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即时检测皮肤癣菌测试培养基与真菌学实验室培养法在犬猫皮肤癣菌病诊断中的比较

Comparison between point-of-care dermatophyte test medium and mycology laboratory culture for diagnosis of dermatophytosis in dogs and cats.

作者信息

Kaufmann Ronnie, Blum Shlomo E, Elad Daniel, Zur Gila

机构信息

Dermatology Department, Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, POB 12, Rehovot, 7610001, Israel.

Department of Clinical Bacteriology and Mycology, The Kimron Veterinary Institute, Veterinary Services, Ministry of Agriculture, Bet Dagan, 5020001, Israel.

出版信息

Vet Dermatol. 2016 Aug;27(4):284-e68. doi: 10.1111/vde.12322. Epub 2016 May 30.

Abstract

BACKGROUND

Point-of-care Dermatophyte Test Medium (PoC-DTM) is a diagnostic procedure to rule in/rule out dermatophytosis in veterinary clinics.

OBJECTIVE

To evaluate the performance of PoC-DTM in the clinic compared to DTM plate culture in a mycology laboratory and to compare results obtained by general practitioners and referral clinicians.

ANIMALS

Hair samples were collected from 47 cats and 54 dogs with suspected dermatophytosis and from nine healthy controls (seven cats and two dogs).

METHODS

This was a multicentre blinded study. In one group (65 suspected cases, 9 healthy controls), PoC-DTM results were evaluated by clinicians in a referral clinic (SP group) who examined the colony morphology macroscopically and microscopically. In the other group (36 suspected cases) PoC-DTM results were evaluated by clinicians from general practice for colour change only, with no macroscopic or microscopic examination (GP group). All hair samples were also cultured on DTM plates in a mycology laboratory. Laboratory culture was considered the gold standard for comparison.

RESULTS

Agreements between tests were 97% (two false positive; κ = 0.839) and 80.6% (five false positives and two false negatives; κ = 0.466) in the SP and GP groups, respectively. This difference between groups was significant (P = 0.024).

CONCLUSION AND CLINICAL IMPORTANCE

When applying macroscopic and microscopic evaluation of the colony, PoC-DTM is accurate for diagnosing dermatophytes with only a 3% chance of error. However, when macroscopic and microscopic examination is not included there is significant (19.4%) chance for an incorrect diagnosis.

摘要

背景

即时护理皮肤癣菌测试培养基(PoC-DTM)是一种在兽医诊所用于确诊/排除皮肤癣菌病的诊断方法。

目的

评估临床环境中PoC-DTM与真菌学实验室中DTM平板培养法相比的性能,并比较全科医生和转诊临床医生获得的结果。

动物

从47只疑似皮肤癣菌病的猫和54只疑似皮肤癣菌病的狗以及9只健康对照动物(7只猫和2只狗)采集毛发样本。

方法

这是一项多中心盲法研究。在一组(65例疑似病例,9只健康对照动物)中,转诊诊所的临床医生(SP组)对PoC-DTM结果进行评估,他们对菌落形态进行宏观和微观检查。在另一组(36例疑似病例)中,全科医生仅根据颜色变化评估PoC-DTM结果,不进行宏观或微观检查(GP组)。所有毛发样本也在真菌学实验室的DTM平板上进行培养。实验室培养被视为用于比较的金标准。

结果

SP组和GP组测试之间的一致性分别为97%(2例假阳性;κ = 0.839)和80.6%(5例假阳性和2例假阴性;κ = 0.466)。两组之间的这种差异具有统计学意义(P = 0.024)。

结论及临床意义

当对菌落进行宏观和微观评估时,PoC-DTM诊断皮肤癣菌准确,误诊几率仅为3%。然而,当不包括宏观和微观检查时,误诊几率显著(19.4%)。

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