After acute brucellosis infection, symptoms persist in a minority of patients for more than 1 year. Such patients are defined as having chronic brucellosis. Since no objective laboratory methods exist to confirm the presence of chronic disease, these patients suffer delays in both diagnosis and treatment. The aim of the current study was to evaluate the usefulness of quantitative real-time PCR (Q-PCR) in the diagnosis and follow-up of these patients. Thirty-five subjects with a well-documented history of brucellosis that had been diagnosed between 2 and 33 years previously were screened by Q-PCR for the presence of Brucella melitensis DNA and by serological tests and blood culture. Subjects were divided into three groups: 8 (23%) focal-disease subjects, 9 (26%) nonfocal-disease subjects with subjective complaints, such as fatigue, malaise, arthralgia, and/or myalgia, and 18 (51%) asymptomatic subjects. All (100%) focal-disease patients and symptomatic nonfocal-disease patients had at least one positive Q-PCR sample. Only six (33%) of the asymptomatic subjects had Q-PCR-positive samples (P < 0.05). Eleven patients (five focal-disease patients and six nonfocal-disease patients with subjective complaints) received therapy during the study. For those patients who completed treatment, six (60%) still had Q-PCR-positive samples at the posttreatment follow-up. The proportion of individuals with B. melitensis DNA was significantly higher for symptomatic nonfocal-disease patients than for asymptomatic subjects. Therefore, Q-PCR appears to be a useful method for identifying chronic brucellosis patients.
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机译：急性布鲁氏菌病感染后，少数患者的症状持续超过1年。这类患者被定义为患有慢性布鲁氏菌病。由于没有客观的实验室方法可以确认是否存在慢性疾病，因此这些患者的诊断和治疗均存在延迟。本研究的目的是评估定量实时PCR（Q-PCR）在这些患者的诊断和随访中的有效性。通过Q-PCR筛选了35例在2到33年前之间被确诊为布鲁氏菌病的受试者，并通过Q-PCR筛选了 Brucella melitensis DNA的存在，并通过血清学测试和血液培养进行了筛选。受试者分为三组：8（23％）个病灶性疾病，9（26％）个非主观疾病病因主观不适，例如疲劳，不适，关节痛和/或肌痛，以及18（51％）无症状科目。所有（100％）局灶性疾病患者和有症状的非局灶性疾病患者均至少有一个阳性Q-PCR样本。无症状的受试者中只有六个（33％）的Q-PCR阳性样本（ P <0.05）。在研究过程中，有11名患者（5名有主观病状的局灶性疾病患者和6名非局灶性疾病患者）接受了治疗。对于那些完成治疗的患者，在治疗后的随访中仍有六名（60％）的Q-PCR阳性样品。具有 B的个人比例。有症状的非局灶性疾病患者的melitensis DNA明显高于无症状的患者。因此，Q-PCR似乎是鉴定慢性布鲁氏菌病患者的有用方法。
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