Hunnam J C, Wilson P R, Heuer C, Stringer L, Clark R G, Mackintosh C G
Epicentre, Massey University, Private Bag 11-222, Palmerston North, New Zealand.
N Z Vet J. 2013 May;61(3):133-40. doi: 10.1080/00480169.2012.755886. Epub 2013 Feb 27.
To develop and validate criteria for identification of abnormal lymph nodes (LN) at commercial slaughter, for the purpose of national surveillance for Mycobacterium avium subspecies paratuberculosis (Map) in New Zealand farmed deer. This included estimation of the predictive value of abnormal LN for Map infection; a standard circumference cut-point for measurement of abnormal LN; and identification of risk factors associated with increasing LN circumference.
In Study 1, official assessors sampled 129 LN with macroscopically visible abnormalities (abnormal LN) from 76 deer herds between May and November 2007. LN samples were cultured for Map, with culture-negative LN further examined for typical histopathological changes. The predictive value of abnormal LN for Map infection was calculated and significance of herd location (North or South Island) assessed. In Study 2, the circumferences of 412 mesenteric LN (MLN) from 79 herds were measured between October 2007 and January 2009, with samples cultured for Map and examined for eight histopathological features. The minimum circumference of an abnormal MLN was defined, based on an arbitrary >95% specificity of a culture-positive Map diagnosis. Associations between the predictor variables Map culture status, carcase weight, animal age and gender, and histopathological features, and increasing MLN circumference were assessed using a linear mixed-effects model.
Based solely on culture, the predictive value of abnormal LN for Map infection was 92.2 (95% CI: 86.2-96.2)% with no difference between the North and South Islands (p = 0.09). Inclusion of three culture-negative LN with histopathological changes typical of Map infection increased the predictive value estimate to 94.6 (95% CI: 89.2-97.3)%. The minimum circumference of an abnormal MLN was defined as 55 mm, with a sensitivity of Map detection at this cut-point of approximately 12%. Increasing MLN circumference was positively associated with the presence of moderate follicular hyperplasia (p < 0.01), focal granulomas (p < 0.01) and a synergistic interaction between focal granulomas and Map status (p = 0.03).
Deer MLN with macroscopically visible abnormalities and/or a circumference of >55 mm have >95% likelihood of Map infection. However, sensitivity of Map diagnosis in MLN with circumference of >55 mm was 12%, indicating use of abnormal LN as a sole criterion in national surveillance for Map in slaughtered deer will underestimate animal-level prevalence.
制定并验证商业屠宰时异常淋巴结(LN)的识别标准,用于新西兰养殖鹿群副结核分枝杆菌(Map)的国家监测。这包括评估异常LN对Map感染的预测价值;测量异常LN的标准周长切点;以及识别与LN周长增加相关的风险因素。
在研究1中,官方评估人员于2007年5月至11月期间从76个鹿群中采集了129个肉眼可见异常的LN(异常LN)。对LN样本进行Map培养,对培养阴性的LN进一步检查典型组织病理学变化。计算异常LN对Map感染的预测价值,并评估鹿群位置(北岛或南岛)的显著性。在研究2中,于2007年10月至2009年1月期间测量了79个鹿群中412个肠系膜淋巴结(MLN)的周长,对样本进行Map培养并检查8种组织病理学特征。基于Map培养阳性诊断的任意>95%特异性定义异常MLN的最小周长。使用线性混合效应模型评估预测变量Map培养状态、胴体重量、动物年龄和性别以及组织病理学特征与MLN周长增加之间的关联。
仅基于培养,异常LN对Map感染的预测价值为92.2(95%可信区间:86.2 - 96.2)%,北岛和南岛之间无差异(p = 0.09)。纳入3个具有Map感染典型组织病理学变化的培养阴性LN后,预测价值估计增加至94.6(95%可信区间:89.2 - 97.3)%。异常MLN的最小周长定义为55毫米,在此切点处Map检测的灵敏度约为12%。MLN周长增加与中度滤泡增生(p < 0.01)、局灶性肉芽肿(p < 0.01)以及局灶性肉芽肿与Map状态之间的协同相互作用(p = 0.03)呈正相关。
肉眼可见异常和/或周长>55毫米的鹿MLN感染Map的可能性>95%。然而,周长>55毫米的MLN中Map诊断的灵敏度为12%,这表明在屠宰鹿的Map国家监测中仅将异常LN作为唯一标准会低估动物层面的患病率。