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因腹痛前往兽医教学医院就诊的马属动物中沙门氏菌排菌情况及相关危险因素(2013 - 2018年)

Prevalence of and risk factors associated with Salmonella shedding among equids presented to a veterinary teaching hospital for colic (2013-2018).

作者信息

Kilcoyne Isabelle, Magdesian K Gary, Guerra Margherita, Dechant Julie E, Spier Sharon J, Kass Philip H

机构信息

Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California, USA.

Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, California, USA.

出版信息

Equine Vet J. 2023 May;55(3):446-455. doi: 10.1111/evj.13864. Epub 2022 Aug 9.

Abstract

BACKGROUND

Gastrointestinal disease has been associated with shedding of Salmonella with previous studies demonstrating that horses with colic have a higher risk of acquiring and shedding Salmonella organisms.

OBJECTIVES

The purpose of this study was to determine the prevalence of and risk factors associated with Salmonella shedding in a colic population at a referral clinic.

STUDY DESIGN

Retrospective case-control study.

METHODS

For each colic case that was positive for Salmonella (n = 56), two colic cases (n = 112) that tested negative for Salmonella, were enrolled as controls. Associations between variables and Salmonella shedding were identified using logistic regression. Univariate and multivariable models were developed pertaining to (1) presenting clinicopathological data and (2) clinical variables that developed during hospitalisation.

RESULTS

Of the equids presenting with colic, 1585/1917 had a sample submitted for Salmonella testing. Of these, 56 were positive for Salmonella yielding a prevalence of 3.5%. Equids shedding Salmonella were more likely to present in July (odds ratio [OR] = 7.2; 95% confidence interval [CI] = 1.63-32.13; p = 0.009) and present with a history of fever (OR = 53.5; 95% CI = 2.57-1113.03; p = 0.01), increased lactate (OR = 1.6; 95% CI = 1.14-2.29; p = 0.007) and/or neutropenia (OR = 0.79; 95% CI = 0.65-0.97; p = 0.02). Hospitalised equids shedding Salmonella were more likely to be febrile (OR = 4.8; 95% CI = 1.47-15.8; p = 0.01) and 10 times more likely to develop reflux (OR = 10.1; 95% CI = 1.67-61.43; p = 0.01) compared to colic controls.

MAIN LIMITATIONS

Retrospective nature of the study and bias inherent to the retrieval of data from medical records cannot be discounted. Classifying Salmonella status based on a single sample may have resulted in misclassification bias.

CONCLUSIONS

The prevalence of Salmonella shedding in this colic population was low compared to earlier reports. Certain predictors such as the development of a fever or reflux in hospitalised colic cases were associated with Salmonella shedding and may help the clinician to promptly identify horses likely to shed; thus, helping institute effective use of barrier nursing precautions.

摘要

背景

胃肠道疾病与沙门氏菌的排出有关,先前的研究表明,患绞痛的马感染和排出沙门氏菌的风险更高。

目的

本研究的目的是确定转诊诊所中患绞痛的马群中沙门氏菌排出的患病率及相关风险因素。

研究设计

回顾性病例对照研究。

方法

对于每例沙门氏菌检测呈阳性的绞痛病例(n = 56),选取两例沙门氏菌检测呈阴性的绞痛病例(n = 112)作为对照。使用逻辑回归确定变量与沙门氏菌排出之间的关联。针对(1)呈现的临床病理数据和(2)住院期间出现的临床变量建立单变量和多变量模型。

结果

在出现绞痛的马匹中,1585/1917 例提交了沙门氏菌检测样本。其中,56 例沙门氏菌检测呈阳性,患病率为 3.5%。排出沙门氏菌的马匹更有可能在 7 月出现(比值比[OR] = 7.2;95%置信区间[CI] = 1.63 - 32.13;p = 0.009),且有发热史(OR = 53.5;95%CI = 2.57 - 1113.03;p = 0.01)、乳酸水平升高(OR = 1.6;95%CI = 1.14 - 2.29;p = 0.007)和/或中性粒细胞减少(OR = 0.79;95%CI = 0.65 - 0.97;p = 0.02)。与绞痛对照组相比,住院期间排出沙门氏菌的马匹更有可能发热(OR = 4.8;95%CI = 1.47 - 15.8;p = 0.01),发生反流的可能性高 10 倍(OR = 10.1;95%CI = 1.67 - 61.43;p = 0.01)。

主要局限性

本研究的回顾性性质以及从医疗记录中检索数据所固有的偏差不可忽视。基于单个样本对沙门氏菌状态进行分类可能导致错误分类偏差。

结论

与早期报告相比,该绞痛马群中沙门氏菌排出的患病率较低。某些预测因素,如住院绞痛病例中出现发热或反流,与沙门氏菌排出有关,可能有助于临床医生及时识别可能排出沙门氏菌的马匹;从而有助于有效实施屏障护理预防措施。

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