PCR

PCR
  • 文章类型: Guideline
    虽然2019年冠状病毒病的大流行仍在继续,自2022年5月以来,猴痘在非流行国家迅速传播。准确和快速的实验室测试对于识别和控制猴痘至关重要。韩国实验室医学学会和韩国疾病预防和控制机构提出了在韩国临床实验室中诊断猴痘的指南。这些指南涵盖了测试的类型,标本的选择,采集标本,诊断方法,测试结果的解释,和生物安全。分子测试被推荐作为确认测试。建议皮肤病变标本在症状阶段进行测试,建议在症状前或前驱阶段收集血液和口咽拭子。
    While the coronavirus disease 2019 pandemic is ongoing, monkeypox has been rapidly spreading in non-endemic countries since May 2022. Accurate and rapid laboratory tests are essential for identifying and controlling monkeypox. Korean Society for Laboratory Medicine and the Korea Disease Prevention and Control Agency have proposed guidelines for diagnosing monkeypox in clinical laboratories in Korea. These guidelines cover the type of tests, selection of specimens, collection of specimens, diagnostic methods, interpretation of test results, and biosafety. Molecular tests are recommended as confirmatory tests. Skin lesion specimens are recommended for testing in the symptomatic stage, and the collection of both blood and oropharyngeal swabs is recommended in the presymptomatic or prodromal stage.
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  • 文章类型: Journal Article
    猫传染性腹膜炎(FIP)是猫最重要的传染病和死亡原因之一;小于2岁的幼猫尤其容易受到伤害。FIP是由猫冠状病毒(FCoV)引起的。据估计,兽医机构中约有0.3%至1.4%的猫科动物死亡是由FIP引起的。
    本文件由猫科动物临床医学专家工作组开发,作为2022年AAFP/EveryCat猫科动物传染性腹膜炎诊断指南,为兽医提供必要的信息,以帮助他们识别出现FIP的猫。
    几乎每一个小动物兽医都会看到案例。由于缺乏病理临床体征或实验室变化,FIP可能难以诊断。尤其是当没有积液时。对每个诊断测试的灵敏度有很好的了解,特异性,预测值,在建立FIP案例时,似然比和诊断准确性很重要。在进行任何诊断测试或商业实验室简介之前,临床医生应该能够回答以下问题:“为什么要进行这种测试?”和“结果意味着什么?”最终,诊断FIP的方法必须针对单个猫的具体表现进行调整。
    鉴于这种疾病未经治疗是致命的,获得正确诊断的能力至关重要。临床医生必须考虑患者的个人病史,选择诊断测试和样本类型时的信号和全面体检结果,以建立怀疑指数“一砖一瓦”。研究表明,新的抗病毒药物在FIP治疗中的疗效,但是这些产品目前在许多国家都无法合法获得。工作组鼓励兽医审查文献,并随时了解临床试验和新药批准情况。
    Feline infectious peritonitis (FIP) is one of the most important infectious diseases and causes of death in cats; young cats less than 2 years of age are especially vulnerable. FIP is caused by a feline coronavirus (FCoV). It has been estimated that around 0.3% to 1.4% of feline deaths at veterinary institutions are caused by FIP.
    This document has been developed by a Task Force of experts in feline clinical medicine as the 2022 AAFP/EveryCat Feline Infectious Peritonitis Diagnosis Guidelines to provide veterinarians with essential information to aid their ability to recognize cats presenting with FIP.
    Nearly every small animal veterinary practitioner will see cases. FIP can be challenging to diagnose owing to the lack of pathognomonic clinical signs or laboratory changes, especially when no effusion is present. A good understanding of each diagnostic test\'s sensitivity, specificity, predictive value, likelihood ratio and diagnostic accuracy is important when building a case for FIP. Before proceeding with any diagnostic test or commercial laboratory profile, the clinician should be able to answer the questions of \'why this test?\' and \'what do the results mean?\' Ultimately, the approach to diagnosing FIP must be tailored to the specific presentation of the individual cat.
    Given that the disease is fatal when untreated, the ability to obtain a correct diagnosis is critical. The clinician must consider the individual patient\'s history, signalment and comprehensive physical examination findings when selecting diagnostic tests and sample types in order to build the index of suspicion \'brick by brick\'. Research has demonstrated efficacy of new antivirals in FIP treatment, but these products are not legally available in many countries at this time. The Task Force encourages veterinarians to review the literature and stay informed on clinical trials and new drug approvals.
