ABSTRACT
The direct methods for diagnosis of bovine brucellosis have several limitations, therefore serological tests are the basis for the diagnosis of the disease. However, a meta-analysis estimating the diagnostic sensitivity (DSe) and diagnostic specificity (DSp) on the main tests used in bovine brucellosis control programs worldwide has not been performed. This systematic review and meta-analysis aimed to estimate the DSe, DSp and thereby accuracy of serological tests individually used in the diagnosis of bovine brucellosis. The databases CABI, Cochrane Library, PubMed/MEDLINE, SciELO, Scopus and Web of Science were used to select articles. The search resulted in 5308 studies, of which 71 were selected for systematic review using quality assessment tools and 65 studies were included in the meta-analysis. For the meta-analysis, 178 assays and 11 different serological tests were considered. To estimate DSe and DSp of the tests, studies were divided according to animal selection for the studies: (1) studies that carried out a random or consecutive selection of participants (noncasecontrol studies) and (2) all studies, including casecontrol studies. Considering only the non-case-control studies to estimate the DSe, the tests that exhibited the best and worst performance were the iELISA test (indirect enzyme immunoassay - bacterial suspension as antigen - BS) (96.5%, 95% CI: 94.1-97.9%) and 2ME (2- mercaptoethanol test) (85.0%, 95% CI: 79.6-89.1%), respectively; while for DSp, the FPA (fluorescence polarization assay) (99, 7%, 95% CI: 99.5-99.8%) and PCFIA tests (protein concentration fluorescence immunoassay) (78.5%, 95% CI: 70.0-85.1%) showed better and worse performance, respectively. Overall, our results showed an overestimation in the DSe and DSp of the eleven serological tests assessed when casecontrol studies were included in the meta-analysis, which is a concern considering its impacts on the time and costs associated with populational diagnosis of the diseases, since several of these tests are routinely used in the control and eradication programs of bovine brucellosis worldwide. Furthermore, the tests that exhibited the best DSe and DSp, iELISA (BS) and FPA, respectively, are relatively easy to perform and interpret and the test which showed the best overall accuracy was FPA.
Subject(s)
Brucellosis, Bovine , Brucellosis , Cattle Diseases , Cattle , Animals , Sensitivity and Specificity , Brucellosis, Bovine/diagnosis , Fluorescence Polarization Immunoassay/methods , Fluorescence Polarization Immunoassay/veterinary , Enzyme-Linked Immunosorbent Assay/veterinary , Enzyme-Linked Immunosorbent Assay/methods , Serologic Tests/veterinary , Brucellosis/diagnosis , Brucellosis/veterinary , Antibodies, BacterialABSTRACT
Bacteria of the genus Brucella are facultative intracellular parasites that cause brucellosis, a severe animal and human disease. Recently, a group of taxonomists merged the brucellae with the primarily free-living, phylogenetically related Ochrobactrum spp. in the genus Brucella. This change, founded only on global genomic analysis and the fortuitous isolation of some opportunistic Ochrobactrum spp. from medically compromised patients, has been automatically included in culture collections and databases. We argue that clinical and environmental microbiologists should not accept this nomenclature, and we advise against its use because (i) it was presented without in-depth phylogenetic analyses and did not consider alternative taxonomic solutions; (ii) it was launched without the input of experts in brucellosis or Ochrobactrum; (iii) it applies a non-consensus genus concept that disregards taxonomically relevant differences in structure, physiology, population structure, core-pangenome assemblies, genome structure, genomic traits, clinical features, treatment, prevention, diagnosis, genus description rules, and, above all, pathogenicity; and (iv) placing these two bacterial groups in the same genus creates risks for veterinarians, medical doctors, clinical laboratories, health authorities, and legislators who deal with brucellosis, a disease that is particularly relevant in low- and middle-income countries. Based on all this information, we urge microbiologists, bacterial collections, genomic databases, journals, and public health boards to keep the Brucella and Ochrobactrum genera separate to avoid further bewilderment and harm.
Subject(s)
Brucella , Ochrobactrum , Ochrobactrum/classification , Ochrobactrum/genetics , Ochrobactrum/pathogenicity , Ochrobactrum/physiology , Brucella/classification , Brucella/genetics , Brucella/pathogenicity , Brucella/physiology , Terminology as Topic , Phylogeny , Brucellosis/drug therapy , Brucellosis/microbiology , Humans , Opportunistic Infections/microbiologyABSTRACT
This systematic review and meta-analysis aimed to recalculate the efficacy of Brucella abortus S19 and RB51 vaccine strains and discuss the main variables associated with controlled trials to evaluate bovine brucellosis vaccine efficacy (VE). The most commonly used vaccine strain was S19, at a dose of 1010 colony forming units (CFU), followed by RB51 at 1010 CFU. The most commonly used challenge strain was B. abortus 2308, at a dose of 107 CFU, by the intraconjunctival route. Regarding the meta-analysis, trials were grouped according to the vaccine strain and dose to recalculate protection against abortion (four groups) or infection (five groups) using pooled risk ratio (RR) and VE. Regarding protection against abortion (n = 15 trials), the S19 vaccine at 109 CFU exhibited the highest protection rate (RR = 0.25, 95% confidence interval (CI) : 0.12-0.52; VE = 75.09%, 95% CI: 48.08-88.05), followed by RB51 at 1010 CFU (RR = 0.31, 95% CI: 0.16-0.61; VE = 69.25%, 95% CI: 39.48-84.38). Regarding protection against infection (n = 23 trials), only two subgroups exhibited significant protection: S19 at 109 CFU (RR = 0.28, 95% CI: 0.14-0.55; VE = 72.03%, 95% CI: 57.70- 81.50) and RB51 at 1010 CFU (RR = 0.43, 95% CI: 0.22-0.84; VE = 57.05%, 95% CI: 30.90-73.30). In conclusion, our results suggest that a dose of 109 CFU for S19 and 1010 CFU for RB51 are the most suitable for the prevention of abortion and infection caused by B. abortus.