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OBJECTIVE To evaluate colonization of Streptococcus suis and Streptococcus parasuis on pig farms in Japan and to identify sources of infections. SAMPLE Saliva, feces, and vaginal swab samples from 84 healthy pigs of several growth stages on 4 farms and swab samples of feed troughs and water dispensers at those farms. PROCEDURES Samples were collected from August 2015 to June 2016. Two quantitative PCR (qPCR) assays (one for S suis and the other for S parasuis) were designed for use in the study. The novel qPCR assays were used in combination with previously described qPCR assays for S suis serotype 2 or 1/2 and total bacteria. Relative abundance of bacteria in each sample was evaluated. RESULTS Streptococcus suis was detected in all saliva samples and some of the other samples, whereas S parasuis was not detected in any of the samples, including saliva samples, which indicated a difference in colonization preference. The ratio of S suis to total bacteria in saliva appeared to increase with age of pigs. Streptococcus suis serotype 2 or 1/2 was detected in a few saliva samples and feed trough swab samples at 2 farms where S suis infections were prevalent. CONCLUSIONS AND CLINICAL RELEVANCE Saliva, especially that of sows, appeared to be a reservoir and source of S suis infection for pigs. The qPCR assay described here may provide an effective way to monitor for S suis in live pigs, which could lead to effective disease control on pig farms.

OBJECTIVE To develop a risk prediction model for factors associated with an SeM-specific antibody titer ≥ 3,200 in horses after naturally occurring outbreaks of Streptococcus equi subsp equi infection and to validate this model. DESIGN Case-control study. ANIMALS 245 horses: 57 horses involved in strangles outbreaks (case horses) and 188 healthy horses (control horses). PROCEDURES Serum samples were obtained from the 57 cases over a 27.5-month period after the start of outbreaks; serum samples were obtained once from the 188 controls. A Bayesian mixed-effects logistic regression model was used to assess potential risk factors associated with an antibody titer ≥ 3,200 in the case horses. A cutoff probability for an SeM-specific titer ≥ 3,200 was determined, and the model was externally validated in the control horses. Only variables with a 95% credibility interval that did not overlap with a value of 1 were considered significant. RESULTS 9 of 57 (6%) case horses had at least 1 titer ≥ 3,200, and 7 of 188 (3.7%) of control horses had a titer ≥ 3,200. The following variables were found to be significantly associated with a titer ≥ 3,200 in cases: farm size > 20 horses (OR, 0.11), history of clinically evident disease (OR, 7.92), and male sex (OR, 0.11). The model had 100% sensitivity but only 24% specificity when applied to the 188 control horses (area under the receiver operating characteristic curve = 0.62.) CONCLUSIONS AND CLINICAL RELEVANCE Although the Bayesian mixed-effects logistic regression model developed in this study did not perform well, it may prove useful as an initial screening tool prior to vaccination. We suggest that SeM-specific antibody titer be measured prior to vaccination when our model predicts a titer ≥ 3,200.

Objective: To evaluate predictor variables for and complications associated with Streptococcus equi subsp equi infection (strangles) in horses., Design: Retrospective case-control study., Animals: 108 horses with strangles (cases) and 215 horses without strangles (controls)., Procedures: Medical records from January 2005 through July 2012 were reviewed. Cases were defined as horses with clinical signs of strangles (pyrexia, retropharyngeal lymphadenopathy, and mucopurulent nasal discharge) that were associated with a confirmed strangles outbreak or had positive results for S equi on PCR assay or bacteriologic culture. Controls were defined as horses with pyrexia that did not meet the other criteria for cases. Data compared between cases and controls included signalment, clinical signs, diagnostic test results, and disease complications and outcome. Logistic regression was used to identify variables associated with strangles and its complications., Results: Clinical signs of strangles were not evident in 12 of 25 cases classified as S equi carriers (infected > 40 days). Predictor variables associated with strangles included mucopurulent nasal discharge and external abscesses in the pharyngeal region. Strangles was more likely to be diagnosed in the spring than in the summer. Cases with anemia were more likely to develop purpura hemorrhagica than were cases without anemia. No risk factors were identified for the development of guttural pouch empyema or metastatic abscesses., Conclusions and Clinical Relevance: Results indicated that not all horses infected with S equi develop clinical signs of strangles. We recommend that guttural pouch endoscopy and lavage with PCR assay of lavage fluid samples be performed to identify S equi carrier horses.

Case Description: A 12-week-old female dromedary camel (Camelus dromedarius) calf was evaluated because of acute (< 24 hours) inappetence and lethargy. The calf was being bottle-fed because of maternal rejection., Clinical Findings: Physical examination revealed decreased bronchovesicular sounds and absent borborygmi. The rectal temperature was 38.9°C (102.0°F). A CBC indicated leukopenia with a degenerative left shift suggestive of a systemic infection. Results of abdominal and thoracic ultrasonography showed severe bicavitary effusion, peripheral lung consolidation, and intestinal hypomotility. Pleural and peritoneal fluid analysis confirmed a diagnosis of septic pleuritis and peritonitis. Results of aerobic bacterial culture of venous blood, peritoneal fluid, and pleural fluid samples indicated Streptococcus equi subsp zooepidemicus septicemia as the etiology for the polyserositis (ie, alpaca fever)., Treatment and Outcome: Treatment with IV broad-spectrum antimicrobials, an NSAID, and pleural drainage was initiated. Clinical signs of pleuropneumonia, peritonitis, and systemic infection improved rapidly 24 hours after initiation of medical treatment. The calf was discharged from the hospital after 11 days, and antimicrobial treatment continued for 2 weeks after discharge. At follow-up approximately 4 weeks after hospital discharge (6 weeks after the initial examination), there were no clinical signs suggestive of relapse or any reported complications., Clinical Relevance: S equi subsp zooepidemicus may cause polyserositis in Old World camelids (eg, dromedary camels) with signs similar to those seen in New World camelids (eg, alpaca and llama). The rapid response to medical treatment for the patient described suggested that S equi subsp zooepidemicus-induced polyserositis (alpaca fever) in dromedary camels may respond favorably to appropriate treatment. Reducing stress, reducing overcrowding, and separate housing of equids and camelids are suggested. Further studies are needed to better assess the epidemiology of alpaca fever in dromedary camels in North America.

