Department of Veterinary Population Medicine, University of Minnesota, St. Paul, 55108, USA.
Department of Veterinary Population Medicine, University of Minnesota, St. Paul, 55108, USA.
Prev Vet Med. 2020 Jun;179:104982. doi: 10.1016/j.prevetmed.2020.104982. Epub 2020 Apr 16.
Our objective was to compare four tests to standard milk culture followed by MALDI-ToF in quarters of cows at dry-off. Cows (n = 432) were randomly selected from seven U.S. dairy herds already participating in a multi-site clinical trial in summer 2018. Aseptic foremilk samples were collected from quarters (n = 1728) two days prior to dry-off, and subjected to index and reference tests. The four index tests included rapid culture, a predictive algorithm, an esterase strip test measuring somatic cell count (SCC) and a cow-side lactate dehydrogenase (LDH) test. Rapid culture was performed by inoculating quarter milk samples onto a commercial rapid culture plate. Plates were evaluated by technicians after 30-40 h of incubation at 37 ± 2 °C. Quarters were classified as infected if any bacterial growth was observed. For the algorithm test method, all quarters were classified as infected if the cow met any of the following criteria: 1) any Dairy Herd Improvement Association (DHIA) test with a SCC > 200,000 cells / ml during the current lactation or 2) two or more clinical mastitis cases during the current lactation. Esterase-SCC and cow-side LDH tests involved adding milk to the test strip and reading for color changes. For esterase-SCC and cow-side LDH tests, low (≥250 cells / ml and ≥100 U / L) and high (≥500 cells / ml and ≥200 U / L) thresholds were used to classify quarters as infected or not. Composite samples (4 × 2 mL quarter-milk samples commingled) were also tested for rapid culture, esterase-SCC and cow-side LDH tests, such that if a composite sample was positive, then all quarters contributing to that sample were classified as infected. The reference test was traditional aerobic culture conducted in an accredited laboratory using MALDI-ToF for identification of isolates. Traditional culture was only conducted on quarter-milk samples, and consequently, IMI was always considered at the quarter-level. Unconditional logistic regression was used to estimate sensitivity (SE), specificity (SP), apparent prevalence, positive predictive values (PPV) and negative predictive values (NPV) for each index test. Cohen's Kappa (κ) was used to measure agreement between tests. Algorithm, esterase-SCC and cow-side LDH tests had poor agreement with the reference test (κ ranging from 0.01 to 0.12), while rapid culture had fair agreement (κ = 0.28). No test had concurrently high SE and SP. Negative predictive values were moderate to high for all tests.
我们的目标是比较四种检测方法与标准牛奶培养后 MALDI-ToF 在干奶期牛群中四分之一的情况。从已经参加 2018 年夏季多地点临床试验的 7 个美国奶牛场中随机选择奶牛(n=432)。在干奶前两天,从四个象限(n=1728)无菌采集前奶样,并进行指数和参考测试。四种指数检测方法包括快速培养、预测算法、测量体细胞计数(SCC)的酯酶条试验和牛侧乳酸脱氢酶(LDH)试验。快速培养是通过将牛奶样本接种到商业快速培养板上进行的。在 37°C±2°C 下孵育 30-40 小时后,由技术人员评估平板。如果观察到任何细菌生长,则将象限分类为感染。对于算法检测方法,如果奶牛符合以下任何标准,则所有象限均被分类为感染:1)当前泌乳期内任何乳品 herd improvement association(DHIA)测试的 SCC>200,000 细胞/ml,或 2)当前泌乳期内出现两次或更多临床乳腺炎病例。酯酶-SCC 和牛侧 LDH 试验涉及向测试条中添加牛奶并读取颜色变化。对于酯酶-SCC 和牛侧 LDH 试验,低(≥250 细胞/ml 和≥100 U/L)和高(≥500 细胞/ml 和≥200 U/L)阈值用于将象限分类为感染或不感染。还对快速培养、酯酶-SCC 和牛侧 LDH 试验进行了复合样本(4×2mL 象限奶样混合)检测,使得如果复合样本呈阳性,则将所有对该样本有贡献的象限均分类为感染。参考测试是在认可的实验室中使用 MALDI-ToF 进行的传统有氧培养,用于鉴定分离株。传统培养仅在牛奶样本中进行,因此,IMI 始终在象限级别考虑。使用无条件逻辑回归估计每种指数检测的敏感性(SE)、特异性(SP)、表观流行率、阳性预测值(PPV)和阴性预测值(NPV)。Cohen's Kappa(κ)用于测量测试之间的一致性。算法、酯酶-SCC 和牛侧 LDH 试验与参考测试的一致性较差(κ 值在 0.01 到 0.12 之间),而快速培养的一致性较好(κ=0.28)。没有一种检测方法同时具有高 SE 和 SP。所有检测的阴性预测值均为中等到高度。