Brusellozda Brucellacapt (Immunocapture-agglutination) ve Rose Bengal testlerinin değerlendirilmesi

Öz

Amaç: Bruselloz, Gram negatif bir bakteri olan brusella türlerinin neden olduğu son derece bulaşıcı bir zoonotik hastalıktır. İnsan brusellozunun tanısında çok çeşitli serolojik testler kullanılmaktadır. Brusellozun serolojik tanısında sıklıkla tercih edilen yöntem olan tüp aglütinasyon testi, blokan antikor varlığını tespit edemediğinden yalancı negatif sonuçlara yol açabilmektedir. Bu çalışmada farklı iki test olan Rose Bengal testi (RBT) ve immuncapture- aglütinasyon (Brucellacapt) testi sonuçlarının analiz edilmesi ve bu testlerin kullanılabilirliğinin değerlendirilmesi amaçlanmıştır. Materyal Metod: Çalışmaya, Ağustos 2009 - Ağustos 2011 tarihleri arasında Kızıltepe Devlet Hastanesi mikrobiyoloji laboratuarına çeşitli polikliniklerden gelen 220 hastadan alınan serum örneği dahil edilmiştir. Her bir hasta serumunda hem RBT (ADR Diagnostics, Medico Chemistry) hem de Brucellacapt (ADR Diagnostics, Medico Chemistry) testleri çalışılmıştır. Her iki test de üretici firmanın talimatları doğrultusunda gerçekleştirilmiştir. Brucellacapt testinde 1/160 serum titresi eşik değer olarak kabul edilmiştir. Çalışma grubuna klinik bulgulara dayanarak bruselloz şüphesi olan 220 hasta dahil edilmiştir. Bulgular: Serum örneklerin serolojik olarak incelenmesi ile her iki test 146 (%66,4) hastada negatif bulunurken, hem RBT hem de Brucellacapt testinin pozitif olduğu hasta sayısı ise 59 (%26,8) olarak bulunmuştur. Ek olarak sadece RBT testinin pozitif olduğu hasta sayısı 9 (%4,1), sadece Brucellacapt testinin pozitif olduğu hasta sayısı ise 6 (%2,7) olarak tespit edilmiştir. Toplamda RBT 68 hastada (%30,9), Brucellacapt testi ise 65 hastada (%29,5) pozitif olarak bulunmuştur. Sonuç: Bölgemizde brusellozun endemik bir problem olarak devam ettiği tespit edilmiştir. RBT, bruselloz tanısında, tecrübeli eleman gerektirmeyen, yorumlanması kolay, maliyeti düşük ve teknik olarak da kolay uygulanabilir bir testdir. Brucellacapt testi de kolay ve pratik bir test olup bruselloz tanısında tamamlayıcı bir test olarak kullanılabilir

Anahtar Kelimeler

• Bruselloz,Rose Bengal,Aglütinasyon

Assesment of Brucellacapt (Immunocapture-agglutination) and Rose Bengal tests in human brucellosis

Öz

OBJECTIVE: Brucellosis is extremely infectious zoonosis caused by the Gram-negative bacteria of the genus Brucella. Several serological tests have been used for the diagnosis of human brucellosis. Although standard tube agglutination test is the frequently preferred method for the serodiagnosis of brucellosis, it may cause false negative results due to its incompetence in detecting the blocking antibodies. In this study, analysis of the results obtained with two different tests which are Rose Bengal test (RBT) and immunocapture- agglutination test (Brucellacapt) for detection of Brucella-specific antibodies in an area of endemicity and evaluation of usefulness of these tests were aimed. METHODS: Atotal of 220 sera from different groups of patients from various polyclinics were included the study between August 2009 and August 2011 dates. Rose Bengal test (ADR Diagnostics, MedicoChemistry) and Brucellacapt (ADR Diagnostics, Medico- Chemistry) were performed for each serum sample. Both of the tests were performed according to manufacturer's recommendations. The threshold serum titre was accepted as 1/160 in Brucellacapt test. In this study, 220 patients with suspected brucellosis based on clinical findings were included. RESULTS: As a result of Serological examination of the clinical samples both of the RBT and Brucellacapt tests were negative in 146 (66.4%) patients. Both of the RBT and Brucellacapt tests were positive in 59 (26.8%) patients. In addition, only RBTwas positive in 9 (4.1%) patients and only Brucellacapt test was positive in 6 (2.7%) patients. Totally, RBT was positive in 68 patients (30.9%) and Brucellacapt test was positive in 65 patients (29.5%). CONCLUSION: Brucellosis continues to be an endemic problem in our region. RBTis a very useful test for the diagnosis of human brucellosis and hasn't got technical difficulties since they didn't require skilled personnel and high-cost material and easy to interpret. Brucellacapt is also simple and practical test and it is suitable complementary test for diagnosis of brucellosis.

