Significance of Fluorescent In-Situ Hybridization Method in Rapid Diagnosis of Brucellosis
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Objective: Brucellosis is a zoonosis commonly seen worldwide it causes severe disease and great economic loss. Rapid and sensitive tests are increasingly required for detection of the disease since currently used conventional diagnostic methods give results late and there are some factors affecting its sensitivity. Recently, a number of diagnostic tests have been determined that use different clinical samples in order to diagnose brucellosis in a short time. However a sufficiently sensitive and specific, optimized, routinely applicable molecular method is still lacking for detection of brucellosis which is defined as a difficult infection in terms of diagnosis and treatment. Fluorescent in situ hybridization (FISH) is a novel molecular diagnostic method that can detect Brucella spp. from hemoculture tubes signaling positively by shortening identification time. In this study, we aimed to compare FISH technique with conventional culture method in diagnosis of brucellosis and to investigate its use routinely. Material and Methods: A total of 100 hemoculture samples of patients who applied with the suspicion of brucellosis were studied with FISH and culture methods concurrently, after gram staining. Standard Wright's tube agglutination (STA) test was also used for interpretation of the FISH results. Results: Of the tested samples, 43 studied with cultures, 52 with STA and 44 with FISH were found positive. The FISH detected Brucella spp. in 34 positive cultures and in 29 STA positive sample. Sensitivity, specifity, positive and negative predictive values of FISH method were found as 79.0%, 82.4%, 77.2% and 83.9% respectively when evaluated together with culture which is the gold standard method. Conclusion: FISH is a rapid and easily applicable method not requiring much equipment. However, it was concluded that it could not be used as a cost-effective diagnostic tool as it was not as sensitive enough as desired, and in case of it is used, it would be useful to confirm FISH negative samples with culture and/or serum tube agglutination test.