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用于诊断犬系统性曲霉病的血液和尿液半乳甘露聚糖抗原检测的敏感性和特异性。

Sensitivity and specificity of a blood and urine galactomannan antigen assay for diagnosis of systemic aspergillosis in dogs.

机构信息

William R. Pritchard Veterinary Medical Teaching Hospital.

出版信息

J Vet Intern Med. 2012 Jul-Aug;26(4):911-9. doi: 10.1111/j.1939-1676.2012.00935.x. Epub 2012 Apr 21.

Abstract

BACKGROUND

Diagnosis of canine systemic aspergillosis requires fungal culture from a sterile site, or confirmatory histopathology from a nonsterile site. Invasive specimen collection techniques may be necessary.

OBJECTIVE

To evaluate the sensitivity and specificity of a serum and urine Aspergillus galactomannan antigen (GMA) ELISA assay for diagnosis of systemic aspergillosis in dogs.

DESIGN

Multicenter study.

ANIMALS

Thirteen dogs with systemic aspergillosis and 89 dogs with other diseases. Thirty-seven of the 89 dogs had signs that resembled those of systemic aspergillosis and 52 dogs were not suspected to have aspergillosis.

PROCEDURE

The GMA ELISA was performed on serum specimens from all dogs and urine specimens from 67 dogs. Galactomannan indices (GMI) ≥ 0.5 were considered positive. Results for dogs in each group were compared.

RESULTS AND CONCLUSIONS

The sensitivity and specificity of the assay for serum were 92 and 86%, respectively, and for urine were 88 and 92%, respectively. False negatives were seen only in dogs with localized pulmonary aspergillosis. Use of a cutoff GMI of 1.5 increased specificity to 93% for both serum and urine without loss of sensitivity for diagnosis of disseminated infection. High-level false positives (> 1.5) occurred in dogs with other systemic mycoses and those treated with Plasmalyte.

CLINICAL RELEVANCE

Serum and urine Aspergillus GMA ELISA is a noninvasive, sensitive, and specific test for the diagnosis of disseminated aspergillosis in dogs when a cutoff GMI of ≥ 1.5 is used.

摘要

背景

犬系统性曲霉病的诊断需要从无菌部位获取真菌培养物,或从非无菌部位获取确认性组织病理学检查。可能需要进行有创标本采集技术。

目的

评估血清和尿液曲霉半乳甘露聚糖抗原(GMA)ELISA 检测试剂盒用于诊断犬系统性曲霉病的敏感性和特异性。

设计

多中心研究。

动物

13 只患有系统性曲霉病的犬和 89 只患有其他疾病的犬。89 只犬中有 37 只具有类似于系统性曲霉病的症状,52 只犬不怀疑患有曲霉病。

程序

对所有犬的血清标本和 67 只犬的尿液标本进行 GMA ELISA 检测。Galactomannan 指数(GMI)≥0.5 被认为是阳性。比较各组犬的结果。

结果与结论

该检测方法对血清的敏感性和特异性分别为 92%和 86%,对尿液的敏感性和特异性分别为 88%和 92%。仅在患有局限性肺曲霉病的犬中出现假阴性。使用截断 GMI 值为 1.5 可将血清和尿液的特异性提高至 93%,而不影响对弥散性感染的诊断敏感性。高水平的假阳性(>1.5)发生在患有其他系统性真菌病和接受 Plasmalyte 治疗的犬中。

临床相关性

当使用截断 GMI 值≥1.5 时,血清和尿液曲霉 GMA ELISA 是一种非侵入性、敏感且特异的犬弥散性曲霉病诊断方法。

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