References

Arnold-Lehna D, Venner M, Berghaus LJ, Berghaus R, Giguère S. Efficacy of treatment and survival rate of foals with pneumonia: retrospective comparison of rifampin/azithromycin and rifampin/tulathromycin. Pferdeheilkunde. 2019; 35:423-430 https://doi.org/10.21836/PEM20190504

Arnold-Lehna D, Venner M, Berghaus LJ, Berghaus R, Giguère S. Changing policy to treat foals with Rhodococcus equi pneumonia in the later course of disease decreases antimicrobial usage without increasing mortality rate. Equine Vet J. 2020; 52:531-537 https://doi.org/10.1111/evj.13219

Baverud V, Franklin A, Gunnarsson A Clostridium difficile associated with acute colitis in mares when their foals are treated with erythromycin and rifampicin for Rhodococcus equi pneumonia. Equine Vet J. 1998; 30:(6)482-488 https://doi.org/10.1111/j.2042-3306.1998.tb04523.x

Berghaus LJ, Giguère S, Sturgill TL, Bade D, Malinski TJ, Huang R. Plasma pharmacokinetics, pulmonary distribution, and in vitro activity of gamithromycin in foals. J Vet Pharmacol Ther. 2012; 35:(1)59-66 https://doi.org/10.1111/j.1365-2885.2011.01292.x

Bordin AI, Huber L, Sanz MG, Cohen ND. Rhodococcus equi foal pneumonia: Update on epidemiology, immunity, treatment and prevention. Equine Vet J. 2022; 54:(3)481-494 https://doi.org/10.1111/evj.13567

Bordin AI, Pillai SD, Brake C Immunogenicity of an electron beam inactivated Rhodococcus equi vaccine in neonatal foals. PLoS One. 2014; 9:(8) https://doi.org/10.1371/journal.pone.0105367

Burton AJ, Giguère S, Sturgill TL, Berghaus LJ, Slovis NM, Whitman JL Macrolide and rifampin-resistance Rhodococcus equi on a horse breeding farm, Kentucky, USA. Emerg Infect Dis. 2013; 19:(2)282-285 https://doi.org/10.3201%2Feid1902.121210

Caston SS, McClure SR, Martens RJ Effect of hyperimmune plasma on the severity of pneumonia caused by Rhodococcus equi in experimentally infected foals. Vet Therapeut. 2006; 7:361-375

Chaffin MK, Cohen ND, Blodgett GP, Syndergaard M. Evaluation of ultrasonographic screening methods for early detection of Rhodococcus equi pneumonia in foals. J Equine Vet Sci. 2012; 32:S20-S21

Cohen ND, O'Conor MS, Chaffin MK, Martens RJ. Farm characteristics and management practices associated with development of Rhodococcus equi pneumonia in foals. J Am Vet Med Assoc. 2005; 226:(3)404-13 https://doi.org/10.2460/javma.2005.226.404

Cohen ND, Carter CN, Scott HM Association of soil concentrations of Rhodococcus equi and incidence of pneumonia attributable to Rhodococcus equi in foals on farms in central Kentucky. Am J Vet Res. 2008; 6:(3)385-395 https://doi.org/10.2460/ajvr.69.3.385

Cohen ND, Chaffin MK, Kuskie KR, Syndergaard MK, Blodgett GP, Takai S. Association of perinatal exposure to airborne Rhodococcus equi with risk of pneumonia caused by R. equi in foals. Am J Vet Res. 2013; 74:102-9 https://doi.org/10.2460/ajvr.74.1.102

Coulson GB, Miranda-CasoLuengo AA, Miranda-Caso Luengo R Transcriptome reprogramming by plasmid-encoded transcriptional regulators is required for host niche adaption of a macrophage pathogen. Infect Immun. 2015; 83:(8)3137-3145 https://doi.org/10.1128%2FIAI.00230-15

Erganis O, Sayin Z, Hadimli HH The effectiveness of anti-R. equi hyperimmune plasma against R. equi challenge in Thoroughbred Arabian foals of mares vaccinated with R. equi vaccine. Sci World J. 2014; https://doi.org/10.1155/2014/480732

Erol E, Locke S, Saied A Antimicrobial susceptibility patterns of Rhodococcus equi from necropsied foals with rhodococcosis. Vet Microbiol. 2020; 242 https://doi.org/10.1016/j.vetmic.2019.108568

Flores-Ahlschwede P, Kahn SK, Ahlschwede S, Bordin AI, Cohen ND. Transfusion with 2 litres of hyperimmune plasma is superior to transfusion of 1 litre for protecting foals against pneumonia attributed to Rhodococcus equi. Equine Vet Educ. 2021; 34:(1)e67-72 https://doi.org/10.1111/eve.13443

