{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:43:12Z","timestamp":1792176192857,"version":"4.4.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,1,6]],"date-time":"2020-01-06T00:00:00Z","timestamp":1578268800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,1,6]],"date-time":"2020-01-06T00:00:00Z","timestamp":1578268800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Brucellosis is endemic in many areas in China. The current diagnosis of Brucellosis predominantly relies on the traditional bacterial culture and serum agglutination test. In this study, we aimed to explore the value of ELISA in the diagnosis of Brucellosis in Chinese population.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>We recruited 235 patients with a diagnosis of Brucellosis at different clinical stages: 117 in acute, 78 in subacute, and 40 in chronic. We also recruited 248 control patients who presented with similar clinical symptoms but with a different diagnosis other than Brucellosis. In addition, 90 healthy volunteers were also recruited. Bacterial culture, agglutination test and ELISA assay were performed to detect Brucella spp.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Among 235 patients with Brucellosis, 51 (21.7%) was positive for bacterial culture, 150 (63.8%) were positive by agglutination test, and 232 (98.7%) were positive by ELISA (IgG and\/or IgM). When we stratified the patients based on the disease stages (acute, subacute and chronic), ELISA was the most sensitive method and showed a highest positive rate in all stages. By Receiver Operating Characteristic Curve analysis of ELISA results, we found that measurement of IgG level was superior to measurement of IgM level (AUC, 0.993 versus 0.877). Since the measurement of IgG itself missed rare cases in acute phase, we recommended measuring IgG and IgM simultaneously by ELISA for the diagnosis of Brucellosis. In term of the specificity of ELISA in the diagnosis of Brucellosis, our study showed that only 1.6% (4\/248) non-Brucellosis patients were positive by ELISA; all positive cases were IgM only and none showed positive IgG. Similar results were found in healthy volunteers. In summary, our study concluded that ELISA is the most sensitive and specific method to detect Brucellosis in Chinese population.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>ELISA assay is sensitive, fast, and convenient to detect Brucellosis. It shows the high sensitivity and specifity and should be used as a routine lab test when Brucellosis is suspected in clinical practice.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12879-019-4729-1","type":"journal-article","created":{"date-parts":[[2020,1,6]],"date-time":"2020-01-06T16:02:43Z","timestamp":1578326563000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["ELISA is superior to bacterial culture and agglutination test in the diagnosis of brucellosis in an endemic area in China"],"prefix":"10.1186","volume":"20","author":[{"given":"Nannan","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengzhe","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4584-3859","authenticated-orcid":false,"given":"Gang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,1,6]]},"reference":[{"issue":"22","key":"4729_CR1","doi-asserted-by":"publisher","first-page":"2325","DOI":"10.1056\/NEJMra050570","volume":"352","author":"G Pappas","year":"2005","unstructured":"Pappas G, Akritidis N, Bosilkovski M, Tsianos E. Brucellosis. N Engl J Med. 2005;352(22):2325\u201336.","journal-title":"N Engl J Med"},{"issue":"Pt 2","key":"4729_CR2","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1099\/ijs.0.65356-0","volume":"58","author":"HC Scholz","year":"2008","unstructured":"Scholz HC, Hubalek Z, Sedlacek I, Vergnaud G, Tomaso H, Al Dahouk S, et al. Brucella microti sp. nov., isolated from the common vole Microtus arvalis. Int J Syst Evol Microbiol. 2008;58(Pt 2):375\u201382.","journal-title":"Int J Syst Evol Microbiol"},{"issue":"2","key":"4729_CR3","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1089\/vbz.2008.0036","volume":"9","author":"HC Scholz","year":"2009","unstructured":"Scholz HC, Hofer E, Vergnaud G, Le Fleche P, Whatmore AM, Al Dahouk S, et al. Isolation of Brucella microti from mandibular lymph nodes of red foxes, Vulpes vulpes, in lower Austria. Vector Borne Zoonotic Dis. 2009;9(2):153\u20136.","journal-title":"Vector Borne Zoonotic Dis"},{"issue":"8","key":"4729_CR4","doi-asserted-by":"publisher","first-page":"1316","DOI":"10.3201\/eid1408.080286","volume":"14","author":"HC Scholz","year":"2008","unstructured":"Scholz HC, Hubalek Z, Nesvadbova J, Tomaso H, Vergnaud G, Le Fleche P, et al. Isolation of Brucella microti from soil. Emerg Infect Dis. 2008;14(8):1316\u20137.","journal-title":"Emerg Infect Dis"},{"issue":"Pt 4","key":"4729_CR5","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1099\/ijs.0.011148-0","volume":"60","author":"HC Scholz","year":"2010","unstructured":"Scholz HC, Nockler K, Gollner C, Bahn P, Vergnaud G, Tomaso H, et al. Brucella inopinata sp. nov., isolated from a breast implant infection. Int J Syst Evol Microbiol. 