Estimation of the sensitivity and specificity of two serum ELISAs and one fecal qPCR for diagnosis of paratuberculosis in sub-clinically infected young-adult French sheep using latent class Bayesian modeling

The development, validation and application of an indirect enzyme-linked immunosorbent assay (ELISA) for the detection of antibodies to Streptococcus dysgalactiae subspecies dysgalactiae in lamb and ewe sera

BACKGROUND

Neonatal infectious arthritis (NIA) is a bacterial disease of lambs caused by Streptococcus dysgalactiae sub species dysgalactiae (SDSD). NIA negatively impacts animal welfare; whilst its control entails widespread antibiotic use. The aims of this study are to develop, validate and apply an indirect, ELISA assay to inform SDSD vaccine development and epidemiology studies.

METHODS

The antigen (inactivated isolate of SDSD) was incubated with sera from SDSD infected sheep, negative control sheep and serum from sheep flocks with outbreaks of SDSD NIA. SDSD antibody was detected with rabbit anti-sheep IgG conjugated with horseradish peroxidase. Antibody levels were estimated using peroxidase substrate and detection of colour change. Test performance was determined by receiver operating characteristic (ROC) curve analysis and by comparison with the animals' concurrent infection status, as determined by a Real Time PCR assay for SDSD bacterial DNA.

RESULTS

Using ROC curve analysis, a median test sensitivity of 85.71 % (95 % CI, 77.51-93.91) and a median test specificity of 73.68 % (95 % CI, 53.89-93.48), with a positive predictive value of 92.31 % (95 % CI, 86.07-98.55), and a negative predictive value of 58.33 % (95 % CI, 36.16-80.50). ELISA test performance was reduced when serum ELISA status (n = 362 sheep) was compared with concurrent SDSD infection status. The SDSD ELISA sensitivity was 39.74 % (95 % CI, 28.83-51.46), the specificity 60.92 % (95 % CI, 54.97-66.63), the PPV 21.83 % (95 % CI, 15.34-29.53), and the NPV was 78.64 % (95 % CI, 72.62-83.86).

CONCLUSION

This ELISA assay could be applied to estimate flock sero-prevalences for SDSD and changing SDSD antibody titres in vaccine trials.

Paratuberculosis in sheep and goats: Pathogenesis, diagnostic findings, and control strategies

Paratuberculosis (PTB), also known as Johne's disease, is a chronic contagious granulomatous disease of a wide variety of animals. It is caused by Mycobacterium avium subsp. paratuberculosis. This review summarizes the pathogenesis, clinical, hematobiochemical, sonographic, pathologic findings, and approaches to treatment and control of PTB in sheep and goats. Decreased appetite, weight loss, and changed fecal consistency were reported in sheep and goats with PTB. Clinical disease in sheep and goats is generally observed in those 2-4 years old. Other findings may include anorexia, coat roughness, and depression. The recorded hematological changes included neutropenia, leukocytosis, erythrocytosis, and increased hematocrit percent and hemoglobin concentration. Serum changes included hypocalcemia, hypoalbuminemia, hypomagnesemia, hypoproteinemia, and increased activity of creatine kinase. An overall increase in the intestinal mucosa thickness was detected on sonography in goats with PTB. Corrugation and folding of the intestinal mucosa may be also imaged in goats with PTB. However, the remarkable enlargement of the mesenteric lymph nodes is the most important finding. In sheep, postmortem findings included thickened intestinal walls, folding and corrugation of intestinal mucosa especially close to the ileocecal junction. Edematous and enlarged ileocecal and mesenteric lymph nodes may be observed. In goats, necropsy findings included enlargement of the mesenteric lymph nodes and thickened walls of the small intestines with folded and corrugated mucosa. No successful therapy of PTB in sheep and goats has been reported. The control of PTB in sheep and goats can be achieved by vaccination. In conclusion, early detection and eradication programs of PTB should be implemented more effectively for the control of PTB in sheep and goats. More research should be directed toward a vaccination program of PTB in these species.

