Efficacy analysis of serum endotoxin test in diagnosis and evaluation of brucellosis
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Department of Laboratory Medicine,the First Affiliated Hospital of Nanjing Medical University,Branch of NationalClinical Research Center for Laboratory Medicine,Nanjing 210029 ,China

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    Abstract:

    Objective:To analyze the epidemiological characteristics of brucellosis patients,and to explore the diagnostic value of lipopolysaccharide(LPS)testing for brucellosis and the therapeutic effect of LPS combined with blood culture on brucellosis. Methods: A total of 61 clinical patients with brucellosis was collected and divided into the current brucellosis group(n=39)and the brucellosis treatment effective group(n=22),the current brucellosis group consisted of 32 cases in the initial diagnosis group and 7 cases in the treatment ineffective group,twenty healthy subjects were used as the normal control group. The clinical characteristics of the patients were retrospectively analyzed,and LPS content was examined quantitatively. The results of blood culture,rose Bengal plate agglutination test(RBT)and LPS level were analyzed. The positive rates of the three detection methods were compared,and the diagnostic sensitivity,specificity,accuracy,negative/positive predictive values,and the diagnostic efficacy of combined diagnosis were evaluated. Results:Among 39 present patients,and the positive rate of LPS test was 100%,higher than those of blood culture(82.05%) and RBT test(97.44%). In 22 patients with effective treatment,the blood culture results were all negative. The false positive rates of LPS and RBT tests were 45.45% and 90.91%,respectively. The LPS level in the treatment effective group were significantly lower than those in the initial diagnosis group and the treatment ineffective group,and there was no statistically significant difference compared to the normal control group. The area under curve(AUC)values of blood culture combined with RBT,blood culture combined with LPS, RBT combined with LPS,and the combination of all three were 0.914,0.957,0.779,and 0.959,respectively. Since the AUC value for the combination of all three did not show a significant increase compared to the combination of blood culture with LPS,we choose the combination of blood culture with LPS as the indicator for evaluating the efficacy of brucellosis treatment. Conclusion:LPS detection has a high value in the diagnosis of present brucellosis and the evaluation of therapeutic effect of brucellosis. It can be used for the diagnosis of brucellosis in key population,improve the diagnosis rate and predict the outcome of the disease.

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缪淑贤,许雨乔,宋为娟.血清内毒素检测对布鲁氏菌病诊断和疗效评价的效能分析[J].南京医科大学学报(自然科学版英文版),2024,(11):1534-1540.

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  • Received:March 22,2024
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  • Online: November 15,2024
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