2010;60(Pt 4):801\u20138.","journal-title":"Int J Syst Evol Microbiol"},{"issue":"5","key":"4729_CR6","doi-asserted-by":"publisher","first-page":"e289","DOI":"10.1016\/j.ijid.2012.12.030","volume":"17","author":"Z Zhong","year":"2013","unstructured":"Zhong Z, Yu S, Wang X, Dong S, Xu J, Wang Y, et al. Human brucellosis in the People's Republic of China during 2005-2010. Int J Infect Dis. 2013;17(5):e289\u201392.","journal-title":"Int J Infect Dis"},{"issue":"9\u201310","key":"4729_CR7","first-page":"487","volume":"49","author":"S Al Dahouk","year":"2003","unstructured":"Al Dahouk S, Tomaso H, Nockler K, Neubauer H, Frangoulidis D. Laboratory-based diagnosis of brucellosis--a review of the literature. Part I: techniques for direct detection and identification of Brucella spp. Clin Lab. 2003;49(9\u201310):487\u2013505.","journal-title":"Clin Lab"},{"issue":"12","key":"4729_CR8","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1016\/S1473-3099(07)70286-4","volume":"7","author":"MP Franco","year":"2007","unstructured":"Franco MP, Mulder M, Gilman RH, Smits HL. Human brucellosis. Lancet Infect Dis. 2007;7(12):775\u201386.","journal-title":"Lancet Infect Dis"},{"key":"4729_CR9","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1016\/j.ejim.2016.07.029","volume":"36","author":"S Bauer","year":"2016","unstructured":"Bauer S, Aubert CE, Richli M, Chuard C. Blood cultures in the evaluation of uncomplicated cellulitis. Eur J Intern Med. 2016;36:50\u20136.","journal-title":"Eur J Intern Med"},{"issue":"4","key":"4729_CR10","doi-asserted-by":"publisher","first-page":"625","DOI":"10.4269\/ajtmh.2009.80.625","volume":"80","author":"BJ Espinosa","year":"2009","unstructured":"Espinosa BJ, Chacaltana J, Mulder M, Franco MP, Blazes DL, Gilman RH, et al. Comparison of culture techniques at different stages of brucellosis. Am J Trop Med Hyg. 2009;80(4):625\u20137.","journal-title":"Am J Trop Med Hyg."},{"issue":"1","key":"4729_CR11","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1093\/infdis\/153.1.122","volume":"153","author":"E Gotuzzo","year":"1986","unstructured":"Gotuzzo E, Carrillo C, Guerra J, Llosa L. An evaluation of diagnostic methods for brucellosis--the value of bone marrow culture. J Infect Dis. 1986;153(1):122\u20135.","journal-title":"J Infect Dis"},{"issue":"2","key":"4729_CR12","first-page":"233","volume":"20","author":"EM Galinska","year":"2013","unstructured":"Galinska EM, Zagorski J. Brucellosis in humans--etiology, diagnostics, clinical forms. Ann Agric Environ Med. 2013;20(2):233\u20138.","journal-title":"Ann Agric Environ Med"},{"issue":"1","key":"4729_CR13","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s12199-018-0712-5","volume":"23","author":"P Guan","year":"2018","unstructured":"Guan P, Wu W, Huang D. Trends of reported human brucellosis cases in mainland China from 2007 to 2017: an exponential smoothing time series analysis. Environ Health Prev Med. 2018;23(1):23.","journal-title":"Environ Health Prev Med"},{"issue":"2","key":"4729_CR14","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/S1473-3099(06)70382-6","volume":"6","author":"G Pappas","year":"2006","unstructured":"Pappas G, Papadimitriou P, Akritidis N, Christou L, Tsianos EV. The new global map of human brucellosis. Lancet Infect Dis. 2006;6(2):91\u20139.","journal-title":"Lancet Infect Dis"},{"issue":"9","key":"4729_CR15","doi-asserted-by":"publisher","first-page":"e0062","DOI":"10.1097\/MD.0000000000010062","volume":"97","author":"M Li","year":"2018","unstructured":"Li M, Zhou X, Li J, Sun L, Chen X, Wang P. Real-time PCR assays for diagnosing brucellar spondylitis using formalin-fixed paraffin-embedded tissues. Med (Baltimore). 