Do post‐surgical multiresistant urinary infections occur in horses? Case of unilateral pyelonephritis caused by extended‐spectrum beta‐lactamase‐producing bacteria as a complication of cystotomy
Abstract Pyelonephritis is a serious condition that is rarely described in horses. In contrast, urinary tract infections are common in humans and small animals, and multi‐drug‐resistant urinary infections are an emerging threat. In this report, we describe a horse with unilateral pyelonephritis caus...
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| Format: | Article |
| Language: | English |
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Wiley
2023-09-01
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| Series: | Veterinary Medicine and Science |
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| Online Access: | https://doi.org/10.1002/vms3.1201 |
| _version_ | 1827813937163272192 |
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| author | Elisa Scala Gaby vanGalen Elin M. Skärlina Inge Durie |
| author_facet | Elisa Scala Gaby vanGalen Elin M. Skärlina Inge Durie |
| author_sort | Elisa Scala |
| collection | DOAJ |
| description | Abstract Pyelonephritis is a serious condition that is rarely described in horses. In contrast, urinary tract infections are common in humans and small animals, and multi‐drug‐resistant urinary infections are an emerging threat. In this report, we describe a horse with unilateral pyelonephritis caused by extended‐spectrum beta‐lactamase‐producing bacteria belonging to the Enterobacter cloacae complex. [Correction added on 9 August 2023, after first online publication: The preceding sentence was corrected.] An 11‐year‐old Swedish warmblood gelding was diagnosed with a cystolith and a cystotomy through an open left para‐inguinal approach was performed. Seven days after surgery the horse presented with pyrexia, dullness and colic. Diagnostic testing and renal transabdominal ultrasonography confirmed the presence of a right‐sided pyelonephritis. Culture and antimicrobial susceptibility testing revealed a pure growth of extended‐spectrum beta‐lactamases‐producing E. cloacae complex bacteria with resistance against beta‐lactams, aminoglycoside and trimethoprim–sulphonamide classes. Treatment included prolonged oral antimicrobials according to susceptibility testing results (enrofloxacin), judicious use of non‐steroidal anti‐inflammatory drugs, fluid therapy and gastric ulcer prophylaxis. The horse recovered successfully and is currently in good health (follow‐up of 5 years). Once the infection resolved, unilateral renal scarring occurred. Multidrug‐resistant upper‐urinary infections occur in horses and should be considered in a post‐surgical patient that develops fever. Early diagnosis, urine bacterial culturing and antimicrobial susceptibility testing were crucial in this case to successful management. |
| first_indexed | 2024-03-11T23:38:43Z |
| format | Article |
| id | doaj.art-3831e8c0ed4e4ed2874a11bf394ea5e5 |
| institution | Directory Open Access Journal |
| issn | 2053-1095 |
| language | English |
| last_indexed | 2024-03-11T23:38:43Z |
| publishDate | 2023-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Veterinary Medicine and Science |
| spelling | doaj.art-3831e8c0ed4e4ed2874a11bf394ea5e52023-09-19T16:49:27ZengWileyVeterinary Medicine and Science2053-10952023-09-01952042205210.1002/vms3.1201Do post‐surgical multiresistant urinary infections occur in horses? Case of unilateral pyelonephritis caused by extended‐spectrum beta‐lactamase‐producing bacteria as a complication of cystotomyElisa Scala0Gaby vanGalen1Elin M. Skärlina2Inge Durie3Evidensia Specialisthästsjukhuset Strömsholm StrömsholmSwedenSydney School of Veterinary Science University of Sydney SydneyNew South WalesAustraliaEvidensia Specialisthästsjukhuset Strömsholm StrömsholmSwedenEvidensia Specialisthästsjukhuset Strömsholm StrömsholmSwedenAbstract Pyelonephritis is a serious condition that is rarely described in horses. In contrast, urinary tract infections are common in humans and small animals, and multi‐drug‐resistant urinary infections are an emerging threat. In this report, we describe a horse with unilateral pyelonephritis caused by extended‐spectrum beta‐lactamase‐producing bacteria belonging to the Enterobacter cloacae complex. [Correction added on 9 August 2023, after first online publication: The preceding sentence was corrected.] An 11‐year‐old Swedish warmblood gelding was diagnosed with a cystolith and a cystotomy through an open left para‐inguinal approach was performed. Seven days after surgery the horse presented with pyrexia, dullness and colic. Diagnostic testing and renal transabdominal ultrasonography confirmed the presence of a right‐sided pyelonephritis. Culture and antimicrobial susceptibility testing revealed a pure growth of extended‐spectrum beta‐lactamases‐producing E. cloacae complex bacteria with resistance against beta‐lactams, aminoglycoside and trimethoprim–sulphonamide classes. Treatment included prolonged oral antimicrobials according to susceptibility testing results (enrofloxacin), judicious use of non‐steroidal anti‐inflammatory drugs, fluid therapy and gastric ulcer prophylaxis. The horse recovered successfully and is currently in good health (follow‐up of 5 years). Once the infection resolved, unilateral renal scarring occurred. Multidrug‐resistant upper‐urinary infections occur in horses and should be considered in a post‐surgical patient that develops fever. Early diagnosis, urine bacterial culturing and antimicrobial susceptibility testing were crucial in this case to successful management.https://doi.org/10.1002/vms3.1201cystotomyESBL‐producing bacteriahorsepost‐operativepyelonephritis |
| spellingShingle | Elisa Scala Gaby vanGalen Elin M. Skärlina Inge Durie Do post‐surgical multiresistant urinary infections occur in horses? Case of unilateral pyelonephritis caused by extended‐spectrum beta‐lactamase‐producing bacteria as a complication of cystotomy Veterinary Medicine and Science cystotomy ESBL‐producing bacteria horse post‐operative pyelonephritis |
| title | Do post‐surgical multiresistant urinary infections occur in horses? Case of unilateral pyelonephritis caused by extended‐spectrum beta‐lactamase‐producing bacteria as a complication of cystotomy |
| title_full | Do post‐surgical multiresistant urinary infections occur in horses? Case of unilateral pyelonephritis caused by extended‐spectrum beta‐lactamase‐producing bacteria as a complication of cystotomy |
| title_fullStr | Do post‐surgical multiresistant urinary infections occur in horses? Case of unilateral pyelonephritis caused by extended‐spectrum beta‐lactamase‐producing bacteria as a complication of cystotomy |
| title_full_unstemmed | Do post‐surgical multiresistant urinary infections occur in horses? Case of unilateral pyelonephritis caused by extended‐spectrum beta‐lactamase‐producing bacteria as a complication of cystotomy |
| title_short | Do post‐surgical multiresistant urinary infections occur in horses? Case of unilateral pyelonephritis caused by extended‐spectrum beta‐lactamase‐producing bacteria as a complication of cystotomy |
| title_sort | do post surgical multiresistant urinary infections occur in horses case of unilateral pyelonephritis caused by extended spectrum beta lactamase producing bacteria as a complication of cystotomy |
| topic | cystotomy ESBL‐producing bacteria horse post‐operative pyelonephritis |
| url | https://doi.org/10.1002/vms3.1201 |
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