Kayla Sample, Claire Fellman, Greg Wolfus, Benjamin Koethe, Jennifer Grady
{"title":"经济实惠的内部菌尿检测可提高抗菌药物管理水平和医疗服务的可及性。","authors":"Kayla Sample, Claire Fellman, Greg Wolfus, Benjamin Koethe, Jennifer Grady","doi":"10.2460/javma.24.05.0307","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical utility of 3 in-house tests to screen for bacteriuria in dogs with urinary conditions: a computerized urine sediment analyzer (SediVue), a rapid immunoassay (RapidBac), and in-house urine culture. Accuracy of culture and antimicrobial susceptibility (C&S) results from submission of the positive in-house culture plate and a 24- to 48-hour refrigerated urine sample was also assessed.</p><p><strong>Methods: </strong>Sterile urine samples from 101 client-owned dogs were used to evaluate sensitivity, specificity, positive predictive value, and negative predictive value of 3 in-house diagnostic tests to detect bacteriuria using C&S testing at a reference laboratory as the reference standard. For positive in-house culture plates, the plate and a 24- to 48-hour refrigerated urine sample were submitted to the reference laboratory for C&S testing and compared to the reference standard.</p><p><strong>Results: </strong>The reference standard C&S was positive in 25 of 101 cases (25%). All 3 in-house diagnostic tests had high negative predictive values: SediVue was 89% (95% CI, 81% to 96%), RapidBac was 93% (95% CI, 88% to 99%), and in-house culture was 99% (95% CI, 96% to 100%). Positive predictive values were 89% (95% CI, 74% to 100%) for SediVue, 77% (95% CI, 61% to 93%) for RapidBac, and 86% (95% CI, 73% to 99%) for in-house culture. Culture and antimicrobial susceptibility results from submission of the positive in-house plates and refrigerated urine samples approximated the reference standard.</p><p><strong>Conclusions: </strong>SediVue, RapidBac, and in-house cultures performed well to rule out canine bacteriuria.</p><p><strong>Clinical relevance: </strong>Inexpensive in-house diagnostic tests can be used to screen for bacteriuria prior to submission of C&S testing, which promotes antimicrobial stewardship, responsible use of client resources, and access to veterinary care.</p>","PeriodicalId":14658,"journal":{"name":"Javma-journal of The American Veterinary Medical Association","volume":" ","pages":"1-8"},"PeriodicalIF":1.6000,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Affordable in-house tests for bacteriuria can improve antimicrobial stewardship and access to care.\",\"authors\":\"Kayla Sample, Claire Fellman, Greg Wolfus, Benjamin Koethe, Jennifer Grady\",\"doi\":\"10.2460/javma.24.05.0307\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To evaluate the clinical utility of 3 in-house tests to screen for bacteriuria in dogs with urinary conditions: a computerized urine sediment analyzer (SediVue), a rapid immunoassay (RapidBac), and in-house urine culture. Accuracy of culture and antimicrobial susceptibility (C&S) results from submission of the positive in-house culture plate and a 24- to 48-hour refrigerated urine sample was also assessed.</p><p><strong>Methods: </strong>Sterile urine samples from 101 client-owned dogs were used to evaluate sensitivity, specificity, positive predictive value, and negative predictive value of 3 in-house diagnostic tests to detect bacteriuria using C&S testing at a reference laboratory as the reference standard. For positive in-house culture plates, the plate and a 24- to 48-hour refrigerated urine sample were submitted to the reference laboratory for C&S testing and compared to the reference standard.</p><p><strong>Results: </strong>The reference standard C&S was positive in 25 of 101 cases (25%). All 3 in-house diagnostic tests had high negative predictive values: SediVue was 89% (95% CI, 81% to 96%), RapidBac was 93% (95% CI, 88% to 99%), and in-house culture was 99% (95% CI, 96% to 100%). Positive predictive values were 89% (95% CI, 74% to 100%) for SediVue, 77% (95% CI, 61% to 93%) for RapidBac, and 86% (95% CI, 73% to 99%) for in-house culture. Culture and antimicrobial susceptibility results from submission of the positive in-house plates and refrigerated urine samples approximated the reference standard.</p><p><strong>Conclusions: </strong>SediVue, RapidBac, and in-house cultures performed well to rule out canine bacteriuria.</p><p><strong>Clinical relevance: </strong>Inexpensive in-house diagnostic tests can be used to screen for bacteriuria prior to submission of C&S testing, which promotes antimicrobial stewardship, responsible use of client resources, and access to veterinary care.</p>\",\"PeriodicalId\":14658,\"journal\":{\"name\":\"Javma-journal of The American Veterinary Medical Association\",\"volume\":\" \",\"pages\":\"1-8\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-09-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Javma-journal of The American Veterinary Medical Association\",\"FirstCategoryId\":\"97\",\"ListUrlMain\":\"https://doi.org/10.2460/javma.24.05.0307\",\"RegionNum\":2,\"RegionCategory\":\"农林科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"VETERINARY SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Javma-journal of The American Veterinary Medical Association","FirstCategoryId":"97","ListUrlMain":"https://doi.org/10.2460/javma.24.05.0307","RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"VETERINARY SCIENCES","Score":null,"Total":0}
Affordable in-house tests for bacteriuria can improve antimicrobial stewardship and access to care.
Objective: To evaluate the clinical utility of 3 in-house tests to screen for bacteriuria in dogs with urinary conditions: a computerized urine sediment analyzer (SediVue), a rapid immunoassay (RapidBac), and in-house urine culture. Accuracy of culture and antimicrobial susceptibility (C&S) results from submission of the positive in-house culture plate and a 24- to 48-hour refrigerated urine sample was also assessed.
Methods: Sterile urine samples from 101 client-owned dogs were used to evaluate sensitivity, specificity, positive predictive value, and negative predictive value of 3 in-house diagnostic tests to detect bacteriuria using C&S testing at a reference laboratory as the reference standard. For positive in-house culture plates, the plate and a 24- to 48-hour refrigerated urine sample were submitted to the reference laboratory for C&S testing and compared to the reference standard.
Results: The reference standard C&S was positive in 25 of 101 cases (25%). All 3 in-house diagnostic tests had high negative predictive values: SediVue was 89% (95% CI, 81% to 96%), RapidBac was 93% (95% CI, 88% to 99%), and in-house culture was 99% (95% CI, 96% to 100%). Positive predictive values were 89% (95% CI, 74% to 100%) for SediVue, 77% (95% CI, 61% to 93%) for RapidBac, and 86% (95% CI, 73% to 99%) for in-house culture. Culture and antimicrobial susceptibility results from submission of the positive in-house plates and refrigerated urine samples approximated the reference standard.
Conclusions: SediVue, RapidBac, and in-house cultures performed well to rule out canine bacteriuria.
Clinical relevance: Inexpensive in-house diagnostic tests can be used to screen for bacteriuria prior to submission of C&S testing, which promotes antimicrobial stewardship, responsible use of client resources, and access to veterinary care.
期刊介绍:
Published twice monthly, this peer-reviewed, general scientific journal provides reports of clinical research, feature articles and regular columns of interest to veterinarians in private and public practice. The News and Classified Ad sections are posted online 10 days to two weeks before they are delivered in print.