Morin D E, Constable P D, McCoy G C
Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana 61802, USA.
J Am Vet Med Assoc. 1998 May 1;212(9):1423-31.
To determine whether clinical parameters could be used to differentiate clinical mastitis (CM) caused by gram-positive bacteria from CM caused by gram-negative bacteria in dairy cows vaccinated against lipopolysaccharide core antigens.
Case series.
143 episodes of CM in 86 dairy cows in a single herd.
Cows were examined at onset of CM, and 24 clinical parameters including rectal temperature, heart rate, rumen contraction rate, degree of dehydration, various udder and milk characteristics, lactation number, stage of lactation, and season of year were recorded. Milk production and milk constituent concentrations before onset of CM were obtained from Dairy Herd Improvement Association records. Values for cows with gram-negative CM were compared with values for cows with gram-positive CM. Logistic regression was used to identify important predictors of gram-negative CM.
64 (45%) CM episodes were caused by gram-negative bacteria and 79 (55%) were caused by gram-positive bacteria. Rumen contraction rate was significantly lower and milk protein percentage before onset of CM was significantly higher in cows with gram-negative, rather than gram-positive, CM. Logistic regression indicated that CM was more likely to have been caused by gram-negative bacteria if it developed during the summer, milk was watery, or rumen contraction rate was low. Sensitivity and specificity of the final regression model were 0.58 and 0.80, respectively. Predictive value of a positive result was 0.74 when proportion of CM episodes caused by gram-negative bacteria was assumed to be 50%.
Results suggest that clinical observations do not allow accurate prediction of CM pathogens and should not be the sole criteria for deciding whether cows with CM are treated with antibiotics.
确定在接种脂多糖核心抗原疫苗的奶牛中,临床参数是否可用于区分由革兰氏阳性菌引起的临床型乳房炎(CM)和由革兰氏阴性菌引起的CM。
病例系列研究。
同一牛群中86头奶牛发生的143次CM病例。
在CM发病时对奶牛进行检查,记录24项临床参数,包括直肠温度、心率、瘤胃收缩率、脱水程度、各种乳房和乳汁特征、泌乳次数、泌乳阶段和年份季节。CM发病前的产奶量和乳汁成分浓度从奶牛改良协会记录中获取。将革兰氏阴性菌CM奶牛的值与革兰氏阳性菌CM奶牛的值进行比较。采用逻辑回归确定革兰氏阴性菌CM的重要预测因素。
64次(45%)CM病例由革兰氏阴性菌引起,79次(55%)由革兰氏阳性菌引起。革兰氏阴性菌CM奶牛的瘤胃收缩率显著较低,CM发病前的乳蛋白百分比显著较高,而非革兰氏阳性菌CM奶牛。逻辑回归表明,如果CM在夏季发生、乳汁呈水样或瘤胃收缩率低,则更可能由革兰氏阴性菌引起。最终回归模型的敏感性和特异性分别为0.58和0.80。假设革兰氏阴性菌引起的CM病例比例为50%时,阳性结果的预测值为0.74。
结果表明,临床观察不能准确预测CM病原体,不应作为决定CM奶牛是否使用抗生素治疗的唯一标准。