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猫下呼吸道疾病中PCR检测的临床及预后相关性

Clinical and prognostic relevance of PCR detection in feline lower respiratory tract disease.

作者信息

Robin Thibaud, Bigay Marie, Touzet Chloé, Le Boedec Kevin

机构信息

Centre Hospitalier Vétérinaire Fregis - IVC Evidensia France, Paris, France.

Clinique vétérinaire Olliolis, Ollioules, France.

出版信息

J Feline Med Surg. 2024 Dec;26(12):1098612X241297870. doi: 10.1177/1098612X241297870.

DOI:10.1177/1098612X241297870
PMID:39718117
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11682572/
Abstract

OBJECTIVES

The aim of this retrospective cohort study was to compare two groups of cats with lower respiratory tract disease, one with detected by PCR in the bronchoalveolar lavage fluid (BALF) (M+) and the other without (M-), with regard to signalment, clinical signs, diagnostic results, treatment response and survival.

METHODS

All cats for which was investigated by PCR in BALF between 2016 and 2023 were included. Cats with evidence of oropharyngeal contamination, or for which PCR results were under the quantification level, or without follow-up information were excluded. Cats that had received antibiotics effective against before BALF collection were excluded if PCR results were negative. Follow-up information was retrieved from the medical records and by contacting referring veterinarians and owners.

RESULTS

A total of 55 cats were included (19 in the M+ group and 36 in the M- group). Significant differences were detected between the two groups in the prevalence of systemic signs (M+: 0%, M-: 28%;  = 0.01), bronchial collapse on bronchoscopy (M+: 28%, M-: 6%;  = 0.03), radiographic alveolar lesions (M+: 57%, M-: 24%;  = 0.04), and percentage of neutrophils (M+: 65%, M-: 35%;  = 0.002) and eosinophils (M+: 9%, M-: 25%;  = 0.03) in the BALF. Antibiotics were used more frequently in M+ cats (M+: 90%, M-: 42%;  = 0.001) than in M- cats. No significant difference was found in treatment response (short term:  = 0.94, long term:  = 0.28) and risk of death ( = 0.42) between the two groups.

CONCLUSIONS AND RELEVANCE

The presence of radiographic alveolar lesions and neutrophilia in BALF was significantly associated with the detection of in BALF. This association might be causal, consequential or contextual (ie, sharing the same cause). The detection of in BALF did not negatively impact prognosis but the necessity to treat using targeted antibiotics remains to be determined.

摘要

目的

这项回顾性队列研究的目的是比较两组患有下呼吸道疾病的猫,一组在支气管肺泡灌洗液(BALF)中通过聚合酶链反应(PCR)检测到(M+),另一组未检测到(M-),比较它们在特征、临床症状、诊断结果、治疗反应和生存率方面的差异。

方法

纳入2016年至2023年间在BALF中通过PCR进行检测的所有猫。排除有口咽污染证据、PCR结果低于定量水平或无随访信息的猫。如果PCR结果为阴性,在BALF采集前接受过有效抗该病原体抗生素治疗的猫也被排除。随访信息从病历中获取,并通过联系转诊兽医和猫主人获得。

结果

共纳入55只猫(M+组19只,M-组36只)。两组在全身症状的患病率(M+:0%,M-:28%;P = 0.01)、支气管镜检查时的支气管塌陷(M+:28%,M-:6%;P = 0.03)、放射影像学上的肺泡病变(M+:57%,M-:24%;P = 0.04)以及BALF中中性粒细胞百分比(M+:65%,M-:35%;P = 0.002)和嗜酸性粒细胞百分比(M+:9%,M-:25%;P = 0.03)方面存在显著差异。M+组猫比M-组猫更频繁地使用抗生素(M+:90%,M-:42%;P = 0.001)。两组在治疗反应(短期:P = 0.94,长期:P = 0.28)和死亡风险(P = 0.42)方面未发现显著差异。

结论及意义

放射影像学上的肺泡病变和BALF中的中性粒细胞增多与BALF中该病原体的检测显著相关。这种关联可能是因果关系、结果关系或背景关系(即有共同原因)。BALF中该病原体的检测对预后没有负面影响,但使用针对性抗生素治疗该病原体的必要性仍有待确定。

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