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. 2023 Feb 21;17(2):e0011131.
doi: 10.1371/journal.pntd.0011131. eCollection 2023 Feb.

Evaluating the efficacy of serological testing of clinical specimens collected from patients with suspected brucellosis

Nannan Xu  1 , Chunmei Qu  1 , Lintao Sai  1 , Sai Wen  1 , Lulu Yang  1 , Shanshan Wang  1 , Hui Yang  1 , Hui Liu  2 , Gang Wang  1
Affiliations

Evaluating the efficacy of serological testing of clinical specimens collected from patients with suspected brucellosis

Nannan Xu et al. PLoS Negl Trop Dis. .

Abstract

Background: This study aims to evaluate the efficacy of the standard agglutination test (SAT), the Brucellacapt test and enzyme-linked immunosorbent assay (ELISA) in clinical specimens collected from patients with suspected brucellosis.

Methods: A prospective study was conducted from December 2020 to December 2021. Brucellosis was diagnosed on the basis of clinical evidence, and confirmed by isolation of Brucella or a four-fold rise in SAT titer. All samples were tested by the SAT, ELISA and the Brucellacapt test. Titers ≥1:100 were considered as SAT positive; ELISA was considered positive when an index greater than 11 was detected, while titers ≥1/160 indicated positivity on the Brucellacapt test. The specificity, sensitivity, and positive (PPVs) and negative predictive values (NPVs) of the three different methods were calculated.

Results: A total of 149 samples were collected from patients with suspected brucellosis. The sensitivities for the SAT, IgG, and IgM detection were 74.42%, 88.37% and 74.42%, respectively. The specificities were 95.24%, 93.65%, and 88.89%, respectively. The simultaneous measurement of IgG and IgM improved the sensitivity (98.84%) but reduced the specificity (84.13%) compared to each antibody test separately. The Brucellacapt test had excellent specificity (100%) and a high PPV (100%); however, the sensitivity and NPV were 88.37% and 86.30%, respectively. The combination of IgG detection by ELISA and the Brucellacapt test had excellent diagnostic performance, with 98.84% sensitivity and 93.65% specificity.

Conclusion: This study showed that the simultaneous performance of IgG detection by ELISA and the Brucellacapt test has the potential to overcome the current limitations of detection.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

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