Urine culture and antimicrobial susceptibility test are the gold standard in order to select a correct treatment in urinary tract infections (UTI). However, a complete urinalysis is the first line investigation in dogs with urinary symptoms and results can help the clinician in the diagnostic workup. The aim of this study was to compare signalment and urinary parameters obtained from dogs with positive urine culture (“UTI-group”) to those with sterile culture (“nUTI-group”) in a population in which UTI was considered among the differential diagnosis. Two-hundred-eighty-two culture and urinalysis results, from urine sampled by cystocentesis in 214 dogs, between 2013 and 2019, were included in this retrospective study. Statistical analysis was performed by chi-square, Wilcoxon or Kruskal-Wallis test using JMP 14 (SAS Inc., Cary, USA). One-hundred-nine urine samples from 85 dogs were positive and 173 samples from 129 dogs were negative to culture. Single isolates were 92.7% and Escherichia coli was the main pathogen (50.5%). Dogs in UTI-group were significantly (p<0.01) older (9.8±4.2 years) compared to nUTI-group (7.6±4.6). No significant difference regarding breed and sex were found. Urine appearance was predominantly yellow in both groups, but pale yellow (11% vs 5%) was overrepresented in UTI-group. Turbid aspect was predominant in UTI-group (32% vs 9%), but 35% of UTI-group samples was clear. UTI-group had lower (p=0.03) urine specific gravity (USG); pH was similar between groups. Positivity to blood and haemoglobin was higher in UTI-group (p<0.01) but negative results (44% and 60% respectively) were present in UTI-group and positive (28% and 17% respectively) in nUTI- group. Nitur test was positive in 13% of UTI-group and 0% in nUTI-group. Urinary red blood cells were not significantly different between groups. White blood cells (>5/hpf) were present in 72% of UTI-group and in 15% of nUTI-group showing a significant difference (p<0.05). Bacteria were detected in 75% of urinary sediments of UTI-group and apparently evident in 5% of nUTI-group. In the 27 dogs of UTI-group in which bacteria were not evident, USG ranged from 1002 to 1048 and resulted below 1014 in 11 cases. Proteinuria staged according to IRIS guidelines was significantly different (p<0.01) between groups: proteinuric and borderline proteinuric were respectively 44% and 28% in UTI-group, while in nUTI- group were 30% and 14%. Although the set of found alterations can lead to a suspicion of infection, urinalysis is not diagnostic of UTI; based on these results, the diagnosis could be missed in at least 25% of patients.

Urinalysis alterations in dogs affected with urinary tract infection: a retrospective case/control study / J. Zambarbieri, M. Busnelli, P. Scarpa - In: Proceeding ECVIM - CA CONGRESS[s.l] : ECVIM, 2020 Sep. (( Intervento presentato al 30th. convegno ECVIM-CA ANNUAL CONGRESS tenutosi a Milano nel 2020.

Urinalysis alterations in dogs affected with urinary tract infection: a retrospective case/control study

J. Zambarbieri;P. Scarpa
2020

Abstract

Urine culture and antimicrobial susceptibility test are the gold standard in order to select a correct treatment in urinary tract infections (UTI). However, a complete urinalysis is the first line investigation in dogs with urinary symptoms and results can help the clinician in the diagnostic workup. The aim of this study was to compare signalment and urinary parameters obtained from dogs with positive urine culture (“UTI-group”) to those with sterile culture (“nUTI-group”) in a population in which UTI was considered among the differential diagnosis. Two-hundred-eighty-two culture and urinalysis results, from urine sampled by cystocentesis in 214 dogs, between 2013 and 2019, were included in this retrospective study. Statistical analysis was performed by chi-square, Wilcoxon or Kruskal-Wallis test using JMP 14 (SAS Inc., Cary, USA). One-hundred-nine urine samples from 85 dogs were positive and 173 samples from 129 dogs were negative to culture. Single isolates were 92.7% and Escherichia coli was the main pathogen (50.5%). Dogs in UTI-group were significantly (p<0.01) older (9.8±4.2 years) compared to nUTI-group (7.6±4.6). No significant difference regarding breed and sex were found. Urine appearance was predominantly yellow in both groups, but pale yellow (11% vs 5%) was overrepresented in UTI-group. Turbid aspect was predominant in UTI-group (32% vs 9%), but 35% of UTI-group samples was clear. UTI-group had lower (p=0.03) urine specific gravity (USG); pH was similar between groups. Positivity to blood and haemoglobin was higher in UTI-group (p<0.01) but negative results (44% and 60% respectively) were present in UTI-group and positive (28% and 17% respectively) in nUTI- group. Nitur test was positive in 13% of UTI-group and 0% in nUTI-group. Urinary red blood cells were not significantly different between groups. White blood cells (>5/hpf) were present in 72% of UTI-group and in 15% of nUTI-group showing a significant difference (p<0.05). Bacteria were detected in 75% of urinary sediments of UTI-group and apparently evident in 5% of nUTI-group. In the 27 dogs of UTI-group in which bacteria were not evident, USG ranged from 1002 to 1048 and resulted below 1014 in 11 cases. Proteinuria staged according to IRIS guidelines was significantly different (p<0.01) between groups: proteinuric and borderline proteinuric were respectively 44% and 28% in UTI-group, while in nUTI- group were 30% and 14%. Although the set of found alterations can lead to a suspicion of infection, urinalysis is not diagnostic of UTI; based on these results, the diagnosis could be missed in at least 25% of patients.
Settore VET/08 - Clinica Medica Veterinaria
set-2020
ECVIM, ESVNU
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/777657
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