Diagnostic Tests in Human Brucellosis
Diagnostic Tests in Human Brucellosis
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人类布鲁氏菌病的诊断测试
DOI：
10.17795/ijep19422
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发表时间：
2014
影响因子：
--
通讯作者：
S. Ebrahimpour
中科院分区：
文献类型：
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作者：
H. Nouri;M. Marashi;M. Rahimi;S. Damavandi;S. Ebrahimpour
背景：布鲁氏菌病是一种人畜共患的细菌性疾病，由一种称为布鲁氏菌的革兰氏阴性细菌引起。在这种细菌的不同种类中，羊布鲁氏菌、流产布鲁氏菌、猪布鲁氏菌和犬布鲁氏菌是导致人类疾病的主要原因。每年报告的布鲁氏菌病新病例超过 50 万例。因此，布鲁氏菌病对社会健康构成显着威胁。由于这种感染有多种非特异性临床症状，如发烧（60%的病例）、盗汗、失眠和厌食等，与其他疾病相似，因此布鲁氏菌病的检测非常耗时，需要更多的审查。证据获取：血培养被认为是检测布鲁氏菌病的金标准，并且该测试在急性形式中的敏感性很高。然而，对于慢性类型的疾病，它是非常低的，此外，在某些情况下，它需要很长的反应时间。然而，今天，一些测试，如自动培养系统和血清学方法，如玫瑰红（RB）测试、血清凝集测试（SAT）、2-巯基乙醇（2ME）和基于凝集操作的库姆斯（coombs）测试，对于前面提到的问题很有用。结论：虽然血清学方法是布鲁氏菌病诊断的常用方法，但某些方法（例如 SAT 方法）仍可观察到错误结果。用于筛选特定性状的酶联免疫吸附测定 (ELISA) 等测试虽然已得到证实，但也有其优点和缺陷。侧向层析检测（LFA）显示了可有效诊断布鲁氏菌病的有希望的证据。根据分子诊断的敏感性和快速回答能力，聚合酶链反应 (PCR) 比其他常见测试更普遍。此外，PCR适合患者在治疗期间的随访，并且与其他方法相比，这种方法更容易对复发进行定罪。
Context: Brucellosis represents a zoonotic bacterial disease, caused by a gram negative bacterium called Brucella. Between the diverses pecies of this bacteria, B. melitensis, B. abortus, B. suis and B. canis consist the main causes of the disease in humans.More than half a million new cases of Brucellosis are reported annually. Consequently, brucellosis is a remarkable threat for the health of society. Because of the multiple nonspecific clinical signs of this infection, such as fever (60% of cases), night sweating, insomnia and anorexia, which are similar to other diseases, the detection of brucellosis is time-consuming and needs more scrutiny. Evidence Acquisition: Blood culture is considered the gold standard for the detection of brucellosis and the sensitivity of this test in the acute form is high. However, for the chronic type of disease, it is remarkably low, in addition, in some cases, it needs long reaction times. Nevertheless, today, some kinds of tests like automatic culturing system and serological methods, such as Rose Bengal (RB) test, serum agglutination test (SAT), 2-mercaptoethanol (2ME) and coombs, which are operated based on agglutination, are useful for the problems mentioned earlier. Conclusion: Although serological methods are common for the diagnosis of brucellosis, false results are observable for several methods, such as the SAT method. Tests like the enzyme-linked immunosorbent assay (ELISA), for the screening of specific traits, although confirmed, have their advantages and defects. The lateral flow assay (LFA) shows promising evidence to be effective in the diagnosis of brucellosis. The polymerase chain reaction (PCR) is more prevalent than other common tests, according to sensitivity and fast answering potency in case of molecular diagnosis. Also, PCR is proper for patients' follow-up during the period of treatment and crimination of relapse by this method is easier compared to others.