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Treatment of methicillin-resistant Staphylococcus epidermidis infection following repair of an ulnar fracture and humeroradial joint luxation in a horse
Authors:Trostle S S  Peavey C L  King D S  Hartmann F A
Institution:Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison 53706-1102, USA.
Abstract:A 27-month-old Rocky Mountain Horse was examined because of a fracture of the proximal portion of the ulna and luxation of the humeroradial joint (Monteggia fracture). Open reduction was performed, using a mechanical distractor, and the ulnar fracture was stabilized by application of a bone plate and screws. After surgery, the horse developed an infection of the surgical site, and bacterial culture of fluid from the surgical site yielded a pure growth of methicillin-resistant Staphylococcus epidermidis susceptible to oxytetracycline, erythromycin, rifampin, and vancomycin. Treatment with oxytetracycline did not result in a favorable clinical response. Therefore, the horse was treated systemically with vancomycin and rifampin, and vancomycin-impregnated polymethyl methacrylate beads were implanted at the surgical site. Six months after surgery, the horse was sound at a walk or trot, and bony union was evident on radiographs of the elbow joint.
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