Characteristics of Rhodococcus equi related to the survival and pathogenicity

La rhodococosis equina producida por Rhodococcus equi (R. equi) es una de las enfermedades de gran impacto económico. Se trata de una neumonía que afecta a potrillos hasta 6 meses de edad con elevada mortalidad y a otras especies animales, incluido el ser humano. R. equi es un patógeno intracelular oportunista, que habita el ambiente y el tracto gastrointestinal de equinos sanos. Las cepas virulentas poseen un plásmido de virulencia con el gen vapA que le permite sobrevivir en macrófagos. La aparición de casos clínicos se relaciona con una elevada concentración de cepas virulentas en el aire inhalado por los potrillos. Las neumonías por R. equi son tratadas frecuentemente con una combinación de antimicrobianos de forma empírica. Entre las combinaciones más empleadas se encuentra la asociación de rifampicina con macrólidos, principalmente azitromicina y eritromicina. Alternativamente, se utilizan distintos protocolos antimicrobianos con el objetivo de disminuir la resistencia antimicrobiana, sin embargo, el uso sostenido de los mismos promueve la aparición de microorganismos resistentes.De esta manera, en este trabajo de revisión se describen las características microbiológicas de R. equi, especialmente aquellas vinculadas a su patogenicidad y a su capacidad de sobrevivir en el ambiente. Por otro lado, se revisó bibliografía relacionada a los mecanismos de resistencia antimicrobiana y el impacto que genera en la salud pública. De esta manera, concluimos que la rhodococosis equina es una enfermedad de alta relevancia a nivel económico y sanitario, que promueve el constante estudio de alternativas profilácticas y terapéuticas adecuadas para mitigar el impacto de la enfermedad.The equine rhodococosis caused by Rhodococcus equi (R. equi), is a disease of high economic impact. The disease generates pneumonia in foals up to six months of age, with high mortality and other animal species, including humans. R. equi is an opportunistic intracellular pathogen that inhabits the environment and the gastrointestinal tract of healthy horses. Virulent strains have a virulence plasmid with the vapA gene that allows it to survive in the macrophages. The high appearance of clinical cases is related to a high concentration of virulent strains in the air inhaled by foals. R. equi pnemonias are frequently treated with empirically combined antimicrobials. Among the most used combinations is rifampicin with macrolides, mainly azithromycin and erythromycin. Alternatively, different antimicrobial protocols are used in order to reduce antibiotic resistance, howevwe, their sustained use promotes the appearance of resistance microorganisms. In this review work, the microbiological characteristics of R. equi are described, especially those related to its pathogenicity and its ability to survive in the environment. The literature related to antimicrobial resistance mechanisms and the impact it generates on public health was reviewed. In this way, we conclude that equine rhodococosis is a highly relevant disease at an economic and health level, which promotes the constant study of appropriate prophylactic and therapeutic alternatives to mitigate the impact of the disease.Fil: Leiva, Romina Florencia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias; ArgentinaFil: Mesplet, Maria. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias; ArgentinaFil: Bustos, Carla Paola. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias; Argentin

Characteristics of Rhodococcus equi related to the survival and pathogenicity

La rhodococosis equina producida por Rhodococcus equi (R. equi) es una de las enfermedades de gran impacto económico. Se trata de una neumonía que afecta a potrillos hasta 6 meses de edad con elevada mortalidad y a otras especies animales, incluido el ser humano. R. equi es un patógeno intracelular oportunista, que habita el ambiente y el tracto gastrointestinal de equinos sanos. Las cepas virulentas poseen un plásmido de virulencia con el gen vapA que le permite sobrevivir en macrófagos. La aparición de casos clínicos se relaciona con una elevada concentración de cepas virulentas en el aire inhalado por los potrillos. Las neumonías por R. equi son tratadas frecuentemente con una combinación de antimicrobianos de forma empírica. Entre las combinaciones más empleadas se encuentra la asociación de rifampicina con macrólidos, principalmente azitromicina y eritromicina. Alternativamente, se utilizan distintos protocolos antimicrobianos con el objetivo de disminuir la resistencia antimicrobiana, sin embargo, el uso sostenido de los mismos promueve la aparición de microorganismos resistentes.De esta manera, en este trabajo de revisión se describen las características microbiológicas de R. equi, especialmente aquellas vinculadas a su patogenicidad y a su capacidad de sobrevivir en el ambiente. Por otro lado, se revisó bibliografía relacionada a los mecanismos de resistencia antimicrobiana y el impacto que genera en la salud pública. De esta manera, concluimos que la rhodococosis equina es una enfermedad de alta relevancia a nivel económico y sanitario, que promueve el constante estudio de alternativas profilácticas y terapéuticas adecuadas para mitigar el impacto de la enfermedad.The equine rhodococosis caused by Rhodococcus equi (R. equi), is a disease of high economic impact. The disease generates pneumonia in foals up to six months of age, with high mortality and other animal species, including humans. R. equi is an opportunistic intracellular pathogen that inhabits the environment and the gastrointestinal tract of healthy horses. Virulent strains have a virulence plasmid with the vapA gene that allows it to survive in the macrophages. The high appearance of clinical cases is related to a high concentration of virulent strains in the air inhaled by foals. R. equi pnemonias are frequently treated with empirically combined antimicrobials. Among the most used combinations is rifampicin with macrolides, mainly azithromycin and erythromycin. Alternatively, different antimicrobial protocols are used in order to reduce antibiotic resistance, howevwe, their sustained use promotes the appearance of resistance microorganisms. In this review work, the microbiological characteristics of R. equi are described, especially those related to its pathogenicity and its ability to survive in the environment. The literature related to antimicrobial resistance mechanisms and the impact it generates on public health was reviewed. In this way, we conclude that equine rhodococosis is a highly relevant disease at an economic and health level, which promotes the constant study of appropriate prophylactic and therapeutic alternatives to mitigate the impact of the disease.Fil: Leiva, Romina Florencia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias; ArgentinaFil: Mesplet, Maria. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias; ArgentinaFil: Bustos, Carla Paola. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias; Argentin

