ELISA versus Conventional Methods of Diagnosing Endemic Brucellosis

Basappa Mantur Department of Microbiology, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Medical Services, Manipal Cure and Care, Bangalore, Karnataka, India; Department of Medicine, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Pediatrics, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Orthopedics, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India

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Aisha Parande Department of Microbiology, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Medical Services, Manipal Cure and Care, Bangalore, Karnataka, India; Department of Medicine, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Pediatrics, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Orthopedics, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India

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Satish Amarnath Department of Microbiology, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Medical Services, Manipal Cure and Care, Bangalore, Karnataka, India; Department of Medicine, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Pediatrics, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Orthopedics, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India

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Giridhar Patil Department of Microbiology, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Medical Services, Manipal Cure and Care, Bangalore, Karnataka, India; Department of Medicine, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Pediatrics, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Orthopedics, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India

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Ravindra Walvekar Department of Microbiology, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Medical Services, Manipal Cure and Care, Bangalore, Karnataka, India; Department of Medicine, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Pediatrics, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Orthopedics, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India

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Arun Desai Department of Microbiology, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Medical Services, Manipal Cure and Care, Bangalore, Karnataka, India; Department of Medicine, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Pediatrics, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Orthopedics, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India

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Mahantesh Parande Department of Microbiology, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Medical Services, Manipal Cure and Care, Bangalore, Karnataka, India; Department of Medicine, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Pediatrics, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Orthopedics, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India

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Rupali Shinde Department of Microbiology, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Medical Services, Manipal Cure and Care, Bangalore, Karnataka, India; Department of Medicine, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Pediatrics, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Orthopedics, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India

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Masiyappa Chandrashekar Department of Microbiology, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Medical Services, Manipal Cure and Care, Bangalore, Karnataka, India; Department of Medicine, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Pediatrics, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Orthopedics, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India

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Satish Patil Department of Microbiology, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Medical Services, Manipal Cure and Care, Bangalore, Karnataka, India; Department of Medicine, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Pediatrics, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India; Department of Orthopedics, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India

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The diagnostic value of enzyme-linked immunosorbent assay (ELISA) was evaluated when blood specimens of 92 patients suspected of brucellosis underwent the ELISA (IgM and IgG), standard tube agglutination (SAT), and 2-mercaptoethanol (2-ME) tests and blood cultures; 38 sera from non-brucellosis patients and 34 sera from blood donors were also subjected to ELISA, SAT, and 2-ME tests. SAT was able to pinpoint only 23 (25%), whereas ELISA confirmed the etiology in 56 (60.9%; P < 0.001) patients with brucellosis, including 31 culture-confirmed cases. The sensitivity and specificity of ELISA were 100% and 71.31%, respectively. Because they were confirmed by ELISA, the diagnosis could never be excluded with SAT in 33 cases. ELISA has been found to be more sensitive in acute (28% higher sensitivity; P < 0.02) and chronic (55% higher sensitivity; P < 0.01) cases. For accurate diagnosis in suspected brucellosis cases detection, we recommend both ELISA IgM and IgG tests. ELISA IgG and 2-ME tests seem to be promising tools in judging prognosis.

Author Notes

*Address correspondence to Basappa Mantur, Department of Microbiology, Belgaum Institute of Medical Sciences, Dr BR Ambedkar Road, Belgaum 590001, Karnataka, India. E-mail: drbgmantur@rediffmail.com

Authors' addresses: Basappa Mantur, Department of Microbiology, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India, E-mail: drbgmantur@rediffmail.com. Aisha Parande, Department of Microbiology, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India, E-mail: naik_aisha@rediffmail.com. Satish Amarnath, Department of Medical Services, Manipal Cure and Care, Bangalore, Karnataka, India, E-mail: satish.amarnath@manipalcureandcare.com. Giridhar Patil, Department of Medicine, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India, E-mail: drgiridharp@yahoo.com. Ravindra Walvekar, Department of Medicine, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India, E-mail: ravindrarw@hotmail.com. Arun Desai, Department of Pediatrics, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India, E-mail: drasdesai@hotmail.com. Mahantesh Parande, Department of Microbiology, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India, E-mail: mvparande@yahoo.com. Rupali Shinde, Department of Microbiology, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India, E-mail: srupali78@rediffmail.com. Masiyappa Chandrashekar, Department of Microbiology, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India, E-mail: mrcsrims@rediffmail.com. Satish Patil, Department of Orthopedics, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India, E-mail: satishptlo@gmail.com.

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