Gram-negative multi-drug resistant bacteria influence survival to discharge for horses with septic synovial structures: 206 Cases (2010–2015)
| Autor: | Donna J. Kelly, Lauren V. Schnabel, Jessica M. Gilbertie, Megan E. Jacob, Thomas P. Schaer, Darko Stefanovski |
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| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Microbiological culture Gram-negative bacteria 040301 veterinary sciences Multi drug resistant bacteria Staphylococcus 030106 microbiology Microbial Sensitivity Tests Biology medicine.disease_cause Microbiology 0403 veterinary science Hospitals Animal 03 medical and health sciences Antibiotic resistance Enterobacteriaceae Drug Resistance Multiple Bacterial Synovitis Gram-Negative Bacteria Synovial Fluid medicine Animals Horses Arthritis Infectious General Veterinary Pseudomonas aeruginosa Enterobacteriaceae Infections 04 agricultural and veterinary sciences General Medicine medicine.disease Antimicrobial biology.organism_classification Patient Discharge Anti-Bacterial Agents Infectious arthritis Horse Diseases Gram-Negative Bacterial Infections |
| Zdroj: | Veterinary Microbiology. 226:64-73 |
| ISSN: | 0378-1135 |
| Popis: | Bacterial colonization of synovial structures can cause infections that are difficult to treat. Systemic and local antimicrobials and repeated joint lavages are the mainstays of therapy. However, despite aggressive treatments, infection may persist, leading to significant tissue damage or death of the patient. In order to investigate the impact of bacterial culture and antimicrobial resistance on survival to discharge, we reviewed medical records of horses admitted to the University of Pennsylvania's large animal teaching hospital from 2010-2015. Two-hundred and six cases with a definitive diagnosis of septic synovitis and a synovial fluid sample submitted for microbiological culture were included in the study. Of these horses, 48% were culture negative and 52% were positive for any bacterial growth, of which 66% were gram-positive and 28% were gram-negative aerobic organisms with 4% anaerobic and 2% fungal organisms. Overall survival to discharge from hospital was 86%. Horses that had negative growth on culture were more likely to survive until discharge (p < 0.02). Multivariable analyses revealed that the likelihood of euthanasia was significantly associated with identification of coagulase positive Staphylococcus spp. (OR 7.66, 5.46-10.74, p < 0.0001), β-hemolytic Streptococcus spp. (OR 5.18, 3.56-7.55, p < 0.0001), Enterococcus spp. (OR 18.38, 11.45-29.52, p = 0.002), Enterobacteriaceae (OR 31.37, 22.28-44.17, p < 0.0001), Pseudomonas aeruginosa (OR 9.31, 5.30-16.34, p = 0.0004) or other gram-negative species (OR 3.51, 2.07-5.94, p = 0.001). Multi-drug resistance and gram-negative bacteria species were associated with significantly decreased survival rates (OR 119.24, 70.57-201.46, p < 0.0001). In conclusion, prognosis for survival to discharge was poor for horses that were infected with gram-negative organisms, particularly those with MDR phenotypes. |
| Databáze: | OpenAIRE |
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