Bergmann Michèle, Llewellyn Julia-Rebecca, Hartmann Katrin
Michèle Bergmann, Medizinische Kleintierklinik, Ludwig-Maximilians-Universität München, Veterinärstraße 13, 80539 München, E-Mail:
Tierarztl Prax Ausg K Kleintiere Heimtiere. 2017 Jun 20;45(3):170-177. doi: 10.15654/TPK-170039. Epub 2017 May 17.
Rapid confirmation of the diagnosis leptospirosis is important in order to apply appropriate treatment; in addition, infected dogs are a zoonotic risk. Culture and isolation of living leptospires from blood, urine, or tissues is considered the reference standard of diagnosis. However, sensitivity are low, and leptospires require weeks to months to grow. Therefore, diagnosis of leptospirosis is most commonly based on antibody testing or the detection of Leptospira spp. DNA by PCR. Microscopic agglutination test (MAT) is currently still the recommended confirmatory test for canine leptospirosis, despite its numerous limitations (e. g., negative results in early infection, positive results due to vaccine-associated antibodies). ELISA can differentiate between IgG and IgM antibodies and thus, discriminate current infections from previous vaccination or exposure. Point-of-care tests and in-house-PCR tests have recently been developed for use in private practice allowing easy and immediate diagnosis. However, only few data on sensitivity and specificity of these tests exist so far. A reliable diagnosis can only be established in case of a positive PCR result or a fourfold titre increase in MAT.
为了进行适当治疗，快速确诊钩端螺旋体病很重要；此外，感染的犬类存在人畜共患病风险。从血液、尿液或组织中培养和分离活钩端螺旋体被认为是诊断的参考标准。然而，其敏感性较低，且钩端螺旋体需要数周至数月才能生长。因此，钩端螺旋体病的诊断最常基于抗体检测或通过聚合酶链反应（PCR）检测钩端螺旋体属DNA。显微镜凝集试验（MAT）目前仍是犬钩端螺旋体病推荐的确诊试验，尽管它有许多局限性（例如，早期感染时结果为阴性，疫苗相关抗体导致结果为阳性）。酶联免疫吸附测定（ELISA）可以区分IgG和IgM抗体，从而区分当前感染与既往疫苗接种或接触情况。即时检测和内部PCR检测最近已开发用于私人诊所，便于进行快速诊断。然而，目前关于这些检测的敏感性和特异性的数据很少。只有在PCR结果为阳性或MAT滴度升高四倍的情况下才能确立可靠的诊断。
