A Retrospective Review of the Clinical Value of Fecal Bacterial Enteric Pathogen Cultures in Mammals Within a Zoological Collection and the Use of Fecal Cytology for Optimization of Additional Diagnostic Testing
The clinical value of fecal bacterial enteric pathogen cultures (FBEPC) as part of routine preventive medicine protocols in mammals is unknown. The objectives of this study were to 1) investigate the clinical utility of FBEPC results in context of subsequent clinical actions and to 2) present the use of fecal cytology as a tool for optimization of additional diagnostic testing. Retrospective FBEPC culture results from 692 tests of 432 mammals taken at Disney’s Animal Kingdom from 2011–2016 were separated into preventive (P; n=485), diagnostic (D; n=177), or recheck (R; n=30) samples, and the results and subsequent clinical actions were assigned a clinical significance factor (CSF) of 1 to 5 for D and P samples. 53 FBEPC isolated bacterial organisms, with 28 yielding clinically relevant findings. Aeromonas spp. was most frequently isolated, followed by Campylobacter spp., and Salmonella spp. Only 26.4% (n=14; P n=2, D n=9, R n=3) warranted treatment. A CSF of 3 to 5 was more frequent in D (55%) compared to P (7.4%) samples. Based on these results, using FBEPC as part of preventive medicine protocols is not warranted as a routinely included test in mammals. Implementation of fecal cytology as an initial step in fecal evaluation resulted in a prompt and substantial reduction in number of submitted FBEPC (n=12/mo before and n=5/mo after implementation). Fecal cytologic evaluation can provide guidance for clinically useful and cost-effective selection of additional fecal diagnostic testing.
The authors thank Professor Ian Handel for his statistical guidance and expertise, as well as Susan Feltman and the rest of the Disney Animal Health medical records team for helping compile the database.