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与犬钩端螺旋体病血清学微凝集试验相比,PCR检测法诊断价值的评估

The Evaluation of the Diagnostic Value of a PCR Assay When Compared to a Serologic Micro-Agglutination Test for Canine Leptospirosis.

作者信息

Martin Elizabeth A, Heseltine Johanna C, Creevy Kate E

机构信息

Department of Cardiology, Veterinary Medicine Faculty Intern, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, United States.

Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, United States.

出版信息

Front Vet Sci. 2022 Apr 26;9:815103. doi: 10.3389/fvets.2022.815103. eCollection 2022.

Abstract

OBJECTIVE

To evaluate PCR assay sensitivity and specificity compared to that of microscopic agglutination test (MAT) for diagnosis of canine leptospirosis. Electronic records search was performed to identify dogs with results for both PCR and MAT testing for leptospirosis.

METHODS

All dogs were clinically ill. Diagnosis of leptospirosis was defined as an unvaccinated dog with a positive MAT titer of ≥1:800 or a vaccinated dog or dog with an unknown vaccination status with a positive MAT titer of ≥1:1,600. Diagnosis of leptospirosis was excluded based on MAT titer <1:800 on both the initial and convalescent samples or an initial MAT titer <1:800 and an alternative definitive diagnosis.

RESULTS

Forty-nine samples (urine, = 39; blood, = 10) were evaluated. Leptospirosis was diagnosed in 17 dogs and excluded in 26 dogs. Urine PCR assay demonstrated sensitivity of 69.2%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 86.6%. Blood PCR assay demonstrated sensitivity of 25%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 25%. Overall PCR sensitivity was 52.4%, specificity was 100%, positive predictive value was 100%, and negative predictive value was 73.7%.

CONCLUSIONS

PCR assay performed on urine or blood has high specificity and positive predictive value when compared to MAT for diagnosis of clinical canine leptospirosis. Sensitivity and negative predictive value are moderate to low, so PCR testing should be performed in conjunction with paired MAT testing for canine leptospirosis. Prior antibiotic therapy does not preclude the use of the PCR test.

摘要

目的

与显微镜凝集试验(MAT)相比,评估聚合酶链反应(PCR)检测法在犬钩端螺旋体病诊断中的敏感性和特异性。通过电子记录搜索来确定同时进行了钩端螺旋体病PCR检测和MAT检测的犬只。

方法

所有犬只均有临床症状。钩端螺旋体病的诊断定义为:未接种疫苗的犬只MAT滴度≥1:800为阳性,或接种过疫苗的犬只或疫苗接种情况未知的犬只MAT滴度≥1:1600为阳性。若初始样本和恢复期样本的MAT滴度均<1:800,或初始MAT滴度<1:800且有其他明确诊断,则排除钩端螺旋体病诊断。

结果

共评估了49份样本(尿液,n = 39;血液,n = 10)。17只犬被诊断为钩端螺旋体病,26只犬被排除。尿液PCR检测法的敏感性为69.2%,特异性为100%,阳性预测值为100%,阴性预测值为86.6%。血液PCR检测法的敏感性为25%,特异性为100%,阳性预测值为100%,阴性预测值为25%。总体PCR敏感性为52.4%,特异性为100%,阳性预测值为100%,阴性预测值为73.7%。

结论

与MAT相比,对尿液或血液进行PCR检测在临床犬钩端螺旋体病诊断中具有较高的特异性和阳性预测值。敏感性和阴性预测值中等至较低,因此PCR检测应与犬钩端螺旋体病的配对MAT检测联合进行。先前的抗生素治疗并不妨碍使用PCR检测。

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