Skip to main content
PMC home page
The Journal of Hygiene logoLink to The Journal of Hygiene
. 1986 Dec;97(3):457–469. doi: 10.1017/s0022172400063634

Evaluation of ELISA in the diagnosis of acute and chronic brucellosis in human beings.

G F Araj, A R Lulu, M Y Mustafa, M I Khateeb
PMCID: PMC2082895  PMID: 3794323

Abstract

An enzyme-linked immunosorbent assay (ELISA) was used to determine the levels of brucella-specific IgG, IgM and IgA in 173 patients with acute brucellosis, 22 patients with chronic brucellosis and in 281 controls consisting of 98 patients with other infectious etiologies, 20 patients with non-infectious diseases and 163 normal healthy adults. The ELISA results were compared with culture findings, the results of slide agglutination tests with Brucella melitensis (M), B. abortus (A) and Ross Bengal (RB) antigens, and of tube and microagglutination tests. Brucella cultures were positive in 53 and 5% of patients with acute and chronic brucellosis respectively. The slide agglutination tests with A, M, A plus M and RB antigens were positive in 42, 44, 51 and 98% of patients with acute brucellosis and in 23, 27, 27 and 64% of patients with chronic brucellosis. There was no significant difference in the results between the tube and microagglutination tests regardless of the type of antigen used. At a titre of greater than or equal to 80 or greater than or equal to 160 these tests were positive in 98% and 92% of patients with acute brucellosis and 60 and 40% of patients with chronic brucellosis. The brucella culture and agglutination tests were negative for all the controls. Brucella ELISA immunoglobulins (Ig) were detected in some individuals in the control groups but the majority of these had titres of less than or equal to 100 for IgG, IgM, and IgA. However, patients with brucellosis had significantly higher ELISA titres in all classes of Ig than controls but the sensitivity and specificity within each Ig class varied with the titre considered. At a titre of greater than or equal to 1600 the brucella IgG had a sensitivity and specificity of 98% for patients with acute or chronic brucellosis; this decreased with lower reciprocal titres. The brucella IgM titre of greater than or equal to 400 had a sensitivity of 98% and a specificity of 98% for patients with acute brucellosis. However, in patients with chronic brucellosis the brucella IgM was very low. The brucella IgA titre of greater than or equal to 200 showed a sensitivity of 98% and a specificity of 99% for patients with either acute or chronic brucellosis. This study indicates that brucella ELISA is a rapid, sensitive and specific assay, provides a profile of Ig classes in the diagnosis of acute and chronic brucellosis, is useful for mass screening and could be considered the method of choice for the serological diagnosis of brucellosis.

