Prevalence of Brucella antibodies on a previously acute brucellosis infected population: sensitivity, specificity and predictive values of Rose Bengal and Wright standard tube agglutination tests
Prevalence of Brucella antibodies on a previously acute brucellosis infected population: sensitivity, specificity and predictive values of Rose Bengal and Wright standard tube agglutination tests
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DOI：
10.1007/s15010-015-0748-z
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发表时间：
2015-06-01
期刊：
影响因子：
7.5
通讯作者：
Tsironi, Maria
中科院分区：
文献类型：
--
作者：
Andriopoulos, Panagiotis;Kalogerakou, Antonia;Tsironi, Maria
布鲁氏菌病是一种在世界范围内分布的人畜共患病。急性感染后抗体的存在以及流行地区血清学阳性的流行情况尚未得到充分记录。急性布氏杆菌病住院患者在初次感染后 3-13 年被重新安置。检索医院初次感染记录，采用孟加拉红试验（RBT）和瑞氏标准管凝集试验（STA）进行布鲁氏菌抗体检查。2000年至2010年住院患者83例； 50.6%是农民，37.4%是畜牧业农民。所有人都患有发热性疾病和各种局灶性并发症。所有人的血清学检测均呈阳性，其中 82.2% 的血培养呈阳性； 91.5% 的患者接受了链霉素加强力霉素治疗。七十二人（86.7%）在后续行动中被重新安置。九人 (12.5%) 的 RBT 和 STA 呈阳性，高达 1/320。职业史与血清学阳性相关（p = 0.0172），8/9 的阳性个体是畜牧养殖户（检查的畜牧养殖户中的 38.0%）。居住地、感染后的年数、布鲁氏菌病的临床表现和治疗与血清学结果无关。两项检测均具有出色的敏感性（接近 100%）、特异性 87.5% 和出色的阴性预测值（接近 100%）；然而，阳性预测值仅为11.4%。快速、低成本的RBT和STA检测对于诊断急性布氏杆菌病仍然非常有用；然而，每一次阳性检测都必须与临床症状和职业史一起检查。这些测试可用作流行人群的筛查测试，以排除急性布鲁氏菌病。
Brucellosis is a zoonosis with worldwide distribution. The presence of antibodies after acute infection and the prevalence of positive serology in endemic area are not well documented.Patients hospitalized with acute brucellosis were relocated 3-13 years after the initial infection. Hospital records of the initial infection were retrieved, and examination of Brucella antibodies using Rose Bengal test (RBT) and Wright standard tube agglutination (STA) test was performed.Eighty-three patients were hospitalized from 2000 to 2010; 50.6 % were farmers and 37.4 % livestock farmers. All had febrile illness and various focal complications. All had positive serology, and 82.2 % had positive blood cultures; 91.5 % were treated with streptomycin plus doxycycline. Seventy-two (86.7 %) were relocated on follow-up. Nine (12.5 %) had positive RBT and STA up to 1/320. Occupational history was associated with positive serology (p = 0.0172), and 8/9 of the positive individuals were livestock farmers (38.0 % of the livestock farmers checked). Residence, years after the infection, clinical presentation of brucellosis and treatment were not associated with serology results. Both tests had excellent sensitivity (nearly 100 %), specificity 87.5 % and excellent negative predictive value (nearly 100 %); however, positive predictive value was only 11.4 %.Rapid and low-cost tests as RBT and STA are still very useful in diagnosing acute brucellosis; however, every positive test must be examined together with clinical symptoms and occupational history. The tests can be used as screening tests in endemic populations to rule out acute brucellosis.