Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-14T04:24:41.177Z Has data issue: false hasContentIssue false
  • English
  • Français

Evaluation of ELISA in the diagnosis of acute and chronic brucellosis in human beings

Published online by Cambridge University Press:  19 October 2009

G. F. Araj ,
A. R. Lulu ,
M. Y. Mustafa  and
M. I. Khateeb
G. F. Araj
Affiliation:
Department of Microbiology, Faculty of Medicine, Kuwait University, P.O. Box 24923, Kuwait
A. R. Lulu
Affiliation:
Medical Department, Jahra Hospital, Ministry of Public Health, Kuwait
M. Y. Mustafa
Affiliation:
Medical Department, Jahra Hospital, Ministry of Public Health, Kuwait
M. I. Khateeb
Affiliation:
Medical Department, Jahra Hospital, Ministry of Public Health, Kuwait
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

An enzyme-linked immunosorbent assay (ELISA) was used to determine the levels of brucella-specific IgG, IgM and IgA in 173 patients with acute brucellosis, 22 patients with chronic brucellosis and in 281 controls consisting of 98 patients with other infectious etiologies, 20 patients with non-infectious diseases and 163 normal healthy adults. The ELISA results were compared with culture findings, the results of slide agglutination tests with Brucella melitensis (M), B. abortus (A) and Ross Bengal (RB) antigens, and of tube and microagglutination tests. Brucella cultures were positive in 53 and 5% of patients with acute and chronic brucellosis respectively. The slide agglutination tests with A, M, A plus M and RB antigens were positive in 42, 44, 51 and 98% of patients with acute brucellosis and in 23, 27, 27 and 64% of patients with chronic brucellosis. There was no significant difference in the results between the tube and microagglutination tests regardless of the type of antigen used. At a titre of ≫ 80 or ≫ 160 these tests were positive in 98% and 92% of patients with acute brucellosis and 60 and 40% of patients with chronic brucellosis. The brucella culture and agglutination tests were negative for all the controls.

Brucella ELISA immunoglobulins (Ig) were detected in some individuals in the control groups but the majority of these had titres of ≫ 100 for IgG, IgM, and IgA. However, patients with brucellosis had significantly higher ELISA titres in all classes of Ig than controls but the sensitivity and specificity within each Ig class varied with the titre considered. At a titre of ≫ 1600 the brucella IgG had a sensitivity and specificity of 98% for patients with acute or chronic brucellosis; this decreased with lower reciprocal titres. The brucella IgM titre of ≫ 400 had a sensitivity of 98% and a specificity of 98% for patients with acute brucellosis. However, in patients with chronic brucellosis the brucella IgM was very low. The brucella IgA titre of ≫ 200 showed a sensitivity of 98% and a specificity of 99% for patients with either acute or chronic brucellosis. This study indicates that brucella ELISA is a rapid, sensitive and specific assay, provides a profile of Ig classes in the diagnosis of acute and chronic brucellosis, is useful for mass screening and could be considered the method of choice for the serological diagnosis of brucellosis.

Type
Research Article
Information
Journal of Hygiene , Volume 97 , Issue 3 , December 1986 , pp. 457 - 469
Copyright
Copyright © Cambridge University Press 1986

