Sørensen T M, Holmslykke M, Nordlund M, Siersma V, Jessen L R
Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlaegevej 16, 1870 Frederiksberg C, Denmark.
The Research Unit for General Practice and Section of General Practice, Dept. of Public Health, University of Copenhagen, Oester Farimagsgade 5, 1014 Koebenhavn K, Denmark.
Vet J. 2019 May;247:65-70. doi: 10.1016/j.tvjl.2019.03.003. Epub 2019 Mar 16.
Clinical signs of lower urinary tract disease in dogs are characteristic but non-specific for infection. It has been hypothesized that age, sex and neuter status influences the prevalence of urinary tract infection (UTI), but the predictive value of the combined clinical presentation has not been explored in dogs. The aim of the study was to assess clinical predictors (sex/neuter status, age, dysuria/stranguria, pollakiuria, macroscopic hematuria, malodorous urine and history of recurrent UTI) for bacterial cystitis, and to develop a clinical decision rule. Data was retrieved from medical records (retrospective cases) or from standardized recording sheets (prospective cases). Bacterial cystitis was defined as significant bacteriuria on quantitative bacterial culture in dogs with compatible clinical signs of urinary tract disease. Dogs of any breed, sex and age were included. A total of 1727 microbiology records were screened and 424 samples were included in the analysis. Bacterial cystitis was confirmed in 46% of the cases. Four variables predicted bacterial cystitis: sex/neuter status, age, pollakiuria and hematuria. A score was designated to each variable and a clinical rule was constructed. This rule attained an AUC of 0.75 and had sensitivity of 83% and specificity of 55% at its optimal cut-off (score ≥2.0). A score cut-off of ≥3.0 had a positive predictive value of 70%. Several factors predicted bacterial cystitis, but the clinical rule had only modest predictive value. Other variables or point-of-care test results should be included in future research to optimize overall precision.
犬下泌尿道疾病的临床体征具有特征性，但并非感染所特有。据推测，年龄、性别和绝育状态会影响尿路感染（UTI）的患病率，但在犬中尚未探讨综合临床表现的预测价值。本研究的目的是评估细菌性膀胱炎的临床预测指标（性别/绝育状态、年龄、排尿困难/尿痛、尿频、肉眼血尿、尿液恶臭和复发性UTI病史），并制定临床决策规则。数据从病历（回顾性病例）或标准化记录表（前瞻性病例）中获取。细菌性膀胱炎定义为有泌尿系统疾病相关临床体征的犬在定量细菌培养中出现显著菌尿。纳入任何品种、性别和年龄的犬。共筛选了1727份微生物学记录，424份样本纳入分析。46%的病例确诊为细菌性膀胱炎。四个变量可预测细菌性膀胱炎：性别/绝育状态、年龄、尿频和血尿。为每个变量指定一个分数，并构建了一个临床规则。该规则的曲线下面积（AUC）为0.75，在最佳临界值（分数≥2.0）时，敏感性为83%，特异性为55%。分数临界值≥3.0时，阳性预测值为70%。有几个因素可预测细菌性膀胱炎，但该临床规则的预测价值仅为中等。未来研究应纳入其他变量或即时检验结果，以优化总体准确性。
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