Characterisation of and risk factors for extended-spectrum β-lactamase producing Enterobacterales (ESBL-E) in an equine hospital with a special reference to an outbreak caused by Klebsiella pneumoniae ST307:CTX-M-1
Abstract Background Extended-spectrum β-lactamase producing Enterobacterales (ESBL-E) are important causative agents for infections in humans and animals. At the Equine Veterinary Teaching Hospital of the University of Helsinki, the first infections caused by ESBL-E were observed at the end of 2011...
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| Format: | Article |
| Language: | English |
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BMC
2022-02-01
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| Series: | Acta Veterinaria Scandinavica |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13028-022-00621-6 |
| _version_ | 1819276999969996800 |
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| author | Katariina Thomson Katarina Eskola Marjut Eklund Kristiina Suominen Merita Määttä Jouni Junnila Suvi Nykäsenoja Kati Niinistö Thomas Grönthal Merja Rantala |
| author_facet | Katariina Thomson Katarina Eskola Marjut Eklund Kristiina Suominen Merita Määttä Jouni Junnila Suvi Nykäsenoja Kati Niinistö Thomas Grönthal Merja Rantala |
| author_sort | Katariina Thomson |
| collection | DOAJ |
| description | Abstract Background Extended-spectrum β-lactamase producing Enterobacterales (ESBL-E) are important causative agents for infections in humans and animals. At the Equine Veterinary Teaching Hospital of the University of Helsinki, the first infections caused by ESBL-E were observed at the end of 2011 leading to enhanced infection surveillance. Contact patients were screened for ESBL-E by culturing infection sites and rectal screening. This study was focused on describing the epidemiology and microbiological characteristics of ESBL-E from equine patients of the EVTH during 2011–2014, and analysing putative risk factors for being positive for ESBL-E during an outbreak of Klebsiella pneumoniae ST307. Results The number of ESBL-E isolations increased through 2012–2013 culminating in an outbreak of multi-drug resistant K. pneumoniae ST307:bla CTX-M-1:bla TEM:bla SHV during 04–08/2013. During 10/2011–05/2014, altogether 139 ESBL-E isolates were found from 96 horses. Of these, 26 were from infection-site specimens and 113 from rectal-screening swabs. A total of 118 ESBL-E isolates from horses were available for further study, the most numerous being K. pneumoniae (n = 44), Escherichia coli (n = 31) and Enterobacter cloacae (n = 31). Hospital environmental specimens (N = 47) yielded six isolates of ESBL-E. Two identical E. cloacae isolates originating from an operating theatre and a recovery room had identical or highly similar PFGE fingerprint profiles as five horse isolates. In the multivariable analysis, mare–foal pairs (OR 4.71, 95% CI 1.57–14.19, P = 0.006), length of hospitalisation (OR 1.62, 95% CI 1.28–2.06, P < 0.001) and passing of a nasogastric tube (OR 2.86, 95% CI 1.03–7.95, P = 0.044) were associated with being positive for ESBL-E during the K. pneumoniae outbreak. Conclusions The occurrence of an outbreak caused by a pathogenic ESBL-producing K. pneumoniae ST307 strain highlights the importance of epidemiological surveillance of ESBL-E in veterinary hospitals. Limiting the length of hospitalisation for equine patients may reduce the risk of spread of ESBL-E. It is also important to acknowledge the importance of nasogastric tubing as a potential source of acquiring ESBL-E. As ESBL-E were also found in stomach drench pumps used with nasogastric tubes, veterinary practices should pay close attention to appropriate equipment cleaning procedures and disinfection practices. |
| first_indexed | 2024-12-23T23:49:09Z |
| format | Article |
| id | doaj.art-2947796fdc98409ea5c0a0a52deec0d7 |
| institution | Directory Open Access Journal |
| issn | 1751-0147 |
| language | English |
| last_indexed | 2024-12-23T23:49:09Z |
| publishDate | 2022-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Acta Veterinaria Scandinavica |
| spelling | doaj.art-2947796fdc98409ea5c0a0a52deec0d72022-12-21T17:25:25ZengBMCActa Veterinaria Scandinavica1751-01472022-02-0164111410.1186/s13028-022-00621-6Characterisation of and risk factors for extended-spectrum β-lactamase producing Enterobacterales (ESBL-E) in an equine hospital with a special reference to an outbreak caused by Klebsiella pneumoniae ST307:CTX-M-1Katariina Thomson0Katarina Eskola1Marjut Eklund2Kristiina Suominen3Merita Määttä4Jouni Junnila5Suvi Nykäsenoja6Kati Niinistö7Thomas Grönthal8Merja Rantala9Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of HelsinkiDepartment of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of HelsinkiDepartment of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of HelsinkiDepartment of Veterinary Biosciences, Faculty of Veterinary Medicine, University of HelsinkiDepartment