Araj G F, Lulu A R, Khateeb M I, Saadah M A, Shakir R A
Department of Microbiology, Faculty of Medicine, Kuwait University.
APMIS. 1988 Feb;96(2):171-6.
Sera from patients in different stages of brucellosis as well as sera and cerebrospinal fluid (CSF) from patients with central nervous system (CNS) brucellosis and controls, were tested by ELISA for Brucella-specific IgG, IgM and IgA. The results were compared with culture findings, micro-agglutination (MA), slide agglutination with Rose Bengal (RB), and Brucella melitensis stained antigens (SA). In sera of patients with acute brucellosis (296), ELISA was positive for IgM (100%), IgG (97%) and IgA (98%), and comparable results were found in sera of patients with subacute brucellosis (44): IgG (100%), IgM (86%) and IgA (100%). However, in patients with chronic brucellosis (40), IgG and IgA were consistently positive (100%) while IgM was only positive in 33% of their sera. The MA and RB showed similar results, being more positive in patients with acute (98%) and subacute (84%) than in chronic (61%) brucellosis. The SA and culture showed significantly lower positive results. In the CSF of patients with CNS brucellosis (45), ELISA was positive in 100%, 20% and 85% for IgG, IgM and IgA, respectively, compared to 13% positive by culture, 25% by MA and 22% by RB. ELISA was negative in the CSF specimens from patients with brucellosis without CNS involvement (66), or meningitis other than Brucella (62), and no meningitis (144). Thus, ELISA with its IgG, IgM and IgA profiles is the test of choice in the diagnosis of patients with brucellosis, especially those with chronic or CNS infection.
采用酶联免疫吸附测定（ELISA）法检测布鲁氏菌病不同阶段患者的血清，以及中枢神经系统（CNS）布鲁氏菌病患者和对照者的血清及脑脊液（CSF）中的布鲁氏菌特异性IgG、IgM和IgA。将结果与培养结果、微量凝集试验（MA）、虎红平板凝集试验（RB）以及马尔他布鲁氏菌染色抗原试验（SA）进行比较。在急性布鲁氏菌病患者（296例）的血清中，ELISA检测IgM阳性率为100%，IgG为97%，IgA为98%；在亚急性布鲁氏菌病患者（44例）的血清中也得到了类似结果：IgG为100%，IgM为86%，IgA为100%。然而，在慢性布鲁氏菌病患者（40例）中，IgG和IgA持续呈阳性（100%），而IgM仅在33%的血清中呈阳性。MA和RB结果相似，急性（98%）和亚急性（84%）患者的阳性率高于慢性（61%）布鲁氏菌病患者。SA和培养法的阳性结果显著较低。在CNS布鲁氏菌病患者（45例）的脑脊液中，ELISA检测IgG、IgM和IgA的阳性率分别为100%、20%和85%，而培养法阳性率为13%，MA为25%，RB为22%。在无CNS受累的布鲁氏菌病患者（66例）、非布鲁氏菌性脑膜炎患者（62例）以及无脑膜炎患者（144例）的脑脊液标本中，ELISA检测均为阴性。因此，具有IgG、IgM和IgA谱的ELISA法是诊断布鲁氏菌病患者，尤其是慢性或CNS感染患者的首选检测方法。
