The clinical presentation of brucellosis in humans is variable and unspecific, and thus, laboratory corroboration of the diagnosis is essential for the patient's proper treatment. The diagnosis of brucellar infections can be made by culture, serological tests, and nucleic acid amplification assays. Modern automated blood culture systems enable detection of acute cases of brucellosis within the routine 5- to 7-day incubation protocol employed in clinical microbiology laboratories, although a longer incubation and performance of blind subcultures may be needed for protracted cases. Serological tests, though they lack specificity and provide results that may be difficult to interpret in individuals repeatedly exposed to Brucella organisms, nevertheless remain a diagnostic cornerstone in resource-poor countries. Nucleic acid amplification assays combine exquisite sensitivity, specificity, and safety and enable rapid diagnosis of the disease. However, long-term persistence of positive molecular test results in patients that have apparently fully recovered is common and has unclear clinical significance and therapeutic implications. Therefore, as long as there are no sufficiently validated commercial tests or studies that demonstrate an adequate interlaboratory reproducibility of the different homemade PCR assays, cultures and serological methods will remain the primary tools for the diagnosis and posttherapeutic follow-up of human brucellosis.

中文翻译：

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人类布鲁氏菌病的实验室诊断。


人类布鲁氏菌病的临床表现多种多样且不具有特异性，因此，诊断的实验室证实对于患者的正确治疗至关重要。布鲁氏菌感染的诊断可以通过培养、血清学检测和核酸扩增测定来进行。现代自动化血液培养系统能够在临床微生物学实验室采用的常规 5 至 7 天孵化方案中检测出布鲁氏菌病的急性病例，尽管对于旷日持久的病例可能需要更长的孵化时间和盲传代培养。血清学检测虽然缺乏特异性，并且提供的结果在反复接触布鲁氏菌的个体中可能难以解释，但仍然是资源匮乏国家的诊断基石。核酸扩增检测结合了精湛的灵敏度、特异性和安全性，能够快速诊断疾病。然而，在明显完全康复的患者中长期持续出现阳性分子检测结果很常见，并且临床意义和治疗意义尚不明确。因此，只要没有充分验证的商业测试或研究证明不同自制 PCR 检测具有足够的实验室间重现性，培养和血清学方法仍将是人类布鲁氏菌病诊断和治疗后随访的主要工具。