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Antimicrobial susceptibility patterns from urinary isolates obtained from cats (2013-2020)
Abstract
Background
Bacterial urinary tract infections have been associated with comorbidities and increased antimicrobial resistance over time.
Objective
To identify bacterial species, antimicrobial susceptibility patterns and risk factors associated with antimicrobial resistance.
Animals
Three hundred sixty-three positive urine cultures from 308 cats.
Methods
Bacterial species and antimicrobial susceptibility data from positive aerobic bacterial urine cultures from cats with growth of ≥103 colony forming units per milliliter (cfu/ml) were included. Medical records were reviewed, and bacteriuria was classified as sporadic bacterial cystitis, recurrent bacterial cystitis or subclinical bacteriuria (SBU). Multivariable logistic regression analysis was used to evaluate antimicrobial resistance risk factors.
Results
A total of 444 bacterial isolates from 363 bacteriuric episodes were identified. Escherichia coli (52%) and SBU (59%) were the most common organism and classification, respectively. When compared to other classifications of bacteriuria, Enterococcus spp. were more likely to be isolated from SBU episodes (P < .001), whereas E. coli was more likely to be isolated from sporadic bacterial cystitis episodes (P < .001). Recurrent bacterial cystitis was associated with an increased risk of antimicrobial resistance to amoxicillin/clavulanic acid (odds ratio [OR], 3.9; 95% confidence interval [CI], 1.3-11.3). The percent susceptibilities of all bacterial isolates to commonly prescribed antimicrobials were amoxicillin/clavulanic acid (72%), cefazolin (49%), enrofloxacin (61%), and trimethoprim/sulfamethoxazole (75%). Multidrug resistance was highest for Enterococcus faecium isolates (65%).
Conclusions and Clinical Importance
No antimicrobial achieved >90% susceptible designation to all bacteria isolated highlighting the importance of performing urine culture and susceptibility testing, particularly for cats with recurrent bacterial cystitis.
Journal Article
شراكات المدرسة والأسرة والمجتمع : دليلك للعمل =
كتاب ثري وعملي يشجعك على البدء في بناء شراكة فاعلة بين المدرسة والأسرة والمجتمع ويقدم لك مختلف الأدوات التي تحتاجها لتبدأ ستجد نموذجا مميزا لمساعدة كل مدرسة على بناء خطة العام للشراكة مع الأسر والمجتمع بالتفصيل ستحصل على خطوات تكوين فرق الشراكة في داخل المدرسة ستحصل على نماذج جاهزة للعمل أيضا قوائم بأنشطة هادفة يمكن تنفيذها وأثبتت جدواها عبر دراسات.
BOOK
Indications for Blood Cultures in Dogs and Associations With Positive Results in 323 Submissions
Abstract
Background
Bacteremia has been associated with many diseases in dogs, but contemporary data from a large and diverse population are lacking.
Hypothesis/Objectives
Report reasons for blood culture, protocols used, and diseases associated with a positive result in a tertiary referral institution. We hypothesized that larger volumes of blood, lack of previous antimicrobial administration, and changes in hematologic variables would be associated with increased rates of microbiological growth.
Animals
A total of 279 dogs from which 323 blood culture results were available.
Methods
For 180 submissions, patient and blood culture protocol data at the time of specimen collection were collected prospectively using a survey form. For 143 submissions, data were retrospectively collected.
Results
Microbial growth was noted in 55/323 (17%) submissions, with 35/55 (63.6%) interpreted as clinically relevant growth and 20 (36.4%) interpreted as contamination, resulting in an overall positive rate of 10.8%. Specimen volume (p = 0.01), white blood cell count (p < 0.001), and neutrophil count (p = 0.001) were positively associated with relevant growth. Diseases associated with relevant growth were suspected discospondylitis (30%, p = 0.05) and illness while on immunosuppressive drugs (44%, p = 0.004). Submissions performed to assess for bacteremia as a secondary cause of immune-mediated disease were less likely to yield relevant growth (0%, p = 0.004) than those performed for other reasons.
Conclusions and Clinical Importance
In this population, blood cultures were most likely to provide diagnostically useful information in dogs with suspected discospondylitis and those receiving immunosuppressive drugs. Specimen volume should be maximized to increase the likelihood of clinically relevant growth.
Journal Article
Etiology and effusion characteristics in 29 cats and 60 dogs with pyothorax (2010-2020)
Abstract
Background
Pyothorax, an accumulation of inflammatory fluid in the pleural space, is often caused by foreign body inhalation in dogs, whereas the etiology in cats can be more difficult to discern.
Objective
Compare clinical, microbiologic findings, and etiology in cats and dogs with pyothorax.