Novel Genotype of Streptococcus dysgalactiae subsp. equisimilis Associated with Mastitis in an Arabian Filly: Genomic Approaches and Phenotypic Properties

Streptococcus dysgalactiae subsp. equisimilis (Sde) is a commensal bacterium of horses that causes opportunistic infections. The aim of the work was to study genotypic and phenotypic properties of the Sde strain related to equine neonatal mastitis. Sde was isolated from an 8 day-old filly and sequenced for genome analysis, antibiotic susceptibility tests and virulence factor (VF) assays. The Sde strain presented the novel emm-subtype stC839.12 and the novel multilocus-sequence type ST-670, which belonged to a specific equine genotype group. Although no specific genotypic mechanisms related to antibiotic resistance were found, it presented genes encoding efflux pumps and transporters pmrA, bmrC and lmrP. Genes encoding several putative VFs including emm, cpa, fbp-2, adcA, hyl, htrA, tig, slo, and ndk and lociencoding phosphoenolpyruvate-protein phosphotransferase systems were identified. This is the first report of an equine neonatal mastitis case caused by a novel genotype and horse specific Sde strain.Fil: Bustos, Carla Paola. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias; ArgentinaFil: Retamar, Gabriela Cecilia. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias; ArgentinaFil: Leiva, Romina Florencia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias; ArgentinaFil: Frosth, Sara. Swedish University Of Agricultural Sciences; SueciaFil: Ivanissevich, Ana Eugenia. Laboratorio Cresal S.a.; ArgentinaFil: Demarchi, María Eugenia. Haras Equino; ArgentinaFil: Walsh, Saoirse. Freie Universität Berlin; AlemaniaFil: Frykberg, Lars. Swedish University Of Agricultural Sciences; SueciaFil: Guss, Bengt. Swedish University Of Agricultural Sciences; SueciaFil: Mesplet, María. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias; ArgentinaFil: Waller, Andrew Stephen. Intervacc Ab; Suecia. Swedish University Of Agricultural Sciences; Sueci

Knowledge, attitudes and perceptions of Latin American healthcare workers relating to antibiotic stewardship and antibiotic use: a cross-sectional multi-country study

Abstract Background The burden of antimicrobial resistance (AMR) in Latin America is high. Little is known about healthcare workers’ (HCWs) knowledge, attitudes, and perceptions of antimicrobial stewardship (AS), AMR, and antibiotic use (AU) in the region. Methods HCWs from 42 hospitals from 5 Latin American countries were invited to take an electronic, voluntary, anonymous survey regarding knowledge, attitudes, and perceptions of AS, AMR, and AU between March–April 2023. Findings Overall, 996 HCWs completed the survey (52% physicians, 32% nurses, 11% pharmacists, 3% microbiologists, and 2% “other”). More than 90% of respondents indicated optimizing AU was a priority at their healthcare facility (HCF), 69% stated the importance of AS was communicated at their HCF, and 23% were unfamiliar with the term “antibiotic stewardship”. Most (> 95%) respondents acknowledged that appropriate AU can reduce AMR; however, few thought AU (< 30%) or AMR (< 50%) were a problem in their HCF. Lack of access to antibiogram and to locally endorsed guidelines was reported by 51% and 34% of HCWs, respectively. Among prescribers, 53% did not consider non-physicians’ opinions to make antibiotic-related decisions, 22% reported not receiving education on how to select antibiotics based on culture results and 60% stated patients and families influence their antibiotic decisions. Conclusions Although HCWs perceived improving AU as a priority, they did not perceive AU or AMR as a problem in their HCF. AS opportunities include improved access to guidelines, access to AMR/AU data, teamwork, and education on AS for HCWs and patients and families