Diagnosis of brucellosis: Combining tests to improve performance.

Autor: Loubet P; Virulence Bactérienne et Infections Chroniques, INSERM U1047, Univ Montpellier, Service des Maladies Infectieuses et Tropicales, Centre National de Reference des brucelloses, CHU Nîmes, Nîmes, France., Magnan C; Virulence Bactérienne et Infections Chroniques, INSERM U1047, Univ Montpellier, Service de Microbiologie et Hygiène Hospitalière, Centre National de Reference des brucelloses, CHU Nîmes, Nîmes, France., Salipante F; Department of Biostatistics, Epidemiology, Public Health and Innovation in Methodology (BESPIM), CHU Nîmes, Univ Montpellier, Nîmes, France., Pastre T; Virulence Bactérienne et Infections Chroniques, INSERM U1047, Univ Montpellier, Service de Microbiologie et Hygiène Hospitalière, Centre National de Reference des brucelloses, CHU Nîmes, Nîmes, France., Keriel A; Virulence Bactérienne et Infections Chroniques, INSERM U1047, Univ Montpellier, Centre National de Reference des brucelloses, Nîmes, France., O'Callaghan D; Virulence Bactérienne et Infections Chroniques, INSERM U1047, Univ Montpellier, Centre National de Reference des brucelloses, Nîmes, France., Sotto A; Virulence Bactérienne et Infections Chroniques, INSERM U1047, Univ Montpellier, Service des Maladies Infectieuses et Tropicales, Centre National de Reference des brucelloses, CHU Nîmes, Nîmes, France., Lavigne JP; Virulence Bactérienne et Infections Chroniques, INSERM U1047, Univ Montpellier, Service de Microbiologie et Hygiène Hospitalière, Centre National de Reference des brucelloses, CHU Nîmes, Nîmes, France.
Jazyk: angličtina
Zdroj: PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2024 Sep 05; Vol. 18 (9), pp. e0012442. Date of Electronic Publication: 2024 Sep 05 (Print Publication: 2024).
DOI: 10.1371/journal.pntd.0012442
Abstrakt: Introduction: Brucellosis, a zoonotic infectious disease caused by bacteria of the genus Brucella, remains a significant global health concern in many parts of the world. Traditional diagnostic methods, including serological tests, suffer from limitations, including low sensibility and high false-positive rates, emphasizing the need for improved diagnostic strategies. In this study, we aimed to optimize diagnostic accuracy by reevaluating serological tests and exploring novel diagnostic algorithms.
Methods: A retrospective observational study was conducted using sera collected between June 2012 and June 2023 at the French National Reference Center for Brucella. Various serological tests, including Rose Bengal plate test (RBT), standard agglutination test (SAT), Brucellacapt, and ELISA for IgM and IgG, were performed. Different diagnostic algorithms were evaluated, combining RBT with SAT, Brucellacapt, and ELISA to enhance the performance of diagnostic tests.
Results: Among 3587 sera analyzed, 148 were confirmed cases of human brucellosis. Individual serological tests exhibited good sensitivity and specificity but lacked diagnostic accuracy. However, combining RBT with SAT or Brucellacapt significantly improved diagnostic performance, with reduced false positives. The most promising results were observed when an algorithm was built combining RBT, Brucellacapt, and ELISA for IgM and IgG (a score value of 0.5 with 90.5% for sensitivity, 99.7% for specificity, 92.4% for PPV, and 99.6% for NPV).
Conclusions: Serological tests remain crucial for brucellosis diagnosis, but their limitations necessitate innovative diagnostic approaches. Combining multiple serological tests in diagnostic algorithms shows promise in improving diagnostic accuracy. Efforts to refine diagnostic, strengthen surveillance, and raise awareness are essential for effective brucellosis control, particularly in resource-limited settings.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Loubet et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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