Biofilms Make Bacterial Endometritis Treatment Tricky

Bacterial endometritis, an infection of the uterine mucosa, can wreak havoc on mares involved in a breeding program. The infection creates a hostile environment for the survival of both sperm and embryos. Traditional treatment with antimicrobials may not be enough to clear the infection if it creates a biofilm, which can be up to 1,000 times more resistant to antibiotic treatment than free-living bacteria. A biofilm is a structure made of bacteria aggregates that are surrounded by a protective layer of exopolysaccharide, which is a polymer made up of sugar residues. This biofilm works to shield the bacteria from treatment.

The biofilm helps the bacteria “hide,” by reducing the horse’s body’s ability to recognize infection. The biofilm also makes the bacteria more tolerant of antimicrobials. It forms in multiple locations, including in the uterine horns and in between the tissue folds, which makes detection by culture swab difficult. Dr. Ryan Derris of Summit Equine Inc. recommends a low-volume lavage for bacterial endometritis testing.

To treat these infections, the biofilm material has to be disrupted and the bacteria in it killed. A study has shown that administering antibiotics and non-antibiotics together is the most effective way to kill a biofilm, with treatment being administered once every 24 hours for at least 72 hours.

Read more at Equine Disease Quarterly.

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