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HOSP I TAL INFECT IONS
Veterinary surgeon
Andrew Illing
XLVets Equine practice
Chapelfield Veterinary
Partnership Ltd
Hospitals are used for many aspects of veterinary work, not only medicine and
surgery but also routine procedures such as vettings or vaccinations. The aim is
to provide the best possible environment for those horses attending the hospital;
this can often be difficult as both sick and healthy animals may have to share
the same clinical areas.
Hospital
infections
Andrew Illing VetMB MA MRCVS,
Chapelfield Veterinary Partnership Ltd
Figure 1.
Ringworm is a common fungal skin
infection
Figure 2.
Placement of an endotracheal tube is a
potential source of infection
19
EQUINE MATTERS
1.
contagious diseases
2.
opportunist infections.
Several strategies are employed by hospitals
to prevent infected animals from transmitting
infections to other animals within the hospital.
But first we must divide and discuss the two
main forms in which an animal can contract
an infection within a hospital:
Contagious diseases
Organisms such as salmonella, equine
influenza, equine herpesvirus, equine
infectious anaemia, clostridial enteritis,
rotavirus and those causing strangles and
MRSA can be very severe for patients, but
also can cause a hospital to close because
of the risk of spread. Once diagnosed, there
is often a long and complicated procedure to
eliminate the organism before the hospital
can return to normal function.
As hospitals are continually admitting horses
from a large geographical area and different
horse populations, there is a constant challenge
regarding biosecurity within the hospital.
In some instances a horse may need moving
from the hospital to an isolation unit in order
to protect other patients, especially in cases
of airborne or faecally transmitted infections.
Routine monitoring of the above and other
infectious organisms is not always
straightforward due to the complexities of
testing and the time taken to obtain results.
Specific bacterial cultures can be taken for
salmonella and other bacteria, with culture
and sensitivity tests to find out which
antibiotics are useful. Viruses require more
specific testing such as PCR (looking for
fragments of DNA) or viral isolation.
Some hospitals will take samples before
admitting patients but there is always a fine
balance between patient health and hospital
biosecurity. Skin infections, such as mange,
lice and ringworm (Figure 1) can live in
housing and are usually picked up on
general examination of the patient and
examination of samples under a microscope.
Patient monitoring before, during and after
admission can help to reduce the chances
of problems developing.
There is also an increased risk from any
patients that have travelled abroad or mares
that have been inseminated with semen
from abroad. Handling these patients must
be done with care as several of these
infections can be zoonotic and so
transmissible to staff and owners as well.
It is important to maintain:
l
patient segregation or isolation
l
staff separation
l
careful handling of high risk patients.
l
monitoring of the animals and
environment
l
proper hygiene