cloxacillin (9.2%), cotrimoxazole (13.8%), kanamycin (13.8%), amoxicillin + clavulanic acid (16.9%), imipenem (16.9%), ampicillin (18.5%), amikacin (23.1%), neomycin (27.7%), nalidixic acid (33.8%), and streptomycin (36.9%). With the exception of 13 Salmonella isolates of S. Drogana (4), S. Newport (4), S. I. 4, 5, 12, 27: r, i: 1, 5 (4) and S. Kottbus (1) serovars, all had one or more than one plasmid. Molecular weight of plasmids ranged between 3 kDa and >87 kDa. One heavy plasmid (≥87 kda) was present in all the 52 plasmid-positive strains. Presence of plasmid could not be correlated with MDR in Salmonella isolates from equids.     

Outbreak of Salmonellosis Caused by Salmonella enterica Serovar Newport MDR‐AmpC in a Large Animal Veterinary Teaching Hospital

Background: Nosocomial salmonellosis is an important problem for large animal veterinary teaching hospitals (VTHs). Objective: To describe failure of an Infection Control Program (ICP) that resulted in an outbreak of salmonellosis caused by Salmonella Newport multidrug resistant (MDR)‐AmpC at a large animal VTH. Animals: Sixty‐one animals identified with the outbreak strain of Salmonella. Methods: Retrospective study: Data collected included signalment, presenting complaint, duration of hospitalization, discharge status, and financial information. Phenotypic and genotypic characterization was performed on Salmonella isolates. Results: The outbreak occurred despite an existing ICP; the ICP was reviewed and weaknesses identified. Routine patient surveillance was not performed before or during the outbreak; fecal sampling was triggered only by a patient algorithm based on clinical signs. Sixty‐one animals were infected with the outbreak strain of S. Newport, and the majority were horses (n = 54). Case fatality rate was 36.1%. S. Newport isolates demonstrated high genetic similarity (Dice ≥ 0.96), and all had the MDR‐AmpC phenotype. Environmental persistence of the organism necessitated complete hospital closure, extensive decontamination, and remediation of the facility. A paradigm shift in the relevance of biosecurity in a VTH and the establishment of a stringent ICP were integral components of successful hospital reopening. Conclusions and Clinical Importance: An ineffective ICP resulted in a nosocomial outbreak caused by a MDR S. Newport in a VTH. Closure of a VTH affected all missions of the institution and had substantial financial impact (US$4.12 million).     

Evaluation of Pet‐Related Management Factors and the Risk of Salmonella spp. Carriage in Pet Dogs from Volunteer Households in Ontario (2005–2006)

The purpose of this study was to determine pet‐related management factors that may be associated with the presence of Salmonella spp. in feces of pet dogs from volunteer households. From October 2005 until May 2006, 138 dogs from 84 households in Ontario were recruited to participate in a cross‐sectional study. Five consecutive daily fecal samples were collected from each dog and enrichment culture for Salmonella spp. was performed. A higher than expected number of the dogs (23.2%; 32/138) had at least one fecal sample positive for Salmonella, and 25% (21/84) of the households had at least one dog shedding Salmonella. Twelve serotypes of Salmonella enterica subsp. enterica were identified, with the predominant serotypes being Typhimurium (33.3%; 13/39), Kentucky (15.4%; 6/39), Brandenburg (15.4%; 6/39) and Heidelberg (12.8%; 5/39). Univariable logistic regression models were created with a random effect for household to account for clustering. Statistically significant risk factors for a dog testing positive included having contact with livestock, receiving a probiotic in the previous 30 days, feeding a commercial or homemade raw food diet, feeding raw meat and eggs, feeding a homemade cooked diet, and having more than one dog in the household. In two‐variable models that controlled for feeding raw food, the non‐dietary variables were no longer statistically significant. These results highlight the potential public health risk of including raw animal products in canine diets.     

Evaluation of Faecal Salmonella Shedding Among Dogs at Seven Animal Shelters across Texas

