Biosecurity for Neonatal Units

Written biosecurity measures should be in place for neonatal care units. See references for sources of current information on veterinary hospital biosecurity. The immune system of the compromised neonatal foal is less functional than adult horses. Therefore an effort should be made to keep the ill foal in the cleanest environment possible. Adequate temperature control, clean dry bedding with washable surfaces is desired. Nosocomial infections in neonatal ICUs have included fungal, Salmonella sp., Clostridium difficile, Cryptosporidia sp., and viral agents.

I. Handwashing is the simplest and most effective means of prevention. It is absolutely necessary prior to handling the foal.
II. Gloves worn by anyone handling the foal is also a cost effective ways of infection prevention.
III. Plastic booties or rubber boots with footbath prior to entering neonatal ICU is recommended.
IV. Foot baths before entering NICU and at individual stalls inside NICU (bleach 4 oz/gallon or Tek-trol® 1/2 oz/gal) have been suggested.
V. Surgery wraps or gowns are recommended in some cases before entering a stall at Neonatal ICU.
VI. Clean, disinfected blankets, pillows and pillowcases are desirable at neonatal ICU. On site laundry is essential due to frequent turnover of reusable materials.
VII. Disinfection

1. Neonatal ICU should be designed to allow the removal of all equipment and complete disinfection of floors, walls, doors, counter tops, and foal table following the completion of a case before a unit is available for another foal.
2. Some clinics uses Tek-trol®, a phenolic disinfectant which is effective against all type of infective agents including highly resistant Clostridium spores.
3. Prevention of nosocomial infection is paramount to the success of a NICU.
4. General procedure for disinfecting the stall.

1. Remove all bedding from the stall and sweep clean.
2. Soak the walls with an anionic detergent solution that will loosen the cracked, dried organic matter.
3. Wash the surfaces with a scrub brush or with pressure washer.
4. Repeat steps 1, 2, 3 as long as needed to clean thoroughly.
5. Spray the disinfectant and be sure to allow to air dry.
6. Repeat disinfectant application and allow to completely dry.
7. Bed the stall
8. Repeat after each patient.
9. Dirt floor stalls and stalls built from wooden material do not disinfect very well.
10. Consult suggested biosecurity protocols available on the web for adaptation to your circumstances [1,2].