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犬接受抗肿瘤化疗时的细菌性尿路感染和亚临床菌尿症。

Bacterial urinary tract infection and subclinical bacteriuria in dogs receiving antineoplastic chemotherapy.

机构信息

Clinic of Small Animal Internal Medicine, Centre for Clinical Veterinary Medicine, Ludwig-Maximilian-University, Munich, Germany.

Department of Veterinary Sciences, Institute of Infectious Diseases and Zoonoses, Faculty of Veterinary Medicine, Ludwig-Maximilian-University, Munich, Germany.

出版信息

J Vet Intern Med. 2022 May;36(3):1005-1015. doi: 10.1111/jvim.16410. Epub 2022 May 7.

Abstract

BACKGROUND

Immunosuppressive treatment with glucocorticoids and cyclosporine increases the risk for positive urine cultures (PUCs) in dogs.

OBJECTIVE

To investigate the prevalence and incidence of PUC in dogs diagnosed with cancer and treated with antineoplastic chemotherapy while distinguishing between subclinical bacteriuria (SB) and urinary tract infection (UTI).

ANIMALS

Forty-six client-owned dogs with nonurogenital cancer treated with antineoplastic chemotherapy.

METHODS

Prospective observational longitudinal clinical study. Dogs in which a urine culture was performed before the start of and at least once during antineoplastic chemotherapy were included. A McNemar's test was used to investigate if the prevalence of PUC increased during antineoplastic chemotherapy. Positive urine cultures were categorized into SB and UTI and multiple PUCs from the same dog and category were grouped together as 1 episode of PUC.

RESULTS

Urine culture was positive in 21/185 urine samples in 8/46 dogs. Antineoplastic chemotherapy did not influence the prevalence of PUC (P = 1.00), which was 11% (5/46 dogs; 95% confidence interval: 5-23%) before the start of and 13% (6/46 dogs; 95% confidence interval: 6-26%) during antineoplastic chemotherapy. Eight dogs had 10 episodes of PUC; 7/10 episodes were classified as SB, and in 3/10 episodes UTI (chronic prostatitis, prostatic abscess, and emphysematous cystitis) was diagnosed. Escherichia coli was the most common pathogen, isolated in 9/10 episodes.

CONCLUSIONS AND CLINICAL IMPORTANCE

We did not find evidence that antineoplastic chemotherapy is a major predisposing factor for the development of PUC. Most dogs with PUC had SB.

摘要

背景

免疫抑制治疗中使用糖皮质激素和环孢素会增加犬类出现阳性尿液培养(PUC)的风险。

目的

在区分亚临床菌尿(SB)和尿路感染(UTI)的同时,调查诊断为癌症并接受抗肿瘤化疗的犬类 PUC 的患病率和发病率。

动物

46 只患有非泌尿生殖系统癌症并接受抗肿瘤化疗的患犬。

方法

前瞻性观察性纵向临床研究。将在开始抗肿瘤化疗之前和至少一次在抗肿瘤化疗期间进行尿液培养的犬纳入研究。采用 McNemar 检验来研究 PUC 的患病率是否在抗肿瘤化疗期间增加。阳性尿液培养物被归类为 SB 和 UTI,同一只犬的多次 PUC 则归为 1 次 PUC。

结果

在 8/46 只犬的 185 份尿液样本中,有 21 份尿液培养阳性。抗肿瘤化疗并未影响 PUC 的患病率(P=1.00),在开始抗肿瘤化疗前为 11%(5/46 只犬;95%置信区间:5-23%),在抗肿瘤化疗期间为 13%(6/46 只犬;95%置信区间:6-26%)。8 只犬出现了 10 次 PUC,其中 7/10 次被归类为 SB,3/10 次诊断为 UTI(慢性前列腺炎、前列腺脓肿和气肿性膀胱炎)。最常见的病原体是大肠杆菌,在 9/10 次感染中分离到该菌。

结论和临床意义

我们没有发现证据表明抗肿瘤化疗是 PUC 发展的主要诱发因素。大多数出现 PUC 的犬都患有 SB。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b9b/9151473/5408178a3667/JVIM-36-1005-g001.jpg

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