Paratuberculosis in sheep and goats: Pathogenesis, diagnostic findings, and control strategies

Paratuberculosis (PTB), also known as Johne's disease, is a chronic contagious granulomatous disease of a wide variety of animals. It is caused by Mycobacterium avium subsp. paratuberculosis. This review summarizes the pathogenesis, clinical, hematobiochemical, sonographic, pathologic findings, and approaches to treatment and control of PTB in sheep and goats. Decreased appetite, weight loss, and changed fecal consistency were reported in sheep and goats with PTB. Clinical disease in sheep and goats is generally observed in those 2-4 years old. Other findings may include anorexia, coat roughness, and depression. The recorded hematological changes included neutropenia, leukocytosis, erythrocytosis, and increased hematocrit percent and hemoglobin concentration. Serum changes included hypocalcemia, hypoalbuminemia, hypomagnesemia, hypoproteinemia, and increased activity of creatine kinase. An overall increase in the intestinal mucosa thickness was detected on sonography in goats with PTB. Corrugation and folding of the intestinal mucosa may be also imaged in goats with PTB. However, the remarkable enlargement of the mesenteric lymph nodes is the most important finding. In sheep, postmortem findings included thickened intestinal walls, folding and corrugation of intestinal mucosa especially close to the ileocecal junction. Edematous and enlarged ileocecal and mesenteric lymph nodes may be observed. In goats, necropsy findings included enlargement of the mesenteric lymph nodes and thickened walls of the small intestines with folded and corrugated mucosa. No successful therapy of PTB in sheep and goats has been reported. The control of PTB in sheep and goats can be achieved by vaccination. In conclusion, early detection and eradication programs of PTB should be implemented more effectively for the control of PTB in sheep and goats. More research should be directed toward a vaccination program of PTB in these species.

Evaluation of three serological tests for the diagnosis of Brucella suis in dogs using Bayesian latent class analysis

Brucella suis infection of dogs is an emerging issue worldwide requiring specific management to address zoonotic risks and animal welfare concerns. Diagnosis in dogs is routinely based on serological testing, but to date these tests have only been validated for use in production animal species and humans. This study aimed to assess the diagnostic performance of three commonly used serological tests in dogs. Canine sera (n = 989) were tested with the Rose Bengal rapid plate agglutination test (RBRPT), the complement fixation test (CFT) and a competitive ELISA (C-ELISA). Diagnostic test performance was evaluated using a three test, two population Bayesian latent class analysis accounting for conditional dependence between the three tests. Positive and negative predictive values (PPV, NPV) were calculated for a range of expected prevalence estimates for the individual tests and test combinations interpreted in series and parallel. The RBRPT showed the highest individual Se of 0.902 (95 % posterior credible interval [PCI] 0.759-0.978) and the CFT the highest individual diagnostic specificity (Sp) of 0.914 (95 % PCI 0.886-0.946). The C-ELISA had marginally the best overall diagnostic performance (Youden's index = 0.807). The CFT and the C-ELISA interpreted in parallel returned the highest combined Se and Sp (0.988 and 0.885, respectively). All tests returned NPVs of > 0.982 in 2-8 % prevalence settings. Series interpretation of the three-test combination as well as the two-test combinations of the RBRPT and the C-ELISA and the CFT and the C-ELISA produced a PPV of 0.502 when the estimated prevalence was 8 %. While all tests are suitable for the detection of B. suis antibodies in dogs, they should not be interpreted in isolation as their diagnostic value is dependent on the pre-test probability of the disease. As such they are useful tools for the diagnosis of B. suis in dogs when exposure, history and clinical presentation indicate a risk of brucellosis.

RT-qPCR Testing and Performance Metrics in the COVID-19 Era

The COVID-19 pandemic highlighted the crucial role of diagnostic testing in managing infectious diseases, particularly through the use of reverse transcription-quantitative polymerase chain reaction (RT-qPCR) tests. RT-qPCR has been pivotal in detecting and quantifying viral RNA, enabling the identification and management of SARS-CoV-2 infections. However, despite its widespread use, there remains a notable gap in understanding fundamental diagnostic metrics such as sensitivity and specificity among many scientists and healthcare practitioners. This gap is not merely academic; it has profound implications for interpreting test results, making public health decisions, and affecting patient outcomes. This review aims to clarify the distinctions between laboratory- and field-based metrics in the context of RT-qPCR testing for SARS-CoV-2 and summarise the global efforts that led to the development and optimisation of these tests during the pandemic. It is intended to enhance the understanding of these fundamental concepts among scientists and healthcare professionals who may not be familiar with the nuances of diagnostic test evaluation. Such knowledge is crucial for accurately interpreting test results, making informed public health decisions, and ultimately managing infectious disease outbreaks more effectively.

