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Comparison the laboratory diagnosis of human brucellosis Young Sill Choi*, Young Rok Kim, Sang Hee Park, Soo Kyung Shim, Kyu Jam Hwang and Mi Yeoun Park.

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Presentation on theme: "Comparison the laboratory diagnosis of human brucellosis Young Sill Choi*, Young Rok Kim, Sang Hee Park, Soo Kyung Shim, Kyu Jam Hwang and Mi Yeoun Park."— Presentation transcript:

1 Comparison the laboratory diagnosis of human brucellosis Young Sill Choi*, Young Rok Kim, Sang Hee Park, Soo Kyung Shim, Kyu Jam Hwang and Mi Yeoun Park Div. of Zoonoses,, Center for Immunology& Pathology, NIH. CDC, Seoul, Korea. Clinical specimens : 469 Serum specimens were collected from cases over period of 4 years(from 2003 to 2006). STA test : STA were diagnosed using standardized suspension of brucella organism prepared from B. abortus (BD, USA). A single titer of ≥1:160 or a fourfold rise in titer was considered significant positive results. ELISA IgM, IgG test : We used enzyme-linked immunosorbent assays kit (ELISA, PANBIO, Australia). PANBIO unit of > 11 was considered significant positive. PCR test : Concerning the bovine brucellosis, the 469 clinical serum were tested by detected the common genes (BCSP 31kDa) of Brucella spp. Materials and Methods Abstract Human brucellosis poses a significant public health problem in many developing countries and requires fast and accurate diagnosis. The diagnosis of brucellosis is frequently difficult to establish. It is not only because clinically, the disease is complicated and chronic cases, but also because the established diagnostic methods are not always successful. Blood cultures represent the “gold standard” of laboratory diagnosis. So, the most certain diagnosis of Brucellosis is culture of isolates. But, time to spend on culture of Brucellosis was very long time and been difficult. Therefore, a diagnosis of Brucellosis uses a serology test and PCR. The purpose of this research was to examine the specificity and sensitivity between the methods for human Brucellosis diagnosis (STA, ELISA, PCR) ResultsResults ConclusionConclusion References ≤ 1:20 1:40 ~ 1:80 1:160 ~ 1:320 ≥1:640 STA titers 0 20 40 60 80 100 120 140 ELISA (Ig M, IgG) unit 11 Fig 1. Distribution of ELISA in STA standard titers ※ Red line( ) : ELISA positive ※ Red box( ) : ELISA positive about STA titers (1:40~1:80) We investigated that the useful diagnosis STA was drawer a parallel with ELISA, and PCR...  It seems that STA was more sensitive than ELISA and PCR. But ELISA and PCR was more specificity than STA.  However, ELISA and PCR can find Brucellosis not be able to find with STA diagnosis in the early infection. The results of ELISA, PCR were similar to STA test, and this test can be used especially in patients with brucellosis.  ELISA test detecting IgM and IgG antibody titers together found to be effective methods increasing the chance of brocellosis diagnosis.  We suggest that in common with STA and ELISA, PCR should experiment for human Brucellosis diagnosis. 321Total (n) PNT= 94% ≥1:160 215/220 97.7%Sensitivity PPT =93% ≤1:20 86/101 85.1%Specificity Predictive value STA titer ELISA(IgM) PPT* : Predictive value of positive test (95% CI) PNT* : Predictive value of negative test. (95% CI) 321Total (n) PNT=86% ≥1:160 207/220 94.0%Sensitivity PPT =90% ≤1:20 80/101 79.2%Specificity Predictive value STA titer ELISA(IgG) 15 86 215 5 050100150200250 11 > Ig M ≤ 11 050100150200250 207 21 13 80 11 > IgG ≤ 11 STA≤ 1:20 STA≥ 1:160 Fig 2. Comparison between STA and ELISA with 202 positive specimens and 101 negative specimens STA titers Tests ≤1:20 1:401:80 ≥1:160 ELISA IgM 15% 77%95%98% ELISA IgG 21% 82%89%94% PCR 0% 55%69%83% Table 2. Predictive value of positive of ELISA IgM and IgG in STA standard titers 466Total (n) PPT* = 73% ≥1:160 181/218 83.0%Sensitivity ≤1:20 0/101 100%Specificity Predictive value STA titer PCR Fig 3. Comparison between STA and PCR with 202 positive specimens and 101 negative specimens ≥ 1:160 STA PCR negative PCR positive 181 101 37 050100150200250 ≤ 1:20 STA STA titers Total  1:20 (%) 1:40 (%)1:80 (%)  1:160 (%) No. of specimens 101 (22%)74 (16%) 220 (46%) 469 Table 1. Total of specimens in STA standard titers 1.Nidia E, Lucero, Gabriela I, Escobar, Sandre M. Ayala and Nestor Jacob. Diagnosis of human brucellosis caused by brucella canis. Journal of Medical Microbiology 2005, 54, 457-461. 2. George F. Araj, Mireille M. Kattar, Layla G. Fattouh, Kayane O. Bajakian, and Sara A. Kobeissi. Evaluation of the PANBIO Brucella Immunogloblulin G (IgG) and IgM Enzyme-Linked Immunosorbent Assays for Diagnosis of Human Brucellosis. Clinical and Diagnostic laboratory immunology. Nov, 2005, 1334-1335. PNT* = 100%


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