Diagnose der Leptospirose beim Hund

Michèle Bergmann; Julia-Rebecca Llewellyn; Katrin Hartmann

doi:10.15654/TPK-170039

Tierärztliche Praxis Ausgabe K: Kleintiere / Heimtiere, Table of Contents

Tierarztl Prax Ausg K Kleintiere Heimtiere 2017; 45(03): 170-177
DOI: 10.15654/TPK-170039

Übersichtsartikel

Schattauer GmbH

Diagnose der Leptospirose beim Hund

Diagnosis of leptospirosis in dogs

Authors

Michèle Bergmann

¹Medizinische Kleintierklinik, Ludwig-Maximilians-Universität München
Julia-Rebecca Llewellyn

¹Medizinische Kleintierklinik, Ludwig-Maximilians-Universität München
Katrin Hartmann

¹Medizinische Kleintierklinik, Ludwig-Maximilians-Universität München

Abstract

Zusammenfassung

Bei Hunden mit Verdacht auf Leptospirose ist es wichtig, eine eindeutige Diagnose zu stellen, um gezielt therapieren zu können. Zudem stellen infizierte Hunde ein Zoonoserisiko dar. Der kulturelle Erregernachweis aus Blut, Urin oder Gewebe gilt als diagnostischer Referenzstandard. Allerdings besitzt er eine geringe Sensitivität und Leptospiren benötigen Wochen bis Monate, um zu wachsen. Die Untersuchung auf Antikörper und der Nachweis von Leptospiren-DNA mittels PCR gehören daher zu den wichtigsten Nachweismethoden in der Praxis. Beim Hund wird der Mikroagglutinationstest (MAT) trotz einiger Limitationen (z. B. negative Ergebnisse in frühen Infektionsstadien, positive Resultate infolge impfinduzierter Antikörper) nach wie vor am häufigsten durchgeführt. ELISAs können zwischen IgG- und IgM-Antikörpern differenzieren und so eine akute Infektion von früheren Impfungen oder persistierenden Infektionen abgrenzen. Inzwischen wurden ELISA-Schnelltests sowie In-House-PCR-Tests für die Praxis entwickelt, die einfache und schnelle Untersuchungen vor Ort ermög lichen. Allerdings gibt es bisher erst wenige Daten zur Sensitivität und Spezifität dieser Tests. Eine sichere Diagnose kann nur bei einem positiven PCR-Ergebnis oder einem vierfachen Titeranstieg im MAT gestellt werden.

Summary

Rapid confirmation of the diagnosis leptospirosis is important in order to apply appropriate treatment; in addition, infected dogs are a zoonotic risk. Culture and isolation of living leptospires from blood, urine, or tissues is considered the reference standard of diagnosis. However, sensitivity are low, and leptospires require weeks to months to grow. Therefore, diagnosis of leptospirosis is most commonly based on antibody testing or the detection of Leptospira spp. DNA by PCR. Microscopic agglutination test (MAT) is currently still the recommended confirmatory test for canine leptospirosis, despite its numerous limitations (e. g., negative results in early infection, positive results due to vaccine-associated antibodies). ELISA can differentiate between IgG and IgM antibodies and thus, discriminate current infections from previous vaccination or exposure. Point-of-care tests and in-house-PCR tests have recently been developed for use in private practice allowing easy and immediate diagnosis. However, only few data on sensitivity and specificity of these tests exist so far. A reliable diagnosis can only be established in case of a positive PCR result or a fourfold titre increase in MAT.

Schlüsselwörter

Kanin - Leptospiren - MAT - ELISA - PCR - Schnelltest

Keywords

Canine - Leptospira species - MAT - ELISA - PCR - point-of-care test

Full Text

References

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