Clinical characteristics and infection biomarkers of 187 patients with Brucellosis

Objective To investigate the diagnosis methods, clinical characteristics and infection biomarkers of Brucella spp infection, and to provide experimental basis for the diagnosis of Brucellosis. Methods Data of 187 cases of Brucellosis in the 940th Hospital of Joint Logistics Support Force of People’s Liberation Army from January 2012 to January 2019 were analyzed, retrospectively. The clinical diagnostic methods, basic diseases and complications were analyzed, respectively. The infection biomarkers, such as procalcitonin (PCT), C-reactive protein (CRP), white blood cell (WBC) and neutrophil (N%) of the patients were analyzed by receiver operating characteristic curve (ROC), 200 cases without bacterial infection were collected as negative control. Results Among the 187 patients with brucellosis, 152 cases were men; the median age of the patients was (49.00 ± 12.23) years and the annual incidence in this region was 36/100 000. The clinical diagnostic methods included pathogenic bacteria culture, serological diagnosis and clinical diagnosis, which were 27% (51/187), 44.92% (84/187) and 40.46% (76/187), respectively. Blood culture was the main pathogenic bacteria culture [24.6% (47/187)], the average blood culture period was (80.86 ± 20.46) h, all the positive bottles were aerobic bottles. The common clinical basic diseases with Brucella spp were mellitus (8.57%, 16/187), hepatitis B (9.09%, 17/187) and cholecystitis (12.83%, 24/187); the main complications of the patients were lumbar spine lesions (49.20%, 92/187), cervical spine lesions (10.70%, 20/187) and knee joint lesions (8.02%, 15/187). ROC analysis of WBC, N%, PCT and CRP of patients with Brucella spp infection showed that, the area under curve were 0.403, 0.444, 0.414 and 0.703, respectively, which indicated CRP had high sensitivity and specificity for Brucella infection, and when CRP was ≥ 1.965 mg/ml, the sensitivity and specificity were 0.589 and 0.676. Conclusions Brucellosis often occurs in middle-aged and elderly men, which could be diagnosed by clinical features, microbiological culture, serological detection and CRP detection; and also commonly with complications of osteoarthrosis, and missed diagnosis should be avoided. Key words: Brucellosis; Brucella spp; Blood culture; Osteoarthropathy; Infection biomarker