Follow-up Brucellacapt and Rose Bengal Tests in 110 Children with Brucellosis

Abstract

Objective The interpretation of serologic tests in brucellosis can be difficult because of nonspecific symptoms and vague signs of disease, and limitations of serological tests to distinguish persistent and cleared infection. Here, we evaluated the role of Brucellacapt test in conjunction with Rose Bengal test (RBT) in the follow-up of children treated for brucellosis.

Methods A total of 174 children diagnosed with brucellosis were included in the study. Data about demographic characteristics of patients, clinical and laboratory findings including Brucellacapt and RBT results, therapeutic approach, and response to treatment were collected from medical records.

Results Of the 174 cases, 109 (62.6%) were boys and 65 (37.4%) were girls. The mean age of children at the diagnosis was 122 ± 54 months. Sixty-four cases were excluded from the study for loss to follow-up. The follow-up period for the remained 110 cases was 4.3 ± 2.9 months. Eleven cases (10%) had persistent illness, 7 (6.4%) had recurrence/relapse, and 92 had favorable outcome. During the follow-up, Brucellacapt titers did not drop under 1/320 in cases with persistent illness, and it increased again to 1/320 in cases with relapses at average 6.1 months after treatment. In 48 of cases with favorable outcome, Brucellacapt titers decreased to 1/160 in average 3.3 ± 1.8 months; in 35 cases, RBT became negative in average 3.8 ± 2.5 months, and there was no statistically significant difference between them (p = 0.241). In cases with higher Brucellacapt titers on admission, decrement of titers took longer time.

Conclusion Persistent serological titers without clinical findings of brucellosis should not lead physician to prolong or repeat treatment because the decline in Brucellacapt titers and RBT negativity may be delayed in contrast to clinical recovery.

Keywords

brucellosis - Brucellacapt - Rose Bengal - children

Ethical Approval

The study was approved by the decision of Clinical Research Ethics Committee of Health Sciences University Diyarbakır Gazi Yaşargil Training and Research Hospital with the number of 325, Jun 14, 2019.

Availability of Data and Materials

The dataset used and analyzed during this study are available from the corresponding author on reasonable request.

Publikationsverlauf

Eingereicht: 04. Mai 2020

Angenommen: 15. September 2020

Artikel online veröffentlicht:
02. November 2020

• References

• 1 Centers for Disease Control (CDC) Brucellosis Reference Guide. 2017 . Accessed May 26, 2020 at: https://www.cdc.gov/brucellosis/pdf/brucellosi-reference-guide.pdf. Accessed May 3, 2020
• 2 Republic of Turkey, Ministry of Health, brucellosis statistical data for 2008–2017.
• 3 Memish Z, Mah MW, Al Mahmoud S, Al Shaalan M, Khan MY. Brucella bacteraemia: clinical and laboratory observations in 160 patients. J Infect 2000; 40 (01) 59-63
• 4 WHO/CDS/EPR/2006.7, Brucellosis in Humans and Animals. Geneva: World Health Organization; 2006
• 5 Kara SS, Cayir Y. Predictors of blood culture positivity in pediatric brucellosis. J Coll Physicians Surg Pak 2019; 29 (07) 665-670
• 6 Guzmán-Bracho C, Salgado-Jiménez B, Beltrán-Parra LG. et al. Evaluation of serological diagnostic tests of human brucellosis for prevention and control in Mexico. Eur J Clin Microbiol Infect Dis 2020; 39 (03) 575-581
• 7 Bosilkovski M. Brucellosis: treatment and prevention. In: Calderwood SB, Edwards MS, Baron EL. eds. UpToDate. Updated October 1, 2019. Available at: www.uptodate.com/contents/Brucellosisi-treatment-and-prevention. Accessed May 26, 2020
• 8 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 (03) 252-254
• 9 Standartları UM. Bulaşıcı Hastalıklar Laboratuvar Tanı Rehberi-I. Ankara: Türkiye Halk Sağlığı Kurumu, SağlıkBakanlığı Yayın No: 934; 2014
• 10 Hassouneh L, Ouadri S, Pichilingue-Reto P. et al. An outbreak of brucellosis: an adult and pediatric case series. Open Forum Infect Dis 2019; 6 (10) 384
• 11 Meng F, Pan X, Tong W. Rifampicin versus streptomycin for brucellosis treatment in humans: a meta-analysis of randomized controlled trials. PLoS One 2018; 13 (02) e0191993
• 12 Ariza J, Corredoira J, Pallares R. et al. Characteristics of and risk factors for relapse of brucellosis in humans. Clin Infect Dis 1995; 20 (05) 1241-1249
• 13 Bosilkovski M, Katerina S, Zaklina S, Ivan V. The role of Brucellacapt test for follow-up patients with brucellosis. Comp Immunol Microbiol Infect Dis 2010; 33 (05) 435-442
• 14 Orduña A, Almaraz A, Prado A. et al. Evaluation of an immunocapture-agglutination test (Brucellacapt) for serodiagnosis of human brucellosis. J Clin Microbiol 2000; 38 (11) 4000-4005
• 15 Casao MA, Navarro E, Solera J. Evaluation of Brucellacapt for the diagnosis of human brucellosis. J Infect 2004; 49 (02) 102-108
• 16 Gómez MC, Nieto JA, Rosa C. et al. Evaluation of seven tests for diagnosis of human brucellosis in an area where the disease is endemic. Clin Vaccine Immunol 2008; 15 (06) 1031-1033