Follow-up standard agglutination and 2-mercaptoethanol tests in 175 clinically cured cases of human brucellosis

Roushan, Mohammad Reza Hasanjani; Amiri, Mehrangiz; Laly, Abolghasem; Mostafazadeh, Amrollah; Bijani, Ali

doi:10.1016/j.ijid.2009.05.008

Cited by 33 publications

(29 citation statements)

References 17 publications

(23 reference statements)

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“…However, extended serological follow-up periods might not be reasonable in patients who are clinically well. Significant SAT titers are found in 3-5% of the clinically cured brucellosis cases 2 years after successful antibiotic treatment [69], and these figures may be even higher in different populations, after another antibiotic regimen, using other serological tests, and so on. …”

mentioning

confidence: 99%

Implications of laboratory diagnosis on brucellosis therapy

Dahouk

Nöckler

2011

Expert Review of Anti-infective Therapy

163

131

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Brucellosis is one of the world's most widespread bacterial zoonoses, leading to tremendous economic losses in endemic regions and serious complaints in affected patients. The infection may be transmitted by direct animal contact, but is usually acquired through the consumption of contaminated food products of animal origin, mainly via unpasteurized goat's milk and cheese. Furthermore, brucellosis is the most common bacterial laboratory-acquired infection worldwide [1].Although many national and international programs have been established to eradicate the pathogen and control its spreading in animal husbandry, brucellosis is still a re-emerging disease. The surveillance of animal brucellosis is difficult due to bacterial persistence in wildlife and environmental reservoirs, with consecutive spill-over to domestic animals [2].Brucellosis is caused by members of the genus Brucella (B.), which are gram-negative, facultative intracellular coccobacilli that were historically differentiated by their preferred animal host, varying pathogenicity and a few selected phenotypic traits. The genus comprises six classical species: B. melitensis bv 1-3 (primarily isolated from sheep and goats); B. abortus bv 1-6 and 9 (from cattle and other Bovidae); B. suis bv 1-3 (from pigs), bv 4 (from reindeer), bv 5 (from small rodents); B. canis (from dogs); B. ovis (from sheep); and B. neotomae (from desert wood rats). Recently, two novel species of marine origin, B. pinnipedialis (isolated from seals) and B. ceti (from dolphins and whales) [3], B. microti isolated from the common vole (Microtus arvalis) [4], red foxes (Vulpes vulpes) [5] and from soil [6], and B. inopinata isolated from a breast implant wound of a 71-year-old female patient [7] have been described. In the past, a lot of atypical Brucella strains arose. These could represent novel species or lineages of already described species, for example various Brucella strains originating from wild native rodent species in North Queensland, Australia [8], a novel Brucella isolate in association with two cases of stillbirth in nonhuman primates [9], and a B. inopinata-like strain (BO2), which was isolated from a lung biopsy of a 52-year-old Australian patient suffering from chronic destructive pneumonia [10].Physicians' awareness of the infection is very poor in many countries, and most cases correctly identified are clinically advanced. Because of its protean clinical manifestations, human brucellosis can be easily confused with other infectious and noninfectious diseases, leading to diagnostic delays and late onset of therapy. The isolation of the fastidious organisms is often unsuccessful or takes a long time, which is why the presumptive clinical diagnosis is usually confirmed by Brucellosis is a worldwide zoonosis with a huge economic impact on animal husbandry and public health. The diagnosis of human brucellosis can be protracted because the disease primarily presents as fever of unknown origin with unspecific clinical signs and symptoms. The isolation rate of the fastidiou...

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confidence: 99%

Implications of laboratory diagnosis on brucellosis therapy

Dahouk

Nöckler

2011

Expert Review of Anti-infective Therapy

163

131

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“…Therefore, another reliable test is needed for the diagnosis and follow-up of all patients with brucellosis. [23][24][25] SAT false-negative results may have occurred in patients with very recent infection or chronic cases. [26][27][28] With regard to the molecular method, we evaluated useful nested PCR assay for the diagnosis of human brucellosis in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

“…This issue neither indicates that clinical recovery relating to the eradication of the organism nor stresses the point that the presence of DNA may be representing an active disease that requires treatment. 24,26 Hence, bacterial DNA persists in the blood of several patients throughout treatment and follow-up in those with significant clinical recovery. 13,14 One of the main characteristics of brucellosis is its noticeable tendency to relapse after treatment.…”

Section: Discussionmentioning

confidence: 99%

Polymerase Chain Reaction–Based Assays for the Diagnosis of Active and Relapsed Cases of Human Brucellosis

Roushan

Marashi

Moulana

2016

The American Society of Tropical Medicine and Hygiene

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Abstract. This study aimed to compare polymerase chain reaction (PCR) with serum agglutination test (SAT) in the diagnosis of patients before and 6 months after treatment. Peripheral blood specimens from 50 patients with brucellosis (case group) and 30 subjects without brucellosis (control group) were selected and entered into the study. The diagnosis of brucellosis was established using SAT ≥ 1:160 and 2-mercaptoethanol (2-ME) ≥ 1:80 with clinical signs and symptoms compatible with brucellosis. For each case, both before treatment and 6 months after completion of therapy, SAT, 2-ME, and PCR were performed. Subjects in the control group were assessed by the same tests at the initial visit. In the case group, 50 patients (36 males, 14 females) with the mean age of 43.6 ± 14.5 years were evaluated. The mean age of the control group was 40.6 ± 14 years. Among the 50 patients whose nested PCR assays were initially positive, 43 (86%) were negative 6 months after completing treatment. Relapse occurred in five (10%) patients within 6 months after treatment and all were PCR positive. None of the patients in the control group was PCR positive. Results show that PCR seems to be highly sensitive and specific, and therefore is a useful method for both the initial diagnosis and detection of relapse or chronic brucellosis.

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“…However, in endemic areas with more patients suffering from acute bacteremia, the SAT titer threshold is of at least 1:320 (47). As SAT in the chronic form has sometimes false-negative results, several studies have showed that in the first few days of the disease, even bacteremic patients had an SAT titer ≤ 1:160 (48).…”

Section: Satmentioning

confidence: 99%

“…In some studies, patients surveyed by PCR, after accomplishment of their treatment, have evidenced the bacteria in blood for a partly longer term brings into discussion the possibility of relapse (76). Relapse usually occurs within 6 months after cessation of treatment (47). Consequently, patients must pursue a treatment plan for 12 months.…”

Section: Pcrmentioning

confidence: 99%

Diagnostic Tests in Human Brucellosis

Nouri¹,

Marashi²,

Rahimi³

et al. 2014

Int J Enteric Pathog

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Context: Brucellosis represents a zoonotic bacterial disease, caused by a gram negative bacterium called Brucella. Between the diverse species 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.

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Follow-up standard agglutination and 2-mercaptoethanol tests in 175 clinically cured cases of human brucellosis

Abstract: SAT and 2-ME may be found in significant titers in less than 5% of clinically treated cases after two years. Serologic cure for both tests with lower titers were higher than with higher titers.

Cited by 33 publications

References 17 publications

Implications of laboratory diagnosis on brucellosis therapy

Implications of laboratory diagnosis on brucellosis therapy

Polymerase Chain Reaction–Based Assays for the Diagnosis of Active and Relapsed Cases of Human Brucellosis

Diagnostic Tests in Human Brucellosis

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