Objective: To evaluate the effectiveness of a novel trimethoprim-sulfadiazine oral suspension for the treatment of naturally acquired Streptococcus equi subsp zooepidemicus infection in horses., Design: Randomized, controlled field trial., Animals: 180 horses with S equi subsp zooepidemicus infection., Procedures: Horses with lower respiratory tract infections caused by S equi subsp zooepidemicus were treated with a new formulation of combined trimethoprim-sulfadiazine oral suspension at a dosage of 24 mg/kg (10.9 mg/lb) twice daily for 10 days (treatment group) or with an equivalent volume of saline (0.9% NaCl) solution (placebo group). Response to treatment, including clinical signs and fecal consistency scores, was assessed twice daily. Any adverse effects were recorded. The primary outcome variable was clinical response; the secondary outcome variable was eradication of S equi subsp zooepidemicus on study day 17 as determined by bacteriologic culture of repeated transtracheal-wash specimens., Results: Of the 119 horses allocated to the treatment group, 69 (58%) had a positive clinical response. A significantly smaller proportion of horses in the placebo group (9/61 [15%]) had a positive clinical response. By day 5, 25 of 61 (41%) placebo horses had been withdrawn from the study because of negative clinical response, compared with only 10 of 119 (8.4%) treated horses. By day 10, 28 of 61 (46%) placebo horses had been withdrawn because of negative clinical response, compared with only 13 of 119 (11%) treated horses. There were few adverse events associated with the trimethoprim-sulfadiazine suspension. There were no significant differences in fecal consistency scores between treatment and placebo groups., Conclusions and Clinical Relevance: The new oral suspension administered at 24 mg/kg twice daily effectively treated the clinical signs of S equi subsp zooepidemicus lower respiratory infection in horses and eliminated the organism from the respiratory tract. Adverse effects were minimal.

Objective: To compare results for 3 commercially available microbiological media plates with those for standard bacteriologic testing of bovine milk., Sample: Milk samples from postpartum cows and cows with a high somatic cell count (SCC) or clinical mastitis (CM)., Procedures: Sample-ready Staphylococcus culture medium (SRSC) plates were used to detect Staphylococcus aureus in milk samples obtained from postpartum cows and cows with a high SCC or CM. Rapid coliform count (RCC) plates were used to detect coliforms in milk samples obtained from cows with CM. Aerobic count (AC) plates were used to detect streptococci in CM samples. Fresh mastitic milk samples were frozen and then thawed to evaluate the effects of freezing for the SRSC and RCC plates. The effects of dilution (1:10) of samples were determined. Agreement of results between the commercially available plates and standard bacteriologic testing was evaluated., Results: The ability of SRSC plates to detect S aureus in milk samples was highest with diluted samples from postpartum cows and cows with a high SCC or CM. Sensitivity of the RCC plate for detection of coliforms was highest with diluted mastitic milk samples. The AC plates had a poor positive predictive value for detection of streptococci in mastitic milk samples. Freezing increased S aureus detection., Conclusions and Clinical Relevance: Overall, the SRSC and RCC plates were accurate, were easy to use, and yielded results comparable to those of standard bacteriologic testing for the detection of S aureus and coliforms in bovine milk.

Objective: To evaluate a commercially available modified-live Streptococcus equi subsp equi vaccine for safety and persistence in vaccinated ponies and to detect recombination or reversion events in the vaccine strain., Animals: 5 ponies that were 1.5 to 8 years old (group 1) and 4 ponies that were 6 months old (group 2)., Procedures: Ponies were vaccinated, with a subsequent booster vaccination 2 to 3 weeks later, and monitored for 50 days. At booster vaccination, an equal amount of a tetracycline-resistant wild-type strain of S equiwas administered. Recovery of all strains was performed by use of bacteriologic culture and PCR assays., Results: Ponies in group 1 had background antibody titers against S equi antigen before vaccination despite the lack of known exposure to S equi. Ponies in group 2 were immunologically naïve. Increases in anti-S equi antibody titers were detected in both groups. Ponies in group 1 did not have clinical signs of disease caused by S equi. In group 2, all ponies developed abscesses in retropharyngeal lymph nodes; 1 pony developed severe clinical disease and was euthanized. The vaccine strain was recovered from ponies in group 2 for up to 24 days after vaccination., Conclusions and Clinical Significance: Although the vaccine was successful in inducing IgG antibodies against S equi in all ponies, findings suggested that the vaccine may have caused substantial morbidity and some deaths in the young ponies. In young ponies, the vaccine strain persisted in tissues for weeks; however, no evidence of recombination was detected.

Objective: To identify factors associated with an increased likelihood that horses would have a serum Streptococcus equi SeM-specific antibody titer > or = 1:1,600., Design: Cross-sectional study., Animals: 188 healthy client-owned horses., Procedures: A single serum sample from each horse was tested for SeM-specific antibody titer with an ELISA. Multivariate logistic regression was used to identify factors associated with having a titer > or = 1:1,600., Results: Age, breed, and vaccination status were significantly associated with the likelihood of having a titer > or = 1:1,600. The odds of having a titer > or = 1:1,600 increased by a factor of 1.07 with each 1-year increase in age. Quarter Horses and horses of other breeds were 4.08 times as likely as were Thoroughbreds and warmbloods to have a titer this high. Horses that had previously received an intranasal S equi vaccine were 4.7 times as likely as were horses without any history of vaccination to have a titer this high., Conclusions and Clinical Relevance: Results indicated that older horses, horses other than Thoroughbreds and warmbloods, and horses that had been vaccinated with an attenuated-live intranasal S equi vaccine between 1 and 3 years previously had an increased likelihood of having a serum SeM-specific antibody titer > or = 1:1,600.

