Epidemiology, surveillance and infection control aspects of Salmonella infections in hospitalized horses

This research work addressed four objectives. The first part was a critical review of published studies that have contributed to the literature of epidemiology and infection control of nosocomial Salmonella infections in hospitalized horses. This review identified several knowledge gaps related to epidemiology, diagnostics, and surveillance and infection control of Salmonella infections in hospitalized horses. The review was followed by three investigations that addressed three of the identified knowledge gaps.;The second part was an investigation of the relationships between clinical parameters (clinical signs and procedures, hematological and plasma chemistry) and Salmonella shedding in horses with signs of GI disease and with or without diarrhea. This study was designed as a case-control study. Results revealed that high plasma triglycerides at admission, abdominal surgery, and season (summer) were associated with Salmonella shedding in horses without diarrhea. These parameters can be considered for evaluation in hospital biosecurity programs to identify equine GI inpatients at high risk of Salmonella shedding.;The third part was an investigation that assessed the diagnostic performance of a real-time polymerase chain reaction (PCR) assay for detection of Salmonella spp in feces of hospitalized horses, compared to bacteriological culture. Fecal samples from horses classified as true-positives and true-negatives were used to assess the relative sensitivity and specificity of the PCR assay, respectively. Two primer sets were evaluated and results revealed that this PCR protocol was reliable, with a relatively high specificity (86-100%) and sensitivity (100%) when compared to bacteriological culture. This real-time PCR protocol can be used as a surveillance tool to detect Salmonella spp in fecal specimen of hospitalized horses.;The fourth part was a survey that assessed the awareness and relevance of a hospital surveillance and infection control program among referral veterinarians and clients who refer or send horses to a referral hospital for veterinary care. A total of 92 RDVMs and 594 clients participated in the survey. Study results revealed that most clients (61%) were not aware that the referral hospital operates an infection control program, and both RDVMs and clients considered it very important that a referral hospital operates a surveillance and infection control program.