Sequential bacterial sampling of the midline incision in horses undergoing exploratory laparotomy

Equine Vet J. 2019 Jan;51(1):38-44. doi: 10.1111/evj.12958. Epub 2018 May 17.

Abstract

Background: There is limited information about bacterial isolates that are present on the equine midline incision during and following exploratory laparotomy.

Objectives: To investigate the bacterial species cultured from the ventral midline pre-, intra- and post- laparotomy, whether particular bacterial isolates are associated with the development of surgical site infections (SSIs) and to report the antimicrobial resistance phenotypes of these isolates.

Study design: Prospective cohort study.

Methods: The ventral midline of 31 horses undergoing exploratory laparotomy was sampled for bacterial culture at set time-points pre, intra and post-operatively. Inclusion criteria were that horses must have undergone exploratory laparotomy within 90 min of the initial colic examination upon hospital admission and must not have been placed in a stable prior to surgery. SSI was defined as any purulent or serous discharge from the laparotomy incision of >24 h duration.

Results: Seven horses (22.6%) developed a SSI. None of the variables tested were associated with the altered risk of SSI. The prevalence of a positive bacterial culture from the incision increased progressively over time and a variety of bacteria were isolated. A positive intra-operative culture was not a predictor of SSI; and when a SSI did occur, it was due to a different bacterial isolate. MRSA and ESBL-producers were identified in the post-operative period in one and four different horses respectively, but none of these developed a SSI.

Main limitations: Sampling was limited to hospitalisation and no culture results were available for horses developing SSI following hospital discharge.

Conclusions: A variety of bacterial species may be isolated from equine laparotomy incisions peri-operatively without development of SSI. SSI does not appear to be solely related to bacterial contamination of the incision peri-operatively and other mechanisms such as bacteraemia merit further investigation.

Keywords: antimicrobial; bacterial culture; colic; drug-resistant; horse; surgical site infection.

MeSH terms

  • Animals
  • Bacteria / classification
  • Bacteria / drug effects
  • Bacteria / isolation & purification*
  • Bacterial Infections / epidemiology
  • Bacterial Infections / microbiology
  • Bacterial Infections / veterinary*
  • Bacterial Load / veterinary
  • Bandages / veterinary
  • Cohort Studies
  • Drug Resistance, Bacterial
  • England / epidemiology
  • Horse Diseases / epidemiology
  • Horse Diseases / microbiology*
  • Horses
  • Laparotomy / veterinary*
  • Perioperative Period / veterinary
  • Phenotype
  • Prevalence
  • Prospective Studies
  • Surgical Wound / microbiology
  • Surgical Wound / veterinary*
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / microbiology
  • Surgical Wound Infection / veterinary*
  • Surveys and Questionnaires