title: Use of a clinical sepsis score for predicting bacteremia in neonatal dairy calves on a calf rearing farm.
abstract: 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.
authors.affiliation: Département de sciences cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec.
authors.forename: G
authors.initials: G
authors.lastname: Fecteau
authors.forename: J
authors.initials: J
authors.lastname: Paré
authors.forename: D C
authors.initials: DC
authors.lastname: Van Metre
authors.forename: B P
authors.initials: BP
authors.lastname: Smith
authors.forename: C A
authors.initials: CA
authors.lastname: Holmberg
authors.forename: W
authors.initials: W
authors.lastname: Guterbock
authors.forename: S
authors.initials: S
authors.lastname: Jang
mesh_terms: D000375:Aging / Q000097:blood / Q000502:physiology; D000822:Animal Husbandry / Q000379:methods*; D000818:Animals; D000831:Animals, Newborn / Q000097:blood* / Q000382:microbiology* / Q000502:physiology; D016470:Bacteremia / Q000175:diagnosis / Q000453:epidemiology / Q000662:veterinary*; D001831:Body Temperature / Q000502:physiology; D002417:Cattle; D002418:Cattle Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006339:Heart Rate / Q000502:physiology; D015994:Incidence; D016014:Linear Models; D008297:Male; D011237:Predictive Value of Tests; D011336:Probability; D012044:Regression Analysis; D012119:Respiration / Q000502:physiology; D012307:Risk Factors; D012680:Sensitivity and Specificity