Rhodococcus equi
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Rhodococcus equi is a Gram-positive coccoid bacteria. The organism commonly lives in dry and dusty soil and can be important for diseases of domesticated animals (horses and goats). The frequency of infection reaches near 60 percent. R. equi is the most important pathogen of pneumonia of foals. In addition there is a the possibility, that the pathogen can transfer to humans. The most endangered groups are immunsupprimised people and AIDS-patients.
In taxonomies, R. equi can have the synonymes Corynebacterium equi, Bacillus hoagii, Corynebacterium purulentus, Mycobacterium equi, Mycobacterium restrictum, Nocardia restricta and Proactinomyces restrictus.
Treatment
Antimicrobial Regimen
- Rhodococcus equi [1]
- Note: Avoid Penicillins/Cephalosporins due to development of resistance; Linezolid effective in vitro, but no clinical reports of use
- 1. First line:
- Preferred regimen: Vancomycin 1 g IV q12h (15 mg/kg q12 for >70 kg) OR Imipenem 500 mg IV q6h AND Rifampin 600 mg PO qd OR Ciprofloxacin 750 mg PO bid OR Erythromycin 500 mg PO qid for at least 4 weeks or until infiltrate disappears
- Note: Should be administrated at least 8 weeks in immunocompromised patients
- 2. Oral/maintenance therapy (after infiltrate clears):
- Preferred regimen (1): Ciprofloxacin 750 mg PO bid
- Preferred regimen (2): Erythromycin 500 mg PO qid
Literature
- Monika Venner und Erich Klug: Die Rhodococcus-equi-Pneumonie beim Fohlen: Diagnose, Therapie, Prophylaxe In: Pferde spiegel Nummer 4, 2005. Seiten 155-158 PDF
- J. Ashour und M. K. Hondalus: Phenotypic mutants of the intracellular actinomycete Rhodococcus equi created by in vivo Himar1 transposon mutagenesis. In: Journal of Bacteriology. Volume 185, Nummer 8, April 2003. Seiten 2644-2652. doi:10.1128/JB.185.8.2644-2652.2003
- A. Triskatis: Semiquantitative Bestimmung von Antikörpern gegen Rhodococcus equi in Serum und Klolostrum bei Stuten und Fohlen mittels ELISA und der Vergleich mit Befunden der Lungenuntersuchung PDF
References
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.