Animals
Twenty-nine cats and 60 dogs.
Methods
Medical records of cats and dogs diagnosed with pyothorax from 2010 to 2020 were reviewed. Clinical findings, fluid analysis, and microbiologic results were retrieved.
Results
Antimicrobials had been administered to equal proportions of cats and dogs before fluid sampling (45% and 47%). Groups did not differ in age or total protein concentration or percentage neutrophils in pleural fluid, but effusion cell count was significantly higher in cats than in dogs (P = .01). Neutrophils containing intracellular bacteria were identified in more cats (27/29, 93%) than dogs (44/60, 73%; P = .05). Penetrating damage to the thorax was implicated as the cause of pyothorax in equal percentages of cats (76%) and dogs (75%). Etiology could not be determined in 2 cats and 1 dog. Cats had higher numbers of bacterial isolates per patient (median, 3) than dogs (median, 1; P = .01) and anaerobes were isolated more often in cats (23/29, 73%) than in dogs (27/60, 45%; P = .003).
Conclusions and Clinical Importance
Pyothorax had similar etiologies in cats and dogs. Cats had higher fluid cell counts, higher numbers of bacterial isolates identified per patient, and intracellular bacteria detected more commonly than did dogs.
Journal Article
Outcome and prognostic factors in infective endocarditis in dogs: 113 cases (2005-2020)
Abstract
Background
Factors associated with outcome in dogs diagnosed with infective endocarditis (IE) are not well characterized.
Objectives
Evaluate outcome and prognostic factors in dogs with IE.
Animals
One hundred and thirteen dogs with IE.
Methods
Medical records for dogs that fulfilled the modified Duke criteria between 2005 and 2020 were retrospectively reviewed. Signalment, preexisting conditions, clinicopathologic findings, treatment regimen, and outcomes were recorded. Univariate logistic regression was performed to identify categorical factors associated with mortality, and then multivariate analysis was performed.
Results
Dogs were categorized as survivors (n = 47), non-survivors (n = 57), or lost to follow-up (n = 9). Survival to discharge and at 1 month was documented in 79 (70%) of 113 and 56 (54%) of 104 dogs, respectively, with median survival time (MST) of 72 days. Risk factors associated with mortality included development of congestive heart failure (odds ratio [OR], 11.8; 95% confidence interval [CI], 1.4-97.8), thromboembolic events (OR, 5.7; 95% CI, 2.3-14.4), and acute kidney injury (OR, 6.2; 95% CI, 2.0-18.8). Administration of antithrombotic medications was associated with survival (OR, 0.35; 95% CI, 0.13-0.97). Dogs that were not treated with antithrombotics had MST of 92 days, whereas dogs treated with antithrombotics did not reach MST during the study period. The heart valves involved and etiologic agent identified did not correlate with outcome.
Conclusion and Clinical Importance
Dogs with IE that had thromboembolic events, acute kidney injury, or congestive heart failure had higher risk of mortality. Administration of antithrombotics was associated with prolonged survival time.
Journal Article
Semiquantitative acid–base analysis in hypokalemic dogs with immune-mediated hemolytic anemia
To describe and compare the traditional and semiquantitative acid-base status of dogs with immune-mediated hemolytic anemia (IMHA) and hypokalemia to those with normokalemia.
Medical records of dogs with IMHA from a single institution over a 10-year period from January 1st, 2012 to December 31st, 2021 were retrospectively reviewed. Dogs were included if they met diagnostic criteria for IMHA based on the 2019 ACVIM consensus guidelines and had at least 1 blood potassium concentration measurement performed within 24 h of initial presentation. The dogs were divided into normokalemic and hypokalemic groups. Hypokalemia was categorized as mild (3-3.5 mEq/L [3-3.5 mmmol/L]), moderate (2-2.9 mEq/L [2-2.9 mmol/L]), or severe (<2 mEq/L [<2 mmol/L]). Population data, clinicopathologic data, and outcome were collected and recorded. Traditional and semiquantitative acid-base diagnoses were attributed to patients with sufficient data.
