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发热原因不明的风险人群和非风险人群中人类布鲁氏菌病的血清阳性率和实时 PCR 分子检测。

Seropositivity of Human Brucellosis among Patients with Pyrexia of Unknown Origin on Both Risk and Non-Risk Group of Individuals and Molecular Detection by Real-time PCR.

机构信息

Dr Mahbubul Alam, MD Resident, Department of Microbiology, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:

出版信息

Mymensingh Med J. 2021 Oct;30(4):936-942.

Abstract

Brucellosis is a zoonotic disease that is one of the important infectious causes of Pyrexia of Unknown Origin (PUO). The objective of the present study was to determine the seropositivity and molecular detection of human brucellosis among the patients with pyrexia of unknown origin on both risk and non-risk group of individuals in greater Mymensingh. A total of 400 blood samples were randomly collected from pyretic patients started from September 2018 to August 2019. Questionnaires were used to collect data on both risk and non-risk group of individuals. All samples were initially screened for anti-Brucella antibodies using the Brucella-specific latex agglutination test. For accurate investigation, seropositive as well as seronegative serum samples were tested by BCSP31 Brucella genus-specific TaqMan real-time PCR. Overall 32(8%) cases were positive out of 400 samples by Brucella-specific latex agglutination test and/or BCSP31 Brucella genus-specific real-time PCR. Brucella-specific latex agglutination test documented 7% (28/400) positivity for brucellosis. 22(5.5%) samples found Brucella genus-specific real-time PCR positive out of 400 samples. Most real-time PCR positive cases were found from sero-positive samples of risk group population (15/32). Sero-negative but real-time PCR positive cases also found only from risk group population (4/32). There were 10 seropositive cases where real-time PCR was negative. In addition to Brucella-specific latex agglutination test as a screening test, Brucella genus-specific real-time PCR was performed for confirmation and also to avoid unjustified costs, drug toxicity, and masking of other potentially dangerous diseases.

摘要

布鲁氏菌病是一种人畜共患疾病,是不明原因发热(PUO)的重要感染原因之一。本研究旨在确定在密支那地区高危和非高危人群中,发热原因不明的患者中人类布鲁氏菌病的血清阳性率和分子检测。2018 年 9 月至 2019 年 8 月,共随机采集了 400 份发热患者的血液样本。使用问卷收集高危和非高危人群的资料。所有样本均采用布鲁氏菌乳胶凝集试验初步筛查抗布鲁氏菌抗体。为了进行准确的调查,对血清阳性和血清阴性样本均采用 BCSP31 布鲁氏菌属特异性 TaqMan 实时 PCR 进行检测。总体而言,在 400 个样本中,布鲁氏菌乳胶凝集试验和/或 BCSP31 布鲁氏菌属特异性实时 PCR 检测出 32 例(8%)阳性病例。布鲁氏菌乳胶凝集试验检测出布鲁氏菌病阳性率为 7%(28/400)。400 个样本中,有 22 个(5.5%)样本布鲁氏菌属特异性实时 PCR 阳性。大多数实时 PCR 阳性病例来自高危人群的血清阳性样本(15/32)。仅从高危人群中也发现了血清阴性但实时 PCR 阳性的病例(4/32)。有 10 例血清阳性病例实时 PCR 阴性。除了作为筛查试验的布鲁氏菌乳胶凝集试验外,还进行了布鲁氏菌属特异性实时 PCR 以进行确认,并避免不必要的成本、药物毒性和掩盖其他潜在危险疾病。

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