BrucellaCapt versus Classical Tests in the Serological Diagnosis and Management of Human Brucellosis
BrucellaCapt versus Classical Tests in the Serological Diagnosis and Management of Human Brucellosis
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DOI：
10.1128/cvi.00348-08
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发表时间：
2009-06-01
影响因子：
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通讯作者：
Diaz, Ramon
中科院分区：
文献类型：
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作者：
Casanova, Aurora;Ariza, Javier;Diaz, Ramon
布鲁氏菌Capt试验是一种免疫捕获凝集试验，有可能在人类布鲁氏菌病的诊断中替代库姆斯试验。本文用48例布鲁氏菌病患者的321例标本(每例6.9+/-1.7例)与经典试验进行了比较，其中包括20例局灶性疾病患者和8例共9次复发的患者(平均随访18个月)。BrucellaCapt检测是根据制造商的说明进行的，我们还使用了BrucellaCapt检测的一种变体，在该方法中，微量平板上没有涂有抗人类总免疫球蛋白(BCAPV)的抗体。BrucellaCapt和BCAPV试验之间的相关性为0.982(P<；0.001)，有260对滴度符合(81%)。与库姆斯试验相比，布鲁氏试验和BCAPV试验的受试者工作特性曲线下面积分别为0.969和0.960。入院时，所有病例的布鲁氏菌检测、BCAPV和Coombs试验及微量凝集试验(MAT)均为阳性：BrucellaCapt试验滴度为1/2,560，BCAPV为1/2,560，Coombs试验为1/1,280，MAT为1/320。与Coombs滴度相比，BrucellaCapt和BCAPV滴度随着时间的推移而显著下降。治疗12个月后持续的累积概率如下：BrucellaCapt试验80%，BCAPV试验80%，Coombs试验87%，MAT 35%。用Coombs试验检测到7例(88%)复发期间的血清学变化，用BrucellaCapt和BCAPV试验检测到5例，用MAT检测到3例。布氏杆菌Capt试验是一种敏感、特异和简单的常规用于人类布鲁氏菌病的试验。BCAPV试验也得到了类似的结果。然而，在一些复发和慢性形式的疾病中，仅在低亲和力抗体中观察到的轻微变化可以通过库姆斯试验更好地检测出来。
The BrucellaCapt test is an immunocapture agglutination test suggested as a possible substitute for the Coombs test in the diagnosis of human brucellosis. Here it is compared with classical tests using 321 samples from 48 patients with brucellosis (6.9 +/- 1.7 samples per patient), including 20 patients with focal disease and 8 patients with a total of 9 relapse episodes (mean follow-up, 18 months). The BrucellaCapt test was used according to the manufacturer's instructions, and we also used a variant of the BrucellaCapt test in which the microtiter plates were not coated with antibodies against total human immunoglobulin (BCAPV). The correlation between the BrucellaCapt and BCAPV tests was 0.982 (P < 0.001), with 260 coincident pairs of titers (81%). The areas under the receiver operating characteristic curve for the BrucellaCapt and BCAPV tests with respect to the Coombs test were 0.969 and 0.960, respectively. Upon admission, the BrucellaCapt, BCAPV, and Coombs tests and the microagglutination test (MAT) were positive for all cases: titers were 1/2,560 by the BrucellaCapt test, 1/2,560 by the BCAPV test, 1/1,280 by the Coombs test, and 1/320 by the MAT. The decreases in the BrucellaCapt and BCAPV titers over time were pronounced in comparison with the Coombs titers. Cumulative probabilities of persistence 12 months after therapy were as follows: 80% by the BrucellaCapt test, 80% by the BCAPV test, 87% by the Coombs test, and 35% by the MAT. Serological changes during relapse were detected in seven cases (88%) by the Coombs test, in five cases by the BrucellaCapt and BCAPV tests, and in three cases by the MAT. The BrucellaCapt test is a sensitive, specific, and simple test for routine use in human brucellosis. Similar results were obtained with the BCAPV test. However, in some cases of relapse and chronic forms of the disease, the slight changes observed in low-affinity antibodies alone are better detected by the Coombs test.