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确定诊断敏感性:虎红试验、库姆斯凝胶试验、酶联免疫吸附测定和细菌培养在布鲁氏菌病诊断中的比较——根据炎症标志物分析临床有效性

Determining Diagnostic Sensitivity: A Comparison of Rose Bengal Test, Coombs Gel Test, ELISA and Bacterial Culture in Brucellosis Diagnosis-Analyzing Clinical Effectiveness in Light of Inflammatory Markers.

作者信息

Barkay Orçun, Karakeçili Faruk, Binay Umut Devrim, Akyüz Sümeyye

机构信息

Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Erzincan Binali Yıldırım University, 24100 Erzincan, Türkiye.

Department of Medical Microbiology, Faculty of Medicine, Erzincan Binali Yıldırım University, 24100 Erzincan, Türkiye.

出版信息

Diagnostics (Basel). 2024 Jul 17;14(14):1546. doi: 10.3390/diagnostics14141546.

Abstract

BACKGROUND

Brucellosis is a zoonotic infectious disease. It is estimated that the number of cases reported today is much less than the actual number. We still have difficulty in diagnosing the disease and its organ involvement. In this sense, new approaches that can be useful in clinical practice are required, and we aimed to evaluate this situation in our study.

METHODS

171 of 213 patients followed in our center between January 2021 and April 2024 were included in the study. A total of 150 patients were included in the study as a control group. Rose Bengal test (RBT), Coombs gel test (CGT), enzyme-linked immunosorbent assay (ELISA), and automated blood culture were used for diagnosing brucellosis. Complete blood count, sedimentation, C-reactive protein, and biochemical parameters were obtained. Inflammation markers such as neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, systemic immune-inflammation index, and systemic inflammation response index were calculated.

RESULTS

The most successful results in the diagnosis were ELISA (89.4%), RBT (88.3%), CGT (83%), and blood culture (34.8%). For diagnosing sacroiliitis and spondylodiscitis, instead of resorting to expensive methods like magnetic resonance, a combination of ELISA positivity with elevated acute phase reactants and inflammatory markers could be significantly instructive.

CONCLUSIONS

Optimizing diagnostic algorithms and exploring novel diagnostic approaches, such as inflammatory markers, hold promise for improving diagnosis and management.

摘要

背景

布鲁氏菌病是一种人畜共患传染病。据估计,如今报告的病例数远低于实际病例数。我们在诊断该疾病及其器官受累情况方面仍存在困难。从这个意义上讲,需要有可用于临床实践的新方法,我们旨在通过本研究评估这种情况。

方法

2021年1月至2024年4月在我们中心随访的213例患者中有171例纳入研究。另外选取150例患者作为对照组纳入研究。采用虎红平板凝集试验(RBT)、库姆斯凝胶试验(CGT)、酶联免疫吸附测定(ELISA)和自动血培养来诊断布鲁氏菌病。检测全血细胞计数、血沉、C反应蛋白和生化指标。计算中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值、全身免疫炎症指数和全身炎症反应指数等炎症标志物。

结果

诊断效果最佳的是ELISA(89.4%)、RBT(88.3%)、CGT(83%)和血培养(34.8%)。对于诊断骶髂关节炎和脊椎椎间盘炎,不必采用磁共振成像等昂贵方法,ELISA阳性结果与急性期反应物及炎症标志物升高相结合可能具有显著的指导意义。

结论

优化诊断算法并探索新型诊断方法,如炎症标志物,有望改善诊断和治疗。

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