Giguère S, Prescott JF. Clinical manifestations, diagnosis, treatment, and prevention of Rhodococcus equi infections in foals. Vet Microbiol. 1997; 56:313-333 https://doi.org/10.1016/s0378-1135(97)00099-0

Giguère S, Gaskin JM, Miller C, Bowman JL. Evaluation of a commercially available hyperimmune plasma product for prevention of naturally acquired pneumonia caused by Rhodococcus equi in foals. J Am Vet Med Assoc. 2002; 220:(1)59-63 https://doi.org/10.2460/javma.2002.220.59

Giguere S, Hernandez J, Gaskin J Performance of five serological assays for diagnosis of Rhodococcus equi pneumonia in foals. Clin Diagn Lab Immunol. 2003; 10:241-245 https://doi.org/10.1128%2FCDLI.10.2.241-245.2003

Giguère S, Lee E, Williams E, Cohen ND Determination of the prevalence of antimicrobial resistance to macrolide antimicrobials or rifampin in Rhodococcus equi isolates and treatment outcome in foals infected with antimicrobial-resistant isolates of R equi. J Am Vet Med Assoc. 2010; 237:(1)74-81 https://doi.org/10.2460/javma.237.1.74

Giguère S, Cohen ND, Keith Chaffin M Diagnosis, treatment, control, and prevention of infections caused by Rhodococcus equi in foals - ACVIM Consensus Statement. J Vet Intern Med. 2011; 19:(6)1-13 https://doi.org/10.1111/j.1939-1676.2011.00835.x

Higuchi T, Arakawa T, Hashikura S, Inui T, Senba H, Takai S. Effect of prophylactic administration of hyperimmune plasma to prevent Rhodococcus equi infection on foals from endemically affected farms. Zentralbl Veterinarmed B. 1999; 46:(9)641-648 https://doi.org/10.1046/j.1439-0450.1999.00284.x

Hildebrand F, Venner M, Giguère S. Efficacy of gamithromycin for the treatment of foals with mild to moderate bronchopneumonia. J Vet Intern Med. 2015; 29:(1)333-338 https://doi.org/10.1111/jvim.12504

Hooper-McGrevy KE, Giguere S, Wilkie BN, Prescott JF. Evaluation of equine immunoglobulin specific for Rhodococcus equi virulence-associated proteins A and C for use in protecting foals against Rhodococcus equi-induced pneumonia. Am J Vet Res. 2001; 62:(8)1307-1313 https://doi.org/10.2460/ajvr.2001.62.1307

Huber L, Gressler LT, Sanz MG, Garbade P, Vargas Á, Silveira BP. Monitoring foals by thoracic ultrasonography, bacterial culture, and PCR: Diagnostic of Rhodococcus equi subclinical pneumonia in south of Brazil. J Equine Vet Sci. 2018; 60:104-108

Hurley JR, Begg AP. Failure of hyperimmune plasma to prevent pneumonia caused by Rhodococcus equi in foals. Aust Vet J. 1995; 72:(11)418-20 https://doi.org/10.1111/j.1751-0813.1995.tb06192.x

Kahn SK, Blodgett GP, Canaday NM, Bevevino KE, Rocha JN, Bordin AI Transfusion with 2 liters of hyperimmune plasma is superior to transfusion of 1 liter or less for protecting foals against sub-clinical pneumonia attributed to Rhodococcus equi. J Equine Vet Sci. 2019; 79:54-58 https://doi.org/10.1016/j.jevs.2019.05.015

Martens RJ, Cohen ND, Chaffin MK Evaluation of 5 serologic assays to detect Rhodococcus equi pneumonia in foals. J Am Vet Med Assoc. 2002; 221:825-833 https://doi.org/10.2460/javma.2002.221.825

McQueen CM, Dindot SV, Foster MJ, Cohen ND. Genetic susceptibility to Rhodococcus equi. J Vet Intern Med. 2015; 29:(6)1648-1959 https://doi.org/10.1111/jvim.13616

Muscatello G, Anderson GA, Gilkerson JR, Browning GF. Associations between the ecology of virulent Rhodococcus equi and the epidemiology of R. equi on Australian thoroughbred farms. Appl Environ Microbiol. 2006; 72:(9)6152-60 https://doi.org/10.1128/aem.00495-06

Perkins GA, Yeager A, Erb HN, Nydam DV, Divers TJ, Bowman JL. Survival of foals with experimentally induced Rhodococcus equi infection given either hyperimmune plasma containing R. equi antibody or normal equine plasma. Vet Ther. 2002; 3:334-46

