马属动物化脓性滑液囊炎的实验室送检标本中,阳性细菌培养率较低,而抗菌药物耐药率较高。
Equine synovial sepsis laboratory submissions yield a low rate of positive bacterial culture and a high prevalence of antimicrobial resistance.
机构信息
Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY.
Department of Public and Ecosystem Health, Cornell University College of Veterinary Medicine, Ithaca, NY.
出版信息
Am J Vet Res. 2023 Jul 17;84(8). doi: 10.2460/ajvr.23.05.0085. Print 2023 Aug 1.
OBJECTIVE
To investigate (1) variables associated with the likelihood of obtaining a positive culture, (2) commonly isolated microorganisms, and (3) antimicrobial resistance patterns of isolates from horses with presumptive synovial sepsis.
SAMPLES
Synovial fluid, synovium, and bone samples from equine cases with presumptive synovial sepsis submitted to the Cornell University Animal Health Diagnostic Center from 2000 to 2020 for microbial culture and antimicrobial sensitivity testing.
PROCEDURES
Univariable and multivariable analyses were performed to determine the effect of variables on the likelihood of positive culture. Frequency distributions for isolated organisms and antimicrobial resistance were generated. Multidrug resistance patterns and associations were assessed with association rule mining.
RESULTS
The positive culture rate for all samples was 37.4%, while the positive culture rate among samples confirmed to be septic by a combination of clinical pathological variables and case details was 43%. Blood culture vial submissions were 1.7 times more likely to yield a positive culture compared to samples submitted in a serum tube. Structure sampled, tissue submitted, and horse age were associated with a positive culture. Staphylococcus spp (23.7%), Streptococcus spp (22.4%), and Enterococcus spp (9.67%) were commonly isolated. Multidrug resistance prevalence decreased from 92% (2000 to 2009) to 76% (2010 to 2020) of gram-negative isolates and 60% (2000 to 2009) to 52% (2010 to 2020) of gram-positive isolates.
CLINICAL RELEVANCE
The positive culture rate from synovial fluid submissions with traditional sampling and culture methods remains low and may be optimized by submitting samples in blood culture vials. Overall, antimicrobial resistance was frequently observed but did not increase from the first to second decade for most genera.
目的
调查(1)获得阳性培养物的可能性相关变量,(2)常见分离微生物,以及(3)疑似滑膜脓毒症马分离物的抗生素耐药模式。
样本
2000 年至 2020 年,来自康奈尔大学动物健康诊断中心的疑似滑膜脓毒症马的关节滑液、滑膜和骨样本,用于微生物培养和抗生素敏感性检测。
程序
进行单变量和多变量分析,以确定变量对阳性培养物可能性的影响。生成分离物和抗生素耐药性的频率分布。使用关联规则挖掘评估多药耐药模式和关联。
结果
所有样本的阳性培养率为 37.4%,而通过临床病理变量和病例细节组合确认的脓毒症样本的阳性培养率为 43%。与在血清管中提交的样本相比,血液培养瓶提交的样本阳性培养的可能性高 1.7 倍。采样结构、提交的组织和马的年龄与阳性培养相关。金黄色葡萄球菌(23.7%)、链球菌(22.4%)和肠球菌(9.67%)是常见的分离物。耐多药的流行率从革兰氏阴性分离物的 92%(2000 年至 2009 年)降至 76%(2010 年至 2020 年),从革兰氏阳性分离物的 60%(2000 年至 2009 年)降至 52%(2010 年至 2020 年)。
临床意义
使用传统采样和培养方法,从关节滑液样本中获得的阳性培养率仍然较低,通过在血培养瓶中提交样本可能会得到优化。总体而言,大多数属的抗生素耐药性虽然经常观察到,但在第一和第二十年间并未增加。