Diagnostic accuracy of a point-of-care urine bacteriologic culture test in dogs

Olin, Shelly J.; Bartges, Joseph W.; Jones, Rebekah D.; Bemis, David A.

doi:10.2460/javma.243.12.1719

Cited by 14 publications

(18 citation statements)

References 7 publications

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“…However, in former studies microscopy was interpreted by experienced technicians or diplomats at referral hospitals, and not by veterinary nurses and veterinarians under busy daily conditions. The accuracy of in‐house bacterial culture in this study was also lower than previously reported with respect to growth or no growth . At least 2 factors might cause this difference: (i) urine collection method and (ii) transportation time to the reference laboratory.…”

Section: Discussioncontrasting

confidence: 76%

“…The accuracy of in-house bacterial culture in this study was also lower than previously reported with respect to growth or no growth. 12,13,30 At least 2 factors might cause this difference: (i) urine collection method and (ii) transportation time to the reference laboratory. Cystocentesis was the main collection method in the previous studies, in contrast to our study in which the majority of samples were collected by voluntary voiding.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of Diagnostic Work‐Up on Medical Decision‐Making for Canine Urinary Tract Infection: An Observational Study in Danish Small Animal Practices

Sørensen

Bjørnvad

Córdoba

et al. 2018

Veterinary Internal Medicne

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BackgroundClinical signs of urinary tract disease in dogs often lead to prescription of antibiotics. Appropriate diagnostic work‐up could optimize treatment and reduce the risk of inappropriate use of antibiotics.Hypothesis/ObjectivesTo describe and evaluate the impact of diagnostic work‐up on decision to treat (DTT) and choice of antibiotic treatment (COT) for dogs presenting with clinical signs of urinary tract disease.AnimalsOne hundred and fifty‐one dogs presenting to 52 Danish veterinary practices.MethodsProspective, observational study. Clinical signs, diagnostic work‐up, and prescriptions were recorded. Urine samples were submitted to a reference laboratory for quantitative bacterial culture (QBC) and susceptibility testing. The laboratory results were used as reference for assessing the appropriateness of DTT and COT.ResultsIn the majority of dogs, veterinarians performed dipstick (99%), microscopic examination of urine (80%) and bacterial culture (56%). Fifty‐one percent of dogs had urinary tract infection (UTI) based on reference QBC. Appropriate DTT was made for 62% of the dogs, while 36% were over‐prescribed and 2% under‐prescribed. Inappropriate use of second‐line agents was found in 57% of the UTI cases. Performing microscopy—but not culture—significantly impacted DTT (P = 0.039) while no difference was seen in COT (P = 0.67). The accuracy of in‐house microscopy and culture were 64.5 and 77%, respectively. Conclusions and Clinical Importance: Over‐prescription of antibiotics was common among dogs with suspected UTI, regardless of the diagnostic work‐up performed. Test inaccuracy under practice conditions and incoherence between diagnostic test results and decision‐making both explained inappropriate and unnecessary use of antibiotics.

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Section: Discussioncontrasting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Effects of Diagnostic Work‐Up on Medical Decision‐Making for Canine Urinary Tract Infection: An Observational Study in Danish Small Animal Practices

Sørensen

Bjørnvad

Córdoba

et al. 2018

Veterinary Internal Medicne

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“…Clinicians must consider whether they are using these tests to recover isolates for subsequent identification and testing by a microbiology laboratory or whether they desire (or require) identification in‐house, as would be the case for in‐house susceptibility testing. At least one of these assays offers a limited ability to determine antimicrobial drug susceptibility, but this component of the kit was found to generate inaccurate results in one field study …”

Section: What Action Should Be Taken To Reduce the Risk And Occurrencmentioning

confidence: 99%

ACVIMConsensus Statement on Therapeutic Antimicrobial Use in Animals and Antimicrobial Resistance