Objective: To determine whether groups C and G streptococci (GCS-GGS) isolated from animals have rheumatogenic traits associated with human GCS-GGS isolates, particularly the potential of the bacteria to interact with human collagen type IV (collagen-IV), known to be targeted during acute rheumatic fever (ARF)., Sample Population: 64 GCS and GGS bacterial strains isolated from infected animals., Procedures: Bacteria were analyzed for their ability to bind and aggregate collagen-IV and for the presence of collagen binding factors, such as the hyaluronic acid capsule, cne gene, and emm gene., Results: Collagen-IV binding ability was detected in 19% (n = 12) of the isolates studied. Of the collagen-IV binding strains, 5 expressed hyaluronic acid capsule. Furthermore, emm was detected in the genome of 1 isolate, whereas all remaining collagen-IV binding isolates possessed the cne gene. Of the collagen binding factors investigated, the hyaluronic capsule was the only factor for which collagen-IV interaction could be detected. Investigation of the potential of these strains to aggregate collagen-IV revealed that animal isolates had a nonaggregating phenotype., Conclusions and Clinical Relevance: Despite efficiently binding collagen-IV via hyaluronic acid, animal isolates lacked the ability to initiate aggregation of this protein. Because collagen-IV aggregation is associated with all collagen-IV-binding rheumatogenic strains, this suggested a lack of rheumatogenic potential among animal-derived GCS and GGS and, therefore, a low chance of acquiring ARF through animal contact.

Case Description: A 4-month-old American Paint Horse colt was evaluated because of acute onset of ataxia, left-sided head tilt, and fever and a recently noticed heart murmur. Upper respiratory tract infection caused by Streptococcus equi subsp equi had been diagnosed at 3 months of age., Clinical Findings: Hematologic abnormalities included leukocytosis, mature neutrophilia, monocytosis, and mild anemia. Analysis of a CSF sample revealed high total protein concentration and total nucleated cell count; nucleated cells consisted mainly of degenerate neutrophils. Results of a real-time PCR assay were positive for S equi subsp equi, and a diagnosis of S equi subsp equi meningoencephalomyelitis was made., Treatment and Outcome: Treatment included administration of potassium penicillin and fluids, but the foal developed uroperitoneum and was subsequently euthanized. Postmortem examination revealed meningoencephalomyelitis, and S equi subsp equi was cultured from a brain aspirate. Additional findings included suppurative cystitis with rupture and neutrophilic myocarditis., Clinical Relevance: Findings suggest that S equi subsp equi meningoencephalomyelitis should be considered in the differential diagnosis for foals with neurologic signs that have a history of strangles or exposure to affected horses.

Four Quarter Horses (9 months to 7 years of age) with submandibular lymphadenopathy and firm muscles (palpation of which elicited signs of pain) were evaluated; in general, the horses had a stiff gait, and 3 horses became recumbent. Streptococcus equi was cultured from aspirates of lymph nodes or samples of purulent material collected from the auditory tube diverticula. Once the horses were recumbent, their condition deteriorated rapidly despite aggressive antimicrobial and antiinflammatory treatment, necessitating euthanasia within 24 to 48 hours. One horse did not become recumbent and recovered completely. Among the 4 horses, common clinicopathologic findings included neutrophilia, hyperfibrinogenemia, and high serum activities of creatine kinase and aspartate aminotransferase. Necropsies of the 3 euthanatized horses revealed large, pale areas most prominent in the semimembranosus, semitendinosus, sublumbar, and gluteal muscles that were characterized histologically by severe acute myonecrosis and macrophage infiltration of necrotic myofibers. Streptococcus equi was identified in sections of affected muscle by use of immunofluorescent stains for Lancefield group C carbohydrate and S. equi M protein. In the 4 horses of this report, acute severe rhabdomyolysis without clinical evidence of muscle atrophy or infarction was associated with S. equi infection; rhabdomyolysis was attributed to either an inflammatory cascade resembling streptococcal toxic shock or potentially direct toxic effects of S. equi within muscle tissue.

Five horses were examined because of signs of muscle stiffness, colic, or both. All 5 had been exposed to Streptococcus equi within 3 weeks prior to examination or had high serum titers of antibodies against the M protein of S equi. Horses had signs of unrelenting colic-like pain and focal areas of muscle swelling. Four horses were euthanatized. The fifth responded to treatment with penicillin and dexamethasone; after 3 weeks of treatment with dexamethasone, prednisolone was administered for an additional 10 weeks. Common hematologic and serum biochemical abnormalities included neutrophilia with a left shift and toxic changes, hyperproteinemia, hypoalbuminemia, and high serum creatine kinase and aspartate transferase activities. Necropsy revealed extensive infarction of the skeletal musculature, skin, gastrointestinal tract, pancreas, and lungs. Histologic lesions included leukocytoclastic vasculitis in numerous tissues and acute coagulative necrosis resembling infarction. These horses appeared to have a severe form of purpura hemorrhagica resembling Henoch-Schönlein purpura in humans and characterized by infarction of skeletal muscles. Early recognition of focal muscle swelling, abdominal discomfort, neutrophilia, hypoalbuminemia, and high serum creatine kinase activity combined with antimicrobial and corticosteroid treatment may enhance the likelihood of a successful outcome.

Objective: To determine whether previously unidentified variations of the SzP protein of Streptococcus equi subsp zooepidemicus were present in horses with various clinical signs of infection and whether any relationship could be identified between SzP protein variants and naturally occurring clinical conditions., Sample Population: 23 isolates of S equi subsp zooepidemicus were recovered from specimens of horses with various clinical conditions and used as a representative population of isolates for evaluation of different SzP protein variants., Procedure: Genetic heterogeneity of the isolates was demonstrated by repetitive extragenic palindromic-polymerase chain reaction analysis. The SzP gene was sequenced and the presumed protein sequence determined for each isolate. Characteristics of the SzP proteins were compared among the isolates and in relation to the clinical conditions of horses from which they were recovered., Results: The signal peptide types, number of proline-glutamic acid-proline-lysine repeats, and anchor sequences were consistent with those previously described for the SzP protein. Many of the isolates clustered with 5 previously described types on the basis of the hypervariable region of the SzP protein. One additional variant, which represented 8 of the isolates, was identified. Particular motifs in the hypervariable region accounted for many of the differences among hypervariable types., Conclusions and Clinical Relevance: The SzP protein appears to be limited to a selected number of types. Variations in the SzP protein are frequently determined on the basis of different motifs rather than random amino acid substitutions. There does not appear to be any association of SzP protein variations and clinical manifestations of infection in horses.

