Ulu-Kilic Aysegul, Metan Gökhan, Alp Emine
Department of Infectious Disease and Microbiology, Erciyes University, Faculty of Medicine, 38039 Kayseri/Turkey.
Recent Pat Antiinfect Drug Discov. 2013 Apr;8(1):34-41.
Brucellosis is a worldwide zoonosis caused by Brucella species. The disease remains a significant economic and public health problem particularly in the Mediterranean countries. Clinical manifestations of brucellosis are variable and often nonspecific, simulating infectious and noninfectious diseases. Osteoarticular involvement is the most common focal complication of brucellosis and morbidity. Mortality rate due to brucellosis is low, mostly secondary to endocarditis and central nerve involvement of disease. The diagnosis of brucellosis depends on the clinical presentations and laboratory tests. Detection of Brucella species by culture method is sometimes unsuccessful; therefore, serological tests are preferred. These tests are easy to perform, and results can be obtained within a short span of time. Several serologic tests have been developed for the diagnosis of human brucellosis, including the standard agglutination tube (SAT) test, anti-human globulin (Coombs) test, indirect fluorescence antibody (IFA) test, and enzyme-linked immunosorbent assay (ELISA). SAT is the primary test used in many clinical laboratories. IFA and ELISA are simple and reliable for the detection of immunoglobulin classes especially in complicated cases. Polymerase chain reaction (PCR) technique is highly sensitive and specific for the determination of Brucella spp. from peripheral blood and other tissues. Recent patents are especially based on molecular assays in the diagnosis of brucellosis. However, PCR is still expensive and may not be appropriate for daily practice.
布鲁氏菌病是一种由布鲁氏菌属引起的全球性人畜共患病。该疾病仍然是一个重大的经济和公共卫生问题，特别是在地中海国家。布鲁氏菌病的临床表现多样且往往不具特异性，类似感染性和非感染性疾病。骨关节受累是布鲁氏菌病最常见的局部并发症和发病形式。布鲁氏菌病导致的死亡率较低，主要继发于疾病的心内膜炎和中枢神经受累。布鲁氏菌病的诊断取决于临床表现和实验室检查。通过培养方法检测布鲁氏菌属有时并不成功；因此，血清学检测更受青睐。这些检测易于操作，且能在短时间内获得结果。已经开发了几种用于诊断人类布鲁氏菌病的血清学检测方法，包括标准凝集试管（SAT）检测、抗人球蛋白（库姆斯）检测、间接荧光抗体（IFA）检测和酶联免疫吸附测定（ELISA）。SAT是许多临床实验室使用的主要检测方法。IFA和ELISA对于检测免疫球蛋白类别简单可靠，尤其是在复杂病例中。聚合酶链反应（PCR）技术对于从外周血和其他组织中检测布鲁氏菌属高度敏感且特异。近期的专利尤其基于布鲁氏菌病诊断中的分子检测方法。然而，PCR仍然昂贵，可能不适用于日常实践。