A Bayesian finite mixture model approach to evaluate dichotomization method for correlated ELISA tests

In diagnostic accuracy studies, a commonly employed approach involves dichotomizing continuous data and subsequently analyzing them using a Bayesian latent class model (BLCM), often relying on binomial or multinomial distributions, rather than preserving their continuous nature. However, this procedure can inadvertently lead to less reliable outcomes due to the inherent loss of information when converting the original continuous measurements into binary values. Through comprehensive simulations, we demonstrated the limitations and disadvantages of dichotomizing continuous biomarkers from two correlated tests. Our findings highlighted notable disparities between the true values and the model estimates as a result of dichotomization. We discovered the crucial significance of selecting a reference test with high diagnostic accuracy in test evaluation in order to obtain reliable estimates of test accuracy and prevalences. Our study served as a call to action for veterinary researchers to exercise caution when utilizing dichotomization.

Sensitivity and specificity of human point-of-care circulating cathodic antigen (POC-CCA) test in African livestock for rapid diagnosis of schistosomiasis: A Bayesian latent class analysis

Schistosomiasis is a major neglected tropical disease (NTD) affecting both humans and animals. The morbidity and mortality inflicted upon livestock in the Afrotropical region has been largely overlooked, in part due to a lack of validated sensitive and specific tests, which do not require specialist training or equipment to deliver and interpret. As stressed within the recent WHO NTD 2021-2030 Roadmap and Revised Guideline for schistosomiasis, inexpensive, non-invasive, and sensitive diagnostic tests for livestock-use would also facilitate both prevalence mapping and appropriate intervention programmes. The aim of this study was to assess the sensitivity and specificity of the currently available point-of-care circulating cathodic antigen test (POC-CCA), designed for Schistosoma mansoni detection in humans, for the detection of intestinal livestock schistosomiasis caused by Schistosoma bovis and Schistosoma curassoni. POC-CCA, together with the circulating anodic antigen (CAA) test, miracidial hatching technique (MHT) and organ and mesentery inspection (for animals from abattoirs only), were applied to samples collected from 195 animals (56 cattle and 139 small ruminants (goats and sheep) from abattoirs and living populations) from Senegal. POC-CCA sensitivity was greater in the S. curassoni-dominated Barkedji livestock, both for cattle (median 81%; 95% credible interval (CrI): 55%-98%) and small ruminants (49%; CrI: 29%-87%), than in S. bovis-dominated Richard Toll ruminants (cattle: 62%; CrI: 41%-84%; small ruminants: 12%, CrI: 1%-37%). Overall, sensitivity was greater in cattle than in small ruminants. Small ruminants POC-CCA specificity was similar in both locations (91%; CrI: 77%-99%), whilst cattle POC-CCA specificity could not be assessed owing to the low number of uninfected cattle surveyed. Our results indicate that, whilst the current POC-CCA does represent a potential diagnostic tool for cattle and possibly for predominantly S. curassoni-infected livestock, future work is needed to develop parasite- and/or livestock-specific affordable and field-applicable diagnostic tests to enable determination of the true extent of livestock schistosomiasis.

Effects of Silirum®-Based Vaccination Programs on Map Fecal Shedding and Serological Response in Seven French Dairy Herds

(1) Background: paratuberculosis is an important disease in ruminants, causing worldwide economic losses to the livestock industry. Although vaccination is known not to prevent transmission of the causative agent Mycobacterium avium subsp. paratuberculosis (Map), it is considered an effective tool for paratuberculosis in infected herds. The objectives of this controlled field study were to evaluate the effects of the whole-cell heat-killed Silirum^® vaccine on Map fecal shedding and serological status in dairy herds infected with paratuberculosis. (2) Methods: The serological status (ELISA) and fecal shedding (qPCR) of 358 vaccinated cows were assessed over 3 years in 7 infected dairy herds in the Meuse department, France. Within each herd, cows from the last non-vaccinated birth cohort (n = 265) were used as controls. The probability and level of Map fecal shedding and the serological status were modeled using multivariable mixed general linear regression models. (3) Results: Overall, 34.7% of cows tested positive at least once on fecal qPCR, with significant differences between herds, but high shedding levels were observed in only 5.5% of cows. Compared to non-vaccinated seronegative cows, a statistically significant reduction in the probability of Map shedding was found only in cows vaccinated before 4 to 5 months of age that tested negative for Map antibodies throughout the study period (odds ratio = 0.5, 95% confidence interval: 0.3-0.9, p = 0.008), but no significant effect of vaccination on the amount of Map shedding could be evidenced. Finally, the younger the cows were when vaccinated, the less they tested positive on the serum ELISA. (4) Conclusions: a beneficial effect of vaccination on Map fecal shedding may exist in cows vaccinated before 4 to 5 months of age. The variability of the serum ELISA response in vaccinated cows remains to be investigated.