Objective: To determine the prevalence of Streptococcus iniae in tilapia (Oreochromis spp), hybrid striped bass (Morone chrysops X M saxatilis), and channel catfish (Ictalurus punctatus) on commercial fish farms in the United States., Animals: 1,543 fish (970 tilapia, 415 hybrid striped bass, and 158 channel catfish)., Procedures: The dry-swab technique was used for collection of specimens for streptococcal isolation. Specimens were shipped by overnight delivery and processed by use of standard bacteriologic techniques., Results: Streptococcus iniae was not isolated from market-size channel catfish. Prevalence in tilapia and hybrid striped bass was 37 of 970 (3.81%) and 30 of 415 (7.23%), respectively. Prevalence by farm ranged from 0.0 to 27.4% for tilapia and 0.0 to 21.6% for hybrid striped bass. In tilapia, prevalence was lowest in market-size and nursery fish (4 of 239 [1.67%] and 3 of 339 [0.88%], respectively), with an increase in prevalence for fish in the grow-out stage (30 of 337 [7.96%]). For hybrid striped bass, prevalence was lowest in nursery and market-size fish (3 of 96 [3.12%] and 1 of 47 [2.12%], respectively) and highest in fish in the grow-out stage (26 of 272 [9.56%]). Prevalence in market-size tilapia and hybrid striped bass was 5 of 286 (1.75%)., Conclusions and Clinical Relevance: Results of this study do not support the contention that S iniae is a serious public health threat associated with commercially raised fish; rather, it represents a limited risk for older or immunocompromised people who incur puncture wounds while handling and preparing fish.

Objectives: To test whether generalized Streptococcus zooepidemicus infection could be induced by intratracheal inoculation in llamas and to characterize this infection., Animals: 6 test and 3 control llamas., Procedure: Test llamas received 1 of 3 dosages of S. zooepidemicus by intratracheal injection, whereas control llamas received sterile culture medium. Physical examination variables and results of clinicopathologic analyses of blood, peritoneal fluid, and tracheal wash fluid were compared in test llamas between, before, and during the development of bacteremia and with control llamas. Bacteriologic culture was performed on all collected body fluids and tissue specimens that were collected at necropsy. Tissue specimens that were collected at necropsy were examined histologically., Results: Infection induced fever, anorexia, and signs of depression. Five of 6 infected llamas developed specific signs of inflammation in the thorax or abdomen, bacteremia, neutrophilic leukocytosis with toxic changes and high band neutrophil cell counts, hyperfibrinogenemia, and high peritoneal fluid WBC counts and protein concentrations. On development of bacteremia, llamas had significant decreases in serum iron (from 118+/-25 to 6+/-4 microg/ml) and increases in serum glucose (from 131+/-5 to 253+/-48 mg/dl) concentrations., Conclusions and Clinical Relevance: Streptococcus zooepidemicus spreads rapidly to other body compartments after intratracheal inoculation in llamas. Fever, anorexia, and signs of depression are the most consistent clinical signs, although other signs are possible. Clinicopathologic analysis of body fluids yields evidence of inflammation. Infection by S. zooepidemicus can be proven by bacteriologic culture of body fluids before death or of tissue specimens after death.

A 19-year-old Quarter Horse mare was evaluated because of bloody vaginal discharge that was apparent immediately following breeding. On transrectal ultrasonography, it was evident that the uterus was filled with fluid containing echogenic particles; linear hyperechoic structures were also visible. Endoscopy was performed, which revealed a number of bones adhered to the cranial wall and floor of the right uterine horn as well as purulent fluid in both uterine horns. Bacterial endometritis and fetal maceration were diagnosed. The mare was treated with antibiotics, and the fetal bones were manually removed from the uterus. Fetal maceration with intrauterine retention of bones is rare in mares. Use of hysteroscopy supplements ultrasonography in the diagnosis of uncommon conditions of the uterus. Macerated bones may be adhered to the endometrium, thereby requiring manual removal.

A 21-year-old male double-yellowheaded Amazon parrot was referred because of possible urolithiasis. The bird had strained to void since it was young, and recently, signs of depression and inappetence had appeared. Radiography revealed 2 mineralized opacities in the left caudal portion of the celomic cavity. A left lateral celiotomy revealed that the left ureter was dilated and contained a calculus, which was later determined to be composed of monosodium uric acid crystals and proteinaceous material. The second mineralized mass could not be located at that time, but was detected in the caudal aspect of the celomic cavity after surgery by use of radiography. Manual attempts to maneuver the uterolith from the ureter through the cloaca were unsuccessful. Five days after the initial surgery, the uterolith was removed by cloacotomy and ventral midline laparotomy. Excretory urography performed 10 and 31 days after surgery revealed that the left ureter was homogeneously opacified and gradually decreased to 3 to 6 mm in diameter. The bird remained healthy and seemed to strain less severely during voiding. Nonspecific signs associated with ureteroliths may result in delay in diagnosis. Surgical removal of ureteroliths may be an effective treatment for this uncommon condition, but it is complicated by certain anatomic features of birds and may result in ureteral stricture.