2018;97(9):e0062.","journal-title":"Med (Baltimore)"},{"issue":"5","key":"4729_CR16","doi-asserted-by":"publisher","first-page":"e0005577","DOI":"10.1371\/journal.pntd.0005577","volume":"11","author":"B Jia","year":"2017","unstructured":"Jia B, Zhang F, Lu Y, Zhang W, Li J, Zhang Y, et al. The clinical features of 590 patients with brucellosis in Xinjiang, China with the emphasis on the treatment of complications. PLoS Negl Trop Dis. 2017;11(5):e0005577.","journal-title":"PLoS Negl Trop Dis"},{"issue":"7","key":"4729_CR17","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1586\/eri.11.55","volume":"9","author":"S Al Dahouk","year":"2011","unstructured":"Al Dahouk S, Nockler K. Implications of laboratory diagnosis on brucellosis therapy. Expert Rev Anti-Infect Ther. 2011;9(7):833\u201345.","journal-title":"Expert Rev Anti-Infect Ther"},{"issue":"2","key":"4729_CR18","doi-asserted-by":"publisher","first-page":"314","DOI":"10.4269\/ajtmh.2010.09-0790","volume":"83","author":"B Mantur","year":"2010","unstructured":"Mantur B, Parande A, Amarnath S, Patil G, Walvekar R, Desai A, et al. ELISA versus conventional methods of diagnosing endemic brucellosis. Am J Trop Med Hyg. 2010;83(2):314\u20138.","journal-title":"Am J Trop Med Hyg"},{"issue":"1","key":"4729_CR19","first-page":"59","volume":"40","author":"Z Memish","year":"2000","unstructured":"Memish Z, Mah MW, Al Mahmoud S, Al Shaalan M, Khan MY. Brucella bacteraemia: clinical and laboratory observations in 160 patients. J Inf Secur. 2000;40(1):59\u201363.","journal-title":"J Inf Secur"},{"issue":"6","key":"4729_CR20","doi-asserted-by":"publisher","first-page":"1031","DOI":"10.1128\/CVI.00424-07","volume":"15","author":"MC Gomez","year":"2008","unstructured":"Gomez MC, Nieto JA, Rosa C, Geijo P, Escribano MA, Munoz A, et al. Evaluation of seven tests for diagnosis of human brucellosis in an area where the disease is endemic. Clin Vaccine Immunol. 2008;15(6):1031\u20133.","journal-title":"Clin Vaccine Immunol"},{"issue":"2","key":"4729_CR21","first-page":"197","volume":"36","author":"MO Gad El-Rab","year":"1998","unstructured":"Gad El-Rab MO, Kambal AM. Evaluation of a Brucella enzyme immunoassay test (ELISA) in comparison with bacteriological culture and agglutination. J Inf Secur. 1998;36(2):197\u2013201.","journal-title":"J Inf Secur"},{"issue":"Suppl 1","key":"4729_CR22","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1080\/1120009X.2001.11782330","volume":"13","author":"AO Osoba","year":"2001","unstructured":"Osoba AO, Balkhy H, Memish Z, Khan MY, Al-Thagafi A, Al Shareef B, et al. Diagnostic value of Brucella ELISA IgG and IgM in bacteremic and non-bacteremic patients with brucellosis. J Chemother. 2001;13(Suppl 1):54\u20139.","journal-title":"J Chemother"},{"issue":"1","key":"4729_CR23","doi-asserted-by":"publisher","first-page":"34","DOI":"10.2174\/1574891X11308010007","volume":"8","author":"A Ulu-Kilic","year":"2013","unstructured":"Ulu-Kilic A, Metan G, Alp E. Clinical presentations and diagnosis of brucellosis. Recent Pat Antiinfect Drug Discov. 2013;8(1):34\u201341.","journal-title":"Recent Pat Antiinfect Drug Discov"},{"issue":"2","key":"4729_CR24","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1093\/infdis\/159.2.219","volume":"159","author":"E Gazapo","year":"1989","unstructured":"Gazapo E, Gonzalez Lahoz J, Subiza JL, Baquero M, Gil J, de la Concha EG. Changes in IgM and IgG antibody concentrations in brucellosis over time: importance for diagnosis and follow-up. J Infect Dis. 1989;159(2):219\u201325.","journal-title":"J Infect Dis"},{"issue":"5","key":"4729_CR25","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1016\/j.cimid.2009.06.001","volume":"33","author":"M Bosilkovski","year":"2010","unstructured":"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(5):435\u201342.","journal-title":"Comp Immunol Microbiol Infect Dis"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-019-4729-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12879-019-4729-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-019-4729-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,5]],"date-time":"2021-01-05T00:11:05Z","timestamp":1609805465000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-019-4729-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,6]]},"references-count":25,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["4729"],"URL":"https:\/\/doi.org\/10.1186\/s12879-019-4729-1","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,6]]},"assertion":[{"value":"5 February 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 December 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 January 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study is approved by the ethics committee of Qilu Hospital. All patients and volunteers signed the consent forms.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no conflict of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"11"}}