A Machine Learning Approach Reveals a Microbiota Signature for Infection with Mycobacterium avium subsp. paratuberculosis in Cattle

Although Mycobacterium avium subsp. paratuberculosis (MAP) has threatened public health and the livestock industry, the current diagnostic tools (e.g., fecal PCR and enzyme-linked immunosorbent assay [ELISA]) for MAP infection have some limitations, such as inconsistent results due to intermittent bacterial shedding or low sensitivity during the early stage of infection. Therefore, this study aimed to develop a novel biomarker focusing on elucidating the gut microbial signature of MAP-positive ruminants, since the clinical signs of MAP infection are closely related to dysbiosis. 16S rRNA-based gut microbial community analysis revealed both a decrease in microbial diversity and the emergence of several distinct taxa following MAP infection. To determine the discriminant taxa diagnostic of MAP infection, machine learning-based feature selection and predictive model construction were applied to taxon abundance data or their transformed derivatives. The selected taxa, such as Clostridioides (formerly Clostridium) difficile, were used to build models using a support vector machine, linear support vector classification, k-nearest neighbor, and random forest with 10-fold cross-validation. The receiver operating characteristic-area under the curve (ROC-AUC) analysis of the models revealed their high accuracy, up to approximately 96%. Collectively, taxonomic signatures of cattle gut microbiotas according to MAP infection status could be identified by feature selection tools and applied to establish a predictive model for the infection state. IMPORTANCE Due to the limitations, such as intermittent bacterial shedding or poor sensitivity, of the current diagnostic tools for Johne's disease, novel biomarkers are urgently needed to aid control of the disease. Here, we explored the fecal microbiota of Johne's disease-affected cattle and tried to discover distinct microbial characteristics which have the potential to be novel noninvasive biomarkers. Through 16S rRNA sequencing and machine learning approaches, a dozen taxa were selected as taxonomic signatures to discriminate the disease state. In addition, when constructing predictive models using relative abundance data of the corresponding taxa, the models showed high accuracy for classification, even including animals with subclinical infection. Thus, our study suggested novel noninvasive microbiological biomarkers that are robustly expressed regardless of subclinical infection and the applicability of machine learning for diagnosis of Johne's disease.

Bayesian estimation of sensitivity and specificity of fecal culture, fecal PCR and serum ELISA for diagnosis of Mycobacterium avium subsp. paratuberculosis infections in sheep

The objective of the present study was to evaluate the diagnostic accuracy of the individual fecal culture (IFC), fecal PCR (FPCR), and serum ELISA for the detection of Mycobacterium avium subsp. paratuberculosis (MAP) infections in sheep from four governorates in Egypt, using a latent class model (LCM) fitted within a Bayesian framework. Furthermore, the within-governorate prevalence of MAP infection in sheep was estimated as a secondary objective. Fecal and blood samples were collected from 370 sheep in four Egyptian governorates. Fecal samples were analyzed by IFC and RT-PCR based on ISMav2 gene, while ELISA was performed on serum samples. The sensitivity (Se) and specificity (Sp) of the three diagnostic tests were estimated using a three-tests-four-populations Bayesian LCM to obtain posterior estimates [medians and 95% Bayesian credible intervals (95% BCI)] for each parameter. The median Se estimates (95% BCI) for IFC, FPCR, and serum ELISA were 31.8% (22.8-41.4), 49.7% (31.8-79.9), and 61.2% (39.8-81.4), respectively. The median Sp estimates (95% BCI) for IFC, FPCR, and serum ELISA were 97.7% (96.1-98.9), 97.7% (95.6-99.5), and 98.4% (96.9-99.3), respectively. The median within-governorate paratuberculosis prevalence (95% BCI) was 5.2% (1.1-13.6), 8.4% (2.9-17.7), 9.4% (3.0-20.7), and 18.2% (10.5-29.5) for the Gharbia, Menoufia, Qalyubia, and Kafr El-Sheikh governorates, respectively. In conclusion, at a ratio of the optical density (OD) sample/OD positive control threshold of > 45%, ELISA showed the highest Se among the three tests and comparable Sp to IFC and FPCR. The test ELISA evaluated in this study is an interesting alternative for detecting MAP in sheep due to its higher Se, lower cost, and shorter turnaround laboratory time compared to IFC and FPCR.