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  • 文章类型: Journal Article
    基于定性和定量PCR的测试广泛用于诊断和研究,以评估兽医学中致病病原体的患病率。这些测试的功效,通常以灵敏度和特异性来衡量,对确认或排除临床诊断至关重要。我们进行了荟萃分析,以评估已发表的PCR诊断方法的内在价值,该方法用于确认和定量与牛呼吸道疾病(BRD)相关的细菌和病毒。本审查遵循了系统审查和荟萃分析(PRISMA)指南的首选报告项目。对九个电子数据库的彻底搜索(WebofScience,EBSCOhost,剑桥在线期刊,ProQuest,PubMed,Sage在线期刊,ScienceDirect,Wiley在线图书馆和MEDLINE)进行了研究,以发现有关使用PCR和/或qPCR检测和/或定量BRD相关生物的研究。所有符合报告定量PCR以鉴定BRD相关微生物的纳入标准的研究都包括在分析中。然后对定量实时PCR实验(MIQE)的最低信息的应用进行评估,并提取PCR引物/探针序列,并使用高水平的严格性测试计算机特异性。本研究共纳入14篇全文。其中,79%的分析文章没有报告MIQE指南在他们的研究中的应用。在144个先前公开的PCR引物/探针序列的计算机模拟测试中的高严格性发现许多具有可疑的特异性。这篇评论确定了具有可变的计算机特异性的引物/探针序列的高发生率,因此这可能对报告的准确性有影响。尽管此分析仅适用于一种特定的疾病状态,怀疑患有牛呼吸道疾病的动物的鉴定,兽医诊断研究似乎更广泛地需要采用国际最佳实践来报告定量PCR诊断数据,使其在研究和方法之间既准确又具有可比性.
    Qualitative and quantitative PCR-based tests are widely used in both diagnostics and research to assess the prevalence of disease-causing pathogens in veterinary medicine. The efficacy of these tests, usually measured in terms of sensitivity and specificity, is critical in confirming or excluding a clinical diagnosis. We undertook a meta-analysis to assess the inherent value of published PCR diagnostic approaches used to confirm and quantify bacteria and viruses associated with bovine respiratory disease (BRD) in cattle. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A thorough search of nine electronic databases (Web of Science, EBSCOhost, Cambridge journals online, ProQuest, PubMed, Sage journals online, ScienceDirect, Wiley online library and MEDLINE) was undertaken to find studies that had reported on the use of PCR and/or qPCR for the detection and/or quantification of BRD associated organisms. All studies meeting the inclusion criteria for reporting quantitative PCR for identification of BRD associated microorganisms were included in the analysis. Studies were then assessed on the applications of the Minimum Information for Publication of Quantitative Real-Time PCR Experiment (MIQE) and PCR primer/probe sequences were extracted and tested for in silico specificity using a high level of stringency. Fourteen full-text articles were included in this study. Of these, 79% of the analysed articles did not report the application of the MIQE guidelines in their study. High stringency in silico testing of 144 previously published PCR primer/probe sequences found many to have questionable specificity. This review identified a high occurrence of primer/probe sequences with a variable in silico specificity such that this may have implications for the accuracy of reporting. Although this analysis was only applied to one specific disease state, identification of animals suspected to be suffering from bovine respiratory disease, there appears to be more broadly a need for veterinary diagnostic studies to adopt international best practice for reporting of quantitative PCR diagnostic data to be both accurate and comparable between studies and methodologies.
