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Laboratory diagnostics: Actinobacillus pleuropneumoniae (APP)

What laboratory diagnostic methods can I use to APP? Which one should I choose according to the situation? How do I interpret the results?

Assays available

Gross pathology

  • Evaluates the presence of tissue lesions which can almost be diagnostic for the disease.
  • Location of lesions: lung
  • Necro-hemorrhagic areas of consolidation in the lung accompanied by fibrinous pleuritis (see Figure 1).
Figure 1: Typical necro hemorrhagic lung lesions associated with characteristic APP infection. Source: ISU-VDPAM.
Figure 1: Typical necro hemorrhagic lung lesions associated with characteristic APP infection. Source: ISU-VDPAM.
  • Pros:
    • Presumptive diagnosis can be made after gross examination of lungs.
  • Cons:
    • Actinobacillus suis can cause some similar lesions although less severe.
    • Cannot identify serotype.

Bacterial culture

  • Isolation of live organism
  • Sample types: lung
  • Pros:
    • Can do in any lab (including in-house)
    • Biotype I requires NAD (usually provided via Staphylococcus aureus nurse colony)
    • Biotype II does not require NAD
    • Relative low cost
  • Cons:
    • Not always easy to grow
    • Cannot serotype
    • Pigs previously treated with antibiotics can prevent bacterial growth

Antimicrobial susceptibility

  • Tests in vitro ability of live organism to grow under specific concentrations of different antimicrobials
  • Sample types: lung
  • Pros:
    • Identification of susceptibility or resistance of specific isolate to common antimicrobials
    • Identification of antimicrobial resistance trends
  • Cons:
    • Requires a bacterial isolate
    • In vitro testing may be slightly different than in vivo results
    • Some specific antimicrobials may not be tested or require separate, special testing
    • Moderate cost

Polymerase chain reaction (PCR) General or Serotyping

  • Detects presence of specific sequence of bacterial nucleic acid (DNA)
  • Sample types: lung and tonsil
  • Pros:
    • High sensitivity
    • General
      • Target ApxIV toxin genes
      • Present in all APP serotypes
    • Serotyping
      • Target different parts of ApxI, ApxII, and ApxIII toxin genes
      • See Table 1 for serotyping and toxin production
    • Moderate cost
      • Can often do pooling of tissue samples to lower cost while minimizing loss of sensitivity.
  • Cons:
    • Require several specific PCR primers to determine serotyping
    • Not all isolates are typable
      • Currently 19 serotypes identified and growing
    • Not all assays validated for testing tonsil tissue

Table 1: Toxin production for each serotype.

Toxin Production
Serotype ApxI ApxII ApxIII ApxIV
1 X X X
2 X X X
3 X X X
4 X X X
5 X X X
6 X X X
7 X X
8 X X X
9 X X X
10 X X
11 X X X
12 X X
13 X X
14 X X
15 X X X
16 X X X
17 X X
18 X X
19 X X

Enzyme-linked immunosorbent assay (ELISA) LPS-O-Antigen

  • Detects presence of antibodies
  • Sample types: serum
  • Target: LPS-O-Antigen
  • Pros:
    • Can be useful in helping serotyping
    • High sensitivity
  • Cons:
    • Large amount of cross reactivity between serotypes due to share capsular and LPS-O antigen epitopes
      • The following serotypes cross react due to shared LPS-O antigens:
        • Cross reaction between serotypes 1, 9, and 11
        • Cross reaction between serotypes 3, 6, 8, 15, 17, and 19
        • Cross reaction between serotypes 4, 7, and 18
    • Unable to determine specific serotype with just one assay
    • Very expensive and impractical to test for all serotypes

Enzyme-linked immunosorbent assay (ELISA) ApxIV antigen

  • Detects presence of antibodies
  • Sample types: serum
  • Target: ApxIV Antigen
  • Pros:
    • High sensitivity
    • Detects all APP serotypes
  • Cons:
    • Unable to determine specific serotype
    • Unable to determine virulence of isolate

Result interpretation

Gross pathology

  • Positive: Often presumptive diagnosis is sufficient
  • Negative: No gross lung lesions

Bacterial culture

  • Positive:
    • Biotype 1: NAD dependent
    • Biotype 2: NAD independent
  • Negative: Negative or animal possibly previously treated with antibiotics

Antimicrobial susceptibility

  • Susceptible: possible good choice for treatment if antimicrobial can reach target tissue
  • Resistant: select different antimicrobial
  • MIC: are done to ensure the antimicrobial selected achieves the listed MIC value in the target organ

PCR

  • Positive:
    • Organism present
    • Can identify presence of different genes which can help serotype
  • Negative:
    • Negative or too late after infection.
    • Animal possibly previously treated with antibiotics
    • Not all isolates can be serotyped (Non-typable)

ELISA LPS-O-Antigen

  • Positive: help serotype or identify group of serotypes
  • Negative: negative, too late after infection, or animal possibly previously treated with antibiotics

ELISA ApxIV antigen

  • Positive: Organism present
  • Negative: negative, too late after infection, or animal possibly previously treated with antibiotics

Scenarios

Growing pigs with sudden death or respiratory disease (acute)

  • Necropsy of 1-3 recently dead or euthanize coughing pigs. Grossly evaluating lung for necro-hemorrhagic areas of consolidation accompanied by fibrinous pleuritis.
  • Submit affected lungs for bacterial culture and APP PCR general testing and if positive then for PCR serotyping.

Establish negative status of herd

  • Sample 30 of largest finishing pigs on farm and test 2-3 times a year using ApxIV ELISA.

See the "Disease manual" for more information

AppPleuropneumonia is a disease of bacterial origin with a high respiratory impact. The production of toxins can often cause sudden death with nasal hemorrhage.

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