Use of standard diagnostic techniques to determine eradication of infection in experimental equine septic arthritis.

Abstract

Septic arthritis is an important disease in horses, necessitating aggressive and prolonged therapy. In order to guide therapy, reliable methods of detecting the eradication of infection are needed. Therefore, the objective of this study was to investigate detection of eradication of infection in an experimental model of equine septic arthritis using standard diagnostic techniques. For this purpose, 17 adult horses were assigned to 3 experimental groups. The middle carpal joint of each horse was injected with <i>Escherichia coli</i> (Septic group, <i>n</i> = 8), lipopolysaccharide (LPS) (LPS group, <i>n</i> = 6), or sterile saline (Control group, <i>n</i> = 3) at day 0. Contralateral joints were not injected. Standard therapy was applied to all joints except non-injected joints in the Control group at day 1. Sequential samples of synovial fluid (SF) were collected for bacterial culture using 3 culture media [Columbia blood agar (CBA), brain heart infusion broth (BHI), and Signal blood culture medium] and for cytological evaluation [percentage neutrophils (PN), total nucleated cell count (TNCC), and total protein (TP)]. <i>Escherichia coli</i>-specific polymerase chain reaction (PCR) was carried out to detect <i>E. coli</i> DNA in synovial fluid. Culture and PCR were positive for <i>E. coli</i> in all joints injected with <i>E. coli</i> at day 1 and 1 joint was positive on BHI at day 4. Based on the results of bacterial culture, PCR, and TNCC, the elimination of infection in our experimental model occurred by day 4 post-infection in 6 out of 7 cases. Total protein (TP) and PN remained elevated at clinical threshold used for diagnosis of septic arthritis until day 14. In our experimental model of <i>E. coli</i>-induced arthritis, we conclude that TP and PN may not be good indicators for detecting the eradication of bacterial infection caused by <i>E. coli</i> from infected and subsequently treated joints.