Burrough Eric R, Derscheid Rachel J, Mainenti Marta, Piñeyro Pablo, Baum David H
J Am Vet Med Assoc. 2024 Dec 12;263(S1):S6-S16. doi: 10.2460/javma.24.10.0657. Print 2025 Jun 1.
Veterinary diagnostic laboratories provide a vast catalog of tests for infectious agents and often have multiple tests and testing modalities for individual pathogens. Understanding which test to select, which sample type is best, and which animal to sample in a population are critical factors for drawing appropriate conclusions and diagnosing a disease. Each diagnostic test has its inherent diagnostic sensitivity and specificity, and, in many situations, multiple tests may be required for proper interpretation. When multiple tests are needed in a large population (eg, animal shelters, farmed animals, and breeding colonies), the cost of diagnostic testing becomes an increasing concern, and knowing when and how to use aggregate or composite samples is critical. A clinical examination is the first and arguably most important diagnostic procedure providing the framework for laboratory test selection. This yields not only a differential diagnosis but an expected stage of disease, which is necessary for determining the most appropriate laboratory tests and how they should be interpreted. This review will discuss the diagnostic process, strengths and limitations of commonly requested tests at a diagnostic laboratory (eg, histopathology, microbial culture, PCR, and ELISA), common sources of error in interpretation, the impact of pooling samples on different tests, and ways to help strengthen conclusions made from diagnostic test data.
兽医诊断实验室提供大量针对传染病原体的检测项目,而且针对单个病原体往往有多种检测方法和检测形式。了解选择何种检测、哪种样本类型最佳以及在群体中对何种动物进行采样,是得出恰当结论和诊断疾病的关键因素。每种诊断检测都有其固有的诊断敏感性和特异性,而且在许多情况下,可能需要多项检测才能做出正确解读。当在大量群体(如动物收容所、养殖动物和繁殖群体)中需要进行多项检测时,诊断检测的成本就会成为日益关注的问题,了解何时以及如何使用混合样本或综合样本至关重要。临床检查是首要且 arguably 最重要的诊断程序,为实验室检测选择提供框架。这不仅能得出鉴别诊断结果,还能确定疾病的预期阶段,而这对于确定最合适的实验室检测及其解读方式是必要的。本综述将讨论诊断过程、诊断实验室中常用检测(如组织病理学、微生物培养、聚合酶链反应和酶联免疫吸附测定)的优缺点、解读中常见的误差来源、混合样本对不同检测的影响以及有助于强化从诊断检测数据得出的结论方法。