Anahtar Kelimeler

• Brucellosis,Rose Bengal,Agglutination

Kaynakça

1. 1. Díaz R, Casanova A, Ariza J, Moriyón I. The Rose Bengal Test in human brucellosis: a neglected test for the diagnosis of a neglected disease. PLoS Negl Trop Dis, 2011;19(4):e950.
2. 2. Gomez MC, Netio JA, Rosa C, Geijo P, Escribano MA, Munoz A, Lopez CP. Evaluation of seven tests for diagnosis of human brucellosis in an area where the disease is endemic. Clin Vaccine Immunol, 2008;15(6):1031-3.
3. 3. Mantur BG, Amarnath SK, Shinde RS. Review of clinical and laboratory features of human brucellosis. Indian J Med Microbiol, 2007;25(3):188-202.
4. 4. Franco MP, Mulder M, Gilman RH, Smits HL. Human brucellosis. Lancet Infect Dis, 2007;7(12):775-86.
5. 5. Corbel MJ, Alton GG, Banai M, Dı´az R, Dranovskaia BA, et al. Brucellosis in human and animals. Geneva: WHO Press, 2006:22-3.
6. 6. Ruiz-Mesa JD, Sanchez-Gonzalez J, Reguera JM, Martin L, Lopez-Palmero S, Colmenero JD. Rose Bengal test: diagnostic yield and use for the rapid diagnosis of human brucellosis in emergency departments in endemic areas. Clin Microbiol Infect 2005;11(3):221-5.
7. 7. Alişkan H, Colakoğlu S, Turunç T, Demiroğlu YZ, Yazic AC, Arslan H. Evaluation of diagnostic value of Brucellacapt test in brucellosis. Mikrobiyol Bul, 2007;41(4):591-5.
8. 8. Orduña A, Almaraz A, Prado A, Gutierrez MP, GarciaPascual A, Dueñas A, Cuervo M, Abad R, Hernández B, Lorenzo B, Bratos MA, Torres AR. Evaluation of an immunocapture- agglutination test (Brucellacapt) for serodiagnosis of human brucellosis. J Clin Microbiol, 2000;38(11):4000-5

9. 9. Dahouk S, Tomaso H, Nöckler K, Neubauer H, Frangoulidis D, Laboratory-based diagnosis of brucellosis-a review of the literature. Part II: serological tests for brucellosis. Clin Lab, 2003;49(11-12):577-89.
10. 10. Alışkan H. The value of culture and serological methods in the diagnosis of human brucellosis. Mikrobiyol Bül, 2008;42(1):185-95.
11. 11. Mantur BG, Amarnath SK, Parande AM, Patil GA, Walvekar RR, Desai AS, Parande MV, Shinde RS, Chandrashekar MR, Patil SD, Shivaram C, Salagare RC. Comparison of a novel immunocapture assay with standard serological methods in the diagnosis of brucellosis. Clin Lab, 2011;57(5-6):333-41.
12. 12. Ciftçi C, Oztürk F, Oztekin A, Karaoğlan H, Saba R, Gültekin M, Mamikoğlu L. Comparison of the serological tests used fort the laboratory diagnosis of brucellosis, Mikrobiyol Bul, 2005; 39(3):291-9.
13. 13. Güzelant A, Kurtoğlu MG, Kaya M, Keşli R, Terzi Y, Baysal B. Comparison of the Brucellacapt with other serological tests used for the diagnosis of Brucellosis, Selçuk Tıp Derg, 2009;25(3):125-131.
14. 14. Sirmatel F, Türker M, Bozkurt AI. Evaluation of the methods used for the serologic diagnosis of brucellosis. Mikrobiyol Bul, 2002;36(2):161-7.
15. 15. Ardic N, Ozyurt M, Sezer O, Erdemoglu A, Haznedaroglu T. Comparison of Coombs' and immunocapture-agglutination tests in the diagnosis of brucellosis. Chin Med J (Engl). 2005;118(3):252-4.
16. 16. Thakur SD, Kumar R, Thapliyal DC. Human brucellosis: review of an under-diagnosed animal transmitted disease. J Commun Dis 2002;34(4):287-301.
17. 17. Memish ZA, Almuneef M, Mah MW, Qassem LA, Osoba AO. Comparison of the Brucella Standard Agglutination Test with the ELISA IgG and IgM in patients with Brucella bacteremia. Diagn Microbiol Infect Dis 2002;44(2):129-32.