Bayesian latent class analysis to estimate the optimal cut-off for the MilA ELISA for the detection of Mycoplasma bovis antibodies in sera, accounting for repeated measures

The MilA ELISA has been identified as a highly effective diagnostic tool for the detection of Mycoplasma bovis specific antibodies and has been validated for serological use in previous studies. This study aimed to estimate the optimal cut-off and corresponding estimates of diagnostic sensitivity (DSe) and diagnostic specificity (DSp) of the MilA ELISA for testing bovine serum. Serum samples from 298 feedlot cattle from 14 feedlots across four Australian states were tested on entry into the feedlot and approximately 42 days later. The paired serum samples were tested with the MilA ELISA, BIO K302 (Bio-X Diagnostics, Belgium) and BIO K260 (Bio-X Diagnostics, Belgium). A cut-off of 135 AU was estimated to be optimal using Bayesian latent class analysis with three tests in multiple populations, accounting for conditional dependence between tests. At this cut-off, the DSe and DSp of the MilA ELISA were estimated to be 92.1 % (95 % highest probability density [HPD] interval: 87.4, 95.8) and 95.5 % (95 % HPD: 92.4, 97.8), respectively. The DSes of the BIO K260 and BIO K302 ELISAs were estimated to be 60.5 % (95 % HPD: 54.0, 66.9) and 44.6 % (95 % HPD: 38.7, 50.7), respectively. DSps were 95.6 % (95 % HPD: 92.9, 97.7) and 97.8 % (95 % HPD: 95.9, 99.0), respectively. Mycoplasma bovis seroprevalence was remarkably high at follow-up after 42 days on the feedlots. Overall, this study estimated a cut-off, DSe and DSp for the MilA ELISA with less dependence on prior information than previous analyses and demonstrated that the MilA ELISA has higher DSe than the BIO K260 and BIO K302 assays.

Enterocytozoon hepatopenaei real-time and Shrimp MultiPathTM PCR assay validation for South-East Asian and Latin American strains of Penaeid shrimp

Enterocytozoon hepatopenaei (EHP) infections are a global challenge for the Penaeid shrimp industry with a sharp rise in prevalence over the last 10 yr. EHP is known to cause sub-optimal growth, large size variation and reduced survival of shrimp. Molecular methods development has mainly focussed on 18S rRNA or spore wall protein 1 (SWP1). Due to the specificity and sensitivity issues with previously designed assays for both targets, new molecular assays are needed by the global shrimp industry and regulators to help manage the risks posed by EHP. This paper describes new real-time PCR (qPCR) methods developed for the novel EHP gene targets polar tube protein 2 (PTP2) and spore wall protein 26 (SWP26), whilst also presenting performance metrics of the new Shrimp MultiPathTM technology EHP assay. qPCR assays PTP2G and SWP26G show high amplification efficiency, a limit of detection (LOD) of between 1 and 4 copies, low assay variation and high diagnostic sensitivity (DSe) and specificity (DSp) compared to imperfect reference assays. Similar performance is seen with Shrimp MultiPathTM EHP showing an LOD of 8 copies, low assay variation and high DSe and DSp. These novel molecular targets for EHP and Shrimp MultiPathTM EHP strengthen global efforts to monitor and mitigate risks of EHP infections and outbreaks. Moreover, this study presents novel data on distribution of EHP in shrimp populations from South-East Asia and Latin America, and how sequence variations need to be considered when monitoring EHP in different geographies.

Application of Bayesian modeling for diagnostic assays of Mycobacterium avium subsp. paratuberculosis in sheep and goats flocks

Background

This study aimed to screen the sera of goats and sheep from flocks suspected of Mycobacterium avium subsp. paratuberculosis (MAP) infection by a newly standardized Mce-truncated ELISA (Mt-ELISA) kit for the detection of antibodies against MAP. Four diagnostic applied tests were evaluated including Indigenous plate-ELISA (IP-ELISA), Mt-ELISA, fecal Polymerase Chain Reaction (f-PCR) and fecal culture (FC).

Materials and methods

Assuming the absence of a gold standard, latent-class models in a Bayesian framework were used to estimate the diagnostic accuracy of the four tests for MAP.

Results

Mt-ELISA had higher Sensitivity (Se) in sheep (posterior median: 0.68 (95% Probability Interval (PI): 0.43–0.95), while IP-ELISA recorded the highest Se in goats as 0.83 (95% PI, 0.61–0.97). The f-PCR Se estimate slightly differed between species [sheep 0.36 (0.19–0.58), goats 0.19 (0.08–0.35)], while the Se of FC was similar between species [sheep 0.29 (0.15–0.51), goats 0.27 (0.13–0.45)]. The specificity estimates for all tests were high, close to unity, and similar between species.

