Assessment of different indirect ELISAs for bovine brucellosis diagnosis: development, validation and performance comparison
Brucella abortus; Acuracy; Diagnostic sensitivity; Diagnostic especificity; Vaccine antigens
Bovine brucellosis, a zoonotic disease caused by Brucella abortus, has a significant economic and health impact on both cattle and human populations. Accurate diagnosis of bovine brucellosis through laboratory testing is a fundamental part of implementing surveillance, control and eradication programs. Cultivation and isolation of the pathogen are considered the gold standard for confirmatory diagnosis of bovine brucellosis; however, they present a number of challenges, such as low sensitivity when the sample is not derived from post-partum/abortion fetal material or vaginal swabs, dependence on viable strains in the sample, and the requirement for biosafety level 3 laboratories (BSL-3). Direct diagnosis through PCR is also possible; however, it does not have well-established accuracy estimates. Many control and eradication programs use a combination of serological tests as the basis for diagnosing the disease, as these are considerably cheaper and easier to perform. The strategy used in these programs is the combination of screening serological tests followed by confirmatory tests. The Rose Bengal Test (RBT) and the Buffered Plate Agglutination Test (BPAT) are examples of highly sensitive tests used in the screening phase, which must then be followed by confirmatory tests such as the Complement Fixation Test (CFT), Fluorescence Polarization Assay (FPA), Enzyme-Linked Immunosorbent Assay (ELISA), and the 2-Mercaptoethanol Test (2-ME). Among these, ELISA stands out for its high scalability and has also been identified as having the highest diagnostic sensitivity (DSe) in a recently conducted systematic review and meta-analysis. It was found that the tests with the highest DSe and diagnostic specificity (DSp) were the indirect ELISA (I-ELISA) and the FPA. However, as one of the limitations pointed out in this study, none of the evaluated ELISA tests presented standardized cutoff points. Currently, the I-ELISA is a less commonly used test in control and eradication programs, and the antigenic composition of the main commercially available ELISA (IDEXX) is unknown, in addition to the high cost of large-scale use. Thus, the aim of this dissertation is to validate and compare the accuracy (DSe and DSp) of different B. abortus antigens in an I-ELISA plataform for the diagnosis of the disease, considering the interference of vaccine antigens and cross-reactions with antigens from other bacterial species (Yersinia enterocolitica O:9).