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  • 文章类型: Journal Article
    尽管它的发现已经过去了30多年,猫免疫缺陷病毒(FIV)对被感染的家猫的健康和寿命的重要性在猫科动物专家中引起了激烈的争论。尽管缺乏高质量的信息,澳大利亚和新西兰(NZ)的兽医应致力于最大程度地减少猫对FIV的暴露。实现这一目标的最可靠方法是建议所有宠物猫都只放在室内,或具有安全的室外通道(例如,猫外壳,安全花园),对任何接触猫进行FIV测试。所有动物饲养设施应旨在单独饲养成年猫,以限制FIV感染在受到压力且没有建立社会等级制度的动物群体中的传播。在澳大利亚和新西兰可以进行现场护理(PoC)FIV抗体测试,可以区分FIV感染和未感染的FIV疫苗接种猫(Witness™和AnigenRapid™)。虽然检测全血,血清或血浆仍然是FIV诊断的金标准,使用唾液进行PoC测试可能会在将来提供一种福利友好的替代方案。PCR检测FIV感染不推荐作为筛选程序,因为阴性PCR结果不排除FIV感染,并且仅在特定情况下推荐。澳大利亚和新西兰是提供双亚型FIV疫苗(Fel-O-Vax®FIV)的三个国家中的两个,并为疾病预防提供了进一步的途径。由于FIV疫苗接种在澳大利亚仅报告了56%的现场有效性,在新西兰可能更低,接种FIV疫苗的猫应在年度FIV再接种之前使用合适的PoC试剂盒进行年度FIV测试,以检查前一年未发生的感染。感染FIV的猫,临床医生应努力比平时更彻底地发现疾病的早期迹象。提高FIV感染猫的生活质量和预期寿命的最有效方法是优化基本饲养并在疾病过程早期治疗任何并发疾病。目前,没有注册用于治疗FIV感染的可用药物。严重的,健康的FIV感染猫的安乐死,和生病的FIV感染的猫没有适当的临床研究,不应该发生。
    Despite the passage of over 30 years since its discovery, the importance of feline immunodeficiency virus (FIV) on the health and longevity of infected domestic cats is hotly debated amongst feline experts. Notwithstanding the absence of good quality information, Australian and New Zealand (NZ) veterinarians should aim to minimise the exposure of cats to FIV. The most reliable way to achieve this goal is to recommend that all pet cats are kept exclusively indoors, or with secure outdoor access (e.g., cat enclosures, secure gardens), with FIV testing of any in-contact cats. All animal holding facilities should aim to individually house adult cats to limit the spread of FIV infection in groups of animals that are stressed and do not have established social hierarchies. Point-of-care (PoC) FIV antibody tests are available in Australia and NZ that can distinguish FIV-infected and uninfected FIV-vaccinated cats (Witness™ and Anigen Rapid™). Although testing of whole blood, serum or plasma remains the gold standard for FIV diagnosis, PoC testing using saliva may offer a welfare-friendly alternative in the future. PCR testing to detect FIV infection is not recommended as a screening procedure since a negative PCR result does not rule out FIV infection and is only recommended in specific scenarios. Australia and NZ are two of three countries where a dual subtype FIV vaccine (Fel-O-Vax® FIV) is available and offers a further avenue for disease prevention. Since FIV vaccination only has a reported field effectiveness of 56% in Australia, and possibly lower in NZ, FIV-vaccinated cats should undergo annual FIV testing prior to annual FIV re-vaccination using a suitable PoC kit to check infection has not occurred in the preceding year. With FIV-infected cats, clinicians should strive to be even more thorough than usual at detecting early signs of disease. The most effective way to enhance the quality of life and life expectancy of FIV-infected cats is to optimise basic husbandry and to treat any concurrent conditions early in the disease course. Currently, no available drugs are registered for the treatment of FIV infection. Critically, the euthanasia of healthy FIV-infected cats, and sick FIV-infected cats without appropriate clinical investigations, should not occur.
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  • 文章类型: Journal Article
    尽管有希望的发现,基于定量PCR(qPCR)的RNA定量测试在其临床应用中经历了严重的限制。明显缺乏技术标准化仍然是基于qPCR的测试翻译的巨大障碍。将基于qPCR的测试纳入临床将受益于临床研究测定验证的指南。这将最终影响患者的临床管理,包括诊断,预后,预测,监测治疗反应,和毒性评估。然而,目前缺乏在临床试验中使用分子测定进行生物标志物研究的明确测定验证方案.这里,我们将专注于必要的步骤,包括样品采集,处理和存储,RNA纯化,目标选择,分析设计,和实验设计,这需要在临床研究中对qRT-PCR检测进行适当的验证。这些建议可以填补仅研究使用(RUO)和体外诊断(IVD)之间的空白。我们的贡献为在生物标志物研究的中间步骤中开发经过验证的测定的基础和临床研究提供了工具。这些指南基于EU-CardioRNACOSTAction联盟的当前理解和共识(www.心肌。欧盟)。其适用性涵盖所有临床领域。
    Despite promising findings, quantitative PCR (qPCR)-based tests for RNA quantification have experienced serious limitations in their clinical application. The noticeable lack of technical standardization remains a huge obstacle in the translation of qPCR-based tests. The incorporation of qPCR-based tests into the clinic will benefit from guidelines for clinical research assay validation. This will ultimately impact the clinical management of the patient, including diagnosis, prognosis, prediction, monitoring of the therapeutic response, and evaluation of toxicity. However, clear assay validation protocols for biomarker investigation in clinical trials using molecular assays are currently lacking. Here, we will focus on the necessary steps, including sample acquisition, processing and storage, RNA purification, target selection, assay design, and experimental design, that need to be taken toward the appropriate validation of qRT-PCR assays in clinical research. These recommendations can fill the gap between research use only (RUO) and in vitro diagnostics (IVD). Our contribution provides a tool for basic and clinical research for the development of validated assays in the intermediate steps of biomarker research. These guidelines are based on the current understanding and consensus within the EU-CardioRNA COST Action consortium (www.cardiorna.eu). Their applicability encompasses all clinical areas.