of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of HelsinkiOy 4Pharma LtdFinnish Food AuthorityVeterinary Teaching Hospital, Faculty of Veterinary Medicine, University of HelsinkiDepartment of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of HelsinkiDepartment of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of HelsinkiAbstract Background Extended-spectrum β-lactamase producing Enterobacterales (ESBL-E) are important causative agents for infections in humans and animals. At the Equine Veterinary Teaching Hospital of the University of Helsinki, the first infections caused by ESBL-E were observed at the end of 2011 leading to enhanced infection surveillance. Contact patients were screened for ESBL-E by culturing infection sites and rectal screening. This study was focused on describing the epidemiology and microbiological characteristics of ESBL-E from equine patients of the EVTH during 2011–2014, and analysing putative risk factors for being positive for ESBL-E during an outbreak of Klebsiella pneumoniae ST307. Results The number of ESBL-E isolations increased through 2012–2013 culminating in an outbreak of multi-drug resistant K. pneumoniae ST307:bla CTX-M-1:bla TEM:bla SHV during 04–08/2013. During 10/2011–05/2014, altogether 139 ESBL-E isolates were found from 96 horses. Of these, 26 were from infection-site specimens and 113 from rectal-screening swabs. A total of 118 ESBL-E isolates from horses were available for further study, the most numerous being K. pneumoniae (n = 44), Escherichia coli (n = 31) and Enterobacter cloacae (n = 31). Hospital environmental specimens (N = 47) yielded six isolates of ESBL-E. Two identical E. cloacae isolates originating from an operating theatre and a recovery room had identical or highly similar PFGE fingerprint profiles as five horse isolates. In the multivariable analysis, mare–foal pairs (OR 4.71, 95% CI 1.57–14.19, P = 0.006), length of hospitalisation (OR 1.62, 95% CI 1.28–2.06, P < 0.001) and passing of a nasogastric tube (OR 2.86, 95% CI 1.03–7.95, P = 0.044) were associated with being positive for ESBL-E during the K. pneumoniae outbreak. Conclusions The occurrence of an outbreak caused by a pathogenic ESBL-producing K. pneumoniae ST307 strain highlights the importance of epidemiological surveillance of ESBL-E in veterinary hospitals. Limiting the length of hospitalisation for equine patients may reduce the risk of spread of ESBL-E. It is also important to acknowledge the importance of nasogastric tubing as a potential source of acquiring ESBL-E. As ESBL-E were also found in stomach drench pumps used with nasogastric tubes, veterinary practices should pay close attention to appropriate equipment cleaning procedures and disinfection practices.https://doi.org/10.1186/s13028-022-00621-6Bacterial infectionClusterHorseMulti-drug resistant bacteriaNosocomial infectionSurveillance |
| spellingShingle | Katariina Thomson Katarina Eskola Marjut Eklund Kristiina Suominen Merita Määttä Jouni Junnila Suvi Nykäsenoja Kati Niinistö Thomas Grönthal Merja Rantala Characterisation of and risk factors for extended-spectrum β-lactamase producing Enterobacterales (ESBL-E) in an equine hospital with a special reference to an outbreak caused by Klebsiella pneumoniae ST307:CTX-M-1 Acta Veterinaria Scandinavica Bacterial infection Cluster Horse Multi-drug resistant bacteria Nosocomial infection Surveillance |
| title | Characterisation of and risk factors for extended-spectrum β-lactamase producing Enterobacterales (ESBL-E) in an equine hospital with a special reference to an outbreak caused by Klebsiella pneumoniae ST307:CTX-M-1 |
| title_full | Characterisation of and risk factors for extended-spectrum β-lactamase producing Enterobacterales (ESBL-E) in an equine hospital with a special reference to an outbreak caused by Klebsiella pneumoniae ST307:CTX-M-1 |
| title_fullStr | Characterisation of and risk factors for extended-spectrum β-lactamase producing Enterobacterales (ESBL-E) in an equine hospital with a special reference to an outbreak caused by Klebsiella pneumoniae ST307:CTX-M-1 |
| title_full_unstemmed | Characterisation of and risk factors for extended-spectrum β-lactamase producing Enterobacterales (ESBL-E) in an equine hospital with a special reference to an outbreak caused by Klebsiella pneumoniae ST307:CTX-M-1 |
| title_short | Characterisation of and risk factors for extended-spectrum β-lactamase producing Enterobacterales (ESBL-E) in an equine hospital with a special reference to an outbreak caused by Klebsiella pneumoniae ST307:CTX-M-1 |
| title_sort | characterisation of and risk factors for extended spectrum β lactamase producing enterobacterales esbl e in an equine hospital with a special reference to an outbreak caused by klebsiella pneumoniae st307 ctx m 1 |
| topic | Bacterial infection Cluster Horse Multi-drug resistant bacteria Nosocomial infection Surveillance |
| url | https://doi.org/10.1186/s13028-022-00621-6 |
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