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沙特阿拉伯西南部纳季兰地区人类布鲁氏菌病的血清学和分子诊断。

Serological and molecular diagnosis of human brucellosis in Najran, Southwestern Saudi Arabia.

机构信息

College of Medicine, Najran University, Najran, Saudi Arabia.

出版信息

J Infect Public Health. 2012 Apr;5(2):189-94. doi: 10.1016/j.jiph.2012.02.001. Epub 2012 Apr 6.

Abstract

This study aimed to investigate the prevalence of human brucellosis in Najran, southwestern Saudi Arabia, and to assess the performances of ELISA and PCR as diagnostic tools for brucellosis with respect to conventional methods. The study included 340 patients with clinical characteristics of brucellosis. Blood samples from cases and controls were subjected to culture, standard tube agglutination test (SAT), ELISA for IgM and IgG, and brucella PCR. The diagnosis of brucellosis was confirmed in 54 (15.9%) of the 340 provisionally diagnosed brucellosis patients. Blood culture identified only 14 (25.9%) cases. The SAT was positive for 50 (92.6%) cases, whereas ELISA IgM, IgG and PCR were found positive in 46, 52 and 38 cases respectively. The sensitivities of ELISA IgM and IgG were 85.2% and 96.3% respectively and the specificity was 100% for each. For PCR, the sensitivity and specificity were 70.4% and 100% respectively. In conclusion, ELISA offers a significant advantage over conventional serological methods in the diagnosis of brucellosis in endemic areas. The PCR test results can be particularly important in patients with clinical signs and symptoms, and negative serological results, allowing the early and rapid confirmation of the brucellosis.

摘要

本研究旨在调查沙特阿拉伯西南部纳季兰地区人类布鲁氏菌病的流行情况,并评估 ELISA 和 PCR 作为布鲁氏菌病诊断工具相对于传统方法的性能。该研究纳入了 340 例具有布鲁氏菌病临床特征的患者。采集病例和对照的血样进行培养、标准试管凝集试验(SAT)、IgM 和 IgG 的 ELISA 以及布鲁氏菌 PCR。在 340 例暂定布鲁氏菌病患者中,有 54 例(15.9%)确诊为布鲁氏菌病。血培养仅检出 14 例(25.9%)。SAT 阳性 50 例(92.6%),而 ELISA IgM、IgG 和 PCR 分别检出 46、52 和 38 例阳性。ELISA IgM 和 IgG 的灵敏度分别为 85.2%和 96.3%,特异性均为 100%。对于 PCR,灵敏度和特异性分别为 70.4%和 100%。总之,在流行地区,ELISA 相对于传统血清学方法在布鲁氏菌病的诊断中有显著优势。对于具有临床症状和体征且血清学结果阴性的患者,PCR 检测结果尤为重要,可早期快速确诊布鲁氏菌病。

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