Identification and seasonal distribution of airborne fungi in three horse stables in Italy

Association between equine asthma and fungal elements in the tracheal wash: An environment-matched case-control study

The presence of fungi in tracheal wash (TW) of horses was recently linked to mild-moderate equine asthma, indicating a possible causal role; however, increased numbers of fungi may also stem from asthma-related alteration of tracheal mucus clearance or from environmental exposure. Our objective was to elucidate the association between the presence of fungi in TW and asthma status while controlling for relevant confounders. We conducted a retrospective case-control study involving 73 horses, including 34 controls and 39 asthmatic cases. Each asthmatic horse was matched with a control from the same barn to account for the influence of environmental exposure. All horses underwent respiratory clinical scoring, endoscopy, TW, and bronchoalveolar lavage (BAL). The association between asthma status and presence of TW fungi was tested with multivariable logistic regression modelling, accounting for selected management factors, tracheal mucus accumulation, and selected TW and BAL cytological characteristics, including multinucleated giant cells (MGCs) in the TW. Given the variability in MGC definitions in the literature, particularly concerning their morphology and number of nuclei, we constructed two distinct models for each outcome (asthma status or presence of fungi in TW): one considering MGCs as cells with ≥ 3 nuclei, and another using a criterion of ≥ 10 nuclei. Horses with a tracheal mucus score ≥ 2 exhibited 3.6 to 4.3 higher odds of being asthmatic, depending on the MGC definition. None of the other variables examined were associated with either asthma status or TW fungi detection. Notably, the presence of fungal elements in the TW was not associated with equine asthma.

The Most Common Environmental Risk Factors for Equine Asthma-A Narrative Review

Equine asthma is a popular subject of research. Many factors influencing the methods used to improve the welfare of asthmatic horses remain unclear. This study reviews scientific articles published after 2000 to collect the most important information on the terminology, symptoms, and potential environmental factors influencing the development and course of equine asthma. Our work highlights the impact of environmental factors on the severity of equine asthma and why these factors should be controlled to improve treatment outcomes. The present article provides horse owners and veterinarians with valuable information on how to improve the well-being of horses that are at risk of developing asthma symptoms.

Detection of fungi in the airways of horses according to the sample site: a methodological study

Fungal detection in equine airways may be performed on either tracheal wash (TW) or bronchoalveolar lavage fluid (BALF) by either cytology or culture. However, method comparisons are sparse. Our objective was to determine the prevalence of fungi in airways of horses according to the sample site and laboratory methodology. Sixty-two adult horses, investigated in the field or referred for respiratory disease, were included. Tracheal wash, and BALF collected separately from both lungs, were collected using a videoendoscope. Fungi were detected in cytologic samples examined by light microscopy, and by fungal culture. Hay was sampled in the field. Prevalence of fungi was of 91.9% in TW and 37.1% in BALF. Fungi were cultured from 82.3% of TW and 20.9% of BALF. Fungal elements were observed cytologically in 69.4% of TW and 22.6% of BALF. In 50% of horses, the same fungi were detected in both TW and hay, but fungi detected in BALF and hay differed in all horses. Poor agreement was found for the detection of fungi between TW and BALF and between fungal culture and cytologic examination (Cohen's kappa coefficient (κ) < 0.20). Moderate agreement was found between cytologic examination of left and right lungs (κ = 0.47). The prevalence of fungi detected cytologically on pooled BALF was significantly different (p = 0.023) than on combined left and right BALF. Fungi were more prevalent in the TW than BALF, and results suggest that hay might not be the primary source of fungi of the lower respiratory tract of horses.

Fungi in respiratory samples of horses with inflammatory airway disease

Background

Fungi contribute to the inflammatory response of lungs in horses with recurrent airway obstruction and in some forms of asthma in humans. The role of fungi in inflammatory airway disease (IAD) has not been assessed.

Objectives

Evaluate the prevalence of fungi in the respiratory samples of horses diagnosed with IAD, describe clinical signs associated with the presence of fungi in respiratory samples, and assess the risk factors associated with IAD and with the presence of fungi in the airways.

Animals

Seven‐hundred thirty‐one active horses referred to a specialized ambulatory practice for signs of respiratory disease or poor performance.

Methods

A prospective observational study was performed, collecting clinical data, environmental conditions, and results of a tracheal wash (TW; cytology, fungal culture, and bacterial culture), and bronchoalveolar lavage (cytology).

