Evaluation of Human Brucellosis Patients with Post-Treatment Standard Tube Agglutination Test Titers

Introduction: This study was designed to determine the differences between brucellosis patients whose standard tube agglutination test (SAT) titers decreased or not after successful treatment. Methods: This retrospective study included patients with a course of antibiotic therapy at least 6 weeks for acute brucellosis or 12 weeks for osteoarticular involvement, and whose post-treatment clinical findings improved. Results: The mean age of the 276 patients was 45.2 years, and 50.7% were female. The SAT titer decreased in 166 patients (60%). No significant differences were found in terms of demographical and epidemiological characteristics between the groups. Patients with decreased SAT titers exhibited an elevated pre-treatment erythrocyte sedimentation rate (ESR) and the lymphocytosis was more prevalent. In the non-decreased SAT group, liver enzymes such as aspartate aminotransferase (AST) and alanine aminotransferase (ALT) values after treatment were higher. The initial SAT titer of 1/160 and the pre-treatment rates of anaemia and thrombocytopenia were significantly higher in patients whose SAT titers became negative. Among patients whose SAT titers remained positive, the initial SAT titer was more frequently ≥1/320, and the post-treatment AST value was higher. Conclusions: This study showed that a serological response can be obtained with a high ESR and lymphocytosis prior to treatment. It should be noted that SAT negativity cannot be observed immediately in patients with pre-treatment SAT titers ≥ 1/320. The healthcare providers are advised to consider the complete clinical picture without relying solely on serological results.