Department of Veterinary Biosciences, Ohio State University College of Veterinary Medicine, Columbus, OH, USA.
Vet Clin Pathol. 2022 Jun;51(2):252-257. doi: 10.1111/vcp.13092. Epub 2022 Feb 27.
Bacterial sepsis is a relatively common, life-threatening condition with a high case fatality rate. The current primary diagnostic tools for detecting bacterial infection in fluids are bacterial culture and fluid cytology. While culture is the gold standard, it can take up to several days for results to be made available to clinicians, which can delay recognition of bacterial sepsis and negatively impact patient outcomes.
The aim of this study was to evaluate the diagnostic accuracy of cytology for detecting bacterial infection in body fluids.
We retrospectively reviewed 10 years of medical records at the Ohio State University's Veterinary Medical Center for mammalian patients with both cytology and bacterial culture of fluid samples, including body cavity fluids (abdominal and thoracic effusion), blood, joint fluid, and CSF. The overall sensitivity and specificity of cytology relative to the reference method of bacterial culture was recorded, as well as among the subcategories of fluid type.
The overall sensitivity and specificity of cytology for the diagnosis of sepsis were 42.6% and 93.0%, respectively. Individual sensitivities and specificities were also calculated for each fluid type. Thoracic fluid cytology had relatively high sensitivity and low specificity, in contrast to the other fluid types analyzed.
Overall, cytology is poorly sensitive but highly specific for the detection of bacterial infection in fluid samples. The results from this study will allow a better comparison between the diagnostic accuracy of cytology and emerging diagnostic tests for the detection of bacterial sepsis in mammalian patients.
细菌性败血症是一种相对常见且危及生命的疾病，病死率较高。目前用于检测体液中细菌感染的主要诊断工具是细菌培养和体液细胞学检查。虽然培养是金标准，但结果可能需要几天时间才能提供给临床医生，这可能会延迟对细菌性败血症的识别，并对患者的预后产生负面影响。
本研究旨在评估细胞学检测体液中细菌感染的诊断准确性。
我们回顾性分析了俄亥俄州立大学兽医学院 10 年来的医学记录，这些记录包括细胞学和体液样本细菌培养的哺乳动物患者，包括体腔液（腹腔和胸腔积液）、血液、关节液和 CSF。记录了细胞学相对于细菌培养的参考方法的总体敏感性和特异性，以及各体液类型的亚类中的敏感性和特异性。
细胞学诊断败血症的总体敏感性和特异性分别为 42.6%和 93.0%。还计算了每种体液类型的个体敏感性和特异性。与分析的其他体液类型相比，胸腔液细胞学检查具有相对较高的敏感性和较低的特异性。
总体而言，细胞学对检测体液中的细菌感染的敏感性较差，但特异性较高。本研究的结果将使人们能够更好地比较细胞学诊断准确性与用于检测哺乳动物患者细菌性败血症的新兴诊断测试之间的差异。
