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

• Published in: Acta veterinaria scandinavica 2022-02, Vol.64 (1), p.4-4, Article 4
• Main Authors: Thomson, Katariina, Eskola, Katarina, Eklund, Marjut, Suominen, Kristiina, Määttä, Merita, Junnila, Jouni, Nykäsenoja, Suvi, Niinistö, Kati, Grönthal, Thomas, Rantala, Merja
• Format: Article
• Language: English
• Subjects: Animals; Anti-Bacterial Agents - therapeutic use; Antimicrobial agents; Bacterial infection; beta-Lactamases; Cluster; Cotton; Disease Outbreaks - veterinary; Disinfection; Drug resistance; Enterobacterales; Epidemiology; Female; Horse; Horse Diseases - drug therapy; Horse Diseases - epidemiology; Horses; Hospitals, Animal; Hospitals, Teaching; Humans; Hygiene; Klebsiella Infections - drug therapy; Klebsiella Infections - epidemiology; Klebsiella Infections - veterinary; Klebsiella pneumoniae; Laboratories; Microbial Sensitivity Tests - veterinary; Multi-drug resistant bacteria; Multidrug resistance; Nosocomial infection; Nosocomial infections; Outbreaks; Patients; Rectum; Risk Factors; Surgery; Surveillance; Teaching hospitals; Veterinary medicine; β Lactamase
• ISSN: 1751-0147; 0044-605X; 1751-0147
• DOI: 10.1186/s13028-022-00621-6

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. The number of ESBL-E isolations increased through 2012-2013 culminating in an outbreak of multi-drug resistant K. pneumoniae ST307:bla :bla :bla 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