Objective: To determine efficacy of vaccines incorporating QuilA, alum, dextran combined with mineral oil, or Freund adjuvant for immunization of feedlot cattle against Streptococcus bovis and Lactobacillus spp., Animals: 24 steers housed under feedlot conditions., Procedure: Steers were randomly assigned to 4 experimental groups and a control group. Animals in experimental groups were inoculated on days 0 and 26 with vaccines containing Freund adjuvant (FCA), QuilA, dextran combined with mineral oil (Dex), or alum as adjuvant. Serum anti-S bovis and anti-Lactobacillus IgG concentrations were measured, along with fecal pH, ruminal fluid pH, and number of S bovis and Lactobacillus spp in ruminal fluid., Results: Throughout the study, serum anti-S bovis and anti-Lactobacillus IgG concentrations for animals in the Dex, QuilA, and alum groups were similar to or significantly higher than concentrations for animals in the FCA group. Serum anti-S bovis and anti-Lactobacillus IgG concentrations were significantly increased on days 26 through 75 in all 4 experimental groups, and there was a linear relationship between anti-S bovis and anti-Lactobacillus IgG concentrations. For animals in the QuilA and Dex groups, mean pH of feces throughout the period of experiment were significantly higher and numbers of S bovis and Lactobacillus spp in ruminal fluid on day 47 were significantly lower than values for control cattle., Conclusions and Clinical Relevance: Results suggest that immunization of feedlot steers against S bovis and Lactobacillus spp with vaccines incorporating Freund adjuvant, QuilA, dextran, or alum as an adjuvant effectively induced high, long-lasting serum anti-S bovis and anti-Lactobacillus IgG concentrations. Of the adjuvants tested, dextran may be the most effective.

A 14-year-old horse was admitted to the veterinary hospital for treatment of tachycardia and lethargy. Initial diagnoses were ventricular tachycardia and renal dysfunction. During hospitalization other findings included fever, renal failure, hepatic failure, hypotension, and intermittent ventricular arrhythmias. Bacteriologic culture of 2 blood samples collected during febrile crises 7 days apart yielded Streptococcus mitis. These culture results along with other clinical and physical examination findings fulfill the criteria for a diagnosis of streptococcal toxic shock syndrome, previously described for humans and dogs. To our knowledge this is the first reported instance of this disease in a horse.

Objective: To determine whether repetitive sequence-based polymerase chain reaction (rep-PCR) could be used to differentiate Streptococcus equi isolates, to examine S equi isolates from throughout the world, and to determine whether a horse had > 1 subtype of S equi during an outbreak of disease., Sample Population: An initial group of 32 S equi isolates, 63 S equi isolates from various geographic areas, and 17 S equi isolates obtained during outbreaks of disease., Procedure: An aliquot of S equi genomic DNA was amplified, using enterobacterial repetitive intergenic consensus primers. Gel electrophoresis was performed on 1.5% agarose gels, and a computed-assisted program was used to compare rep-PCR results., Results: Use of these primers to analyze 100 ng of S equi genomic DNA resulted in patterns of 6 to 14 bands. The 32 initial isolates were separated into 7 rep-PCR subtypes. There were 30 rep-PCR subtypes found among 29 S equi isolates obtained from Minnesota, Michigan, Canada, and Australia and 34 S equi isolates obtained from Kentucky and other sources. Furthermore, the same clone was identified in several horses during an outbreak of disease. Infected horses on the same farm all had a single clone of S equi., Conclusion and Clinical Relevance: Analysis of these results suggests that rep-PCR is useful for delineating S equi into rep-PCR subtypes. Results revealed that isolates with the same geographic source or similar date of collection did not always have the same rep-PCR subtype. A single clone of S equi usually predominated during an outbreak of disease.

Objective: To determine whether lactoferrin (LF) or milk influenced adherence of Streptococcus uberis to bovine mammary epithelial cells., Sample Population: Three strains of S uberis from cows with mastitis, pooled milk samples from 3 clinically healthy Jersey cows early in the lactation period, and bovine mammary epithelial cells from a clonal cell line., Procedures: Adherence of S uberis to bovine mammary epithelial cells in the presence of various concentrations of LF or milk and after pretreatment of bacteria with LF or milk was tested. Bacteria were cultured with mammary epithelial cell monolayers for 1 hour. The culture supernatant was removed, and the epithelial cells were lysed. Adherence index was calculated as number of colony-forming units (CFU) in the cell lysate divided by number of CFU in the supernatant times 10,000., Results: All 3 strains of S uberis were found to bind to purified LF and LF in milk. Addition of LF to the culture medium enhanced adherence of all 3 strains to mammary epithelial cells, whereas addition of milk enhanced adherence of 2 strains and decreased adherence of the third. Pretreatment of bacteria with LF or milk increased adherence of 1 of the strains but decreased adherence of the other 2. Increased adherence was antagonized by rabbit antibovine LF antibody., Conclusions: Results suggest that LF may function as a bridging molecule between S uberis and bovine mammary epithelial cells, facilitating adherence of the bacteria to the cells.

Objective: To determine whether streptococcal pneumonia is caused by strains of Streptococcus zooepidemicus similar to those obtained from the tonsils of healthy horses., Sample Population: 5 tonsils from healthy horses, 8 tracheal washes and 6 lung specimens from foals with pneumonia, and 5 nasopharyngeal swab specimens from donkeys with acute bronchopneumonia., Procedure: Variable M-like protectively immunogenic SzP proteins of 5 isolates of S. zooepidemicus from each tonsil and clinical specimen were compared, using immunoblots. The SzP gene of 13 isolates representative of various SzP immunoblot phenotypes from 1 healthy horse and 9 horses and donkeys with pneumonia were sequenced and compared. Cell-associated hyaluronic acid concentration and resistance to phagocytosis of some isolates were measured., Results: Tonsils of each healthy horse were colonized by several SzP phenotypes similar to those of foals or donkeys with pneumonia. In contrast, multiple isolates from animals with pneumonia had the same SzP phenotype, indicating infection by a single strain or clone. Analysis of the SzP sequence confirmed that differences in immunoblot phenotype were associated with sequence differences and that several SzP genotypes were in healthy horses and animals with pneumonia. Isolates with high concentrations of cell-associated hyaluronic acid were more resistant to phagocytosis., Conclusions and Clinical Relevance: An SzP-specific immunoblot is a useful, sensitive measure of diversity among strains of S. zooepidemicus. Single strains with SzP phenotypes similar to those found in tonsils of healthy horses cause pneumonia. Because of the diversity of SzP phenotype and genotype among isolates from animals with pneumonia, SzP phenotype is not an important determinant of invasiveness or epizootic capabilities.

