Evaluation of the Efficacy of Disinfectant Footmats for the Reduction of Bacterial Contamination on Footwear in a Large Animal Veterinary Hospital

Background

Infection control is critical to providing high‐quality patient care. Many veterinary teaching hospitals (VTHs) utilize footbaths or footmats at entrances and key control points throughout the facility to decrease trafficking of pathogenic microorganism on contaminated footwear.

Hypothesis/Objectives

To compare efficacy of 4 disinfectants used in footmats for decreasing bacterial contamination of footwear in a large animal hospital.

Animals

A single adult dairy cow was housed in a stall for 4 days to facilitate stall contamination with fecal material.

Methods

Overboots were experimentally contaminated with organic material in a standardized manner. Each boot was randomly assigned to 1 of 5 treatments (no treatment, or exposure to 1 of 4 disinfectants: an accelerated peroxygen [AHP], a peroxygen [VIRKON], a quaternary ammonium [QUAT], and a phenolic disinfectant [PHENOLIC]) by stepping on a soaked footmat and collecting samples from boot soles. Generalized linear modeling was used to analyze differences in bacterial counts.

Results

Reductions in colony‐forming units (CFUs) on treated boots ranged from no detectable reduction to 0.45 log₁₀ and varied by disinfectant. Percentage reductions in total bacterial counts generally were larger (albeit still modest) for AHP and QUAT disinfectants (range 37–45%) and smallest for the PHENOLIC (no detectable reduction).

Conclusions and Clinical Importance

In general, use of disinfectant footmats was associated with significant reductions in viable bacteria on overboots—albeit with variable efficacy. Footmats may be useful adjuncts to cleaning and disinfection programs for decreasing trafficking of microorganisms throughout VTHs but should not be considered as a sole prevention method.

Comparison of disinfectant efficacy when using high-volume directed mist application of accelerated hydrogen peroxide and peroxymonosulfate disinfectants in a large animal hospital

REASONS FOR PERFORMING STUDY

Effective decontamination of animal holding environments is critical for providing high quality patient care and maintaining a safe working environment. Disinfection of animal holding environments is a significant challenge during times of epidemic disease.

OBJECTIVES

The purpose of this study was to evaluate the disinfectant efficacy of 3 strategies for high-volume directed mist application of accelerated hydrogen peroxide and peroxymonosulfate disinfectants; 4.25% accelerated hydrogen peroxide (Accel(®) ; AHP) at a 1:16 dilution and single and double applications of 2% peroxymonosulfate solution (Virkon-S(®) ; VIR-1 and VIR-2) for decontamination of a large animal hospital environment.

STUDY DESIGN

Experiment.

METHODS

After cleaning and disinfection of the hospital environment, transparencies experimentally contaminated with known concentrations of Staphylococcus aureus, Salmonella enterica and Pseudomonas aeruginosa were placed on vertical surfaces. Disinfectant solution was applied by directed mist application and, after 30 min of contact time, transparencies were collected and individually placed into tubes containing 10 ml Dey-Engley broth. The process was repeated for each disinfectant. Tenfold dilutions of each sample were plated onto tryptic soy blood agar with 5% sheep blood. Bacterial counts from transparencies exposed to disinfectants were compared with counts from control transparencies (unexposed to disinfectants) to evaluate reduction in colony forming units.

RESULTS

The least squares mean reduction (log10 ) in colony forming units (CFUs) for S. aureus and P. aeruginosa was 1.5-2.5 logs and approximately 0.8-1.0 logs for S. enterica. Reductions were generally largest for VIR-2 and smallest for AHP, although these differences were not all statistically significant and the magnitude of differences may not be clinically relevant.

CONCLUSIONS

For the organisms evaluated, all 3 disinfectants applied as a directed mist were effective at reducing CFUs in a veterinary hospital environment. Effective disinfection using this method of application is dependent on adequate cleaning prior to application, and use of adequate volumes of disinfectant.

Detection of different serotypes of Salmonella enterica in experimentally inoculated equine fecal samples by commercially available rapid tests

Background

Salmonella enterica can significantly impact management of animal facilities. Comprehensive screening is essential for effective control in high‐risk populations. Availability of reliable point‐of‐care diagnostic tests would facilitate these efforts.

Hypothesis/Objectives

Compare the ability of commercially available rapid diagnostic assays (2 lateral flow immunoassays [LFIs], DNA hybridization [DNAH], real‐time PCR [qPCR]), and culture to detect common serotypes of S. enterica in feces.

