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

Search for other papers by Basappa Mantur in
Current site
Google Scholar
PubMed
Close
,
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

Search for other papers by Aisha Parande in
Current site
Google Scholar
PubMed
Close
,
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

Search for other papers by Satish Amarnath in
Current site
Google Scholar
PubMed
Close
,
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

Search for other papers by Giridhar Patil in
Current site
Google Scholar
PubMed
Close
,
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

Search for other papers by Ravindra Walvekar in
Current site
Google Scholar
PubMed
Close
,
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

Search for other papers by Arun Desai in
Current site
Google Scholar
PubMed
Close
,
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

Search for other papers by Mahantesh Parande in
Current site
Google Scholar
PubMed
Close
,
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

Search for other papers by Rupali Shinde in
Current site
Google Scholar
PubMed
Close
,
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

Search for other papers by Masiyappa Chandrashekar in
Current site
Google Scholar
PubMed
Close
, and
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

Search for other papers by Satish Patil in
Current site
Google Scholar
PubMed
Close
Restricted access

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.

  • 1.

    Sohn AH, Probert WS, Glaser CA, Gupta N, Bollen AW, Wong JD, Grace EM, McDonald WC, 2003. Human neurobrucellosis with intracerebral granuloma caused by a marine mammal Brucella spp. Emerg Infect Dis 9: 485488.

    • Search Google Scholar
    • Export Citation
  • 2.

    McDonald WL, Jamaludin R, Mackereth G, Hansen M, Humphrey S, Short P, Taylor T, Swingler J, Dawson CE, Whatmore AM, Stabberfield E, Perrett LL, Simmons G, 2006. Characterization of a Brucella spp. strain as a marine-mammal type despite isolation from a patient with spinal osteomyelitis in New Zealand. J Clin Microbiol 44: 43634370.

    • Search Google Scholar
    • Export Citation
  • 3.

    Wallach JC, Miguel SE, Baldi PC, Guarnera E, Goldbaum FA, Fossati CA, 1994. Urban outbreak of a Brucella melitensis infection in an Argentine family: clinical and diagnostic aspects. FEMS Immunol Med Microbiol 8: 4956.

    • Search Google Scholar
    • Export Citation
  • 4.

    Young EJ, 1983. Human brucellosis. Rev Infect Dis 5: 821842.

  • 5.

    Maas KS, Mendez M, Zavaleta M, Manrique J, Franco MP, Mulder M, Bonifacio N, Castaneda ML, Chacaltana J, Yagui E, Gilman RH, Guillen A, Blazes DL, Espinosa B, Hall E, Abdoel TH, Smits HL, 2007. Evaluation of brucellosis by PCR and persistence after treatment in patients returning to the hospital for follow-up. Am J Trop Med Hyg 76: 698702.

    • Search Google Scholar
    • Export Citation
  • 6.

    Buchanan TM, Faber LC, 1980. 2-mercaptoethanol Brucella agglutination test: usefulness for predicting recovery from brucellosis. J Clin Microbiol 11: 691693.

    • Search Google Scholar
    • Export Citation
  • 7.

    Mantur BG, Biradar MS, Bidri RC, Mulimani MS, Veerappa, Kariholu P, Patil SB, Mangalgi SS, 2006. Protean clinical manifestations and diagnostic challenges of human brucellosis in adults: 16 years' experience in an endemic area. J Med Microbiol 55: 897903.

    • Search Google Scholar
    • Export Citation
  • 8.

    Zourbas J, Masse L, Roussey A, David C, Maurin J, Torte J, 1977. Sampling survey on brucellosis among farmers and their families in IIIe-et-Vilaine (Brittany). Int J Epidemiol 6: 335343.

    • Search Google Scholar
    • Export Citation
  • 9.

    Gilbert GL, Beaton CP, Forsyth JR, Bell CO, 1980. An epidemiological survey of human brucellosis in three Victorian abattoirs. Med J Aust 1: 482486.

    • Search Google Scholar
    • Export Citation
  • 10.

    Daz R, Maravi-Poma E, Rivero A, 1976. Comparison of counter-immuno-electrophoresis with other serological tests in the diagnosis of human brucellosis. Bull World Health Organ 53: 417424.

    • Search Google Scholar
    • Export Citation
  • 11.

    Gad El-Rab MO, Kambal AM, 1998. Evaluation of a Brucella enzyme immunoassay test (ELISA) in comparison with bacteriological culture and agglutination. J Infect 36: 197201.

    • Search Google Scholar
    • Export Citation
  • 12.

    Osoba AO, Balkhy H, Memish Z, Khan MY, Al-Thagafi A, Al Shareef B, Al Mowallad A, Oni GA, 2001. Diagnostic value of Brucella ELISA IgG and IgM in bacteremic and non-bacteremic patients with brucellosis. J Chemother 13 (Suppl 1): 5459.

    • Search Google Scholar
    • Export Citation
  • 13.

    Buchanan TM, Sulzer CR, Frix MK, Feldman RA, 1974. Brucellosis in the United States, 1960–1972: an abattoir-associated disease. Part II. Diagnostic aspects. Medicine (Baltimore) 53: 415425.

    • Search Google Scholar
    • Export Citation
  • 14.

    Ariza J, Pellicer T, Pallares R, Foz A, Gudiol F, 1992. Specific antibody profile in human brucellosis. Clin Infect Dis 14: 131140.

  • 15.

    Gazapo E, Gonzalez Lahoz J, Subiza JL, Baquero M, Gil J, de la Concha EG, 1989. Changes in IgM and IgG antibody concentrations in brucellosis over time: importance for diagnosis and follow-up. J Infect Dis 159: 219225.

    • Search Google Scholar
    • Export Citation
  • 16.

    Reddin JL, Anderson RK, Jenness R, Spink WW, 1965. Significance of 7S and macroglobulin Brucella agglutinins in human brucellosis. N Engl J Med 272: 12631268.

    • Search Google Scholar
    • Export Citation
  • 17.

    Sippel JE, El-Masry NA, Farid Z, 1982. Diagnosis of human brucellosis with ELISA. Lancet 2: 1921.

  • 18.

    Magee JT, 1980. An enzyme-labelled immunosorbent assay for Brucella abortus antibodies. J Med Microbiol 13: 167172.

  • 19.

    Young EJ, 1991. Serologic diagnosis of human brucellosis: analysis of 214 cases by agglutination tests and review of the literature. Rev Infect Dis 13: 359372.

    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 45 45 14
Full Text Views 447 133 0
PDF Downloads 193 51 0
 
Membership Banner
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save