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用于检测肝胆疾病犬猫胆汁菌血症的胆汁样本显微镜检查与细菌培养结果的一致性

Agreement between microscopic examination and bacterial culture of bile samples for detection of bactibilia in dogs and cats with hepatobiliary disease.

作者信息

Pashmakova Medora B, Piccione Julie, Bishop Micah A, Nelson Whitney R, Lawhon Sara D

出版信息

J Am Vet Med Assoc. 2017 May 1;250(9):1007-1013. doi: 10.2460/javma.250.9.1007.

Abstract

OBJECTIVE To evaluate the agreement between results of microscopic examination and bacterial culture of bile samples from dogs and cats with hepatobiliary disease for detection of bactibilia. DESIGN Cross-sectional study. ANIMALS 31 dogs and 21 cats with hepatobiliary disease for which subsequent microscopic examination and bacterial culture of bile samples was performed from 2004 through 2014. PROCEDURES Electronic medical records of included dogs and cats were reviewed to extract data regarding diagnosis, antimicrobials administered, and results of microscopic examination and bacterial culture of bile samples. Agreement between these 2 diagnostic tests was assessed by calculation of the Cohen κ value. RESULTS 17 (33%) dogs and cats had bactibilia identified by microscopic examination of bile samples, and 11 (21%) had bactibilia identified via bacterial culture. Agreement between these 2 tests was substantial (percentage agreement [positive and negative results], 85%; κ = 0.62; 95% confidence interval, 0.38 to 0.89) and improved to almost perfect when calculated for only animals that received no antimicrobials within 24 hours prior to sample collection (percentage agreement, 94%; κ = 0.84; 95% confidence interval, 0.61 to 1.00). CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that agreement between microscopic examination and bacterial culture of bile samples for detection of bactibilia is optimized when dogs and cats are not receiving antimicrobials at the time of sample collection. Concurrent bacterial culture and microscopic examination of bile samples are recommended for all cats and dogs evaluated for hepatobiliary disease.

摘要

目的 评估患有肝胆疾病的犬猫胆汁样本显微镜检查结果与细菌培养结果在检测菌血症方面的一致性。 设计 横断面研究。 动物 2004 年至 2014 年期间对 31 只患有肝胆疾病的犬和 21 只患有肝胆疾病的猫进行了胆汁样本的后续显微镜检查和细菌培养。 程序 回顾纳入的犬猫的电子病历,以提取有关诊断、使用的抗菌药物以及胆汁样本显微镜检查和细菌培养结果的数据。 通过计算 Cohen κ 值评估这两种诊断测试之间的一致性。 结果 17 只(33%)犬猫通过胆汁样本显微镜检查发现菌血症,11 只(21%)通过细菌培养发现菌血症。 这两种测试之间的一致性较高(一致性百分比[阳性和阴性结果],85%;κ = 0.62;95% 置信区间,0.38 至 0.89),当仅针对在样本采集前 24 小时内未接受抗菌药物治疗的动物进行计算时,一致性提高到几乎完美(一致性百分比,94%;κ = 0.84;95% 置信区间,0.61 至 1.00)。 结论及临床意义 结果表明,当犬猫在样本采集时未接受抗菌药物治疗时,胆汁样本显微镜检查和细菌培养在检测菌血症方面的一致性最佳。 对于所有接受肝胆疾病评估的猫和犬,建议同时进行胆汁样本的细菌培养和显微镜检查。

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