Weese

Giguère

Guardabassi

et al. 2015

Veterinary Internal Medicne

232

211

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Consensus Statements of the American College of Veterinary Internal Medicine (ACVIM) and EuropeanCollege of Equine Internal Medicine (ECEIM) provide the veterinary community with up-to-date information on the pathophysiology, diagnosis, and treatment of clinically important animal diseases. The ACVIM Board of Regents oversees selection of relevant topics, identification of panel members with the expertise to draft the statements, and other aspects of assuring the integrity of the process. The statements are derived from evidence-based medicine whenever possible and the panel offers interpretive comments when such evidence is inadequate or contradictory. A draft is prepared by the panel, followed by solicitation of input by the ACVIM membership which may be incorporated into the statement. It is then submitted to the Journal of Veterinary Internal Medicine, where it is edited prior to publication. The authors are solely responsible for the content of the statements. ACVIM Consensus Statement on Therapeutic Antimicrobial Use inAnimals and Antimicrobial Resistance J.S. Weese, S. Gigu ere, L. Guardabassi, P.S. Morley, M. Papich, D.R. Ricciuto, and J.E. SykesThe epidemic of antimicrobial resistant infections continues to challenge, compromising animal care, complicating food animal production and posing zoonotic disease risks. While the overall role of therapeutic antimicrobial use in animals in the development AMR in animal and human pathogens is poorly defined, veterinarians must consider the impacts of antimicrobial use in animal and take steps to optimize antimicrobial use, so as to maximize the health benefits to animals while minimizing the likelihood of antimicrobial resistance and other adverse effects. This consensus statement aims to provide guidance on the therapeutic use of antimicrobials in animals, balancing the need for effective therapy with minimizing development of antimicrobial resistance in bacteria from animals and humans.

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“…For example, one expert reached an accuracy of 100% using Flexicult Vet for bacterial identification [4]. On the other hand, less experienced evaluators achieved the lower accuracies of 53% [4], 58-77% [17], and 92-98% [18]. Furthermore, the test's AST performance resulted in accuracies between 39 and 99% [4,17,18].…”

Section: Introductionmentioning

confidence: 99%

How Accurate Are Veterinary Clinicians Employing Flexicult Vet for Identification and Antimicrobial Susceptibility Testing of Urinary Bacteria?

Cugmas

Avberšek²,

Rosa³

et al. 2021

Antibiotics

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Antibiotics are frequently used for treating urinary tract infections (UTI) in dogs and cats. UTI often requires time-consuming and expensive antimicrobial susceptibility testing (AST). Alternatively, clinicians can employ Flexicult Vet, an affordable chromogenic agar with added antibiotics for in-clinic AST. We investigated how well veterinary microbiologists and clinicians, without any prior experience, employ Flexicult Vet for the identification and AST of the most common canine and feline urinary pathogenic bacteria. We prepared 47 monoculture plates containing 10 bacterial species. The test’s mean accuracy was 75.1% for bacteria identification (84.6% and 68.7% for microbiologists and clinicians, respectively) and 79.2% for AST (80.7% and 78.2%). All evaluators employed Flexicult Vet with the accuracies over 90% for the distinctively colored bacteria like Escherichia coli (red), Enterococcus faecalis (turquoise), and Proteus spp. (pale brown). However, the evaluators’ experience proved important in recognizing lightly colored bacteria like Staphylococcus pseudintermedius (accuracies of 82.6% and 40.3%). Misidentifications of E. faecium additionally worsened AST performance since bacterial intrinsic resistance could not be considered. Finally, only 33.3% (3/9) of methicillin-resistant S. pseudintermedius (MRSP) were correctly detected. To conclude, Flexicult Vet proved reliable for certain urinary pathogens. In contrast, light-colored bacteria (e.g., Staphylococcus), often misidentified, require a standard AST.

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Diagnostic accuracy of a point-of-care urine bacteriologic culture test in dogs

Abstract: Use of the CCSP led to accurate exclusion of UTI in dogs without a UTI but was less reliable for diagnosis of UTI, particularly infections caused by gram-positive cocci. Standard aerobic microbiological culture remains the gold standard for detection of UTI in dogs.

Cited by 14 publications

References 7 publications

Effects of Diagnostic Work‐Up on Medical Decision‐Making for Canine Urinary Tract Infection: An Observational Study in Danish Small Animal Practices

Effects of Diagnostic Work‐Up on Medical Decision‐Making for Canine Urinary Tract Infection: An Observational Study in Danish Small Animal Practices

ACVIMConsensus Statement on Therapeutic Antimicrobial Use in Animals and Antimicrobial Resistance

How Accurate Are Veterinary Clinicians Employing Flexicult Vet for Identification and Antimicrobial Susceptibility Testing of Urinary Bacteria?

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