Comparison of a brucella enzyme immunoassay and the standard agglutination with 2-mercaptoethanol test in the diagnosis and monitoring of brucellosis in mexican patients Article uri icon

abstract

  • Background: The diagnosis of human brucellosis is difficult based on clinical grounds alone. Thus, the diagnosis is based on microbiological and serological tests. Therefore, the diagnosis relies predominantly on laboratory test-ing. The objective of this study was to determine the most efficient test for the diagnosis and monitoring of pa-tients treated for brucellosis by comparing the standard agglutination test in a tube with 2-mercaptoethanol (SAT-2Me) to an enzyme-linked immunosorbent assay for the detection of antibodies against Brucella IgM (IgM ELISA). Methods: A retrospective chart review was performed. A total of 108 patients with brucellosis were analyzed at di-agnosis and at the first and second follow-ups after treatment. The data were captured and analyzed using the SPSS 18.0 program. Frequencies, percentages, the Pearson%27s chi-square test, the kappa coefficient, sensitivity, specificity, predictive values, odds ratio, and conditional odds ratio (OR and COR) were calculated. Results: Diagnostic test: The IgM ELISA showed 96.3%25 sensitivity vs. 73.1%25 sensitivity for the SAT-2Me (p < 0.001). First follow-up: The IgM ELISA presented significant differences vs. the SAT-2Me in sensitivity (97.2%25 vs. 72.2%25) and specificity (89.7%25 vs. 44.1%25). Additionally, the second follow-up data showed significant differences in the sensitivity (85.7%25 vs. 71.4%25) and specificity (82.8%25 vs. 41.4%25) for the IgM ELISA vs. the SAT-2Me, re-spectively. In addition, the IgM ELISA showed significant concordance (0.836, p < 0.001 and 0.563, p < 0.001) at the first and second follow-ups, respectively, vs. the SAT-2Me. Conclusions: The IgM ELISA is a more reliable and useful assay for the diagnosis and monitoring of brucellosis patients than the SAT-2 Me, avoiding up to 45.6%25 of unnecessary treatments. The SAT-2Me showed lower effi-ciency for diagnosis than the IgM ELISA and limited relevance for monitoring. © 2020 Verlag Klinisches Labor GmbH. All rights reserved.
  • Background: The diagnosis of human brucellosis is difficult based on clinical grounds alone. Thus, the diagnosis is based on microbiological and serological tests. Therefore, the diagnosis relies predominantly on laboratory test-ing. The objective of this study was to determine the most efficient test for the diagnosis and monitoring of pa-tients treated for brucellosis by comparing the standard agglutination test in a tube with 2-mercaptoethanol (SAT-2Me) to an enzyme-linked immunosorbent assay for the detection of antibodies against Brucella IgM (IgM ELISA). Methods: A retrospective chart review was performed. A total of 108 patients with brucellosis were analyzed at di-agnosis and at the first and second follow-ups after treatment. The data were captured and analyzed using the SPSS 18.0 program. Frequencies, percentages, the Pearson's chi-square test, the kappa coefficient, sensitivity, specificity, predictive values, odds ratio, and conditional odds ratio (OR and COR) were calculated. Results: Diagnostic test: The IgM ELISA showed 96.3%25 sensitivity vs. 73.1%25 sensitivity for the SAT-2Me (p < 0.001). First follow-up: The IgM ELISA presented significant differences vs. the SAT-2Me in sensitivity (97.2%25 vs. 72.2%25) and specificity (89.7%25 vs. 44.1%25). Additionally, the second follow-up data showed significant differences in the sensitivity (85.7%25 vs. 71.4%25) and specificity (82.8%25 vs. 41.4%25) for the IgM ELISA vs. the SAT-2Me, re-spectively. In addition, the IgM ELISA showed significant concordance (0.836, p < 0.001 and 0.563, p < 0.001) at the first and second follow-ups, respectively, vs. the SAT-2Me. Conclusions: The IgM ELISA is a more reliable and useful assay for the diagnosis and monitoring of brucellosis patients than the SAT-2 Me, avoiding up to 45.6%25 of unnecessary treatments. The SAT-2Me showed lower effi-ciency for diagnosis than the IgM ELISA and limited relevance for monitoring. © 2020 Verlag Klinisches Labor GmbH. All rights reserved.

publication date

  • 2020-01-01