Animals

n/a.

Methods

In an experimental study, 112 S. enterica isolates were randomly selected from the 10 most common serotypes recovered at a veterinary hospital. Archived isolates were amplified in broth and standardized inocula (100 colony forming units) were incubated with equine feces in tetrathionate broth (TET). Cultures were tested in a blinded fashion by using LFIs, DNAH, qPCR, and culture.

Results

The LFIs detected 84% and 67% of isolates, respectively, but reactivity varied among serotypes. Both reacted poorly with serotype Cerro (Group K) isolates, and 1 LFI did not react with any serotype Mbandaka (Group C1) or Montevideo (Group C1) isolates. DNAH detected 94% of isolates, whereas culture and qPCR most reliably detected all serotypes. False‐positive results were obtained for 4 negative controls by using DNAH and 1 negative control by using qPCR, but LFIs and culture had no false‐positive results.

Conclusions and Clinical Importance

Culture, qPCR, and DNAH were effective in detecting most Salmonella isolates, but have limited application at point‐of‐care settings. LFIs are appealing as point‐of‐care tests because of low cost and ease of use, but limited detection of some serotypes needs to be evaluated with samples obtained from naturally infected animals.

Acquired urethral obstruction in New World camelids: 34 cases (1995-2008)

OBJECTIVE

Document the clinical features, short- and long-term outcomes and prognostic factors in New World camelids with acquired urethral obstruction.

DESIGN

Retrospective case study.

METHODS

Case data from medical records of 34 New World camelids presenting with acquired urethral obstruction were collected and follow-up information on discharged patients was obtained. Associations with short- and long-term survival were evaluated using Wilcoxon rank-sum tests, exact-logistic regressions and Kaplan-Meier survival curves.

RESULTS

Of the 34 New World camelids 23 were intact males and 11 were castrated; 4 animals were euthanased upon presentation, 7 were treated medically and 23 surgically, including urethrotomy, bladder marsupialisation, tube cystostomy alone or combined with urethrotomy, urethrostomy or penile reefing. Necrosis of the distal penis was found in 4 animals and all were short-term non-survivors. Short-term survival for surgical cases was 65%, and 57% for medical cases. Incomplete urethral obstruction at admission and surgical treatment were associated with increased odds of short-term survival. Of 14 records available for long-term follow-up, 6 animals were alive and 8 were dead (median follow-up 4.5 years, median survival time 2.5 years). Recurrence of urethral obstruction was associated with long-term non-survival.

CONCLUSIONS

Surgically treated New World camelids with incomplete urethral obstruction have the best odds of short-term survival and those with recurrence of urethral obstruction have a poor prognosis for long-term survival.

Using syndromic surveillance to estimate baseline rates for healthcare-associated infections in critical care units of small animal referral hospitals

BACKGROUND

Expected rates of healthcare-associated infections (HCAI) have not been established in veterinary hospitals. Baseline rates are critically needed as benchmarks for quality animal care.

OBJECTIVE

To estimate the occurrence of events related to HCAI identified using a standardized syndromic surveillance system in small animals in critical care cases at referral hospitals.

ANIMALS

Weaned dogs and cats (n = 1,951) that were hospitalized in the critical care unit of referral teaching hospitals during a 12-week period.

METHODS

Multicenter, prospective longitudinal study. A survey was completed for all enrolled animals to record basic demographics, information about procedures and treatments that animals received, and to document the occurrence of defined nosocomial syndromes. Data were analyzed to identify risk factors associated with the occurrence of these nosocomial syndromes.

RESULTS

Controlling for hospital of admission, 16.3% of dogs (95% confidence intervals [CI], 14.3-18.5) and 12% of cats (95% CI, 9.3-15.5) were reported to have had ≥ 1 nosocomial syndrome occur during hospitalization. Risk factors found to have a positive association with the development of a nosocomial syndrome were longer hospital stays, placement of a urinary catheter, surgical procedures being performed, and the administration of antiulcer medications and antimicrobial drugs excluding those given perioperatively.

CONCLUSIONS AND CLINICAL IMPORTANCE

Syndromic surveillance systems can be successfully standardized for use across multiple hospitals to effectively collect data pertinent to HCAI rates and risk factors for occurrence.