Conclusion

Overall, the results showed that the Mt-ELISA method can be used for MAP detection in small ruminants’ flocks.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12917-022-03141-7.

Establishment and evaluation of an indirect ELISA for detection of antibodies to goat Klebsiella pneumonia

BACKGROUND

Klebsiella pneumonia, a Gram-negative bacterium belonging to the genus Enterobacter, causes many human and livestock diseases. Notably, infected goats may develop pneumonia, septicemia, which can lead to occasional death, resulting in great economic losses in goat-farming industry. However, there are little systematic methods for detection of goat Klebsiella pneumoniae in livestock production.

RESULTS

In this study, we developed a Klebsiella pneumoniae goat polyclonal antibody and established an indirect ELISA method to detect the Klebsiella pneumoniae. After screening and optimizing the conditions for detection, we determined the optimal working dilutions of the coated-bacterial antigen, the polyclonal antibody, and the enzyme-labeled secondary antibody that were 1:800 (2.99 × 10⁷ CFU/ml), 1:6400, and 1:5000, respectively. The optimal condition of coating and blocking were both 4 °C for 12 h. The optimal dilution buffers of bacterial antigen, the antibodies, and the blocking buffer were 0.05 mol/L carbonate buffer, 1% BSA phosphate buffer, and 1.5% BSA carbonate buffer, respectively. The cut-off value was determined to be 0.28, and the analytical sensitivity was 1:800 (dilution of a positive sample). Furthermore, there was no cross-reaction between the coated antigen and goat serum positive for antibodies against other bacteria, indicating that indirect ELISA could detect Klebsiella pneumoniae specifically in most cases. The average coefficients of variation of intra-assay and inter-assay were 4.37 and 5.17% indicating favorable reproducibility of indirect ELISA. In the detection of clinical veterinary samples, the positive rate of indirect ELISA was 6.74%, higher than that of conventional agglutination assays.

CONCLUSIONS

Taken together, we successfully established an indirect ELISA method for detecting antibodies against Klebsiella pneumoniae in goats, which can be applied in production.

Biomarkers as diagnostic tools for mycobacterial infections in cattle

Mycobacterial infections are widely distributed in animals and cause considerable economic losses, especially in livestock animals. Bovine paratuberculosis and bovine tuberculosis, which are representative mycobacterial infections in cattle, are difficult to diagnose using current-generation diagnostics due to their relatively long incubation periods. Thus, alternative diagnostic tools are needed for the detection of mycobacterial infections in cattle. A biomarker is an indicator present in biological fluids that reflects the biological state of an individual during the progression of a specific disease. Therefore, biomarkers are considered a potential diagnostic tool for various diseases. Recently, the number of studies investigating biomarkers as tools for diagnosing mycobacterial infections has increased. In human medicine, many diagnostic biomarkers have been developed and applied in clinical practice. In veterinary medicine, however, many such developments are still in the early stages. In this review, we summarize the current progress in biomarker research related to the development of diagnostic biomarkers for mycobacterial infections in cattle.

Estimation of the sensitivity and specificity of four serum ELISA and one fecal PCR for diagnosis of paratuberculosis in adult dairy cattle in New Zealand using Bayesian latent class analysis

