Progress in applied laboratory diagnostic techniques for brucellosis

doi:10.3877/cma.j.issn.1674-0785.2024.10.011

Abstract

Abstract:

Brucellosis is an acute or chronic zoonotic infectious disease caused by Brucella.This disease is a natural focal disease with strong infectivity and is widely distributed around the world.More than 500000 cases of brucellosis are reported worldwide every year, seriously threatening people's lives and health.The direct economic loss caused by this disease exceeds 3 billion US dollars every year.In view of the great harmfulness of brucellosis and its characteristics of lack of typical clinical symptoms, non-specificity,and easy recurrence, timely carrying out sensitive, accurate, and specific laboratory tests is particularly urgent and important for the diagnosis of this disease.This paper reviews the common diagnostic methods used in existing laboratories and the emerging diagnostic methods with the development of biomolecular biology and bioinformatics technology in recent years, in order to provide theoretical reference and technical support for the laboratory diagnosis of brucellosis.

Key words: Brucellosis, Serological examination, Bacteriological examination, Molecular biological examination

Xinjing Fu, Yesaier·Ainiwaer Mu, Fan Zhao, Shoukui Hu. Progress in applied laboratory diagnostic techniques for brucellosis[J]. Chinese Journal of Clinicians(Electronic Edition), 2024, 18(10): 949-954.

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References 63

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分类	实验名称	检出率	检测时长	优点	缺点	适用范围	标本类型
细菌学技术	分离培养	较低	7～15 d	金标准，可具体分型	操作要求条件高，生物危险程度高	急性菌血症时期的患者；可鉴定种属	血液、骨髓、体液、炎性病灶渗出液等
	RBPT	较高	5 min	操作简单，价格低廉。	特异性较差，易出现假阳性	大批量初筛	血清
	SAT	较高	24 h	检测IgM 的敏感性高	易出现假阴性，存在交叉反应	实验室确诊试验之一，适用于急性病例	血清
血清学技术	ELISA	较高	3～4 h	通量大，可自动化	特异性差	基层临床实验室大批量筛查，多于RBPT 并联诊断。	血清
	CFT	较高	24 h	特异性强	步骤繁琐，操作复杂	畜牧业应用较多，较少用于人血清	血清
	Coombs	较高	24 h	灵敏度和特异性均较好	操作复杂、耗时长	实验室确诊试验之一，多用于慢性病例	血清
	GICA	较高	30 min	操作简单，结果易于判定	GICA 试剂盒较多，不能标化抗体水平	现场快速筛查	血清
	FPA	较高	5～10 min	快速简便、成本低，所需的样本量极少	设备较贵	野外样本的检疫和筛查工作	血清
	PCR	高	2～4 h	最低检出限低，灵敏度高	人员设备要求均较高	种型鉴定	血清、尿液、脑脊液、胸膜液等
分子生物学技术	LAMP	高	50～70 min	最低限度低，操作简单	易受到污染	基层实验室筛查	血清
	MCDA	高	50～70 min	最低检出限低，判读直观	报道较少，未广泛应用	潜在的快速检测方法	全血，血清
	NGS	高	7～14 d	准确度高，可细致到基因型的鉴定	价格昂贵	流行病学调查溯源传播链及科研	血清、脑脊液、胸膜液等

分类	实验名称	检出率	检测时长	优点	缺点	适用范围	标本类型
细菌学技术	分离培养	较低	7～15 d	金标准，可具体分型	操作要求条件高，生物危险程度高	急性菌血症时期的患者；可鉴定种属	血液、骨髓、体液、炎性病灶渗出液等
	RBPT	较高	5 min	操作简单，价格低廉。	特异性较差，易出现假阳性	大批量初筛	血清
	SAT	较高	24 h	检测IgM 的敏感性高	易出现假阴性，存在交叉反应	实验室确诊试验之一，适用于急性病例	血清
血清学技术	ELISA	较高	3～4 h	通量大，可自动化	特异性差	基层临床实验室大批量筛查，多于RBPT 并联诊断。	血清
	CFT	较高	24 h	特异性强	步骤繁琐，操作复杂	畜牧业应用较多，较少用于人血清	血清
	Coombs	较高	24 h	灵敏度和特异性均较好	操作复杂、耗时长	实验室确诊试验之一，多用于慢性病例	血清
	GICA	较高	30 min	操作简单，结果易于判定	GICA 试剂盒较多，不能标化抗体水平	现场快速筛查	血清
	FPA	较高	5～10 min	快速简便、成本低，所需的样本量极少	设备较贵	野外样本的检疫和筛查工作	血清
	PCR	高	2～4 h	最低检出限低，灵敏度高	人员设备要求均较高	种型鉴定	血清、尿液、脑脊液、胸膜液等
分子生物学技术	LAMP	高	50～70 min	最低限度低，操作简单	易受到污染	基层实验室筛查	血清
	MCDA	高	50～70 min	最低检出限低，判读直观	报道较少，未广泛应用	潜在的快速检测方法	全血，血清
	NGS	高	7～14 d	准确度高，可细致到基因型的鉴定	价格昂贵	流行病学调查溯源传播链及科研	血清、脑脊液、胸膜液等

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