1887

Abstract

A single-tube nested PCR assay identifying a 52 bp fragment from the genus-specific IS gene was used prospectively in clinical practice for the diagnosis of human brucellosis in Kuwait. Patients with suspected brucellosis and with other infections were investigated as clinically indicated but in all of them culture, serology and PCR for were carried out. Out of 263 suspected cases of brucellosis, diagnostic tests were positive in 199, serology was positive in 199 and culture in 89, while the PCR was positive in 193 (sensitivity 96.98 %, 95 % confidence interval 94.5–99.5 %). Chronic brucellosis, involving symptoms for more than 1 year, was diagnosed in 49 out of these 193 patients. Diagnoses in four out of the six patients with positive serology but negative PCR and culture were non- bacterial meningitis and viral meningitis. False-negative PCR results were possible in the remaining two; both had been on long-term antibiotics for previously diagnosed brucellosis but their adherence may have been questionable, allowing a relapse. The PCR was negative in 244 patients with other infections (specificity 100 %) and in 180 control subjects with negative culture and serology. PCR results were available within 24 h of sample receipt, providing diagnostic information rapidly. The PCR is expensive and technically demanding and may not be appropriate for all cases. Future studies will help define how it may best be used. For example and tuberculous meningitides can be very similar, PCR may allow prompt distinction between the two, avoiding the need for prolonged empirical treatment for both.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.45772-0
2005-08-01
2019-11-19
Loading full text...

Full text loading...

/deliver/fulltext/jmm/54/8/JM540805.html?itemId=/content/journal/jmm/10.1099/jmm.0.45772-0&mimeType=html&fmt=ahah

References

  1. Al-Aska, A. K. & Chagla, A. ( 1989;). Laboratory-acquired brucellosis. J Hosp Infect 14, 69–71.[CrossRef]
    [Google Scholar]
  2. Al-Nakkas, A., Wright, S. G., Mustafa, A. S. & Wilson, S. ( 2002;). Single tube, nested PCR for the diagnosis of human brucellosis. Ann Trop Med Parasitol 96, 397–403.[CrossRef]
    [Google Scholar]
  3. Baily, G. G., Krahn, J., Drasar, B. S. W. & Stoker, N. ( 1992;). Detection of Brucella melitensis and Brucella abortus by DNA amplification. J Trop Med Hyg 95, 271–275.
    [Google Scholar]
  4. Bannatyne, R. M., Jackson, M. C. & Memish, Z. ( 1997;). Rapid diagnosis of Brucella bacteremia by using the BACTEC 9240 system. J Clin Microbiol 35, 2673–2674.
    [Google Scholar]
  5. Bricker, B. J. & Halling, S. M. ( 1994;). Differentiation of Brucella abortus bv.1, 2 and 4, Brucella melitensis, Brucella ovis and Brucella suis by PCR. J Clin Microbiol 32, 2660–2666.
    [Google Scholar]
  6. Kawasaki, E. S. ( 1990;). Sample preparation from blood, cells and other fluids. In PCR Protocols: a Guide to Methods and Applications, 1st edn, pp. 146–152. Edited by M. A. Innis, D. H. Gelfand, J. J. Sninsky & T. J. White. San Diego: Academic Press.
  7. Lulu, A. R., Araj, G., Khateeb, M., Mustafa, M., Yusuf, A. & Fenech, F. ( 1988;). Human brucellosis in Kuwait: a prospective study of 400 cases. Q J Med 66, 39–54.
    [Google Scholar]
  8. Madkour, M. ( 2001;). Epidemiological aspects. In Brucellosis, 2nd edn, pp. 21–32. Edited by M. Madkour. Berlin/Heidelberg/New York: Springer.
  9. Matar, G. M., Khneisser, I. A. & Abdelnoor, A. M. ( 1996;). Rapid laboratory confirmation of human brucellosis by PCR analysis of a target sequence on the 31-kilodalton Brucella antigen DNA. J Clin Microbiol 34, 477–478.
    [Google Scholar]
  10. Morata, P., Queipo-Ortuno, M. I., Garcia-Ordonez, M. A., Cardenas, A. & Colmonero, J. D. ( 2003;). Development and evaluation of PCR-enzyme-linked immunosorbent assay for diagnosis of human brucellosis. J Clin Microbiol 41, 144–148.[CrossRef]
    [Google Scholar]
  11. Mousa, A. M., Elhag, K. M., Khogali, M. & Marafie, A. A. ( 1988;). The nature of human brucellosis in Kuwait: study of 379 cases. Rev Infect Dis 10, 211–217.[CrossRef]
    [Google Scholar]
  12. Ouaharani, S., Soubrier, M. P. & Liautard, J. ( 1996;). IS6501-anchored PCR for the detection and identification of Brucella species and strains. J Appl Bacteriol 81, 154–160.[CrossRef]
    [Google Scholar]
  13. Queipo-Ortuno, M. I., Morata, P., Ocon, P., Manchado, P. & Colmonero, J. D. ( 1997;). Rapid diagnosis of human brucellosis by peripheral-blood PCR assay. J Clin Microbiol 35, 2927–2930.
    [Google Scholar]
  14. Young, E. J. ( 2001;). Immunology of brucellosis. In Brucellosis, 2nd edn. pp. 39–50. Edited by M. Madkour. Berlin/Heidelberg/New York: Springer.
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.45772-0
Loading
/content/journal/jmm/10.1099/jmm.0.45772-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error