Detection and control of a nosocomial outbreak caused by Salmonella newport at a large animal hospital

BACKGROUND

Nosocomial salmonellosis is often assumed to occur because infection control and surveillance practices are inadequate, but published evidence is lacking to support the related contention that rigorous application of these practices can impact the severity of outbreaks.

OBJECTIVE

Describe active surveillance, early recognition, and intensive mitigation efforts used in an effort to control an outbreak of nosocomial Salmonella enterica serotype Newport infections without hospital closure.

ANIMALS

Large animals hospitalized at a referral hospital.

METHODS

This prospective outbreak investigation was initiated when Salmonella Newport infections were detected among hospitalized animals by active surveillance. Data were analyzed to identify temporal and spatial patterns for epidemic spread of Salmonella in the hospital. Mitigation efforts were aggressively adjusted in response to surveillance data. Genetic relatedness of isolates was investigated by pulsed-field gel electrophoresis.

RESULTS

Of 145 large animals sampled, 8 (5.6%) were infected with the Salmonella strain associated with this outbreak, and all but 1 shed Salmonella in the absence of or before the onset of disease. This strain was recovered from 14.2% (42/295) of environmental samples (ENV samples), indicating that widespread environmental contamination had occurred. Isolates of Salmonella Newport obtained from infected animals and the environment were genetically indistinguishable, confirming clonal dissemination.

CONCLUSIONS AND CLINICAL IMPORTANCE

Active surveillance allowed early detection of nosocomial Salmonella transmission and hospital contamination. Use of aggressive interventions was followed by cessation of transmission. Active surveillance can allow earlier recognition and mitigation compared with programs by only sampling of clinically affected animals.

Selenium and vitamin E

Deficiency of selenium and vitamin E has recently been identified as a major health concern of sheep producers in certain regions of the United States, and familiarity with published data on these nutrients seems to be of value to small ruminant practitioners. This article begins with a description of the biochemical roles and metabolism of selenium and vitamin E. A literature review follows in which the influence of these nutrients on the musculoskeletal, reproductive, and immune systems, as well as on flock productivity, is discussed. Methods for detection of deficiency and supplementation strategies are also described.

Virulence factors in Escherichia coli isolated from the blood of bacteremic neonatal calves

Twenty-five Escherichia coli isolates from the blood of critically ill bacteremic calves sampled in two separate studies on a calf-rearing farm housing over 15,000 calves, in the San Joaquin Valley, California were studied. Isolates were characterized for O serogroups and for pathotypes as determined by the presence of specific virulence factors including heat-labile enterotoxin (LT), heat-stable enterotoxins a and b (STa, STb), verotoxins 1 and 2 (VT1, VT2), cytotoxic necrotizing factor (CNF), aerobactin, intimin Eae and P, F17 and CS31A fimbrial adhesins, and resistance to bactericidal effects of serum. These isolates constituted a heterogeneous group. However, isolates were mostly aerobactin positive and often resistant to the bactericidal effects of serum. Isolates of pathotypes O78 (n=6), O119:CS31a (n=3), and P positive but O non-typeable (n=3) were associated with a high mortality rate. The remaining isolates belonged to diverse pathotypes, often possessing the adhesins P, F17, CS31A and Eae but belonging to O serogroups other than O78 and O119, and were less frequently associated with mortality. Although no virulence factor common to all isolates was identified, the capacity to use iron by the presence of aerobactin which is important to the capture of iron was a predominant factor. Moreover, certain pathotypes appear to be associated with primary colisepticemia whereas other pathotypes may cause a bacteremia without necessarily leading to septicemia.

Diagnosis of enteric disease in small ruminants

Diagnosis of gastrointestinal disease in small ruminants requires integration of information obtained in the signalment, history, physical or necropsy examination, and ancillary diagnostic tests. The purpose of this article is to provide the practitioner with a review of the clinical features of several common gastrointestinal diseases of sheep and goats. Rumen acidosis, enterotoxemia, gastrointestinal parasitism, neonatal diarrhea, and salmonellosis are discussed, and where appropriate, reviews of the pathophysiology, prevention, and control of these diseases are cited for further reading.

Brucellosis induced by RB51 vaccine in a pregnant heifer

Brucellosis developed in a 14.5-month-old Gelbvieh heifer after the animal was vaccinated with the calfhood dose of strain RB51 Brucella abortus vaccine s.c. during the fourth month of its first pregnancy. The heifer experienced dystocia and was euthanatized during cesarean section because of a large uterine tear. The fetus was dead at delivery. Suppurative placentitis and fetal pneumonia were evident at necropsy. Brucella abortus strain RB51 was isolated from the placenta and the fetus' lung.

