我们的目标是在季度和复合水平上评估200,000个细胞/mL体细胞计数(SCC)的切点,以确定其在识别纽约中部一个商业乳牛群中的亚临床乳腺炎感染方面的有效性。来自107头荷斯坦奶牛的牛奶样品用于分析。所有奶牛都有资格注册,只要它们有4个工作的乳房宿舍,在牛奶中>14和<365天,并且在采样前d没有临床乳腺炎事件或乳房内抗生素治疗≤14d。分析了来自34只初产和73只多产动物的428个四分之一和107个复合样品的总SCC和有氧培养。针对黄金标准有氧培养物评估SCC用于鉴定亚临床感染动物的性能。在季度和复合基础上,200,000个细胞/mL切点的灵敏度为28.6%,在季度和综合基础上,特异性分别为91.5%和87.3%,分别。在四分之一的基础上确定的受试者工作特征(ROC)曲线发现,优化阳性培养物的灵敏度和特异性的切点为32,000细胞/mL,灵敏度为76.2%,特异性为62.4%,曲线下面积(AUC)为0.73。优化复合样品的灵敏度和特异性的ROC曲线切点为75,000个细胞/mL,灵敏度为57.1%,特异性为78.9%,AUC为0.67。大部分培养阳性初产奶牛(38%)的SCC较低(四分之一的中位数为101,000个细胞/mL,复合水平为80,000个细胞/mL),因此,当多胎母牛单独检查时,在四分之一的基础上优化灵敏度和特异性的切点增加到645,000个细胞/mL,相应的灵敏度为34.8%,特异性为97.5%,AUC为0.65。在综合基础上,基于多胎母牛的切割点是152,000个细胞/mL,相应的灵敏度为60.0%,特异性为82.0%,AUC为0.65。我们的数据表明,200,000细胞/mL切点在识别亚临床感染的动物方面效率低下,无论采用季度抽样还是综合抽样。亚临床感染的患病率低以及次要病原体的比例大,尤其是在初产动物中,造成了这种低效率。本案例研究提供了证据,随着乳腺炎控制的持续改善和主要乳腺炎病原体的减少,总体切点可能不再像以前那样提供相同的诊断有用性.
Our objective was to evaluate a 200,000 cells/mL somatic cell count (SCC) cut-point on both the quarter and composite level to determine its effectiveness at identifying subclinical mastitis infections in one commercial dairy herd in Central New York. Milk samples from 107 Holstein cows were used for analysis. All cows were eligible for enrollment provided they had 4 working udder quarters, were >14 and <365 d in milk, and had no clinical mastitis event or treatment with intramammary antibiotics ≤14 d prior to d of sampling. A total of 428 quarter and 107 composite samples from 34 primiparous and 73 multiparous animals were analyzed for total SCC and aerobic culture. Performance of SCC for identification of subclinically infected animals was evaluated against the gold standard aerobic culture. Sensitivities for a 200,000 cells/mL cut-point on both the quarter and composite basis were 28.6%, and specificities were 91.5% and 87.3% on the quarter and composite basis, respectively. Receiver operating characteristic (ROC) curves determined on a quarter basis found the cut-point that optimized the sensitivity and specificity of a positive culture was 32,000 cells/mL, with a sensitivity of 76.2%, a specificity of 62.4%, and an area under the curve (AUC) of 0.73. The ROC curve cut-point that optimized the sensitivity and specificity for the composite samples was 75,000 cells/mL, with a sensitivity of 57.1%, a specificity of 78.9%, and an AUC of 0.67. A large proportion of culture positive primiparous cows (38%) had low SCC (median of 101,000 cells/mL on the quarter and 80,000 cells/mL on the composite level), and therefore, when multiparous cows were examined separately, the cut-point that optimized sensitivity and specificity on the quarter basis increased to 645,000 cells/mL with a corresponding sensitivity of 34.8%, specificity of 97.5%, and AUC of 0.65. On the composite basis, the cut-point based on multiparous cows only was 152,000 cells/mL, with a corresponding sensitivity of 60.0%, and specificity of 82.0%, and an AUC of 0.65. Our data indicate that the 200,000 cells/mL cut-point was inefficient in identifying subclinically infected animals, regardless of whether quarter or composite sampling was used. The low prevalence of subclinical infections as well as the large proportion of minor pathogens, especially in primiparous animals, contributed to this inefficiency. This
case study provides evidence that, with continued improvement upon mastitis control and reduction in major mastitis pathogens, blanket cut-points may no longer provide the same diagnostic usefulness as they once did.