2021 journal article
Factors associated with clinical interpretation of tracheal wash fluid from dogs with respiratory disease: 281 cases (2012‐2017)
Journal of Veterinary Internal Medicine.
author keywords: aerobic culture; antibiotics; endotracheal; transtracheal
MeSH headings : Animals; Anti-Bacterial Agents / therapeutic use; Bacteria; Dog Diseases / diagnosis; Dogs; Respiratory Tract Diseases / diagnosis; Respiratory Tract Diseases / veterinary; Retrospective Studies; Trachea
TL;DR:
Endotracheal wash fluid, in particular, should be screened for gross mucus or turbidity to maximize the likelihood of an adequate specimen, while presence of bacteria on cytology was a good predictor of any growth, while their absence was aGood predictor of the absence of growth of 1+ or more.
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open access via onlinelibrary.wiley.com (publisher PDF)
UN Sustainable Development Goal Categories
3. Good Health and Well-being
(Web of Science)
Source: ORCID
Added: February 10, 2021
AbstractBackgroundClinicians face several dilemmas regarding tracheal washes (TWs) for the diagnosis of respiratory disease, including method and prediction of bacterial growth from cytology results.ObjectiveTo compare cytology and culture of endotracheal and transtracheal washes and identify factors associated with discordancy and bacterial growth.AnimalsTwo hundred forty‐five dogs with respiratory disease.MethodsRetrospective study. Tracheal wash submissions were included if cellularity was sufficient for cytologic interpretation and aerobic cultures were performed. Collection technique, cytology, bacterial growth, and antibiotic history were analyzed.ResultsFewer transtracheal specimens (9/144, 6.3%) were excluded for hypocellularity than endotracheal (28/174, 16.1%); otherwise, results were similar and were combined. Of 281 specimens with cellularity sufficient for interpretation, 97 (34.5%) had bacteria on cytology and 191 (68.0%) had bacterial growth. Cytology positive/culture negative discordancy was uncommon (8/97, 8%). Cytology negative/culture positive discordancy was frequent (102/184, 55.4%), but occurred less often (28/184, 14.2%) when only 1+ growth or greater was considered positive. Oropharyngeal contamination was associated with bacterial growth, but not discordancy. No association was found between antibiotic administration and bacterial growth.Conclusions and Clinical ImportanceEndotracheal wash fluid, in particular, should be screened for gross mucus or turbidity to maximize the likelihood of an adequate specimen. Otherwise, endotracheal and transtracheal specimens were similar. Presence of bacteria on cytology was a good predictor of any growth, while their absence was a good predictor of the absence of growth of 1+ or more. Recent antibiotic usage should not discourage TW culture if there is compelling reason to avoid delay.