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False Positives in Brucellosis Serology: Wrong Bait and Wrong Pond?
Borbála Bányász1,2, József Antal3, Béla Dénes1
1Department of Microbiology and Infectious Diseases, University of Veterinary Medicine Budapest, 1143 Budapest, Hungary.
Tropical Medicine and Infectious Disease
|May 26, 2023
Summary
False positive serologic results in Brucella testing stem from using similar antigens. New methods using R-type bacteria antigens, brucellin skin tests, or microbial DNA are needed for accurate Brucella diagnosis.
Area of Science:
- Immunology
- Microbiology
- Serology
Background:
- False positive serologic results (FPSR) are a significant challenge in Brucella diagnostics.
- Understanding the molecular basis of FPSR is crucial for improving diagnostic accuracy.
Purpose of the Study:
- To review the current status of resolving FPSR in Brucella serology.
- To compile knowledge on the molecular background of FPSR.
- To highlight prospects for resolving FPSR.
Main Methods:
- Analysis of cell wall components of Gram-negative bacteria, focusing on lipopolysaccharide (LPS) in Brucella.
- Evaluation of existing efforts to improve serologic test specificity.
- Review of proposed novel approaches for accurate Brucella detection.
Main Results:
- The root cause of FPSR is the use of S-type LPS antigen in current approved tests.
- Deeper understanding of Brucella immunology and serology tests is required.
- Solutions for FPSR will necessitate significant research investment.
Conclusions:
- Current serologic tests for Brucella suffer from cross-reactivity due to shared antigens.
- Novel diagnostic strategies are essential to overcome FPSR.
- Promising approaches include using R-type bacterial antigens, developing specific brucellin skin tests, or employing microbial cell-free DNA as an analyte.
