Elmas Colette R, Koenig Judith B, Bienzle Dorothee, Cribb Nicola C, Cernicchiaro Natalia, Coté Nathalie M, Weese J Scott
Department of Clinical Studies (Elmas, Koenig, Cribb); Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, Ontario (Weese, Bienzle); Department of Diagnostic Medicine and Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, United States (Cernicchiaro); and Milton Equine Hospital, Campbellville, Ontario (Coté).
Can J Vet Res. 2013 Jul;77(3):211-7.
Septic synovitis is a potentially debilitating and life-threatening disorder in horses. We hypothesized that a universal bacterial real-time PCR (RT-PCR) assay would have improved sensitivity and decreased turn-around time for detection of bacteria in synovial fluid (SF) samples. Forty-eight SF samples were collected from 36 horses that presented to two referral institutions with suspected septic synovitis. Universal RT-PCR, bacterial culture and SF analysis were performed on all samples, and an interpretation on the sample being septic or not was derived by three board certified specialists from the history, clinical assessment and SF characteristics. RT-PCR results were compared to a composite standard comprised of positive culture and interpretation by all three specialists of samples as "septic". For 41 of 48 samples (85%), culture and RT-PCR results were concordant. Compared to the composite standard, 83% of samples were correctly classified by RT-PCR (turn-around time of approximately 4 hours). Relative sensitivity and specificity of RT-PCR were 87% and 72% respectively, and 56% and 86% for culture. Hence, universal RT-PCR was a rapid and highly sensitive test, which may accelerate diagnosis and improve outcome for horses with septic synovitis.
化脓性滑膜炎是马匹中一种可能导致身体衰弱并危及生命的疾病。我们推测，一种通用的细菌实时聚合酶链反应（RT-PCR）检测方法将提高滑膜液（SF）样本中细菌检测的灵敏度，并缩短周转时间。从36匹因疑似化脓性滑膜炎就诊于两家转诊机构的马匹中采集了48份SF样本。对所有样本进行了通用RT-PCR、细菌培养和SF分析，并由三位获得委员会认证的专家根据病史、临床评估和SF特征对样本是否为化脓性进行判断。将RT-PCR结果与由阳性培养结果以及三位专家均判定样本为“化脓性”组成的综合标准进行比较。在48个样本中的41个（85%）中，培养结果和RT-PCR结果一致。与综合标准相比，RT-PCR对83%的样本分类正确（周转时间约为4小时）。RT-PCR的相对灵敏度和特异性分别为87%和72%，培养的相对灵敏度和特异性分别为56%和86%。因此，通用RT-PCR是一种快速且高度灵敏的检测方法，可能会加快对患有化脓性滑膜炎马匹的诊断并改善其预后。