Objective: To determine whether antibiotic and supportive treatment would improve outcome for dairy cows with naturally developing clinical mastitis, compared with supportive treatment alone., Design: Randomized controlled trial., Animals: 124 cows in one herd with 172 episodes of clinical mastitis., Procedure: Cows were examined at the onset of clinical mastitis, assigned a severity score, and randomly assigned to receive antibiotic (intramammary administration of cephapirin, i.v. administration of oxytetracycline, or both) and supportive treatment (administration of oxytocin, stripping of affected glands, and, in severely affected cows, administration of flunixin meglumine or fluids) or supportive treatment alone. Treatment was continued until 24 hours after signs of clinical mastitis resolved (clinical cure). Milk samples from affected glands were submitted for bacterial culture before initial treatment and every 2 weeks thereafter until the causative organism was no longer isolated (bacteriologic cure)., Results: When mastitis was caused by Streptococcus spp or coliform bacteria, clinical cure rate by the tenth milking was significantly higher if antibiotics were used. Bacteriologic cure rate at 14 days was significantly higher when antibiotics were used, particularly if mastitis was caused by Streptococcus spp. Cows receiving antibiotics developed fewer subsequent episodes of clinical mastitis during the 60 days after the initial episode of mastitis and had less severe clinical disease than cows that did not., Clinical Implications: Results suggest that, in herds in which mastitis is often caused by environmental bacteria, antibiotic and supportive treatment may result in a better outcome for cows with clinical mastitis than supportive treatment alone.

Objective: To determine frequency and antibiotic susceptibility patterns of bacterial pathogens from cows with mastitis treated at a private practice during a 2-year period., Design: Observational study., Animals: Lactating dairy cows from 47 herds of 40 to 600 cows each., Procedure: Bacteria isolated from milk samples were identified as coliforms, Staphylococcus spp, or Streptococcus spp, using selective media. Antibiotic susceptibility testing was performed, using the disk diffusion method with the following antibiotics: gentamicin, amikacin sulfate, penicillin G, penicillin G-novobiocin, ampicillin, cephalothin sodium, ticarcillin, ceftiofur, lincomycin, erythromycin, pirlimycin hydrochloride, sulfonamide, tetracycline, and polymyxin B., Results: Of 354 samples tested, 82 (23.2%) yielded no growth. Of bacteria isolated, 54 (15.3%) were coliforms, 96 (27.1%) were Staphylococcus spp, and 94 (26.6%) were Streptococcus spp. Antibiotic susceptibility testing was performed on 62.4% of all samples cultured. For Staphylococcus isolates, cephalothin was the most effective antibiotic in vitro for which a commercially available preparation exists. Penicillin G-novobiocin was the most effective antibiotic in vitro for Streptococcus isolates. Commercial antibiotic preparations approved for intramammary use were not effective in vitro against coliforms that were found to cause mastitis., Clinical Implications: Mastitis caused by coliform organisms does not respond to commercial preparations intended for intramammary use; however, it may respond to parenterally administered antibiotics. Mastitis caused by Staphylococcus spp or Streptococcus spp should be treated first with a cephalothin or penicillin G-novobiocin preparation.

Objective: To evaluate the efficacy of parenteral administration of procaine penicillin G, spiramycin, or enrofloxacin in the treatment of clinical mastitis in lactating cows., Design: Noncontrolled, clinical retrospective study., Animals: 487 cows with mastitis involving 543 quarters., Procedure: Clinical signs, histories, and results of bacteriologic examination, somatic cell count, and N-acetyl-beta-D-glucosaminidase activity of milk samples taken before and 3 to 4 weeks after treatment were retrieved from hospital records. Cows treated parenterally with procaine penicillin G, spiramycin, or enrofloxacin for 3 to 5 days were included. Supportive treatment alone was given to 35 cows infected with Escherichia coli. Factors possibly affecting outcome were analyzed, using ANOVA, correlation analyses, and the Mann-Whitney test. chi 2 Test was used to compare bacteriologic cure rates., Results: Bacteriologic cure rates for mastitis caused by Staphylococcus aureus, coagulase-negative staphylococci, and streptococci were 34, 76, and 65%, respectively. Cure rates in cows in their first lactation and infected with S aureus and coagulase-negative staphylococci were significantly higher than those for older cows. In cows with mastitis caused by E coli, the cure rate was 74% for those treated with penicillin G and 71% for those not treated with antimicrobials. High N-acetyl-beta-D-glucosaminidase activity in milk samples obtained at initial examination indicated a poor outcome in S aureus and streptococcal mastitis. Cows infected in the early lactation period had more severe inflammatory responses and clinical signs if infected with coagulase-negative staphylococci and coliforms., Clinical Implications: 3 to 5 days of treatment with parenterally administered penicillin G for clinical mastitis caused by penicillin-susceptible S aureus strains is efficacious in young cows. Parenteral administration of spiramycin or enrofloxacin does not give satisfactory results in mastitis caused by penicillin-resistant S aureus. Use of antimicrobials in the treatment of mastitis caused by coliform bacteria is questionable.

Bronchoalveolar lavage (BAL) was performed twice to evaluate a stranded Atlantic bottle-nosed dolphin for pulmonary disease. A pediatric gastroscope with a working length of 1,090 mm and an outer diameter of 9.8 mm was of appropriate size for BAL in this dolphin. Fifty milliliters of sterile saline (0.9% NaCl) solution was used in each of 2 sites for the first lavage. Fluid recovery was 58 and 66% from the 2 sites; however, results of cytologic analyses were typical of a bronchial wash rather than BAL. Larger volumes of saline solution (85 to 100 ml/site) were used in the second lavage. Although fluid recovery was only 25 and 30% from the 2 sites, results of cytologic analyses were consistent with BAL. Mononuclear cells accounted for 72 and 90% of total WBC. Although the dolphin of this report did not appear to have pulmonary disease, experience obtained by performing BAL provided valuable information for the practical application of this technique in dolphins.