References

REFERENCES

Ardussalam, M. & Fein, D. A. (1976). Brucellosis ns a world problem. Development of Biological Standards 31, 9–23.Google Scholar
Alausa, O. K. (1980). Brucellosis: socio-economic problems and control in various countries. Tropical and Geographical Medicine 32, 5–11.Google ScholarPubMed
Alton, G. G., Jones, L. M. & Pietz, D. E. (1975). Laboratory Techniques in Brucellosis, 2nd ed. World Health Organization Monograph Series no. 55. Geneva.Google Scholar
Araj, G. F., Lulu, A. R., Saadah, M. A., Mousa, A. M., Strannegard, I.-L. & Shakir, R. A. (1986). Rapid diagnosis of central nervous system brucellosis by ELTSA. Journal of Neuroimmunology (In the Press).CrossRefGoogle Scholar
Bettelheim, K. A., Maskill, W. J. & Pearce, J. (1983). Comparison of standard tube and microagglutination techniques for determining brucella antibodies. Journal of Hygiene 90, 33–39.CrossRefGoogle ScholarPubMed
Biegeleisen, J., Bradshaw, B. R. & Moody, M. D. (1962). Demonstration of brucella antibodies in human serum. A comparison of the fluorescent antibody and agglutination techniques. Journal of Immunology 88, 109–112.CrossRefGoogle ScholarPubMed
Buchanan, I. M. & Faber, L. C. (1980). 2-Mercaptoethanol brucella agglutination test: usefulness for predicting recovery from brucellosis. Journal of Clinical Microbiology 11, 691–693.CrossRefGoogle ScholarPubMed
Coohlan, J. D. & Lonomore, H. (1973). The significance of Brucella antibodies in patients ins rural area. Practitioner 211, 645–652.Google Scholar
Coohlan, J. D. & Weir, D. M. (1967). Antibodies in human brucellosis. British Medical Journal 2, 269–271.CrossRefGoogle Scholar
de Klerk, E. & Anderson, R. (1985). Comparative evaluation of the enzyme-linked immunosorbent assay in the laboratory diagnosis of brucellosis. Journal of Clinical Microbiology 21, 381–386.CrossRefGoogle ScholarPubMed
Diaz, R., Maravi-Poma, E., Delgado, G. & Rivero, A. (1978). Rose Bengal plate agglutination and counterimmunoelectrophoresis tests on spinal fluid in the diagnosis of Brucella meningitis. Journal of Clinical Microbiology 7, 236–237.CrossRefGoogle ScholarPubMed
Diaz, R., Marvi-Poma, E. & Rivero, A. (1976). Comparison of counter-immunoelectrophoresis with other serological tests in the diagnosis of human brucellosis. Bulletin of The World Health Organisation 53, 417–424.Google Scholar
Edwards, J. M. B., Tannahill, A. J. & Bradstreet, C. M. P. (1970). Comparison of the indirect fluorescent antibody test with agglutination, complement fixation, and Coombs tests for Brucella antibody. Journal of Clinical Pathology 23, 161–165.CrossRefGoogle ScholarPubMed
FAO/WHO Expert Committee on Brucellosis (1971). World Health Organization technical report series no. 464: 5th report. Geneva.Google Scholar
Gilbert, G. L. & Hawes, L. A. (1981). The antibody response to Brucella: Immunoglobulin measured by enzyme linked immunosorbent assay and conventional tests. Australian and New Zealand Journal of Medicine 11, 40–45.CrossRefGoogle ScholarPubMed
Health Stastistics Annual Report (1984). Department of Public Health and Planning, Vital and Health Statistics Division, Ministry of Public Health, Kuwait.Google Scholar
Kambal, A. M., Mahooub, E. S., Jamjoom, G. A. & Chowdhury, N. H. (1983). Brucellosis in Riyadh, Saudi Arabia. A microbiological and clinical study. Transactions of the Royal Society of Tropical Medicine and Hygiene 77, 820–824.CrossRefGoogle ScholarPubMed
Kaufman, A. F. & Mortone, W. J. (1980). Brucellosis. In Public Health and Preventive Medicine, 11th ed. (Ed. Maxcy-Rosenau, M. J.), pp. 419–422. New York: Appleton-Century-Croft.Google Scholar
Kerr, W. R., Coohlan, J. D., Payne, D. J. H. & Robertson, L. (1966). The laboratory diagnosis of chronic brucellosis. Lancet ii, 1181–1183.CrossRefGoogle Scholar
