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Use of a clinical sepsis score for predicting bacteremia in neonatal dairy calves on a calf rearing farm.

机译:临床败血症评分在小牛饲养场中预测新生儿奶牛中菌血症的用途。

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摘要

In human, equine, and bovine neonates, early diagnosis of bacteremia remains a challenge for the internist. The objective of this study was to develop a predictive model for risk of bacteremia, based on a clinical evaluation system called the clinical sepsis score. Blood from 90 ill calves, 1- to 14-days-old from a calf-raising farm in the San Joaquin Valley of California was cultured. The calves were also scored according to a clinical score for hydration status, fecal appearance, general attitude, appearance of scleral vessels, and umbilical abnormality. Age, rectal temperature, heart rate, respiratory rate, and presence or absence of a focal site of infection were recorded. Prevalence of bacteremia was 31% (28/90). A logistic regression model indicated that high clinical score, presence of a focal infection, and increased age were associated with an increased risk of bacteremia in ill calves (P < 0.06). Calves for which the model predicted bacteremia with a probability > or = 40.8% were considered bacteremic, yielding acceptable sensitivity (75%) and specificity (71%) estimates. The predictive model was validated through a 2nd sampling of 100 calves (79 ill calves and 21 controls), of which 17 calves were bacteremic. The classification was 75% correct using the model, with an estimated sensitivity of 76% and specificity of 75%. Overall, results indicated that the model could be a useful tool for predicting bacteremia in ill calves in a clinical setting.
机译:在人类,马和牛的新生儿中,菌血症的早期诊断仍然是内科医生的挑战。这项研究的目的是基于称为临床败血症评分的临床评估系统,开发一种菌血症风险的预测模型。从加利福尼亚圣华金河谷饲养犊牛的1至14天大的90只患病小牛进行了血液培养。还根据水合状态,粪便外观,总体态度,巩膜血管外观和脐带异常的临床评分对小牛评分。记录年龄,直肠温度,心率,呼吸频率以及是否存在感染灶。菌血症的患病率为31%(28/90)。 Logistic回归模型表明,较高的临床评分,局灶性感染的存在和年龄的增加与患病小牛菌血症的风险增加相关(P <0.06)。该模型预测其菌血症的可能性大于或等于40.8%的犊牛被视为具有细菌性,可产生可接受的敏感性(75%)和特异性(71%)估计值。通过对100头小牛(79头小牛和21头对照)进行第二次抽样验证了预测模型,其中17头是细菌菌。使用该模型,分类正确率为75%,估计灵敏度为76%,特异性为75%。总体而言,结果表明该模型可能是在临床环境中预测小牛犊菌血症的有用工具。

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