Estimates of prevalence of faecal Salmonella shedding among dogs in the United States have varied widely. Surveillance among shelter dogs has been limited, although dogs in animal shelters may be at elevated risk of Salmonella infection because of their previous exposure history as well as factors inherent to shelter environments. Our objectives were to estimate the prevalence of Salmonella shedding among shelter dogs across Texas, to identify risk factors for shedding and to characterize the isolates. Using a repeated cross‐sectional study design, we collected faecal samples from dogs on two or three visits to each of seven Texas animal shelters between May 2013 and December 2014. Standard bacteriologic culture methods were used to isolate Salmonella from samples, and isolates were characterized via serotyping and anti‐microbial susceptibility testing. The prevalence of faecal Salmonella shedding among sampled dogs was 4.9% (27/554), and within‐shelter prevalence ranged from 1.9% to 8.3%. There was a marginal association (P = 0.09) between watery faecal samples and positive Salmonella status, as estimated by a logistic regression model that controlled for shelter as a random effect. However, over 60% of Salmonella‐positive dogs had grossly normal faeces. Salmonella prevalence did not vary significantly by age group or sex. The most common serovars were Newport (22%) and Javiana (15%), both of which were widespread among shelters. Resistance to anti‐microbial agents was uncommon. The prevalence of faecal Salmonella shedding among shelter dogs in Texas appears to be comparable to that seen among pet dogs in general.     

Diagnosing salmonellosis in horses culturing of multiple versus single faecal samples

Summary

Three rectal faecal samples were taken at 24‐hour intervals from 136 horses in order to investigate whether multiple faecal cultures yield a greater number of Salmonella‐positive horses compared to single faecal cultures. Of these 136 horses, 89 were suspected of salmonellosis on clinical grounds and 47 belonged to a control group. From the ‘Salmonella suspected’ group, 22 horses (25 %) were Salmonella positive on one or more occasions. Only twelve of these 22 positive horses (55 %) were positive at first sampling. Of the control group, only three horses (6 %) were positive for Salmonella. Thirty‐one (69 %) of the 45 positive cultures from the ‘Salmonella suspected’ group were found only after enrichment in Selenite broth. From the results of the present study it is concluded that multiple faecal cultures are superior to single faecal cultures for diagnosing clinical salmonellosis in horses and that there is no relation between the course of the disease and whether the Salmonellae were cultured directly or indirectly, after enrichment in Selenite broth. Salmonellae were cultured from the faeces of horses treated with antibiotics before their referral, even when the isolated strain was sensitive to the antimicrobial drug used by the practitioner.     

Influence of On‐farm pig Salmonella status on Salmonella Shedding at Slaughter

The risk of Salmonella shedding among pigs at slaughter with regard to their previous on‐farm Salmonella status was assessed in a group of pigs from a farm from NE of Spain. A total of 202 pigs that had been serologically monitored monthly during the fattening period and from which mesenteric lymph nodes (MLN) and faecal (SFEC) samples were collected at slaughter for Salmonella isolation were included. A repeated‐measures anova was used to assess the relationship between mean OD% values during the fattening period and sampling time and bacteriology on MLN and SFEC. Pigs were also grouped into four groups, that is pigs seronegative during the fattening period and Salmonella negative in MLN (group A; n = 69); pigs seronegative during the fattening period but Salmonella positive in MLN (B; n = 36); pigs seropositive at least once and Salmonella positive in MLN (C; n = 50); and pigs seropositive at least once but Salmonella negative in (D; n = 47). Pigs shedding at slaughter seroconverted much earlier and showed much higher mean OD% values than non‐shedders pigs. The proportion of Salmonella shedders in groups A and D was high and similar (26.1% and 29.8%, respectively), but significantly lower than that for groups B and C. The odds of shedding Salmonella for groups B and C were 4.8 (95% CI = 1.5–15.5) and 20.9 (3.7–118) times higher, respectively, when compared to A. It was concluded that a large proportion of Salmonella seronegative pigs may shed Salmonella at slaughter, which would be likely associated to previous exposure with contaminated environments (i.e. transport and lairage). For pigs already infected at farm, the likelihood of shedding Salmonella was much higher and may depend on whether the bacterium has colonized the MLN or not. The odds of shedding Salmonella spp. were always much higher for pigs in which Salmonella was isolated from MLN.     

Relationship between Salmonella infection,shedding and serology in fattening pigs in low–moderate prevalence areas

Salmonella is a major foodborne pathogen causing important zoonosis worldwide. Pigs asymptomatically infected in mesenteric lymph nodes (MLN) can be intermittent shedders of the pathogen through faeces, being considered a major source of human infections. European baseline studies of fattening pig salmonellosis are based on Salmonella detection in MLN. This work studies the relationship between Salmonella infection in MLN and intestinal content (IC) shedding at slaughter and the relationship between the presence of the pathogen and the serologic status at farm level. Mean Salmonella prevalence in the selected pigs (vertically integrated production system of Navarra, Spain) was 7.2% in MLN, 8.4% in IC and 9.6% in serum samples. In this low–moderate prevalence context, poor concordance was found between MLN infection and shedding at slaughter and between bacteriology and serology. In fact, most of shedders were found uninfected in MLN (83%) or carrying different Salmonella strains in MLN and in IC (90%). The most prevalent Salmonellae were Typhimurium resistant to ACSSuT ± Nx or ASSuT antibiotic families, more frequently found invading the MLN (70%) than in IC (33.9%). Multivariable analysis revealed that risk factors associated with the presence of Salmonella in MLN or in IC were different, mainly related either to good hygiene practices or to water and feed control, respectively. Overall, in this prevalence context, detection of Salmonella in MLN is an unreliable predictor of faecal shedding at abattoir, indicating that subclinical infections in fattening pigs MLN could have limited relevance in the IC shedding.     