Full text

PDF
458

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abdussalam M., Fein D. A. Brucellosis as a world problem. Dev Biol Stand. 1976;31:9–23. [PubMed] [Google Scholar]
  2. Alausa O. K. Brucellosis: socio-economic problems and control in various countries. Trop Geogr Med. 1980 Mar;32(1):5–11. [PubMed] [Google Scholar]
  3. BIEGELEISEN J. Z., Jr, BRADSHAW B. R., MOODY M. D. Demonstration of Brucella antibodies in human serum. A comparison of the fluorescent antibody and agglutination techniques. J Immunol. 1962 Jan;88:109–112. [PubMed] [Google Scholar]
  4. Bettelheim K. A., Maskill W. J., Pearce J. Comparison of standard tube and microagglutination techniques for determining Brucella antibodies. J Hyg (Lond) 1983 Feb;90(1):33–39. doi: 10.1017/s0022172400063804. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Buchanan T. M., Faber L. C. 2-mercaptoethanol Brucella agglutination test: usefulness for predicting recovery from brucellosis. J Clin Microbiol. 1980 Jun;11(6):691–693. doi: 10.1128/jcm.11.6.691-693.1980. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Coghlan J. D., Longmore H. J. The significance of brucella antibodies in patients in a rural area. Practitioner. 1973 Nov;211(265):645–652. [PubMed] [Google Scholar]
  7. Coghlan J. D., Weir D. M. Antibodies in human brucellosis. Br Med J. 1967 Apr 29;2(5547):269–271. doi: 10.1136/bmj.2.5547.269. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. De Klerk E., Anderson R. Comparative evaluation of the enzyme-linked immunosorbent assay in the laboratory diagnosis of brucellosis. J Clin Microbiol. 1985 Mar;21(3):381–386. doi: 10.1128/jcm.21.3.381-386.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Dáz R., Maravi-Poma E., Rivero A. Comparison of counter-immunoelectrophoresis with other serological tests in the diagnosis of human brucellosis. Bull World Health Organ. 1976;53(4):417–424. [PMC free article] [PubMed] [Google Scholar]
  10. Díaz R., Maraví-Poma E., Delgado G., Rivero A. Rose Bengal plate agglutination and counterimmunoelectrophoresis tests on spinal fluid in the diagnosis of Brucella meningitis. J Clin Microbiol. 1978 Feb;7(2):236–237. doi: 10.1128/jcm.7.2.236-237.1978. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Edwards J. M., Tannahill A. J., Bradstreet C. M. Comparison of the indirect fluorescent antibody test with agglutination, complement-fixation, and Coombs test for Brucella antibody. J Clin Pathol. 1970 Mar;23(2):161–165. doi: 10.1136/jcp.23.2.161. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Gilbert G. L., Hawes L. A. The antibody response to Brucella: immunoglobulin response measured by enzyme-linked immunosorbent assay and conventional tests. Aust N Z J Med. 1981 Feb;11(1):40–45. doi: 10.1111/j.1445-5994.1981.tb03734.x. [DOI] [PubMed] [Google Scholar]
  13. Kambal A. M., Mahgoub E. S., Jamjoom G. A., Chowdhury M. N. Brucellosis in Riyadh, Saudi Arabia. A microbiological and clinical study. Trans R Soc Trop Med Hyg. 1983;77(6):820–824. doi: 10.1016/0035-9203(83)90297-3. [DOI] [PubMed] [Google Scholar]
  14. Kerr W. R., Coghlan J. D., Payne D. J., Robertson L. The laboratory diagnosis of chronic brucellosis. Lancet. 1966 Nov 26;2(7474):1181–1183. doi: 10.1016/s0140-6736(66)90492-2. [DOI] [PubMed] [Google Scholar]
  15. Kerr W. R., McCaughey W. J., Coghlan J. D., Payne D. J., Quaife R. A., Robertson L., Farrell I. D. Techniques and interpretations in the serological diagnosis of brucellosis in man. J Med Microbiol. 1968 Nov;1(2):181–193. doi: 10.1099/00222615-1-2-181. [DOI] [PubMed] [Google Scholar]
  16. Klein G. C., Behan K. A. Determination of brucella immunoglobulin G agglutinating antibody titer with dithiothreitol. J Clin Microbiol. 1981 Jul;14(1):24–25. doi: 10.1128/jcm.14.1.24-25.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Macdonald A., Elmslie W. H. Serological investigations in suspected brucellosis. Lancet. 1967 Feb 18;1(7486):380–382. doi: 10.1016/s0140-6736(67)92914-5. [DOI] [PubMed] [Google Scholar]
  18. Magee J. T. An enzyme-labelled immunosorbent assay for Brucella abortus antibodies. J Med Microbiol. 1980 Feb;13(1):167–172. doi: 10.1099/00222615-13-1-167. [DOI] [PubMed] [Google Scholar]
  19. Makarem E. H., Karjoo R., Omidi A. Frequency of Brucella melitensis in Southern Iran. J Trop Pediatr. 1982 Apr;28(2):97–100. doi: 10.1093/tropej/28.2.97. [DOI] [PubMed] [Google Scholar]
  20. Manès G. Epidemiological situation of brucellosis in the Mediterranean countries. Dev Biol Stand. 1984;56:739–747. [PubMed] [Google Scholar]
  21. McDevitt D. G. Symptomatology of chronic brucellosis. Br J Ind Med. 1973 Oct;30(4):385–389. doi: 10.1136/oem.30.4.385. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. McDevitt D. G. The relevance of the anti-human globulin (Coombs) test and the complement-fixation test in the diagnosis of brucellosis. J Hyg (Lond) 1970 Jun;68(2):173–187. doi: 10.1017/s0022172400028655. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. McNaught D. J., Chappel R. J., Allan G. S., Bourke J. A., Rogerson B. A. The effects of IgG2 and of antigen concentration on prozoning in the complement fixation test for bovine brucellosis. Res Vet Sci. 1977 Mar;22(2):194–197. [PubMed] [Google Scholar]
  24. Otero J. R., Fuertes A., Palenque E., Noriega A. R. Microtiter-adapted method that facilitates the Coombs test for brucellosis. J Clin Microbiol. 1982 Oct;16(4):737–738. doi: 10.1128/jcm.16.4.737-738.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Parratt D., Nielsen K. H., White R. G. Radioimmunoassay of IgM, IgG, and IgA Brucella antibodies. Lancet. 1977 May 21;1(8021):1075–1078. doi: 10.1016/s0140-6736(77)92334-0. [DOI] [PubMed] [Google Scholar]
  26. Payne D. J. Letter: Chronic brucellosis. Br Med J. 1974 Apr 27;2(5912):221–222. doi: 10.1136/bmj.2.5912.221-c. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. REDDIN J. L., ANDERSON R. K., JENNESS R., SPINK W. W. SIGNIFICANCE OF 7S AND MACROGLOBULIN BRUCELLA AGGLUTININS IN HUMAN BRUCELLOSIS. N Engl J Med. 1965 Jun 17;272:1263–1268. doi: 10.1056/NEJM196506172722403. [DOI] [PubMed] [Google Scholar]
  28. Sippel J. E., El-Masry N. A., Farid Z. Diagnosis of human brucellosis with ELISA. Lancet. 1982 Jul 3;2(8288):19–21. doi: 10.1016/s0140-6736(82)91154-0. [DOI] [PubMed] [Google Scholar]
  29. Strannegard I. L., Araj G. F., Fattah H. A. Neurobrucellosis in an eight-year-old child. Ann Trop Paediatr. 1985 Dec;5(4):191–194. doi: 10.1080/02724936.1985.11748390. [DOI] [PubMed] [Google Scholar]
  30. WILSON M. M., MERRIFIED E. V. O. The antiglobulin (Coombs) test in brucellosis. Lancet. 1951 Nov 17;2(6690):913–914. doi: 10.1016/s0140-6736(51)91875-2. [DOI] [PubMed] [Google Scholar]
  31. White R. G. Immunoglobulin profiles of the chronic antibody response: discussion in relation to brucellosis infections. Postgrad Med J. 1978 Sep;54(635):595–602. doi: 10.1136/pgmj.54.635.595. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Wilkinson P. C. Immunoglobulin patterns of antibodies against Brucella in man and animals. J Immunol. 1966 Mar;96(3):457–463. [PubMed] [Google Scholar]
  33. Wise R. I. Brucellosis in the United States. Past, present, and future. JAMA. 1980 Nov 21;244(20):2318–2322. [PubMed] [Google Scholar]
  34. Young E. J. Human brucellosis. Rev Infect Dis. 1983 Sep-Oct;5(5):821–842. doi: 10.1093/clinids/5.5.821. [DOI] [PubMed] [Google Scholar]

Articles from The Journal of Hygiene are provided here courtesy of Cambridge University Press

RESOURCES