Serum Levels of Interferon Gamma in Patients with Brucellosis in a Saudi Hospital
Maha A. Abo-Shadi *
Microbiology and Immunology Department, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt.
Alhanouf Ibrahim H. Al-Harbi
Biology Department, Faculty of Science, Taibah University, AlMadinah, Saudi Arabia.
Elmahi M. Ballal
Internal Medicine Department, Prince Sultan Armed Forces Hospital, AlMadinah, Saudi Arabia.
*Author to whom correspondence should be addressed.
Abstract
Background: Brucellosis is a major zoonotic disease that is endemic in Saudi Arabia and it remains a major health problem that has not been eradicated in the country yet.
Place and Duration of Study: This retrospective study was conducted in a Saudi Hospital at Al Madinah city during the period of 1 November, 2010 to 31 October, 2011.
Methodology: All sera of patients suspected to have brucellosis (n= 65) and 18 healthy subjects were tested for brucella antibody using slide latex agglutination (SAT) and ELISA. Quantitation of IFN-É£ was also done using ELISA.
Results: Brucellosis was detected in all age groups but the incidence was higher and reached 33.3% in age group (40- <50) years with average of 43.9±2.53 years. Male to female ratio in infected patients was 2:1 by using SAT. The incidence of seropositive cases was high (80.1%) in the three months (April, May and June), with the highest peak in May (46.7%). Drinking raw milk was the most encountered risk factor with a prevalence of 66.1% followed by consumption of milk products (11.9%). The most prevalent species among the examined cases was B. melitensis (93.3%). Among the studied cases, 60 cases (92.3%) were serologically positive for brucellosis by SAT. Among the 60 cases yielding significant titers against brucella, 14 sera (23.3%) had agglutinin levels of 1:80, 34 sera (56.7%) had titers of 1:160 and 12 sera (20%) had titers of 1:320. By estimating IgM and IgG levels in the sera of examined cases using ELISA, 52 cases (80%) had brucellaIgM while 42 cases (64.6%) had brucella IgG. Sensitivities of SAT, IgM ELISA and IgG ELISA were 91.5%, 88.1% and 71.2%, respectively compared with combined ELISA. Mean IFN-É£ levels ± SD in the subacute phase was 136.7±70.07pg/ml, 120.2±54.25pg/ml in the acute phase, and 121.3±51.09 pg/ml in the chronic phase of brucellosis.
Conclusion: The sensitivity and specificity of ELISA to diagnose human brucellosis was higher when combined ELISA (IgM/IgG or both) was used. Mean IFN-É£ levels were lower, but not significantly, in the chronic phase of the disease than in the sub acute phase and healthy subjects.
Keywords: Human brucellosis, Saudi B, melitensis, B. abortus, Slide agglutination test, ELISA, IFN-É£.