In New Zealand, a new diagnostic approach for the control of paratuberculosis in mixed aged milking cows has been developed using a combination of ELISA and quantitative fecal PCR (f-qPCR). Our analysis was designed to evaluate performance of these individual tests in infected or infectious mixed aged cows across the prevalence of infection typically encountered on NZ dairy farms and calculate test accuracy when used as a screening test of serological ELISAs for four separate antigens read in parallel followed by a confirmatory quantitative f-qPCR test. Data from a cross-sectional study of 20 moderate prevalence herds was combined with existing data from 2 low and 20 high prevalence herds forming a dataset of 3845 paired serum and fecal samples. Incidence of clinical Johne's disease (JD) was used to classify herds into three prevalence categories. High (≥ 3% annual clinical JD for the last three years), moderate (<3 - 1%) and low (<1% incidence for at least the last five years). Positive tests were declared if> 50 ELISA units and f-qPCR at two cut-points (≥1 × 10⁴ genomes/mL or >1 × 10³ genomes/mL). Fixed Bayesian latent class models at both f-qPCR cut-points, accounted for conditional independence and paired conditional dependence. Mixed models at both f-qPCR cut-points, using a different mechanism to account for conditional dependencies between tests were also implemented. Models (24 in number) were constructed using OpenBUGS. The aim was to identify Mycobacterium avium subsp. paratuberculosis (MAP) infected cows that met at least one of two criteria: shedding sufficient MAP in feces to be detected by f-qPCR or mounting a detectable MAP antibody response. The best fit to the data was obtained by modelling pairwise dependencies between tests in a fixed model or by accounting for dependencies in a mixed model at a fecal cut-off of ≥1 × 10⁴ genomes/mL. Test performance differed with prevalence, but models were robust to prior assumptions. For the fixed model, at a prevalence of 0.29 (95 % probability interval (PI) = 0.25-0.33), as a screening plus confirmatory f-qPCR, post-test probability for disease in a positive animal was 0.84 (95 %PI = 0.80-0.88) and 0.16 (95 %PI = 0.15-0.18) for disease in a test negative animal. In low prevalence herds (0.01(95 %PI = 0.00-0.04)) the equivalent figures were 0.84 (95 %PI = 0.08-0.92) and 0.00 (95 %PI = 0.00-0.02). These results suggest this is a useful tool to control JD on dairy farms, particularly in herds with higher levels of infection, where the sampling and testing cost per animal is defrayed across more detected animals.

Ovine Paratuberculosis: Seroprevalence and comparison of fecal culture and direct fecal PCR assay

Johne's disease is chronic, incurable disease, caused by Mycobacterium avium subsp. paratuberculosis (MAP). Most studies in Egypt focused on incidence of the disease in cattle but few studies were reported presence of antibodies against MAP in sheep. The present study determined the seroprevalence rate of MAP among sheep in four Governorates and assessed the associated risk factors to MAP-infection. The seroprevalence rate of MAP among sheep was non-significant varied between different Governorates, it was ranged between 3.75%-12.3%. The results revealed that the seroprevalence rate of the disease was significantly increased in diarrheic sheep (11 %, 95 %CI: 7.2-16.2) during spring (15 %, 95 %CI: 8.3-25) and summer (8%, 95 %CI: 4.13-13.8) seasons. Contrary, the age of sheep and contact with other ruminants like cattle or goats had non-significant effect of spreading of MAP-infection among sheep. The detection of MAP in feces of sheep was carried out using culture and PCR to determine the efficiency of both tests. The kappa test revealed good agreement between both tests for detection of MAP. The obtained finding confirms the presence of MAP among sheep in Egypt. So, the appropriate control measures should be taken to reduce spreading of the disease among sheep and reduce its economic losses.

Estimating prevalence and test accuracy in disease ecology: How Bayesian latent class analysis can boost or bias imperfect test results

Obtaining accurate estimates of disease prevalence is crucial for the monitoring and management of wildlife populations but can be difficult if different diagnostic tests yield conflicting results and if the accuracy of each diagnostic test is unknown. Bayesian latent class analysis (BLCA) modeling offers a potential solution, providing estimates of prevalence levels and diagnostic test accuracy under the realistic assumption that no diagnostic test is perfect.In typical applications of this approach, the specificity of one test is fixed at or close to 100%, allowing the model to simultaneously estimate the sensitivity and specificity of all other tests, in addition to infection prevalence. In wildlife systems, a test with near-perfect specificity is not always available, so we simulated data to investigate how decreasing this fixed specificity value affects the accuracy of model estimates.We used simulations to explore how the trade-off between diagnostic test specificity and sensitivity impacts prevalence estimates and found that directional biases depend on pathogen prevalence. Both the precision and accuracy of results depend on the sample size, the diagnostic tests used, and the true infection prevalence, so these factors should be considered when applying BLCA to estimate disease prevalence and diagnostic test accuracy in wildlife systems. A wildlife disease case study, focusing on leptospirosis in California sea lions, demonstrated the potential for Bayesian latent class methods to provide reliable estimates under real-world conditions.We delineate conditions under which BLCA improves upon the results from a single diagnostic across a range of prevalence levels and sample sizes, demonstrating when this method is preferable for disease ecologists working in a wide variety of pathogen systems.

Flock sensitivity and specificity of pooled fecal qPCR and pooled serum ELISA for screening ovine paratuberculosis

The aim of our study was to evaluate the flock sensitivity and specificity of fecal qPCR and serum ELISA using pooled samples for screening paratuberculosis in French sheep.