Objective: To determine the association between intramammary infections caused by various bacteria and hepatic damage, as measured by serum sorbitol dehydrogenase (SDH) activity, WBC counts, and PCV and the association of clinical variables with milk production after a case of clinical mastitis., Design: Prospective, cohort study., Animals: 82 cows with clinical mastitis., Procedure: Information on milk production, mastitis status, and selected physiologic variables was collected during a 1-year period. Milk samples for bacteriologic evaluation were collected on day 1 of an episode of clinical mastitis. Physical examination was performed and blood samples for laboratory evaluation were collected on days 1, 5, and 9. Primary outcome was mature equivalent 305-day (ME305) milk production. Correlations were assessed using a multiple regression model., Results: Higher WBC counts were associated with higher ME305 values. For cows with coliform mastitis, increases in SDH values were associated with higher ME305 values. For cows with coliform and streptococci/staphylococci mastitis, PCV was associated with ME305 values. Higher PCV values were associated with lower ME305 values for streptococci/ staphylococci and coliform infections., Clinical Implications: The association between milk production and WBC count indicated that cows mobilizing WBC were better able to neutralize mammary gland infections, which may result in better milk production. The association between milk production and PCV suggested that maintaining hydration in cows with clinical mastitis may be a critical aspect of treating all cows with mastitis.

A 4-month-old Quarter Horse was admitted for evaluation of infection that developed following bilateral hemicircumferential periosteal transection and elevation. Sepsis of the common digital extensor tendon sheath was diagnosed. Treatment included lavage of the tendon sheath, placement of an indwelling drain for lavage after surgery, establishment of drainage, and administration of antimicrobial and anti-inflammatory drugs. Three months after treatment, the foal was clinically normal.

Objective: To determine whether treating cows with antimicrobials at the end of lactation would lower the incidence of clinical mastitis, improve milk production, and decrease somatic cell count (SCC) in the subsequent lactation., Design: Randomized blind field trial., Animals: 233 Holstein cows from a single herd. All cows were in lactation 2 or greater., Procedure: Cows were randomly assigned to treatment groups. Treated cows were given procaine penicillin G and novobiocin by intramammary infusion. Control cows were not treated. Farm personnel recorded cases of clinical mastitis. Milk yield and SCC were recorded during the subsequent lactation., Results: Treatment did not significantly reduce the incidence of clinical mastitis when data for all cows were grouped or when data were stratified by lactation groups (lactation 2 vs lactation > or = 3) or by last SCC (< or = 500,000 cells/ml vs > 500,000 cells/ml). Somatic cell counts (first, mean of first 5, maximum of first 5) for treated and control cows were similar, and proportions of treated and control cows with SCC > 500,000 cells/ml at least once were not significantly different. Treated cows produced 179 kg (394 lb) more milk during the first 17 weeks of lactation than did control cows., Clinical Implications: Treating cows with antimicrobials at the end of lactation increased 17-week milk production during the subsequent lactation and, at current milk prices, was financially preferable to not treating them.

Objective: To characterize history, clinical signs, and pathologic findings in horses with histologically confirmed acute hemorrhagic pulmonary infarction and necrotizing pneumonia., Design: Retrospective study., Animals: 21 horses., Results: 19 of the 21 horses were Thoroughbred racehorses in training. Eighteen horses had had strenuous exercise immediately prior to onset of illness. Fifteen horses had a serosanguineous nasal discharge during hospitalization. Seventeen horses had radiographic evidence of pulmonary consolidation and pleural effusion. Nine of 14 horses had ultrasonographic evidence of large pulmonary parenchymal defects consistent with consolidation. Pleurocentesis yielded a suppurative, serosanguineous effusion in the 14 horses in which it was performed. Bacteria were isolated from all transtracheal aspirates (14) and from 6 of 12 pleural fluid samples. Actinobacillus suis-like organisms and Streptococcus equi subsp zooepidemicus were most commonly isolated. Nineteen horses were hospitalized and treated. Mean duration of treatment was 5 days, and most horses were euthanatized because of secondary complications, continued costs of medical treatment, or poor prognosis for future performance. Pathologic lesions included well-demarcated regions of hemorrhagic pulmonary infarction with necrosis and a serosanguineous pleural effusion. Thrombosis of pulmonary vessels was found in 11 horses., Clinical Implications: An acute or peracute onset of severe respiratory distress, with serosanguineous nasal discharge, ultrasonographic and radiographic evidence of severe pulmonary consolidation, and serosanguineous suppurative pleural effusion, is strongly suggestive of pulmonary infarction in horses. Horses with pulmonary infarction responded poorly to conventional treatment for pleuropneumonia and had a poor prognosis for recovery.

Objective: To determine whether particular dairy management practices and herd characteristics were associated with somatic cell count (SCC) of bulk tank milk., Design: Analysis of records., Sample Population: Milk samples collected from 59,435 cows housed in 843 dairy herds between March 1992 and June 1994., Procedure: Results of bacterial culture of milk samples and data on farm housing, sanitation, milking system, and management were collected. Multiple regression analysis was used to determine sources of variation in bulk tank milk SCC among herds., Results: Prevalence of Streptococcus agalactiae and Staphylococcus aureus mastitis was associated with bulk tank milk SCC. In herds free of S agalactiae mastitis, prevalence of S aureus and Corynebacterium bovis mastitis were important. For herds without S agalactiae mastitis, use of sawdust bedding was associated with a decrease in SCC and a dirty loose housing area was associated with an increase. Increased milk production, repeated mastitis control visits, and use of particular predip compounds were significantly associated with reduced SCC in all herds, regardless of whether any cows in the herd had S agalactiae mastitis. In herds with S agalactiae mastitis, use of iodine (certain concentrations), chlorhexidine, peroxide, or sodium chlorite-lactic acid as a predip was associated with a decrease in SCC. Only use of sodium chlorite-lactic acid predip was significantly associated with a decrease in SCC in herds without S agalactiae mastitis., Clinical Implications: Important factors associated with bulk tank milk SCC were prevalence of S agalactiae and S aureus mastitis, careful application of particular predip compounds, avoiding a dirty loose housing area, and use of a service to regularly monitor prevalence of mastitis in the herd.