Phumoonna T, Muscatello G, Chicken C Clinical evaluation of a peptide-ELISA based upon N-terminal B-cell epitope of the VapA protein for diagnosis of Rhodococcus equi pneumonia in foals. J Vet Med B Infect Dis Vet Public Health. 2006; 53:(3)126-132 https://doi.org/10.1111/j.1439-0450.2006.00929.x

Reuss SM, Chaffin MK, Cohen ND. Extrapulmonary disorders associated with Rhodococcus equi infection in foals: 150 cases (1987–2007). J Am Vet Med Assoc. 2009; 235:(7)855-863 https://doi.org/10.2460/javma.235.7.855

Sanz M, Loynachan A, Sun L, Oliveira A, Breheny P, Horohov DW. The effect of bacterial dose and foal age at challenge on Rhodococcus equi infection. Vet Microbiol. 2013; 167:(3-4)623-31 https://doi.org/10.1016/j.vetmic.2013.09.018

Sanz MG, Loynachan A, Horohov DW. Rhodococcus equi hyperimmune plasma decreases pneumonia severity after a randomized experimental challenge of neonatal foals. Vet Rec. 2016; 178 https://doi.org/10.1136/vr.103095

Stieler AL, Sanchez LC, Mallicote MF, Martabano BB, Burrow JA, MacKay RJ. Macrolide-induced hyperthermia in foals: role of impaired sweat responses. Equine Vet J. 2016; 48:(5)590-594 https://doi.org/10.1111/evj.12481

Venner M, Reinhold B, Beyerbach M, Feige K. Efficacy of azithromycin in preventing pulmonary abscesses in foals. Vet J. 2009; 179:(2)301-303 https://doi.org/10.1016/j.tvjl.2007.10.002

Venner M, Rödiger A, Laemmer M, Giguère S. Failure of antimicrobial therapy to accelerate spontaneous healing of subclinical pulmonary abscesses on a farm with endemic infections caused by Rhodococcus equi. Vet J. 2012; 192:(3)293-8 https://doi.org/10.1016/j.tvjl.2011.07.004

Venner M, Credner N, Lämmer M, Giguère S. Comparison of tulathromycin, azithromycin and azithromycin-rifampin for the treatment of mild pneumonia associated with Rhodococcus equi. Vet Rec. 2013a; 173:(16) https://doi.org/10.1136/vr.101867

Venner M, Astheimer K, Lämmer M, Giguère S. Efficacy of mass antimicrobial treatment of foals with subclinical pulmonary abscesses associated with Rhodococcus equi. J Vet Intern Med. 2013b; 27:(1)171-176 https://doi.org/10.1111/jvim.12030

Wetzig M, Venner M, Giguère S. Efficacy of the combination of doxycycline and azithromycin for the treatment of foals with mild to moderate bronchopneumonia. Equine Vet J. 2020; 52:(4)613-619 https://doi.org/10.1111/evj.13211

An update on Rhodococcus equi pneumonia in foals

02 January 2023
10 mins read
Volume 7 · Issue 1

Abstract

Rhodococcus equi is one of the most common causes of pneumonia in foals. Despite the widespread presence of R.equi in the environment, there is marked variation in disease prevalence. Several studies have investigated the factors that may play a role in this variation, although further research is required. The insidious nature of R.equi can make early diagnosis challenging, therefore screening of foals is common practice on endemic farms. A consequence of this has been the mass overtreatment of foals with subclinical infection, which has contributed to the development of antimicrobial resistance. Further strategies are required to better identify foals that require treatment, in order to reduce antimicrobial use without resulting in increased mortality. Effective preventative measures are also an area of great importance. Currently, the administration of hyperimmune plasma is the mainstay of prevention, but vaccination represents the ideal prevention strategy and is a major goal for the future.

Rhodococcus equi is a soil saprophytic, Gram-positive, intracellular bacteria and one of the most common causes of pneumonia in foals worldwide. The bacteria are ubiquitous and can be cultured from the environment of virtually all horse farms. However, the prevalence of clinical disease varies from endemic on some farms to sporadic or unseen on others.

Bronchopneumonia is the most common clinical manifestation of R.equi in foals aged between 1 and 6 months. Disease in adult horses has been described, although this is limited to cases with severe underlying immunodeficiency. Similarly, R.equi infection has also been reported in immunodeficient humans, for example those with HIV or those undergoing chemotherapy for cancer. In addition to pneumonia, R.equi can also result in infections in other body systems, for example bone infection, ocular disease, diarrhoea and abdominal abscesses. On farms where the disease is endemic, costs associated with treatment and foal losses can be substantial. This article provides an update on the epidemiology, diagnosis and treatment of R.equi, in addition to current strategies for the prevention of disease.

Register now to continue reading

Thank you for visiting UK-VET Equine and reading some of our peer-reviewed content for veterinary professionals. To continue reading this article, please register today.