Using individual feces with low or high qPCR Ct values from ewes sampled in 14 infected flocks, a total of 555 pools of size 5, 10 and 20 were created by diluting individual materials in negative feces and analysed using a commercial IS900 qPCR kit. The relative performances of pooled serum ELISA analysis were evaluated based on the analysis of 181 different pools of size 5 and 10, composed of individual serum samples of various individual S/P values. Results showed that for pools of size 5, 10 or 20, individual fecal samples with low Ct values were invariably detected. Conversely fecal samples with high Ct values were associated with a lower detection rate in both pools of size 5 (87.0% to 90.0%), 10 (63.0% to 70.7%) and 20 (46.7% to 60.0%). After lowering the decision threshold to 25% and 15% for serum pools of size 5 and 10 respectively, the pooled serum ELISA relative sensitivity ranged between 62.2% and 100.0% depending on the composition of the pools.

Finally, a simulation study was carried out to evaluate the performances of 16 screening strategies at flock level, with varying pool size (5 to 20) and number (5 to 60). The use of pooled serum ELISA led to very false positive detection rate ranging between 37.6% and 91.8% in paratuberculosis free flocks and prevents its further use in that context. For infection prevalence ≤ 5%, the flock sensitivity based on pooled fecal qPCR ranged between 39.0% (5 pools of size 10) and 99.9% (300 sampled individuals, with pools of size 5,10 or20), and was always above 93% when the infection prevalence was greater or equal to 15%. We conclude that pooled-fecal qPCR but not pooled-serum ELISA could be a useful tool to detect sheep flocks infected with paratuberculosis.

Sero-surveillance of Mycobacterium avium subspecies paratuberculosis infection in ruminants in Medina

Objective:

The present study aimed to assess for the first time, in Medina, the prevalence of Mycobacterium avium subsp. paratuberculosis in ruminants due to its potential zoonotic importance.

Materials and methods:

A total of 823 sera samples and 364 milk samples were used to determine the incidence of Mycobacterium avium subsp. Paratuberculosis (MAP) using the indirect Enzyme-Linked Immunosorbent Assay.

Results:

The seroprevalence of MAP was 11.1% in sheep and 13.8% in goats, while no infection was recorded among camels. MAP infection was not influenced by the animal’s gender, but it was influenced by its locality since the infection rate in local animals was higher than that in imported ones with a significant correlation (p < 0.05). MAP infection had a significant correlation (p < 0.05) with 2 years aged animals. On the other hand, the detection of MAP in milk revealed that 17 (13.8%) goats and 12 (4.9%) sheep were infected. The prevalence of MAP in milk samples was not influenced by either the animal’s age or locality.

Conclusion:

Sheep and goats may act as a reservoir for MAP to the Medina community. Since Medina is an active area of mass gatherings as a destination for pilgrims throughout the year, therefore, necessary control measures should be implemented to lower the economic losses, zoonotic infections, and the possibility of a global epidemic.

Validation of an in-house real-time PCR fecal assay and comparison with two commercial assays for the antemortem detection of Mycobacterium avium subsp. paratuberculosis infection in culled sheep

Paratuberculosis is a chronic infectious enteritis of ruminants caused by Mycobacterium avium subsp. paratuberculosis (MAP). In sheep, the antemortem detection of the infection is challenging given the slow progression of the disease and the lack of sensitive, specific, and cost-effective validated tests. We adapted an in-house real-time PCR (rtPCR) assay targeting the multi-copy IS 900 element of MAP. The sensitivity and specificity of this essay for the detection of MAP infection were estimated in a convenience sample of culled ewes from 7 infected flocks and compared to a commercial fecal rtPCR, a commercial ELISA, and fecal culture. An infected ewe was defined as a ewe with a positive culture of the ileum and/or mesenteric lymph node. A non-infected ewe was defined as a ewe negative in intestinal tissue culture, negative in fecal culture, and with no lesions consistent with paratuberculosis. The in-house rtPCR had a sensitivity estimate of 84% (95% confidence interval [CI]: 59%, 97%) among the 44 infected ewes, which was significantly higher ( p ⩽ 0.05) than the sensitivity of a commercial fecal rtPCR (52%, 95% CI: 27%, 76%; or 63%, 95% CI: 35%, 87% depending on the cutoff used), an ELISA (14%, 95% CI:2.0%, 41%), and fecal culture (21%, 95% CI: 2.7%, 59%). No statistical difference in assay specificities was observed for the 30 non-infected ewes. The in-house rtPCR is a promising tool that could be used advantageously for the antemortem detection of MAP infection in sheep.