Results

A positive fungal culture was obtained in 55% (402/731) of horses. Horses with fungal elements observed on the TW cytology had 2 times greater chance of having IAD than horses without fungi (odds ratio [OR] = 2.1; 95% CI 1.08‐3.33; P = .0003). Risks of being diagnosed with IAD and likelihood of fungi in TW were higher when horses were bedded on straw (OR = 2.0; 95% CI 1.2‐3.2 and OR = 1.9; 95% CI 1.3‐2.6, respectively) or fed dry hay (OR = 2.7; 95% CI 1.7‐4.4 and OR = 2.6; 95% CI 1.6‐3.4, respectively).

Conclusions and Clinical Importance

Horses inhaling aerosolized fungal particles are at a significantly higher risk of developing IAD. The type of bedding and forage represent significant risk factors for IAD and fungal contamination of equine airways.

Microbiological quality of air in free-range and box-stall stable horse keeping systems

The aim of this study was to assess the microbiological quality of air in three horse riding centers differing in the horse keeping systems. The air samples were collected in one facility with free-range horse keeping system and two with box stalls of different sizes. The samples were collected over a period of 3 years (2015-2017), four times per year (spring, summer, autumn, winter) to assess the effect of seasonal changes. The prevalence of aerobic mesophilic bacteria, mold fungi, actinomycetes, Staphylococcus spp., and Escherichia coli was determined by the air collision method on Petri dishes with appropriate microbiological media. At the same time, air temperature, relative humidity, and particulate matter concentration (PM₁₀, PM_2.5) were measured. It was found that the horse keeping system affects the occurrence of the examined airborne microorganisms. Over the 3-year period of study, higher temperature and humidity, as well as particulate matter concentration-which notoriously exceeded limit values-were observed in the facilities with the box-stall system. The air sampled from the largest horse riding center, with the largest number of horses and the box-stall system of horse keeping, was also characterized by the heaviest microbiological contamination. Among others, bacteria from the following genera: Staphylococcus spp., Streptococcus spp., Bacillus spp., and E. coli and fungi from the genera Aspergillus, Fusarium, Mucor, Rhizopus, Penicillium, Trichothecium, Cladosporium, and Alternaria were identified in the analyzed samples.

Factors affecting vegetable growers' exposure to fungal bioaerosols and airborne dust

We have quantified vegetable growers' exposure to fungal bioaerosol components including (1→3)-β-d-glucan (β-glucan), total fungal spores, and culturable fungal units. Furthermore, we have evaluated factors that might affect vegetable growers' exposure to fungal bioaerosols and airborne dust. Investigated environments included greenhouses producing cucumbers and tomatoes, open fields producing cabbage, broccoli, and celery, and packing facilities. Measurements were performed at different times during the growth season and during execution of different work tasks. Bioaerosols were collected with personal and stationary filter samplers. Selected fungal species (Beauveria spp., Trichoderma spp., Penicillium olsonii, and Penicillium brevicompactum) were identified using different polymerase chain reaction-based methods and sequencing. We found that the factors (i) work task, (ii) crop, including growth stage of handled plant material, and (iii) open field versus greenhouse significantly affected the workers' exposure to bioaerosols. Packing of vegetables and working in open fields caused significantly lower exposure to bioaerosols, e.g. mesophilic fungi and dust, than harvesting in greenhouses and clearing of senescent greenhouse plants. Also removing strings in cucumber greenhouses caused a lower exposure to bioaerosols than harvest of cucumbers while removal of old plants caused the highest exposure. In general, the exposure was higher in greenhouses than in open fields. The exposures to β-glucan during harvest and clearing of senescent greenhouse plants were very high (median values ranging between 50 and 1500 ng m(-3)) compared to exposures reported from other occupational environments. In conclusion, vegetable growers' exposure to bioaerosols was related to the environment, in which they worked, the investigated work tasks, and the vegetable crop.

Installation of mechanical ventilation in a horse stable: effects on air quality and human and equine airways

OBJECTIVES

To examine the effects of installing a mechanical ventilation system at a riding-school stable on indoor air quality and human and horse airways.

METHODS

The intervention was the installation of mechanical ventilation in a riding-school stable. Carbon dioxide (CO2), ammonia, particles, horse allergen, microorganisms and endotoxins were measured in the stable. The stable-workers and riding-students completed a questionnaire and underwent the following tests: analysis of nasal lavage for inflammation biomarkers; levels of exhaled nitrogen oxide (NO); measurements of daily peak-expiratory flow (PEF). The horses were examined clinically by airway endoscopy and bronchoalveolar lavage (BAL) and were analysed for cytology and biomarkers.

