Influence of brucellosis history on serological diagnosis and evolution of patients with acute brucellosis.
Serological diagnosis of human brucellosis is problematic in endemic brucellosis regions and with patients having a history of brucellosis. The aim of this study is to ascertain the serologic and evolutionary behavior of the tests of serum agglutination, Coombs anti-Brucella, immunocapture-agglutination, enzyme-linked immunosorbent assay (ELISA) IgG, IgA, IgM and ELISA-IgG avidity against Brucella lipopolysaccharide (S-LPS), in patients with acute brucellosis based on whether or not a history of brucellosis exists. Titers and seropositivity in all the tests assayed were higher in the patients having brucellosis history (from 90.9% in ELISA-IgM to 100% in ELISA-IgG) than in the patients lacking such history (from 79.3% in ELISA-IgM to 86.2% in Coombs, immunocapture-agglutination, and ELISA-IgG). IgG S-LPS avidity results in patients with brucellosis history were significantly higher (always over 84%) than in patients without brucellosis history (from 48.0% in the initial sera to 81% ten months later) (p<0.001). The titers of antibodies against Brucella in the initial sera and ELISA-IgG avidity against S-LPS may allow distinguishing patients with brucellosis caused by primary infection in the initial stages of the disease from patients seropositive due to prior infections from Brucella.
Unidad de Investigación, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
María de Los Angeles
Mde L
Mantecón
María Purificación
MP
Gutiérrez
María Del Pilar
Mdel P
Zarzosa
Luis
L
Fernández-Lago
Juan de Dios
Jde D
Colmenero
Nieves
N
Vizcaíno
Miguel Angel
MA
Bratos
Ana
A
Almaraz
Africa
A
Cubero
Maria Fe
MF
Muñoz
A
A
Rodríguez Torres
Antonio
A
Orduña
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000372:Agglutination Tests; D000907:Antibodies, Bacterial / Q000097:blood*; D002002:Brucella / Q000276:immunology*; D002006:Brucellosis / Q000175:diagnosis* / Q000276:immunology; D002648:Child; D003298:Coombs Test; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012698:Serologic Tests; D055815:Young Adult
D000907:Antibodies, Bacterial