Hugonnard Marine, Chalvet-Monfray Karine, Dernis Jérémy, Pouzot-Nevoret Céline, Barthélémy Anthony, Vialard Jacquemine, Goy-Thollot Isabelle
1Clinic for Small Animal Internal Medicine, VetAgro Sup, Veterinary Campus of Lyon, University of Lyon, France.
J Feline Med Surg. 2013 Oct;15(10):843-8. doi: 10.1177/1098612X13477414. Epub 2013 Feb 11.
The incidence of catheter-associated urinary tract infections in cats catheterised for an obstructive lower urinary tract disease (LUTD) has not previously been evaluated. The objective of this study was to evaluate the frequency of significant bacteriuria in cats with obstructive LUTD managed for 48 h with a closed urine collection system. Eighteen male cats admitted for a non-infectious obstructive LUTD were evaluated. This was a prospective study. A standard protocol was used for aseptic catheter placement and maintenance. Three urine samples were collected from each animal through the catheter immediately after placement, 24 h after placement and just before removal. All samples underwent complete urinalysis, including bacterial culture. Catheter tips were tested by bacterial culture. Six cats (33.3%) developed significant bacteriuria during catheterisation. The causative bacteria were common feline uropathogens (Escherichia coli, Staphylococcus species) in five cases, and Streptococcus bovis in one. One cat developed a fungal infection. The presence of bacteria in urinary sediment was correlated strongly with positive urine culture results. The catheter tips from 10/18 cats (55.5%) were positive for culture. The positive predictive value of a positive culture from the urinary catheter tip was 87.5%. The specificity was 53.8%. The same infectious agents were cultured from both urine and catheter tip in six cases. In summary, one-third of cats developed significant bacteriuria during catheterisation. Silent bacteriuria could not be clearly differentiated from true urinary tract infection. The presence of bacteria in the urinary sediment was strongly indicative of bacteriuria. The specificity of urinary catheter tip culture was low.
此前尚未评估因下尿路梗阻性疾病(LUTD)而留置导尿管的猫发生导管相关性尿路感染的发生率。本研究的目的是评估采用密闭尿液收集系统处理48小时的梗阻性LUTD猫的显著菌尿发生率。对18只因非感染性梗阻性LUTD入院的雄性猫进行了评估。这是一项前瞻性研究。采用标准方案进行无菌导尿管置入和维护。在导尿管置入后立即、置入后24小时以及即将拔除前,通过导尿管从每只动物采集三份尿液样本。所有样本均进行了包括细菌培养在内的完整尿液分析。对导尿管尖端进行细菌培养检测。6只猫(33.3%)在导尿期间发生了显著菌尿。其中5例的致病菌为常见的猫尿道病原体(大肠杆菌、葡萄球菌属),1例为牛链球菌。1只猫发生了真菌感染。尿沉渣中细菌的存在与尿培养阳性结果密切相关。18只猫中有10只(55.5%)的导尿管尖端培养呈阳性。导尿管尖端培养阳性的阳性预测值为87.5%。特异性为53.8%。6例尿液和导尿管尖端培养出相同的感染病原体。总之,三分之一的猫在导尿期间发生了显著菌尿。无症状菌尿与真正的尿路感染无法明确区分。尿沉渣中细菌的存在强烈提示菌尿。导尿管尖端培养的特异性较低。