Treatment of sodium balance disorders. Water intoxication and salt toxicity

Electrolyte disorders are commonly identified in food animal medicine. Some of these electrolyte disturbances require that the veterinarian be aware of the potential for causing harm during routine fluid therapy. Hyponatremia (water intoxication) and hypernatremia (salt toxicity) are two such disorders. Both create osmolar disturbances that effect changes in the brain's osmolar state. During fluid resuscitation it is possible to cause iatrogenic central nervous system damage in these cases. It is important to recognize those cases where sodium imbalance may complicate routine therapy, understand the underlying mechanisms for osmolar changes in the plasma and brain, and know the appropriate steps to take for safe correction of the sodium disturbance.

Miniature pigs

Miniature pigs have become popular pets in North America, and veterinarians of a variety of clinical specialties may be called on for their care. Successful collection of blood from these animals requires familiarity with the location of sites for venipuncture and knowledge of adequate methods of restraint. In this article, restraint and techniques for venipuncture are described, as well as techniques for cerebrospinal fluid collection, semen collection, and vaginal cytologic examination. Interpretation of hematologic, serum biochemical, and urinalysis data are also discussed. Methods for diagnosis of skin diseases, gastrointestinal parasitism, and enteric infectious diseases are included in order to provide the practitioner with the essential knowledge and skills for a variety of clinical pathologic studies of this unique pet.

Treatment of hypernatremia in an acidotic neonatal calf

A 7-day-old Jersey calf was evaluated because of diarrhea and pneumonia. The calf was hypernatremic, hypoproteinemic, and acidemic, and was treated initially with i.v. administration of fluids with sodium concentration (175 mEq/L) similar to the calf's serum sodium concentration. Sodium concentration of the administered fluids was gradually decreased over the following days, but the calf's serum sodium concentration decreased too rapidly, and the calf developed neurologic signs attributed to cerebral edema. Treatment with mannitol and i.v. administration of fluids with a higher concentration of sodium resulted in abatement of clinical signs. In calves, hypernatremia may develop over several days. Prescribing traditional isotonic or hypotonic fluids in such cases will be harmful, because during chronic hypernatremia, the brain's adaptive mechanisms involve accumulation of organic osmoles that may take several days to equilibrate across cell membranes, and cerebral edema may result. Administration of fluids containing sodium concentration approximately equal to the patient's measured serum sodium concentration is required to decrease serum sodium concentration more slowly than is possible with traditional isotonic fluids.

Detection of low serum immunoglobulin concentrations in clinically ill calves

The sensitivity, specificity, and accuracy of classification of 4 tests for failure of passive transfer (FPT) were examined in clinically ill neonatal calves. Comparisons were made with serum IgG1 concentrations determined by radial immunodiffusion. Serum samples were obtained from 27 clinically ill calves < or = 21 days of age. The results of 4 commonly used assays, the sodium sulfite turbidity test, the zinc sulfate turbidity test, refractometry, and the serum gamma-glutamyl transferase (GGT) activity test, were compared with radial immunodiffusion determinations of serum IgG1 concentration. Serum GGT activity using a 50 IU/L threshold resulted in correct classification of the highest percentage of calves (93%) with regard to their passive transfer status. The sodium sulfite test with a 1+ end point and refractometry using a 5.5 g/dL end point resulted in correct classification of 85% of the calves studied. When using the sodium sulfite test, the 2+ and 3+ test end points had lower specificity, 0.58 and 0.00, respectively, than the 1+ end point. This loss in specificity resulted in misclassification of calves with adequate serum immunoglobulin concentrations as having FPT. The zinc sulfate turbidity test was inadequately specific (0.33) and resulted in misclassification of 33% of calves.

Allergic respiratory disease

Allergic rhinitis and extrinsic allergic alveolitis are the most common allergic disorders of the bovine respiratory system. Environmental and management factors play significant roles in the pathogenesis of these disorders. When compared to infectious or toxic respiratory disease, allergic respiratory disease is relatively rare and of far less economic importance in North American cattle; however, the environmental and management conditions conducive to these diseases exist in many regions. Therefore, familiarity with the clinical and epidemiologic features of these unique diseases will aid the veterinarian in establishing an accurate diagnosis. Signs of respiratory dysfunction are common to anaphylactic and anaphylactoid reactions. Early recognition of these adverse reactions will provide the practitioner with the greatest chance of successful treatment.