Carriage of Clostridium difficile and Other Enteric Pathogens Among a 4‐H Avocational Cohort

Clostridium difficile (CD), Salmonella, Campylobacter and enterohemorrhagic Escherichia coli (EHEC) are major causes of morbidity in a variety of enteric diseases in humans and animals, but subclinical carriage in both is probably more common than are clinical cases. Little is known regarding the prevalence of these pathogens in animals raised for exhibit at Michigan county fairs or the frequency with which Michigan citizens raising these animals may have been subclinically colonized. To address these issues, 361 fecal specimens from 158 humans and 203 of their farm animals were cultured for CD, Salmonella and Campylobacter. Additionally, 50 people and their cattle were tested for EHEC. No EHEC, Salmonella or Campylobacter were detected. However, 16 specimens (4.4%) were positive for CD: 13 humans, two horses and one pig. None of the farm animal specimens submitted by any of the 13 CD‐positive humans were positive for CD. Strain characterization [toxinotype, pulsed‐field gel electrophoresis (PFGE)] demonstrated that the human CD isolates were similar to what has been reported previously in the general US population. We conclude that horses and farm animals (cattle, sheep, goats and swine) at 1–2 months before market weight showed no evidence of wide‐spread carriage of the common enteric pathogens, including the recently reported CD toxinotype V. These results provide no support to the hypothesis that 4‐H members or others visiting county fair animal husbandry projects in these counties may be at increased risk for acquisition of CD, Salmonella, Campylobacter or EHEC from animals.     

Nosocomial infections and bacterial antibiotic resistance in a university equine hospital

A base-line study of bacteria isolated from horses admitted to the Veterinary Medical Teaching Hospital during a 6-month period was performed to determine the extent of multiresistant nosocomial infections caused by gram-negative aerobic bacteria other than Salmonella spp. Results of this study indicated that 21.9% of the 105 horses from which cultures and sensitivities were available had developed nosocomial gram-negative aerobic infections, with high rates of resistance to gentamicin, kanamycin, and trimethoprim sulfadiazine, three of the most often prescribed antibiotics in this hospital. In addition, a prospective study of antibiotic-resistant bacteria of fecal origin was performed to determine whether there was a change in the degree of antibiotic resistance of a horse's intestinal flora while the horse was hospitalized. Bacterial culturing for gram-negative lactose fermenting bacteria was done on fecal specimens collected directly from the rectum on day 1 and day 7 of a horse's hospitalization. Susceptibility testing was done on each isolant. Of the 24 paired fecal specimens obtained, Escherichia coli and Klebsiella sp isolated on day 7 were resistant to a significantly higher number of antibiotics than day 1 isolants (P = 0.003, P = 0.043, respectively).     

Methicillin-resistant Staphylococcus aureus in horses at a veterinary teaching hospital: frequency, characterization, and association with clinical disease

Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging equine pathogen. To attempt to control nosocomial and zoonotic transmission, an MRSA screening program was established for all horses admitted to the Ontario Veterinary College Veterinary Teaching Hospital, whereby nasal screening swabs were collected at admission, weekly during hospitalization, and at discharge. MRSA was isolated from 120 (5.3%) of 2,283 horses: 61 (50.8%) at the time of admission, 53 (44.2%) during hospitalization, and 6 from which the origin was unclear because an admission swab had not been collected. Clinical infections attributable to MRSA were present or developed in 14 (11.7%) of 120 horses. The overall rate of community-associated colonization was 27 per 1,000 admissions. Horses colonized at admission were more likely to develop clinical MRSA infection than those not colonized at admission (OR 38.9, 95% CI 9.49 160, P < 0.0001). The overall nosocomial MRSA colonization incidence rate was 23 per 1,000 admissions. The incidence rate of nosocomial MRSA infection was at the rate of 1.8 per 1,000 admissions, with an incidence density of 0.88 per 1,000 patient days. Administration of ceftiofur or aminoglycosides during hospitalization was the only risk factor associated with nosocomial MRSA colonization. MRSA screening of horses admitted to a veterinary hospital was useful for identification of community-associated and nosocomial colonization and infection, and for monitoring of infection control practices.