School of Veterinary Medicine, Murdoch University, Murdoch, Western Australia, Australia.
J Vet Emerg Crit Care (San Antonio). 2022 Jan;32(1):141-145. doi: 10.1111/vec.13144. Epub 2021 Oct 4.
There is no consensus on obtaining blood cultures routinely in companion animals with suspected sepsis, and there is a paucity of evidence concerning their utility. The objectives of this retrospective study were to determine the yield of positive blood cultures from hospitalized dogs, the prevalence of resistant bacteria, and the frequency and nature of changes to antimicrobial therapy once the culture result became available.
Forty-five dogs had a blood culture submitted over a 10-year period, of which 9(20%) yielded positive growth and 36 (80%) yielded no bacterial growth. The most frequent reasons for submission of blood culture were pyrexia of unknown origin (n = 14), suspected soft tissue infection (7), and suspected discospondylitis (7). The most frequent final diagnoses were soft tissue infection (n = 11), discospondylitis (7), and unknown (6). No significant difference was found between the culture-positive versus culture-negative groups with regard to the most frequent reasons for blood culture (P = 0.55), final diagnoses (P = 0.80), survival until the blood culture result (P = 0.37), or whether the infection was hospital- or community-acquired (P = 0.99). There were significantly more immunosuppressed dogs in the culture-positive group (P = 0.02). Resistance to one or more antimicrobials was documented in all dogs with susceptibility reported. In the culture-positive dogs, 63% had antimicrobial de-escalation and none had escalation, whereas 19% of the culture-negative dogs had de-escalation and 7% had escalation.
Blood cultures were submitted infrequently, but the proportion of resistance was higher than expected and supports the use of blood cultures in cases of suspected infection resulting in bacteremia.
目前对于疑似脓毒症的伴发动物,尚未就常规采血培养达成共识,有关其应用价值的证据也很少。本回顾性研究的目的是确定住院犬血液培养的阳性率、耐药菌的流行率以及在获得培养结果后抗菌治疗的改变频率和性质。
在 10 年期间,有 45 只犬送检了血培养,其中 9 只(20%)血培养阳性,36 只(80%)血培养无细菌生长。送检血培养的最常见原因是不明原因发热(n=14)、疑似软组织感染(7)和疑似椎间盘炎(7)。最常见的最终诊断为软组织感染(n=11)、椎间盘炎(7)和原因不明(6)。在血培养阳性组与血培养阴性组之间,最常见的血培养原因(P=0.55)、最终诊断(P=0.80)、直至血培养结果的存活时间(P=0.37)或感染是院内还是社区获得(P=0.99)无显著差异。在血培养阳性组中,免疫抑制的犬明显更多(P=0.02)。所有有药敏报告的犬均有 1 种或多种抗生素耐药。在血培养阳性的犬中,63%进行了抗菌药物降阶梯治疗,无一例升阶梯治疗,而在血培养阴性的犬中,19%进行了降阶梯治疗,7%进行了升阶梯治疗。
血培养送检不频繁,但耐药率高于预期,支持在疑似感染导致菌血症的情况下进行血培养。