Detecting Clostridioides (Clostridium) difficile using canine teams: What does the nose know?
Detecting Clostridioides (Clostridium) difficile using canine teams: What does the nose know?
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DOI：
10.1016/j.infpip.2019.100005
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发表时间：
2019-03-01
影响因子：
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通讯作者：
Bryce, E.
中科院分区：
文献类型：
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作者：
Charles, M. K.;Wang, Y.;Bryce, E.
背景资料：受过训练的犬能够检测梭菌（梭菌）艰难梭菌（CD）在环境中;然而，主要的气味上的利益，狗alert.Aim：评价者间的可靠性的两个犬检测团队的能力，以区分气味垫含有CD毒素阳性和阴性气味和他们的能力，区分梭菌菌株。方法：在六个月的时间里，两个犬队每周进行测试，以检测CD毒素阳性气味的能力，并区分这些和阴性气味。为了进一步确定犬的辨别能力，用代表常见CD毒素类型的参考分离物的气味浸渍气味垫，（包括毒素阴性CD分离株）或来自代表其他梭菌属的临床分离株。共检测了264份样本，总体灵敏度分别为94.7%（A组）和86.8%（B组），特异性分别为96.9%和98.7%。评价者间可靠性非常好（Cohen kappa 0.87）。当用产毒素和不产毒素的菌株进行挑战时，研究小组对96.3%的CD分离株气味（包括非产毒素菌株）和46.7%的密切相关物种发出了警报。结论：犬团队在临床粪便标本和参考CD分离株（产毒素和不产毒素）上均表现出较强的评分者间可靠性，但在区分CD和密切相关的梭菌菌种方面受到挑战。只要狗及其训导员受到适当的训练并在正确的环境中使用，这些发现强烈支持气味检测计划的开发。2019年，作者。由Elsevier Ltd代表The Healthcare Infection Society发布。这是一个CC BY-NC-ND许可证下的开放获取文章（http：//creativecommons.org/licenses/by-nc-nd/4.0/）。
Background: Trained canines are capable of detecting Clostridioides (Clostridium) difficile (CD) in the environment; however, the primary odour of interest on which the dogs alert is unclear.Aim: To evaluate the inter-rater reliability of two canine detection teams for their ability to discriminate between scent pads containing CD-toxin-positive and-negative odours and their ability to discriminate between clostridial strains.Methods: During a six-month period, two canine teams were tested weekly for their ability to detect CD-toxin-positive odours and discriminate between these and-negative odours. To further determine the canines' discrimination capability, scent pads impregnated with odours from reference isolates representing common CD toxin types (including toxin -negative CD isolates) or from clinical isolates representing other clostridial species were used.Results: A total of 264 samples were tested with an overall sensitivity of 94.7% (Team A) and 86.8% (Team B) and specificities of 96.9% and 98.7%, respectively. Inter-rater reliability was very good (Cohen's kappa 0.87). When challenged with toxin-and non -toxin-producing strains, the teams alerted on 96.3% of all CD isolate odours (including nontoxigenic strains) and 46.7% of closely related species. Conclusions: The canine teams exhibited strong inter-rater reliability on both clinical faecal specimens and reference CD isolates (both toxin and non-toxin producing) but were challenged to discriminate between CD and closely related clostridial species. These findings strongly support the development of scent detection programmes provided dogs and their handlers are properly trained and used in the right context.& COPY; 2019 The Authors. Published by Elsevier Ltd on behalf of The Healthcare Infection Society.This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).