Sepsis and survival in critically ill calves: Risk factors and antimicrobial use
Abstract Background Sepsis is a life‐threatening disease for which critically important antimicrobials (CIA) frequently are used. Diagnostic and therapeutic guidelines for sepsis and critically ill calves are largely lacking. Objectives Identify factors associated with mortality in critically ill ca...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | Journal of Veterinary Internal Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jvim.16607 |
| _version_ | 1797938018484486144 |
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| author | Mathilde L. Pas Jade Bokma Thomas Lowie Filip Boyen Bart Pardon |
| author_facet | Mathilde L. Pas Jade Bokma Thomas Lowie Filip Boyen Bart Pardon |
| author_sort | Mathilde L. Pas |
| collection | DOAJ |
| description | Abstract Background Sepsis is a life‐threatening disease for which critically important antimicrobials (CIA) frequently are used. Diagnostic and therapeutic guidelines for sepsis and critically ill calves are largely lacking. Objectives Identify factors associated with mortality in critically ill calves and describe bacteria obtained from blood cultures of critically ill calves with sepsis and their antimicrobial resistance. Animals Two‐hundred thirty critically ill calves, mainly Belgian Blue beef cattle. Methods Retrospective cohort study. Logistic regression, survival analysis, and decision tree analysis were used to determine factors associated with mortality. Results Of the critically ill calves, 34.3% had sepsis and 61.3% died. The final survival model indicated that calves with sepsis (hazard risk [HR]: 1.6; 95% confidence interval [CI]: 1.0‐2.5; P = .05), abnormal behavior (HR: 2.3; 95% CI: 1.3‐4.0; P = .005), and hypothermia (HR: 0.82; 95% CI: 0.72‐0.95; P = .01) had a significantly higher mortality risk. In a second survival model, hypothermia (HR: 0.87; 95% CI: 0.78‐0.96; P = .004) and hypoglycemia (HR: 2.2; 95% CI: 1.5‐3.3; P < .001) were risk factors for mortality. Decision tree analysis emphasized the importance of behavior, hypochloremia, hypoglycemia, hyperkalemia, and lung ultrasonography for mortality risk. Escherichia coli (30.6%) was most frequently isolated from blood cultures, of which 90.9% were multidrug resistant. Inappropriate use of antimicrobials was frequent for penicillin, amoxicillin, and sulfamethoxazole/trimethoprim, but less for CIA. Conclusions and Clinical Importance Many critically ill calves have sepsis, which increases mortality risk. Bacteria involved are often resistant to first‐intention antimicrobials but less resistant to CIA. The other identified risk factors for mortality can support therapeutic decision‐making. |
| first_indexed | 2024-04-10T18:53:12Z |
| format | Article |
| id | doaj.art-07b7288307fb402da91f48382fb766d4 |
| institution | Directory Open Access Journal |
| issn | 0891-6640 1939-1676 |
| language | English |
| last_indexed | 2024-04-10T18:53:12Z |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Veterinary Internal Medicine |
| spelling | doaj.art-07b7288307fb402da91f48382fb766d42023-02-01T04:49:52ZengWileyJournal of Veterinary Internal Medicine0891-66401939-16762023-01-0137137438910.1111/jvim.16607Sepsis and survival in critically ill calves: Risk factors and antimicrobial useMathilde L. Pas0Jade Bokma1Thomas Lowie2Filip Boyen3Bart Pardon4Department of Internal Medicine, Reproduction and Population Medicine Ghent University Merelbeke BelgiumDepartment of Internal Medicine, Reproduction and Population Medicine Ghent University Merelbeke BelgiumDepartment of Internal Medicine, Reproduction and Population Medicine Ghent University Merelbeke BelgiumDepartment of Pathobiology, Pharmacology and Zoological Medicine, Faculty of Veterinary Medicine Ghent University Merelbeke BelgiumDepartment of Internal Medicine, Reproduction and Population Medicine Ghent University Merelbeke BelgiumAbstract Background Sepsis is a life‐threatening disease for which critically important antimicrobials (CIA) frequently are used. Diagnostic and therapeutic guidelines for sepsis and critically ill calves are largely lacking. Objectives Identify factors associated with mortality in critically ill calves and describe bacteria obtained from blood cultures of critically ill calves with sepsis and their antimicrobial resistance. Animals Two‐hundred thirty critically ill calves, mainly Belgian Blue beef cattle. Methods Retrospective cohort study. Logistic regression, survival analysis, and decision tree analysis were used to determine factors associated with mortality. Results Of the critically ill calves, 34.3% had sepsis and 61.3% died. The final survival model indicated that calves with sepsis (hazard risk [HR]: 1.6; 95% confidence interval [CI]: 1.0‐2.5; P = .05), abnormal behavior (HR: 2.3; 95% CI: 1.3‐4.0; P = .005), and hypothermia (HR: 0.82; 95% CI: 0.72‐0.95; P = .01) had a significantly higher mortality risk. In a second survival model, hypothermia (HR: 0.87; 95% CI: 0.78‐0.96; P = .004) and hypoglycemia (HR: 2.2; 95% CI: 1.5‐3.3; P < .001) were risk factors for mortality. Decision tree analysis emphasized the importance of behavior, hypochloremia, hypoglycemia, hyperkalemia, and lung ultrasonography for mortality risk. Escherichia coli (30.6%) was most frequently isolated from blood cultures, of which 90.9% were multidrug resistant. Inappropriate use of antimicrobials was frequent for penicillin, amoxicillin, and sulfamethoxazole/trimethoprim, but less for CIA. Conclusions and Clinical Importance Many critically ill calves have sepsis, which increases mortality risk. Bacteria involved are often resistant to first‐intention antimicrobials but less resistant to CIA. The other identified risk factors for mortality can support therapeutic decision‐making.https://doi.org/10.1111/jvim.16607antimicrobial resistancecattlecritically important antimicrobialsmortality |
| spellingShingle | Mathilde L. Pas Jade Bokma Thomas Lowie Filip Boyen Bart Pardon Sepsis and survival in critically ill calves: Risk factors and antimicrobial use Journal of Veterinary Internal Medicine antimicrobial resistance cattle critically important antimicrobials mortality |
| title | Sepsis and survival in critically ill calves: Risk factors and antimicrobial use |
| title_full | Sepsis and survival in critically ill calves: Risk factors and antimicrobial use |
| title_fullStr | Sepsis and survival in critically ill calves: Risk factors and antimicrobial use |
| title_full_unstemmed | Sepsis and survival in critically ill calves: Risk factors and antimicrobial use |
| title_short | Sepsis and survival in critically ill calves: Risk factors and antimicrobial use |
| title_sort | sepsis and survival in critically ill calves risk factors and antimicrobial use |
| topic | antimicrobial resistance cattle critically important antimicrobials mortality |
| url | https://doi.org/10.1111/jvim.16607 |
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