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  • 文章类型: Journal Article
    Amphibians have been disappearing at an unprecedented rate worldwide. Among the proposed contributing factors are infectious diseases. Investigations have focused mainly on ranavirus and chytrids; however, additional agents may be relevant stressors. Two novel batrachoviruses have been discovered (ranid herpesvirus 3 [RaHV-3] and bufonid herpesvirus 1 [BfHV-1]). Their clinical role is still to be clarified; however, both have been associated with obvious skin lesions in their respective hosts. Herein we present 2 consensus PCR protocols that can be used to detect all of the known and, possibly, yet to be discovered batrachoviruses. We targeted a 200 nt long, highly conserved region of the DNA terminase gene. We established a sensitive protocol, which can detect both European batrachoviruses (European batrachovirus PCR protocol; RaHV-3 and BfHV-1) and a panbatrachovirus PCR protocol detecting all known batrachoviruses, including ranid herpesvirus 1 and 2 (RaHV-1, -2). The limit of detection (LOD) for the European batrachovirus protocol was 101 copies of RaHV-3 and 102 copies of BfHV-1 per reaction. The panbatrachovirus protocol could detect all known batrachoviruses with LODs of 103 (RaHV-3, BfHV-1, RaHV-1) to 104 copies (RaHV-2) per reaction. These novel detection tools can be used as a first line of detection when herpesviral infection in amphibians is suspected, followed by additional PCRs with herpesvirus-specific primers in the case of known viral species, or sequencing as in the case of novel batrachoviruses.
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  • 文章类型: Journal Article
    猫白血病病毒(FeLV)和猫免疫缺陷病毒(FIV)感染在全世界的猫中发现。两种感染都与各种临床症状相关,并可能影响生活质量和寿命。
    本文件是2008年美国猫科动物协会猫科动物逆转录病毒管理指南的更新,代表了目前对发病机理的认识,诊断,预防和治疗猫的逆转录病毒感染。
    尽管许多国家都有FeLV疫苗,一些国家也有FIV疫苗,识别被感染的猫仍然是预防新感染的重要因素。应该知道每只有感染风险的猫的逆转录病毒状态。猫被收购后应尽快进行测试,暴露于感染的猫或未知感染状态的猫后,在接种FeLV或FIV之前,每当临床疾病发生时。可能无法根据单个时间点的测试来确定猫的感染状态;可能需要使用不同的方法进行重复测试。虽然FeLV和FIV感染可能与临床疾病相关,一些被感染的猫,尤其是那些感染了FIV的人,可以生活多年,生活质量很好。
    对感染猫的治疗方法进行评估的数据很少,尤其是抗逆转录病毒和免疫调节药物。感染猫的管理集中在有效的预防性保健策略上,及时识别和治疗疾病,以及限制感染的传播。
    Feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) infections are found in cats worldwide. Both infections are associated with a variety of clinical signs and can impact quality of life and longevity.
    This document is an update of the 2008 American Association of Feline Practitioners\' feline retrovirus management guidelines and represents current knowledge on pathogenesis, diagnosis, prevention and treatment of retrovirus infections in cats.
