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慢性肾病犬的菌尿症发生率:一项对201例病例的回顾性研究

Frequency of bacteriuria in dogs with chronic kidney disease: A retrospective study of 201 cases.

作者信息

Lamoureux Anaïs, Da Riz Fiona, Cappelle Julien, Boulouis Henri-Jean, Benchekroun Ghita, Cadoré Jean-Luc, Krafft Emilie, Maurey Christelle

机构信息

Département des Animaux de Compagnie de Loisir et de Sport, Université de Lyon, VetAgro Sup, Campus Vétérinaire de Lyon, Marcy L'Etoile, France.

Unité de Médecine Interne, Ecole Nationale Vétérinaire d'Alfort, Maisons Alfort, France.

出版信息

J Vet Intern Med. 2019 Mar;33(2):640-647. doi: 10.1111/jvim.15434. Epub 2019 Feb 14.

Abstract

BACKGROUND

Studies have shown an increased prevalence of positive urine culture (PUC) in cats with chronic kidney disease (CKD); no information is available in dogs.

OBJECTIVES

To document the PUC frequency in a cohort of dogs with CKD, determine risk factors for PUC, and identify associations between clinicopathologic data and PUC.

ANIMALS

Two hundred one client-owned dogs with CKD.

METHODS

Retrospective, observational study. Dogs recruited from 2 veterinary teaching hospitals were included if they were diagnosed with CKD and had a culture performed on urine collected by cystocentesis. The PUC frequency was calculated, multivariate analysis was performed to identify risk factors, and associations with clinicopathologic data were investigated.

RESULTS

Sixty-five dogs (32%) with CKD had PUC, including 8 (28%) in International Renal Interest Society (IRIS) stage 1; only 8% showed signs of a urinary tract infection. Escherichia coli was the most common isolate (67%). A PUC was more likely in females (odds ratio [OR], 3.22; 95% confidence interval [CI], 1.67-6.37; P < .001) than males and in dogs with isosthenuria (OR, 2.48; 95% CI, 1.24-5.03; P = .01) than in dogs with urine-specific gravity 1.013-1.024. A positive leukocyte esterase test and microorganisms found by urine sediment analysis were significantly associated with PUC (both P < .001).

CONCLUSIONS AND CLINICAL IMPORTANCE

Dogs with CKD, even IRIS stage 1, have a high frequency of PUC and most cases are asymptomatic. A urine culture could be considered in the routine evaluation of dogs with CKD, but the clinical relevance of a PUC remains unknown and needs further evaluation.

摘要

背景

研究表明,患有慢性肾病(CKD)的猫尿培养阳性(PUC)的患病率有所增加;关于犬类的此类信息尚无报道。

目的

记录一组患有CKD的犬类的PUC频率,确定PUC的风险因素,并确定临床病理数据与PUC之间的关联。

动物

201只客户拥有的患有CKD的犬。

方法

回顾性观察研究。从2家兽医教学医院招募的犬类,如果被诊断患有CKD且对通过膀胱穿刺采集的尿液进行了培养,则纳入研究。计算PUC频率,进行多变量分析以确定风险因素,并研究与临床病理数据的关联。

结果

65只(32%)患有CKD的犬出现PUC,其中国际肾脏兴趣协会(IRIS)1期的有8只(28%);只有8%表现出尿路感染的迹象。大肠杆菌是最常见的分离菌(67%)。雌性犬发生PUC的可能性高于雄性(优势比[OR],3.22;95%置信区间[CI],1.67 - 6.37;P < 0.001),等渗尿的犬发生PUC的可能性高于尿比重为1.013 - 1.024的犬(OR,2.48;95% CI,1.24 - 5.03;P = 0.01)。白细胞酯酶试验阳性和尿沉渣分析发现微生物与PUC显著相关(均P < 0.001)。

结论及临床意义

患有CKD的犬,即使是IRIS 1期,PUC发生率也很高,且大多数病例无症状。在对患有CKD的犬进行常规评估时可考虑进行尿培养,但PUC的临床相关性尚不清楚,需要进一步评估。

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