Epstein Steven E, Mellema Matthew S, Hopper Kate
William R. Pritchard, Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California– Davis, Davis, CA 95616, USA.
J Vet Emerg Crit Care (San Antonio). 2010 Dec;20(6):587-94. doi: 10.1111/j.1476-4431.2010.00587.x. Epub 2010 Oct 7.
To compare airway microbiological culture and susceptibility results in 2 groups of dogs and cats: 1 with respiratory failure requiring positive pressure ventilation (PPV) and 1 with respiratory disease.
Retrospective study.
University teaching hospital.
Fifty-two dogs and cats requiring PPV that had an airway microbiologic culture submitted from October 1, 2003 to October 31, 2008 were included. One hundred and four airway microbiologic cultures from dogs and cats with respiratory disease not requiring PPV were randomly sampled for comparison.
None.
Patients with respiratory failure were more likely to have a gram-negative enteric isolate identified (P<0.001), while patients with respiratory disease were more likely to have a gram-negative nonenteric isolate (P<0.001) or anaerobic isolate (P<0.001) identified. Aerobic bacterial isolates from patients with respiratory failure were less likely to be susceptible to ampicillin (P=0.006), amoxicillin/clavulonate (P<0.001), chloramphenicol (P=0.004), enrofloxacin (P<0.001), ticarcillin/clavulonate (P=0.004), and the combination of ampicillin with enrofloxacin (P<0.001) than were aerobic bacterial isolates from patients with respiratory disease.
Canine and feline patients with respiratory failure severe enough to require PPV exhibit a different pattern of bacterial isolates cultured from their airways when compared with isolates from patients with respiratory disease that has not resulted in ventilator dependence. These isolates are more likely to be resistant to commonly used antimicrobials/antimicrobial combinations than patients in the respiratory disease group. These findings suggest that in canine and feline patients with infectious lower respiratory tract disease, consideration of the severity of the pulmonary insult may allow for better prediction of likely isolates and their antimicrobial susceptibilities. Further prospective studies with a standardized collection technique are warranted.
比较两组犬猫的气道微生物培养及药敏结果,一组为需要正压通气(PPV)的呼吸衰竭患者,另一组为患有呼吸系统疾病的患者。
回顾性研究。
大学教学医院。
纳入了2003年10月1日至2008年10月31日期间提交气道微生物培养报告的52例需要PPV的犬猫。随机抽取104例患有无需PPV的呼吸系统疾病的犬猫的气道微生物培养样本进行比较。
无。
呼吸衰竭患者更有可能分离出革兰氏阴性肠道菌(P<0.001),而患有呼吸系统疾病的患者更有可能分离出革兰氏阴性非肠道菌(P<0.001)或厌氧菌(P<0.001)。与患有呼吸系统疾病的患者的需氧菌分离株相比,呼吸衰竭患者的需氧菌分离株对氨苄西林(P=0.006)、阿莫西林/克拉维酸(P<0.001)、氯霉素(P=0.004)、恩诺沙星(P<0.001)、替卡西林/克拉维酸(P=0.004)以及氨苄西林与恩诺沙星联合用药(P<0.001)的敏感性较低。
与未导致呼吸机依赖的呼吸系统疾病患者相比,严重到需要PPV的犬猫呼吸衰竭患者气道培养出的细菌分离株模式不同。这些分离株比呼吸系统疾病组的患者更有可能对常用抗菌药物/抗菌药物组合耐药。这些发现表明,在患有感染性下呼吸道疾病的犬猫患者中,考虑肺部损伤的严重程度可能有助于更好地预测可能的分离株及其药敏情况。有必要采用标准化采集技术进行进一步的前瞻性研究。