Bacteriological culture of blood from critically ill neonatal calves

The objectives of this study were to estimate the prevalence of bacteremia in critically ill, neonatal calves with severe diarrhea or depression, and to describe the variety of bacteria involved. Two studies were conducted in the summers of 1991 and 1993 involving 190 neonatal calves, 1-day to 19-days-old. Bacteremia was detected by blood culture in 31% (28/90) of calves in study 1, and in 24% (19/79) of ill calves and 0% (0/21) of control calves in study 2. Bacteria cultured from blood included Escherichia coli (51% of all isolates), other gram-negative enterics (25.5%), gram-negative anaerobes (5.9%), gram-positive cocci (11.8%), and gram-positive rods (5.9%). Among clinically ill calves, the average age was significantly lower in the blood culture-negative group (5.5 d) than in the blood culture-positive group (7.5 d) (P = 0.004). Mean serum IgG concentration was significantly (P = 0.0001) lower in blood culture-positive calves (1.146 g/L) than in blood culture-negative calves (3.077 g/L). The mortality rate was significantly (P < 0.0001) higher in the blood culture-positive group (57.4%) than in the blood culture-negative group (15.1%). Bacteremia appeared to be a frequent entity in this particular rearing situation. Early recognition of the problem, as well as appropriate treatment, may be beneficial in increasing survival rates. Results also support the need to address the failure of passive transfer of maternal antibodies to prevent bacteremia in calves.

Use of a clinical sepsis score for predicting bacteremia in neonatal dairy calves on a calf rearing farm

In human, equine, and bovine neonates, early diagnosis of bacteremia remains a challenge for the internist. The objective of this study was to develop a predictive model for risk of bacteremia, based on a clinical evaluation system called the clinical sepsis score. Blood from 90 ill calves, 1- to 14-days-old from a calf-raising farm in the San Joaquin Valley of California was cultured. The calves were also scored according to a clinical score for hydration status, fecal appearance, general attitude, appearance of scleral vessels, and umbilical abnormality. Age, rectal temperature, heart rate, respiratory rate, and presence or absence of a focal site of infection were recorded. Prevalence of bacteremia was 31% (28/90). A logistic regression model indicated that high clinical score, presence of a focal infection, and increased age were associated with an increased risk of bacteremia in ill calves (P < 0.06). Calves for which the model predicted bacteremia with a probability > or = 40.8% were considered bacteremic, yielding acceptable sensitivity (75%) and specificity (71%) estimates. The predictive model was validated through a 2nd sampling of 100 calves (79 ill calves and 21 controls), of which 17 calves were bacteremic. The classification was 75% correct using the model, with an estimated sensitivity of 76% and specificity of 75%. Overall, results indicated that the model could be a useful tool for predicting bacteremia in ill calves in a clinical setting.

Utero-cecal fistula in a doe

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Delivery of a live calf after in vitro maturation and fertilization of oocytes obtained from ovaries removed from a moribund cow

An aged Holstein cow of high genetic merit and economic value was determined to have a squamous cell carcinoma of the tarsus. Treatment was unsuccessful, as was an attempt at superovulation and embryo collection; thus, the owner elected euthanasia. On day 17 of the estrous cycle, the ovaries were removed via laparotomy and the cow was immediately euthanatized. Oocytes were aspirated from ovarian follicles and subjected to in vitro maturation and fertilization procedures. Seven morulae that developed in culture were transferred nonsurgically to 3 recipient females, resulting in birth of a full-term healthy male calf. In vitro maturation and fertilization procedures can be used to obtain offspring from valuable, terminally ill cows for which conventional embryo collection techniques have proven unsuccessful.

Otitis media/interna and suppurative meningoencephalomyelitis associated with Listeria monocytogenes infection in a llama

Listeria monocytogenes was found to be the cause of fatal suppurative meningoencephalomyelitis in a 3.5-month-old cria. The cria initially had clinical signs of unilateral peripheral vestibular disease, but on the following day, the cria developed progressive signs of encephalitis. Treatment with antibiotics, flunixin meglumine, and anticonvulsant drugs failed to stop progression of the disease, and the cria was euthanatized. Post-mortem examination revealed otitis media-interna and diffuse suppurative meningoencephalomyelitis. Listeria monocytogenes was isolated from CSF and brain tissue.