Elbehiry Ayman, Aldubaib Musaad, Marzouk Eman, Abalkhail Adil, Almuzaini Abdulaziz M, Rawway Mohammed, Alghamdi Ali, Alqarni Abdullah, Aldawsari Mohammed, Draz Abdelmaged
Department of Public Health, College of Public Health and Health Informatics, Qassim University, Al Bukayriyah 52741, Saudi Arabia.
Department of Bacteriology, Mycology and Immunology, Faculty of Veterinary Medicine, University of Sadat City, Sadat City 32511, Egypt.
Vaccines (Basel). 2023 Mar 14;11(3):654. doi: 10.3390/vaccines11030654.
Brucellosis is considered one of the most serious zoonotic diseases worldwide. This disease affects both human and animal health, in addition to being one of the most widespread zoonotic illnesses in the Middle East and Northern Africa. Human brucellosis generally presents in a diverse and non-specific manner, making laboratory confirmation of the diagnosis critical to the patient's recovery. A coordinated strategy for diagnosing and controlling brucellosis throughout the Middle East is required, as this disease cannot be known to occur without reliable microbiological, molecular, and epidemiological evidence. Consequently, the current review focuses on the current and emerging microbiological diagnostic tools for the early detection and control of human brucellosis. Laboratory assays such as culturing, serology, and molecular analysis can frequently be used to diagnose brucellosis. Although serological markers and nucleic acid amplification techniques are extremely sensitive, and extensive experience has been gained with these techniques in the laboratory diagnosis of brucellosis, a culture is still considered to be the "gold standard" due to the importance of this aspect of public health and clinical care. In endemic regions, however, serological tests remain the primary method of diagnosis due to their low cost, user-friendliness, and strong ability to provide a negative prediction, so they are commonly used. A nucleic acid amplification assay, which is highly sensitive, specific, and safe, is capable of enabling rapid disease diagnosis. Patients who have reportedly fully healed may continue to have positive molecular test results for a long time. Therefore, cultures and serological methods will continue to be the main tools for diagnosing and following up on human brucellosis for as long as no commercial tests or studies demonstrate adequate interlaboratory reproducibility. As there is no approved vaccine that prevents human brucellosis, vaccination-based control of animal brucellosis has become an important part of the management of human brucellosis. Over the past few decades, several studies have been conducted to develop vaccines, but the problem of controlling brucellosis in both humans and animals remains challenging. Therefore, this review also aims to present an updated overview of the different types of brucellosis vaccines that are currently available.
布鲁氏菌病被认为是全球最严重的人畜共患疾病之一。这种疾病不仅影响人类和动物健康,还是中东和北非地区传播最广泛的人畜共患疾病之一。人类布鲁氏菌病的症状通常多样且不具特异性,因此实验室确诊对患者康复至关重要。由于没有可靠的微生物学、分子学和流行病学证据就无法确定该病是否发生,所以需要在整个中东地区制定一个诊断和控制布鲁氏菌病的协调策略。因此,本综述重点关注用于早期检测和控制人类布鲁氏菌病的现有和新兴微生物诊断工具。培养、血清学和分子分析等实验室检测方法常用于诊断布鲁氏菌病。尽管血清学标志物和核酸扩增技术极其灵敏,并且在布鲁氏菌病的实验室诊断中积累了丰富经验,但由于其在公共卫生和临床护理方面的重要性,培养仍被视为“金标准”。然而,在流行地区,血清学检测因其成本低、操作简便且具有较强的阴性预测能力,仍然是主要的诊断方法,因此被广泛使用。核酸扩增检测高度灵敏、特异且安全,能够实现疾病的快速诊断。据报道,已完全康复的患者可能在很长一段时间内分子检测结果仍为阳性。因此,只要没有商业检测或研究证明具有足够的实验室间可重复性,培养和血清学方法将继续作为诊断和随访人类布鲁氏菌病的主要工具。由于没有获批的预防人类布鲁氏菌病的疫苗,基于疫苗接种控制动物布鲁氏菌病已成为人类布鲁氏菌病管理中的重要组成部分。在过去几十年里,已经开展了多项研究来开发疫苗,但控制人类和动物布鲁氏菌病的问题仍然具有挑战性。因此,本综述还旨在介绍当前可用的不同类型布鲁氏菌病疫苗的最新概况。