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估算用于高通量定量实时PCR检测牛呼吸道细菌病原体的临床相关临界值

Estimating Clinically Relevant Cut-Off Values for a High-Throughput Quantitative Real-Time PCR Detecting Bacterial Respiratory Pathogens in Cattle.

作者信息

Klompmaker Alicia F, Brydensholt Maria, Michelsen Anne Marie, Denwood Matthew J, Kirkeby Carsten T, Larsen Lars Erik, Goecke Nicole B, Otten Nina D, Nielsen Liza R

机构信息

Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.

Centre for Diagnostics, Technical University of Denmark, Kongens Lyngby, Denmark.

出版信息

Front Vet Sci. 2021 May 25;8:674771. doi: 10.3389/fvets.2021.674771. eCollection 2021.

Abstract

Bovine respiratory disease (BRD) results from interactions between pathogens, environmental stressors, and host factors. Obtaining a diagnosis of the causal pathogens is challenging but the use of high-throughput real-time PCR (rtPCR) may help target preventive and therapeutic interventions. The aim of this study was to improve the interpretation of rtPCR results by analysing their associations with clinical observations. The objective was to develop and illustrate a field-data driven statistical method to guide the selection of relevant quantification cycle cut-off values for pathogens associated with BRD for the high-throughput rtPCR system "Fluidigm BioMark HD" based on nasal swabs from calves. We used data from 36 herds enrolled in a Danish field study where 340 calves within pre-determined age-groups were subject to clinical examination and nasal swabs up to four times. The samples were analysed with the rtPCR system. Each of the 1,025 observation units were classified as sick with BRD or healthy, based on clinical scores. The optimal rtPCR results to predict BRD were investigated for , and by interpreting scatterplots and results of mixed effects logistic regression models. The clinically relevant rtPCR cut-off suggested for and was ≤ 21.3. For it was ≤ 17.4, while no cut-off could be determined for and . The demonstrated approach can provide objective support in the choice of clinically relevant cut-offs. However, for robust performance of the regression model sufficient amounts of suitable data are required.

摘要

牛呼吸道疾病(BRD)是由病原体、环境应激源和宿主因素之间的相互作用引起的。确定致病病原体具有挑战性,但使用高通量实时PCR(rtPCR)可能有助于针对性地进行预防和治疗干预。本研究的目的是通过分析rtPCR结果与临床观察结果之间的关联来改进对其结果的解读。目标是开发并说明一种基于现场数据驱动的统计方法,以指导为与BRD相关的病原体选择相关的定量循环截止值,该方法适用于基于小牛鼻拭子的高通量rtPCR系统“Fluidigm BioMark HD”。我们使用了来自丹麦一项现场研究的36个牛群的数据,在该研究中,对预先确定年龄组内的340头小牛进行了临床检查和多达四次的鼻拭子采集。样本用rtPCR系统进行分析。根据临床评分,将1025个观察单位中的每一个都分类为患有BRD或健康。通过解释散点图和混合效应逻辑回归模型的结果,研究了预测BRD的最佳rtPCR结果,针对[此处原文缺失相关病原体名称]、[此处原文缺失相关病原体名称]、[此处原文缺失相关病原体名称]和[此处原文缺失相关病原体名称]。建议的与临床相关的rtPCR截止值,对于[此处原文缺失相关病原体名称]和[此处原文缺失相关病原体名称]为≤21.3。对于[此处原文缺失相关病原体名称]为≤17.4,而对于[此处原文缺失相关病原体名称]和[此处原文缺失相关病原体名称]无法确定截止值。所展示的方法可为选择临床相关截止值提供客观支持。然而,为了使回归模型具有稳健的性能,需要足够数量的合适数据。

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