Utility of Serological Tests in the Era of Molecular Testing for Diagnosis of Human Brucellosis in Endemic Area with Limited Resources

Purwar, Shashank; Metgud, Sharada C; Mutnal, Manohar B.; Nagamoti, Mahantesh; Patil, C. S.

doi:10.7860/jcdr/2016/15525.7311

Cited by 14 publications

(8 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Positive and negative controls provided with the test kit were used to validate the test. The reported sensitivity and speci city of SAT are 95.6-100% and 96-100%, respectively [8,9]. Due to the endemic nature of brucellosis in our country, an antibody titer of at least 1:640 of either Brucella spp.…”

Section: Laboratory Testsmentioning

confidence: 84%

Lack of Correlation of Brucella Antibody Titers With Clinical Outcomes and Culture Positivity of Brucellosis

Alsubaie

Turkistani

Zeaiter

et al. 2020

Preprint

View full text Add to dashboard Cite

BackgroundBrucellosis is a zoonotic disease caused by Brucella spp., namely B. melitensis and B. abortus in humans. Culturing is the gold standard method for diagnosis; however, because Brucella is a slow-growing bacterium, which may delay diagnosis, other faster methods, such as serology, are used. Studies on the correlation between Brucella antibody titers and clinical outcomes are limited. Therefore, this study assessed such correlation and evaluated the correlation between baseline serological results with culture positivity and clinical picture.MethodsPatients tested positive for Brucella antibodies at baseline and diagnosed with brucellosis between January 2008 and December 2018 were included. Collected data included clinical outcomes, baseline culture positivity (growth in culture), arthralgia, baseline and end of therapy (EOT) temperature, white blood cell count, C-reactive protein level, and erythrocyte sedimentation rate.ResultsOf 695 patients tested for Brucella antibodies, only 94 had positive baseline serology and diagnosed with acute brucellosis, among whom 63 had EOT serology. No significant correlations were found between EOT antibody titers of both Brucella spp. and clinical cure, mortality, length of stay, and duration of therapy. Additionally, no correlations were found between baseline serology and culture positivity, arthralgia, temperature, and other lab values.ConclusionBrucella serology does not correlate with clinical outcomes at EOT nor with culture positivity at baseline. Therefore, healthcare providers are advised to consider the whole clinical picture of a brucellosis patient without relying solely on serological results during follow up and not replace culturing with serology testing alone at the time of diagnosis.

show abstract

Section: Laboratory Testsmentioning

confidence: 84%

Lack of Correlation of Brucella Antibody Titers With Clinical Outcomes and Culture Positivity of Brucellosis

Alsubaie

Turkistani

Zeaiter

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Positive and negative controls provided with the test kit were used to validate the test. The reported sensitivity and specificity of SAT are 95.6–100% and 96–100%, respectively [ 10 , 11 ]. Due to the endemic nature of brucellosis in our country, an antibody titer of at least 1:640 of either Brucella spp.…”

Section: Methodsmentioning

confidence: 99%

Lack of correlation of Brucella antibody titers with clinical outcomes and culture positivity of brucellosis

Alsubaie

Turkistani

Zeaiter

et al. 2021

Trop Dis Travel Med Vaccines

View full text Add to dashboard Cite

Background Brucellosis is a zoonotic disease caused by Brucella spp., namely B. melitensis and B. abortus in humans. Culturing is the gold standard method for diagnosis; however, because Brucella is a slow-growing bacterium, which may delay diagnosis, other faster methods, such as serology, are used. Studies on the correlation between Brucella antibody titers and clinical outcomes are limited. Therefore, this study assessed such correlation and evaluated the correlation between baseline serological results with culture positivity and clinical picture. Methods Patients tested positive for Brucella antibodies at baseline and diagnosed with brucellosis between January 2008 and December 2018 were included. Collected data included clinical outcomes, baseline culture positivity (growth in culture), arthralgia, baseline and end of therapy (EOT) temperature, white blood cell count, C-reactive protein level, and erythrocyte sedimentation rate. Results Of 695 patients tested for Brucella antibodies, only 94 had positive baseline serology and diagnosed with acute brucellosis, among whom 63 had EOT serology. No significant correlations were found between EOT antibody titers of both Brucella spp. and clinical cure, mortality, length of stay, and duration of therapy. Additionally, no correlations were found between baseline serology and culture positivity, arthralgia, temperature, and other lab values. Conclusion Brucella serology does not correlate with clinical outcomes at EOT nor with culture positivity at baseline. Therefore, healthcare providers are advised to consider the whole clinical picture of a brucellosis patient without relying solely on serological results during follow up and not replace culturing with serology testing alone at the time of diagnosis.

show abstract

“…Naturally, the Castañeda method is not specific for brucellae, and other microorganisms, including true pathogens and contaminants, may grow in the flask; therefore, full identification of the isolate is required. Although the performance of the Castañeda method has been superseded in recent years by automated blood culture systems, it is still extensively employed in countries of endemicity with limited economic and technical resources due to its low cost and practicality (27,(42)(43)(44)(45)(46)(47).…”

Section: Table 1 Factors That Determine the Positivity Rate Of Blood mentioning

confidence: 99%

Laboratory Diagnosis of Human Brucellosis

2019

View full text Add to dashboard Cite

SUMMARY The clinical presentation of brucellosis in humans is variable and unspecific, and thus, laboratory corroboration of the diagnosis is essential for the patient’s proper treatment. The diagnosis of brucellar infections can be made by culture, serological tests, and nucleic acid amplification assays. Modern automated blood culture systems enable detection of acute cases of brucellosis within the routine 5- to 7-day incubation protocol employed in clinical microbiology laboratories, although a longer incubation and performance of blind subcultures may be needed for protracted cases. Serological tests, though they lack specificity and provide results that may be difficult to interpret in individuals repeatedly exposed to Brucella organisms, nevertheless remain a diagnostic cornerstone in resource-poor countries. Nucleic acid amplification assays combine exquisite sensitivity, specificity, and safety and enable rapid diagnosis of the disease. However, long-term persistence of positive molecular test results in patients that have apparently fully recovered is common and has unclear clinical significance and therapeutic implications. Therefore, as long as there are no sufficiently validated commercial tests or studies that demonstrate an adequate interlaboratory reproducibility of the different homemade PCR assays, cultures and serological methods will remain the primary tools for the diagnosis and posttherapeutic follow-up of human brucellosis.

show abstract

Utility of Serological Tests in the Era of Molecular Testing for Diagnosis of Human Brucellosis in Endemic Area with Limited Resources

Cited by 14 publications

References 18 publications

Lack of Correlation of Brucella Antibody Titers With Clinical Outcomes and Culture Positivity of Brucellosis

Lack of Correlation of Brucella Antibody Titers With Clinical Outcomes and Culture Positivity of Brucellosis

Lack of correlation of Brucella antibody titers with clinical outcomes and culture positivity of brucellosis

Laboratory Diagnosis of Human Brucellosis

Contact Info

Product

Resources

About