    Although vaccines are available for FeLV in many countries and for FIV in some countries, identification of infected cats remains an important factor for preventing new infections. The retrovirus status of every cat at risk of infection should be known. Cats should be tested as soon as possible after they are acquired, following exposure to an infected cat or a cat of unknown infection status, prior to vaccination against FeLV or FIV, and whenever clinical illness occurs. It might not be possible to determine a cat\'s infection status based on testing at a single point in time; repeat testing using different methods could be required. Although FeLV and FIV infections can be associated with clinical disease, some infected cats, especially those infected with FIV, can live for many years with good quality of life.
    There is a paucity of data evaluating treatments for infected cats, especially antiretroviral and immunomodulatory drugs. Management of infected cats is focused on effective preventive healthcare strategies, and prompt identification and treatment of illness, as well as limiting the spread of infection.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Journal Article
    背景:真菌感染在免疫功能低下和免疫功能正常的患者中的发病率和重要性日益增加。及时的诊断依赖于在易感患者中适当使用实验室测试。方法:查阅与侵袭性肺曲霉病诊断相关的相关文献,侵袭性念珠菌病,系统回顾了常见的地方性真菌病。适当时进行Meta分析。建议是使用建议等级评估制定的,发展,和评价方法。结果:本指南包括关于在血清和BAL中使用半乳甘露聚糖检测以及诊断侵袭性肺曲霉病的具体建议,PCR在侵袭性肺曲霉病诊断中的作用,β-d-葡聚糖测定在侵袭性念珠菌病诊断中的作用,以及血清学和抗原检测在地方性真菌病诊断中的应用。结论:快速,真菌感染的准确诊断依赖于实验室检测的适当应用,包括抗原检测,血清学检测,和基于PCR的检测。
    Background: Fungal infections are of increasing incidence and importance in immunocompromised and immunocompetent patients. Timely diagnosis relies on appropriate use of laboratory testing in susceptible patients.Methods: The relevant literature related to diagnosis of invasive pulmonary aspergillosis, invasive candidiasis, and the common endemic mycoses was systematically reviewed. Meta-analysis was performed when appropriate. Recommendations were developed using the Grading of Recommendations Assessment, Development, and Evaluation approach.Results: This guideline includes specific recommendations on the use of galactomannan testing in serum and BAL and for the diagnosis of invasive pulmonary aspergillosis, the role of PCR in the diagnosis of invasive pulmonary aspergillosis, the role of β-d-glucan assays in the diagnosis of invasive candidiasis, and the application of serology and antigen testing in the diagnosis of the endemic mycoses.Conclusions: Rapid, accurate diagnosis of fungal infections relies on appropriate application of laboratory testing, including antigen testing, serological testing, and PCR-based assays.
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  • 文章类型: Journal Article
    BACKGROUND: Molecular diagnostic panels for enteric pathogens offer increased sensitivity and reduced turnaround time. However, many pathogen detections do not change clinical management, and the cost is substantial.
    METHODS: We performed a retrospective chart review of adult outpatients with diarrhea at the University of Virginia who had samples tested by the FilmArray Gastrointestinal Panel (BioFire Diagnostics, Salt Lake City, UT) to identify the clinical yield and to validate the clinical criteria for testing recommended in the 2017 Infectious Diseases Society of America (IDSA) guidelines.
    RESULTS: We analyzed 629 tests sent from adult outpatients with diarrhea between March 23, 2015, and July 18, 2016. A pathogen was detected in 127 of 629 specimens (20.2%). The most common pathogens were enteropathogenic Escherichia coli (47, 7.5%), norovirus (24, 3.8%), enteroaggregative E. coli (14, 2.2%), Campylobacter (9, 1.4%), and Salmonella (9; 1.4%). The clinical yield of testing was low, with antimicrobial treatment clearly indicated for only 18 subjects (2.9%) and any change in clinical management indicated for 33 subjects (5.2%). Following the clinical criteria for diagnostic testing from the 2017 IDSA guidelines, which suggest diagnostic testing for patients with fever, abdominal pain, blood in stool, or an immunocompromising condition, would have reduced testing by 32.3% without significantly reducing the clinical yield (sensitivity, 97.0%; 95% confidence interval [CI], 84.2%-99.9%; negative predictive value, 99.5%; 95% CI, 97.3%-100.0%).
    CONCLUSIONS: The clinical yield of molecular diagnostic testing in this population was low. Compliance with IDSA guidelines in adult outpatients with diarrhea could reduce testing by approximately one-third.
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