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贝叶斯潜在类别估计 PMS-PCR 试验检测牛隐性感染分支杆菌副结核亚种的敏感性和特异性参数。

Bayesian latent class estimation of sensitivity and specificity parameters of the PMS-PCR test for the diagnosis of cattle sub-clinically infected with Mycobacterium avium subsp. paratuberculosis.

机构信息

Instituto de Medicina Preventiva Veterinaria, Universidad Austral de Chile, Valdivia, Chile.

Instituto de Medicina Preventiva Veterinaria, Universidad Austral de Chile, Valdivia, Chile.

出版信息

Prev Vet Med. 2020 Sep;182:105076. doi: 10.1016/j.prevetmed.2020.105076. Epub 2020 Jun 23.

DOI:10.1016/j.prevetmed.2020.105076
PMID:32682154
Abstract

The objective of this study was to estimate the performance of the peptide magnetic separation PCR test (PMS-PCR) for the diagnosis of Mycobacterium avium subsp. paratuberculosis (MAP) in sub-clinically infected dairy cattle. Twenty-one herds were randomly selected from a source population of 131 commercial dairy herds with a known history of MAP infection, located in the De Los Rios and De Los Lagos regions, in southern Chile. In the selected herds, all milking cows with ≥2 parities and without any clinical signs were sampled, collecting feces and blood-serum samples. The PMS-PCR test was used to analyze the fecal samples, while serum samples were analyzed using a commercial ELISA kit. A Bayesian latent class model was used to estimate the sensitivity (Se) and specificity (Sp) of the diagnostic tests. A total of 1381 animals were sampled in the 21 selected dairy herds, with an average sample size of 65 animals per herd (range 10-721). The PMS-PCR test had a greater Se than the ELISA test, with a median of 85.5 % (posterior probability interval (PPI) 95 %: 79.3-91.0%), while the ELISA test presented a median of 21.7 % (95 % PPI: 18.3-25.4%). On the other hand, the ELISA test had a better Sp than the PMS-PCR test, with a median of 97.7 % (95 % PPI: 96.6-98.5%), whereas PMS-PCR presented a median of 90.8 % (95 % PPI: 88.3-93.9%). Model results showed that PMS-PCR has a better Se than all available tests for MAP diagnosis in subclinical animals. However, this test should be used with care in herds with high infection rates, where a high MAP environmental load is expected, potentially increasing the frequency of false positive cases due to the pass-through phenomenon.

摘要

本研究旨在评估肽磁分离 PCR 检测(PMS-PCR)在亚临床感染奶牛中诊断禽分枝杆菌副结核亚种(MAP)的性能。从智利南部德洛斯里奥斯和德洛斯 Lagos 地区已知存在 MAP 感染史的 131 个商业奶牛场的源人群中随机选择了 21 个牛群。在选定的牛群中,采集了所有产奶量≥2 胎且无任何临床症状的奶牛的粪便和血清样本。使用 PMS-PCR 检测分析粪便样本,使用商业 ELISA 试剂盒分析血清样本。采用贝叶斯潜在类别模型估计诊断试验的敏感性(Se)和特异性(Sp)。在 21 个选定的奶牛场中,共对 1381 头动物进行了采样,每个牛群的平均采样量为 65 头(范围为 10-721 头)。PMS-PCR 检测的 Se 高于 ELISA 检测,中位数为 85.5%(95%后验概率区间(PPI):79.3-91.0%),而 ELISA 检测的中位数为 21.7%(95% PPI:18.3-25.4%)。另一方面,ELISA 检测的 Sp 优于 PMS-PCR 检测,中位数为 97.7%(95% PPI:96.6-98.5%),而 PMS-PCR 检测的中位数为 90.8%(95% PPI:88.3-93.9%)。模型结果表明,PMS-PCR 在亚临床动物中诊断 MAP 的所有现有检测方法中具有更好的 Se。然而,在预期 MAP 环境负荷较高的高感染率牛群中,应谨慎使用该检测方法,因为由于穿透现象,可能会增加假阳性病例的频率。

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