Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, Minnesota.
J Vet Intern Med. 2020 Mar;34(2):783-789. doi: 10.1111/jvim.15719. Epub 2020 Jan 31.
Quantitative bacterial culture and susceptibility testing is the gold standard diagnostic for determining bacterial urinary tract infection. Transport of samples to external reference laboratories is common practice in veterinary medicine.
To compare bacterial culture and susceptibility results from clinical urine samples when streak plate inoculation is performed immediately after sample collection versus after transport to a reference laboratory. To determine the clinical implications of discrepant culture results.
One hundred and ninety-four canine and 45 feline urine samples that were submitted for urinalysis and urine culture and susceptibility testing.
This was a prospective, cross-sectional study. Streak plate inoculations were performed on urine samples immediately after collection and also after transport to a reference laboratory. Samples were stored in plain sterile tubes and refrigerated up to 24 hours before transport. Culture results were compared, and discordant results were evaluated for clinical relevance. Signalment, comorbidities, lower urinary tract signs, and antimicrobial history were recorded.
Kappa coefficient for agreement between plating methods was 0.884. Twenty-two (71%) of 31 discrepant results were determined to have no clinical impact. Though 35% of clean midstream samples had discrepant culture results, only 8% of these had clinical impact. Conversely, 8.6% from cystocentesis were discrepant, but 41% of these had clinical impact.
Provided urine samples are stored and transported appropriately, the immediate preplating of urine for culture and susceptibility testing is unnecessary in the majority of cases. Despite more discrepancies in plating methods for midstream samples, the minority were of clinical importance.
定量细菌培养和药敏试验是确定细菌性尿路感染的金标准诊断方法。将样本运送到外部参考实验室是兽医实践中的常见做法。
比较临床尿液样本在采集后立即进行划线接种与运送到参考实验室后进行细菌培养和药敏试验的结果。确定培养结果不一致的临床意义。
194 份犬尿液样本和 45 份猫尿液样本,用于尿液分析和尿液培养及药敏试验。
这是一项前瞻性、横断面研究。在采集后立即和运送到参考实验室后对尿液样本进行划线接种。将样本储存在普通无菌管中,冷藏至运输前最多 24 小时。比较培养结果,并评估不一致结果的临床相关性。记录了品种、合并症、下尿路感染体征和抗菌药物使用史。
两种接种方法之间的一致性kappa 系数为 0.884。31 个不一致结果中有 22 个(71%)被认为没有临床影响。虽然 35%的清洁中段尿液样本有不一致的培养结果,但只有 8%的样本有临床影响。相反,8.6%的膀胱穿刺尿液样本有不一致的培养结果,但其中 41%的样本有临床影响。
只要尿液样本得到适当的储存和运输,在大多数情况下,对尿液进行立即预接种以进行培养和药敏试验是不必要的。尽管中段尿液样本的划线接种方法存在更多的差异,但其中只有少数具有临床意义。