Kerr, W. R., McCauohey, W. J., Coghlan, J. D., Payne, D. J. H.Quaife, R. A., Robertson, L. & Farrell, I. D. (1968). Techniques and interpretation in the serological diagnosis of brucellosis in man. Journal of Medical Microbiology 1, 181–193.CrossRefGoogle ScholarPubMed
Klein, G. C. & Behan, K. A. (1981). Determination of brucella immunoglobulin G agglutinating titre with dithiothreitol. Journal of Clinical Microbiology 14, 24–25.CrossRefGoogle ScholarPubMed
Lennett, E. H., Balows, A., Hausler, W. J. Jr & Traunt, (1980). Manual of Clinical Microbiology, 3rd ed.Washington, D.C., USA. American Society for Microbiology.Google Scholar
Macdonald, A. & Elmslie, W. H. (1967). Serological investigations in suspected brucellosis. Lancet i, 380–382.CrossRefGoogle Scholar
McDevitt, D. G. (1970). The relevance of the anti-human globulin (Coombs) test and the complement-fixation test in the diagnosis of brucellosis. Journal of Hygiene, 68, 173–187.CrossRefGoogle ScholarPubMed
McDevitt, D. G. (1973). Symptomatology of chronic brucellosis. British Journal of Industrial Medicine 30, 385–389.Google ScholarPubMed
McNauoht, D. J., Chappel, R. J., Allan, G. S., Bourke, J. A. & Rogerson, B. A. (1977). The effect of IgG2 and antigen concentration in the complement fixation test for bovine brucellosis. Research in Veterinary Science 22, 194–197.CrossRefGoogle Scholar
Magee, J. T. (1980). An enzyme-labelled immunosorbent assay for Brucella abortus antibodies. Journal of Medical Microbiology 13, 167–172.CrossRefGoogle ScholarPubMed
Makarem, E. H., Karjoo, R. & Omidi, A. (1982). Frequency of Brucella melitensis in Southern Iran. Journal of Tropical Pediatrics 28, 97–100.CrossRefGoogle ScholarPubMed
Manes, G. (1983). Epidemiological situation of brucellosis in the Mediterranean countries. Development of Biological Standards 56, 739–747.Google Scholar
Otero, J. R., Palenque, A. F. E. & Noriega, A. R. (1982). Microtiter-adapted method that facilitate the Coombs test for brucellosis. Journal of Clinical Microbiology 16, 737–738.CrossRefGoogle ScholarPubMed
Parratt, D., Nielsen, K. H., White, R. G. & Payne, D. J. H. (1977). Radioimmunoasssay of IgM, IgG and IgA brucella antibodies. Lancet i, 1075–1078.CrossRefGoogle Scholar
Payne, D. J. H. (1974). Chronic brucellosis. British Medical Journal 2, 221–222.CrossRefGoogle ScholarPubMed
Reddin, J. L.Anderson, R. K., Jenness, R. & Spink, W. W. (1965). Significance of 7S and macroglobulin Brucella agglutinins in human brucellosis. New England Journal of Medicine 272, 1263–1268.CrossRefGoogle ScholarPubMed
Saiis, A. L. (1978). Brucellosis (Malta fever; undulant fever). In Handbook of Clinical Neurology. Vinken, P. J. & Bruyn, G. W., vol. 33, pp. 305–326. Amsterdam: North-Holland Publishing Company.Google Scholar
Sippel, J. E., El-Masry, N. A. & Farid, Z. (1982). Diagnosis of human brucellosis with ELISA. Lancet ii, 19–21.CrossRefGoogle Scholar
Stranneoard, I.-L., Araj, G. F. & Fattah, H. A. (1985). Neurobrucellosis in an eight-year-old child. Annals of Tropical Paediatrics 5, 191–194.CrossRefGoogle Scholar
White, G. (1978). Immunoglobulin profiles of the chronic antibody response: discussion in relation to brucellosis infection. Postgraduate Medical Journal 54, 595–602.CrossRefGoogle Scholar
Wilkinson, P. C. (1966). Immunoglobulin patterns of anti-bodies against Brucella in man and animals. Journal of Immunology 96, 457–463.CrossRefGoogle Scholar
Wilson, M. A. & Merrifield, E. V. O. (1951). The antiglobulin (Coombs) test in brucellosis. Lancet ii, 913–914.CrossRefGoogle Scholar
Wise, R. I. (1980). Brucellosis in the United States, past present and future. Journal of American Medical Association 244, 2318–2322.CrossRefGoogle ScholarPubMed
Young, E. J. W. (1983). Human brucellosis. Revieivs of Infectious Diseases 5, 821–824.CrossRefGoogle ScholarPubMed