RESULTS

Levels of CO2 were nearly halved and airborne horse allergen levels were markedly reduced (5-0.8 kU/m3) after the intervention. A decreased level of ultrafine particles was observed (8000-5400 particles/cm3) after the intervention, while total and respirable dust levels were mainly unchanged (200 and 130 μg/m3). Levels of microorganisms in surface samples decreased following the intervention, whereas airborne microorganisms and endotoxin increased. There was no significant change in human symptoms, PEF-variability, exhaled NO or inflammatory biomarkers in the nasal lavage. In horses, the mean score of lower airway mucus was significantly reduced together with the mean level of expression of interleukin-6 mRNA in BAL cells after the intervention.

CONCLUSIONS

The installation of a mechanical ventilation system resulted in an increased air exchange rate, as demonstrated by reduced levels of CO2, ammonia, ultrafine particles and horse allergen. There was no significant clinical effect on human airways, but there was a tendency for reduced inflammation markers. The results on the horses may indicate less impact on their airways after the intervention.

A case of primary localized cutaneous infection due to Fusarium oxysporum

Fusarium is a ubiquitous hyalohyphomycete isolated from food, widespread in the environment (plants, soil) and present at all latitudes. Fusarium oxysporum and Fusarium solani are the most frequent pathogenic species, followed by F. moniliforme and F. chlamydosporum. Infections due to this mold may be disseminated or localized. Localized forms include cutaneous and subcutaneous infection, onychomycosis, endophtalmitis, otitis, sinusitis, arthritis, osteomyelitis, and brain abscess. Disseminated forms are those in which two or more noncontiguous sites may be involved. These latter are observed in patients with severe neutropenia. Wounds, digital ulcers, onychomycosis, and paronychia are the typical cutaneous portal of entry. We report a case of primary localized cutaneous infection due to Fusarium in a 29-year-old woman presenting with a nodular lesion, partially ulcerated, asymptomatic on the first finger of the left hand, appeared 4 months earlier. Histological examination showed spongiosis and acanthosis in the stratum corneum, ulceration and inflammation with prevalently mononucleate cells and septate and branched fungal structures in the epidermis and in dermis. The fungus was identified as Fusarium oxysporum by culture of biopsy fragments on Sabouraud dextrose agar with chloramphenicol. The culture was deposited in the culture collection of the mycology section of IHEM, Brussels (IHEM21984 col no. 125). The patient had normal immune status and was successfully treated with surgical excision. Recovery was confirmed at follow-up 8 months later.

Exposure to inhalable dust, endotoxins, beta(1->3)-glucans, and airborne microorganisms in horse stables

OBJECTIVES

Workers in horse stables are likely exposed to high levels of organic dust. Organic dusts play a role in increased risk of inflammatory reactions and are associated with respiratory diseases. The aim of this study was to investigate dust, endotoxin, beta(1-->3)-glucan, and culturable microorganisms exposure levels in horse stables.

METHODS

Ambient (n = 38) and personal (n = 42) inhalable dust samples were collected using PAS-6 sampling heads. As a special measurement, we included sampling near the horses' heads. Samples were analyzed for endotoxin and beta(1-->3)-glucan by Limulus amebocyte lysate assay and an inhibition enzyme immunoassay, respectively. Culturable bacteria and fungi were collected with an Anderson impactor.

RESULTS

Geometric means (GMs) of personal exposure to dust, endotoxin, and beta(1-->3)-glucan were 1.4 mg m(-3) (range 0.2-9.5), 608 EU m(-3) (20-9846), and 9.5 microg m(-3) (0.4-631 microg m(-3)), respectively. Exposure levels in the morning shift were higher compared to other shifts. The GMs (ranges) of culturable bacteria and fungi were 3.1 x 10(3) colony-forming unit (CFU) m(-3) (6.7 x 10 to 1.9 x 10(4)) and 1.9 x 10(3) CFU m(-3) (7.4 x 10 to 2.4 x 10(4)), respectively. Variance components for endotoxin and beta(1-->3)-glucan were considerably higher than for dust. Based on dummy variable in a mixed regression analysis, the predominant task explaining exposure levels of dust, endotoxin, and beta(1-->3)-glucan was sweeping the floor. For beta(1-->3)-glucan, feeding the horse was also an important determinant.

CONCLUSION

Dust, endotoxin, and beta(1-->3)-glucan exposure are considerable in horse stables. Bacterial and fungal exposure levels were moderate. Endotoxin exposures were above the Dutch proposed standard limits, suggesting workers in horse stables to be at risk of adverse health effects.