Equine synovial sepsis laboratory submissions review

Equine synovial sepsis laboratory submissions yield a low rate of positive bacterial culture and a high prevalence of antimicrobial resistance

Am J Vet Res. 2023 Jul 17;1-10.
Authors
Garett B Pearson 1 , Brittany Papa 1 , Abdolreza Mosaddegh 2 , Hannah Cooper 3 , Melissa Aprea 4 , John Pigott 3 , Craig Altier 5 , Casey L Cazer 2 5 , Heidi L Reesink 1
Affiliations

1 Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY.
2 Department of Public and Ecosystem Health, Cornell University College of Veterinary Medicine, Ithaca, NY.
3 Cornell Ruffian Equine Specialists, Elmont, NY.
4 Animal Health Diagnostic Center, Cornell University College of Veterinary Medicine, Ithaca, NY.
5 Department of Population Medicine and Diagnostic Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY.

PMID: 37460096
DOI: 10.2460/ajvr.23.05.0085

Abstract

Objective: To investigate (1) variables associated with the likelihood of obtaining a positive culture, (2) commonly isolated microorganisms, and (3) antimicrobial resistance patterns of isolates from horses with presumptive synovial sepsis.

Samples: Synovial fluid, synovium, and bone samples from equine cases with presumptive synovial sepsis submitted to the Cornell University Animal Health Diagnostic Center from 2000 to 2020 for microbial culture and antimicrobial sensitivity testing.

Procedures: Univariable and multivariable analyses were performed to determine the effect of variables on the likelihood of positive culture. Frequency distributions for isolated organisms and antimicrobial resistance were generated. Multidrug resistance patterns and associations were assessed with association rule mining.

Results: The positive culture rate for all samples was 37.4%, while the positive culture rate among samples confirmed to be septic by a combination of clinical pathological variables and case details was 43%. Blood culture vial submissions were 1.7 times more likely to yield a positive culture compared to samples submitted in a serum tube. Structure sampled, tissue submitted, and horse age were associated with a positive culture. Staphylococcus spp (23.7%), Streptococcus spp (22.4%), and Enterococcus spp (9.67%) were commonly isolated. Multidrug resistance prevalence decreased from 92% (2000 to 2009) to 76% (2010 to 2020) of gram-negative isolates and 60% (2000 to 2009) to 52% (2010 to 2020) of gram-positive isolates.

Clinical relevance: The positive culture rate from synovial fluid submissions with traditional sampling and culture methods remains low and may be optimized by submitting samples in blood culture vials. Overall, antimicrobial resistance was frequently observed but did not increase from the first to second decade for most genera.