305 client-owned dogs with IMHA met the inclusion criteria. 186 dogs (61.0%) were normokalemic and 119 (39.0%) were hypokalemic (blood potassium concentration ≤ 3.5 mEq/L [≤ 3.5 mmol/L]) on presentation. The median blood potassium concentration in the hypokalemic group was 3.2 mEq/L (3.2 mmol/L) (interquartile range: 2.8-3.4 mEq/L [2.8-3.4 mmol/L]). Hypokalemia was mild in 78/119 (65.5%) dogs, moderate in 40/119 (33.6%) and severe in 1/119 (0.84%) cases. Metabolic acidosis was the most common traditional acid-base disorder identified in both normokalemic (26/82, 31.7%) and hypokalemic (44/92, 47.8%) dogs but the proportion was significantly higher in the hypokalemic group (
= 0.03). The semiquantitative approach identified acid-base abnormalities in 82/83 (98.8%) hypokalemic dogs. The most common abnormalities among the hypokalemic group were an unmeasured ion effect (74/83, 89.2%) and an alkalotic albumin effect (69/83, 83.1%). In the normokalemic group, the semiquantitative approach identified acid-base abnormalities in 62/63 (98.4%) dogs with unmeasured ions (55/63, 87.3%) and an alkalotic albumin effect (42/63, 66.7%) being the most common. Survival to discharge was significantly lower in the hypokalemic dogs (85/119, 71.4%) compared to the normokalemic population (163/186, 87.6%) (
= 0.02).
Hypokalemia is common in dogs with IMHA within the first 24 h of presentation and is associated with a variety of acid-base abnormalities. Hypokalemic dogs with IMHA appear more likely to develop metabolic acidosis and less likely to survive to hospital discharge.
Journal Article
Environmental History in the JIH, 1970–2020
Over the last five decades since the first Earth Day, the JIH and environmental history, one newborn and the other already well established, have evolved within the broader context of climate change and the human reaction to it. Two of the JIH’s special issues, “History and Climate” (1980) and the “Little Ice Age: Climate and History Reconsidered” (2014), serve as bookends for an examination of how the journal responded to the latest scientific and historical findings. No other area of research requires interdisciplinary methods from so many branches of learning as does environmental history. Articles published in the JIH during the 1980s and thereafter reveal the advances in both climate research and environmental history that testify to the journal’s influence. All signs point to a vigorous and continuing role for the JIH in keeping these subjects at the forefront of an interdisciplinary endeavor ranging across the entire planet and its deep history.
Journal Article
Prospective Evaluation of Cardiopulmonary Resuscitation Performed in Dogs and Cats According to the RECOVER Guidelines. Part 2: Patient Outcomes and CPR Practice Since Guideline Implementation
Cardiopulmonary resuscitation (CPR) outcomes have not been prospectively described since implementation of the Reassessment Campaign on Veterinary Resuscitation (RECOVER) guidelines. This study aimed to prospectively describe CPR outcomes and document arrest variables in dogs and cats at a U.S. veterinary teaching hospital since implementation of the RECOVER guidelines using the 2016 veterinary Utstein-style CPR reporting guidelines. One-hundred and seventy-two dogs and 47 cats that experienced cardiopulmonary arrest (CPA) underwent CPR following implementation of the RECOVER guidelines and were prospectively included. Supervising clinicians completed a data form for CPR events immediately following completion of CPR from December 2013 to June 2018. Seventy-five (44%) dogs and 26 (55%) cats attained return of spontaneous circulation (ROSC), 45 dogs (26%) and 16 cats (34%) had ROSC ≥ 20 min, 13 dogs (8%) and 10 cats (21%) were alive 24 h after CPR, and 12 dogs (7%) and 9 cats (19%) survived to hospital discharge. The most common cause of death in animals with ROSC ≥ 20 min was euthanasia. Patient outcomes were not significantly different since publication of the RECOVER guidelines except for a higher feline survival to hospital discharge rate. Dogs (
= 0.02) but not cats with initial shockable rhythms had increased rates of ROSC while the development of a shockable rhythm during CPR efforts was not associated with ROSC (
= 0.30). In closed chest CPR an end-tidal carbon dioxide (EtCO
) value of >16.5 mmHg was associated with a 75% sensitivity and 64% specificity for achieving ROSC. Since publication of the RECOVER guidelines, CPR practice did not clinically significantly change at our institution and no improvement of already high ROSC rates was noted. The percentage of cats surviving to hospital discharge was higher than previously reported and the reason for this improvement is not evident with these results. Euthanasia remains a major confounding factor in assessing intermediate and long-term CPR outcomes in dogs and cats.
Journal Article
A World of Standards but not a Standard World: Toward a Sociology of Standards and Standardization
Standards and standardization aim to render the world equivalent across cultures, time, and geography. Standards are ubiquitous but underappreciated tools for regulating and organizing social life in modernity, and they lurk in the background of many sociological works. Reviewing the relevance of standards and standardization in diverse theoretical traditions and sociological subfields, we point to the emergence and institutionalization of standards, the difficulties of making standards work, resistance to standardization, and the multiple outcomes of standards. Rather than associating standardization with totalizing narratives of globalization or dehumanization, we call for careful empirical analysis of the specific and unintended consequences of different sorts of standards operating in distinct social domains.
Journal Article