Objectives: To develop a reference database for characterization of bovine Staphylococcus aureus and Streptococcus agalactiae strains by automated ribotyping and to use it to assess the discriminatory power of this typing procedure and the geographic distribution of Sta aureus and Str agalactiae strains in New York state dairy herds., Sample Population: 22 commercial dairy herds., Procedure: Isolates of Sta aureus and Str agalactiae from bovine milk were identified by standard bacteriologic procedures, then typed by automated ribotyping. Antimicrobial susceptibility of isolates was tested in vitro. Two indicators made from the data were percentage of farms with multiple ribotypes and percentage of single ribotypes found in several geographic regions. Standard bacteriologic diagnosis, automated ribotyping, and determination of antibiograms (Kirby-Bauer method) also were done., Results: Of 50 Sta aureus and 44 Str agalactiae isolates from composite milk samples of 12 and 10 herds, respectively, 18 and 14 ribotypes, respectively, were identified. The discriminatory power of automated ribotyping was approximately 0.96 (Hunter-Gaston's formula). A higher percentage of herds with Sta aureus had multiple ribotypes. The most common Sta aureus ribotypes tended to have broader geographic distribution. Some Sta aureus ribotypes were significantly associated with antibiotic resistance profiles., Conclusions: Automated ribotyping appears to characterize bovine strains of bacteria associated with intramammary infections with a high discriminatory index. Potential applications include identification of strains that appear to have broad geographic distribution suggesting interfarm transfer, discrimination between recurrent versus new intramammary infections (ie, for control of Str agalactiae and Sta aureus), and evaluation of antibiotic therapy.

Objective: To evaluate the effect of natural udder infection with minor pathogens on subsequent natural infection with major pathogens., Sample Population: 7 dairy herds with low bulk milk somatic cell count., Procedure: During a 20-month prospective study, milk samples were collected from diary cows at regular intervals and from quarters with clinical signs of mastitis. Incidence of intramammary infection was calculated in uninfected quarters and in quarters infected with minor pathogens. A within-cow, matched case-control analysis was used to evaluate the effect of minor pathogens on subsequent infection with major pathogens., Results: Quarters infected with minor pathogens had higher somatic cell count than did uninfected quarters. In quarters infected with Corynebacterium bovis, the rate of infection with major pathogens was lower, whereas in quarters infected with coagulase-negative Micrococcaceae, the rate of infection with major pathogens was higher than that in uninfected quarters. From the within-cow comparison, it appeared that, in quarters infected with minor pathogens, infection with major pathogens was significantly lower than that in comparable control quarters not infected with minor pathogens., Conclusions: Minor pathogens have a protective effect against infection with major pathogens. The protective effect of C bovis against subsequent infection with major pathogens appears to be greater than the effect of coagulase-negative Micrococcaceae.

Objective: To determine the clinical, pathologic, and bacteriologic findings in dogs that developed severe invasive infections with group G streptococci (GGS) over a 6-month period in southern Ontario., Design: Prospective case series., Animals: 7 dogs n southern Ontario with severe streptococcal infection during a 6-month period., Procedure: Using pulsed-field gel electrophoresis, molecular typing of streptococcal isolates was performed. Isolates were examined for the M protein gene emm1.0, pyrogenic exotoxin genes speA, speB, speF, hyaluronic acid synthase genes hasA, hasB, and for C5a peptidase gene scpA by use of DNA probes or polymerase chain reaction., Results: 3 dogs with streptococcal shock without necrotizing fasciitis died or were euthanatized within 48 hours of admission, whereas 4 dogs with streptococcal shock and necrotizing fasciitis survived following surgical debridement, supportive medical treatment, and treatment with antibiotics. Of the 6 Lancefield group G streptococcal isolates available for characterization, 5 were Streptococcus canis and 1 had characteristics of group G streptococcal strains of human origin. Results of molecular typing indicated that isolates were unrelated to each other. Examination of the canine isolates for putative virulence genes found in human group A streptococci resulted in identification of the emm1.0 gene only in 1 of the isolates. The canine isolates otherwise lacked virulence genes associated with human group A streptococcal toxic shock infections. CLINICAL-IMPLICATIONS: The development of severe invasive infection in dogs resulting from GGS indicates that a virulent form of GGS has developed in southern Ontario.

Objective: To investigate intramammary infections in llamas, identify the pathogens responsible, and determine whether effects of intramammary infection could be detected by use of mastitis indicator tests commonly used for cows., Design: Observational study., Animals: 100 llamas on 10 farms., Procedure: Milk samples were evaluated by bacterial culturing and by determination of somatic cell count (SCC), using direct microscopic and automated counting methods, California Mastitis Test score, pH, and N-acetyl-beta-d-glucosaminidase activity. Correlation coefficients were determined among the various mastitis indicator tests, and test results were determined for milk from infected and uninfected glands., Results: Evidence of intramammary infection was evident in 76 of 369 (21%) milk samples, with 54 of 94 (57%) llamas having at least 1 infected gland. Staphylococcus sp other than Staphylococcus aureus were the predominant pathogens. None of the llamas had clinical signs of mastitis, and significant differences were not detected in SCC, California Mastitis Test score, pH, or N-acetyl-beta-d-glucosaminidase activity between infected and uninfected samples. California Mastitis Test scores were negative or trace for 307 of 313 (98%) samples, and SCC were low. In contrast, pH and N-acetyl-beta-d-glucosaminidase activity of milk from uninfected glands were higher than values reported for milk from uninfected cows, and neither variable was significantly correlated with the number of somatic cells in samples of llama milk., Clinical Implications: Although intramammary infections develop in llamas, inflammation (mastitis) appears to be rare. Values for mastitis indicator tests used for cows cannot be directly extrapolated to llamas. Subclinical mastitis is apparently not an important problem in llamas in the United States.