Multidrug-resistant wound infections are associated with greater mortality, larger costs, and longer hospitalizations than susceptible infections in canine patients.

IF 1.8 2区 农林科学 Q2 VETERINARY SCIENCES Javma-journal of The American Veterinary Medical Association Pub Date : 2025-02-07 Print Date: 2025-05-01 DOI:10.2460/javma.24.11.0727
Delaina Allegretti, Scarlett M Sumner, Laura Huber, Katelyn Hlusko, Kayla M Corriveau, Brad Matz, Michael Tillson
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Abstract

Objective: To investigate the prevalence, risk factors, and economic impact of multidrug-resistant (MDR) infections in dogs at a tertiary referral hospital.

Methods: This was a retrospective cohort study including dogs with positive aerobic culture associated with a traumatic wound or surgical site infection between July 2018 and November 2023. Data collected from medical records included signalment, wound type, culture results, medications (antibiotics, NSAIDs, steroids, immunosuppressives), wound care, hospitalization duration, concurrent illnesses, surgical variables, and cost. Multivariable logistic regression analysis was performed to identify factors associated with MDR development.

Results: 80 dogs met the inclusion criteria, and 19 had MDR infections. Multidrug resistance increased the odds of longer hospitalization duration by 2.98 times (95% CI, 1.09 to 8.19), mortality rates by 11.8 times (95% CI, 1.24 to 112.08), and total costs by 3.57 times (95% CI, 1.3 to 9.83). Steroid use within the past year, NSAID or steroid use within 1 week before culture, and initial preculture use of either penicillin or clindamycin in the past 3 months increased the risk of MDR development by 4.51 to 7.4 times (95% CI, 1.71 to 32.09).

Conclusions: Multidrug-resistant infections were associated with greater mortality, larger costs, and longer hospitalizations. Risk factors for MDR infections included steroid use within the past year, NSAID or steroid use within 1 week before culture, and either penicillin or clindamycin within 3 months before culture.

Clinical relevance: Multidrug-resistant pathogens have clinical and economic impacts on veterinary healthcare, and there is a need to implement standardized surveillance and prevention programs in veterinary hospitals.

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与犬类易感感染患者相比,多药耐药伤口感染具有更高的死亡率、更高的费用和更长的住院时间。
目的:了解某三级转诊医院犬类多药耐药(MDR)感染的流行情况、危险因素及经济影响。方法:这是一项回顾性队列研究,包括2018年7月至2023年11月期间与创伤性伤口或手术部位感染相关的有氧培养阳性犬。从医疗记录中收集的数据包括信号、伤口类型、培养结果、药物(抗生素、非甾体抗炎药、类固醇、免疫抑制剂)、伤口护理、住院时间、并发疾病、手术变量和费用。进行多变量logistic回归分析以确定与MDR发展相关的因素。结果:80只狗符合纳入标准,其中19只存在MDR感染。多药耐药使住院时间延长的几率增加了2.98倍(95% CI, 1.09 ~ 8.19),死亡率增加了11.8倍(95% CI, 1.24 ~ 112.08),总费用增加了3.57倍(95% CI, 1.3 ~ 9.83)。在过去一年内使用类固醇,在培养前1周内使用非甾体抗炎药或类固醇,以及在培养前3个月内首次使用青霉素或克林霉素,使MDR发生的风险增加4.51至7.4倍(95% CI, 1.71至32.09)。结论:耐多药感染与更高的死亡率、更高的费用和更长的住院时间相关。耐多药感染的危险因素包括过去一年内使用类固醇,培养前1周内使用非甾体抗炎药或类固醇,培养前3个月内使用青霉素或克林霉素。临床相关性:耐多药病原体对兽医保健具有临床和经济影响,兽医医院需要实施标准化的监测和预防计划。
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来源期刊
CiteScore
1.60
自引率
15.80%
发文量
539
审稿时长
6-16 weeks
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.
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