The Rose Bengal Test in human brucellosis: a neglected test for the diagnosis of a neglected disease.
The Rose Bengal Test in human brucellosis: a neglected test for the diagnosis of a neglected disease.
复制标题
DOI：
10.1371/journal.pntd.0000950
复制
发表时间：
2011-04-19
影响因子：
3.8
通讯作者：
Moriyón I
中科院分区：
文献类型：
--
作者：
Díaz R;Casanova A;Ariza J;Moriyón I
布鲁氏菌病是一种影响牲畜和人类的高度传染性人畜共患病。这种人类疾病缺乏病原学症状，实验室测试是诊断的关键。然而，大多数检测很难在布鲁氏菌病流行的地区和国家实施。本文比较了简便易行的孟加拉玫瑰试验(RBT)与血清凝集试验、Coombs试验、竞争酶联免疫吸附试验、Brucellacapt试验、侧向流动免疫层析试验以及布鲁氏菌蛋白免疫沉淀法检测IgM和Ig G的结果。我们检测了208份经细菌分离确诊的布鲁氏菌病患者的血清，20份非布鲁氏菌病接触者的血清，以及1559份没有最近接触者或布鲁氏菌病症状的血清。RBT在急性和长期演变的布鲁氏菌病中高度敏感，这与其检测IgM、Ig G和Ig A的能力有关，与Pre-zones的缺失以及在试验的pH条件下阻断Ig A的凝集活性有关。RBT在没有接触过布鲁氏菌的人的血清中也具有高度的特异性。在这项研究中，没有一项测试的效果优于RBT，也没有一项测试在区分接触者和感染者方面是完全令人满意的。当修改为检测血清稀释度时，RBT的诊断效价>；4导致87.4%的敏感性(感染患者)和100%的特异性(接触者)。我们讨论了血清学检测在人类布鲁氏菌病诊断中的局限性，特别是在更慢性的形式中，并得出结论，RBT的简单性和可负担性使其接近于小型和人手不足的医院和实验室的理想检测。采用孟加拉玫瑰试验(RBT)检测布鲁氏菌病血清稀释度，并对布鲁氏菌培养阳性患者、接触过布鲁氏菌但无症状者、未发病的兽医意外注射疫苗REV1和正常人的血清进行检测。使用标准方法，RBT在鉴定布鲁氏菌感染患者方面并不优于更复杂和昂贵的检测方法(血清凝集试验、Coombs试验、竞争性酶联免疫吸附试验、Brucellacapt试验和横向流动免疫层析检测IgM和Ig G试验)。所有测试都未能完全特异性地区分血清与接触者或注射了Rev 1的个体。然而，在适用于检测效价高于1>；4的血清稀释度的改良RBT中，这些血清都没有阳性。当怀疑布鲁氏菌病时，建议将RBT作为第一项检测，根据滴度的不同，阳性结果不需要通过其他(通常更昂贵、更复杂和更耗时的)检测来确认。
Brucellosis is a highly contagious zoonosis affecting livestock and human beings. The human disease lacks pathognomonic symptoms and laboratory tests are essential for its diagnosis. However, most tests are difficult to implement in the areas and countries were brucellosis is endemic. Here, we compared the simple and cheap Rose Bengal Test (RBT) with serum agglutination, Coombs, competitive ELISA, Brucellacapt, lateral flow immunochromatography for IgM and IgG detection and immunoprecipitation with Brucella proteins. We tested 208 sera from patients with brucellosis proved by bacteriological isolation, 20 contacts with no brucellosis, and 1559 sera of persons with no recent contact or brucellosis symptoms. RBT was highly sensitive in acute and long evolution brucellosis cases and this related to its ability to detect IgM, IgG and IgA, to the absence of prozones, and to the agglutinating activity of blocking IgA at the pH of the test. RBT was also highly specific in the sera of persons with no contact with Brucella. No test in this study outperformed RBT, and none was fully satisfactory in distinguishing contacts from infected patients. When modified to test serum dilutions, a diagnostic titer >4 in RBT resulted in 87.4% sensitivity (infected patients) and 100% specificity (contacts). We discuss the limitations of serological tests in the diagnosis of human brucellosis, particularly in the more chronic forms, and conclude that simplicity and affordability of RBT make it close to the ideal test for small and understaffed hospitals and laboratories. The Rose Bengal Test (RBT) for brucellosis serological diagnosis was adapted to test serum dilutions and its usefulness evaluated using sera of Brucella culture positive patients, persons with contact with Brucella but no symptoms, veterinarians accidentally injected with vaccine Rev 1 who had not developed the disease and normal persons. Using the standard protocol, RBT was not outperformed by more sophisticated and expensive tests (serum agglutination, Coombs, competitive ELISA, Brucellacapt, and lateral flow immunochromatography for IgM and IgG detection) in identifying Brucella infected patients. All tests failed to discriminate with total specificity the sera from contacts or Rev 1 injected individuals. However, none of these sera was positive in the modified RBT adapted to test serum dilutions at titers higher than 1>4. When there is suspicion of brucellosis, RBT is recommended as the first test and, depending upon the titer, a positive result does not need confirmation by other (usually more expensive, sophisticated and time consuming) tests.
登录
查看更多内容
影响因子：
39.2
作者：
EISELE, CW;MCCULLOUGH, NB;BEAL, GA
通讯作者：
BEAL, GA
影响因子：
2.8
作者：
ARAJ, GF;LULU, AR;SHAKIR, RA
通讯作者：
SHAKIR, RA
影响因子：
2.2
作者：
BLASCO, JM;GARINBASTUJI, B;CAU, C
通讯作者：
CAU, C
影响因子：
--
作者：
Casanova, Aurora;Ariza, Javier;Diaz, Ramon
通讯作者：
Diaz, Ramon
影响因子：
11.8
作者：
Ariza, J;Pigrau, C;Pahissa, A
通讯作者：
Pahissa, A