2-mercaptoethanol Brucella agglutination test: usefulness for predicting recovery from brucellosis

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Abstract
Patients (92) with brucellosis were studied for 18 mo. and 15-29 sera from each patient were tested by the standard tube brucella agglutination test and by the 2-mercaptoethanol (2ME) brucella agglutination test. The standard tube test remained positive (.gtoreq. 160) for 1.5 yr in 44 of the 92 patients (48%), despite adequate antibiotic treatment. The 2ME titers remained positive (.gtoreq. 160) in only 8 of 92 patients (9%) after 1 yr and in only 4 of 92 patients (4%) after 1.5 yr. Positive 2ME titers 1 yr after initiation of treatment were present in 3 of 10 patients (30%) with drug allergies that interfered with antibiotic treatment, in contrast to only 5 of 82 patients (6%) without any drug allergies (P = 0.039). None of 84 patients with negative 2ME titers after 12 mo. of treatment had significant signs or symptoms of brucellosis and none developed chronic brucellosis. In contrast 4 of 8 patients with positive 2ME titers after 12 mo. of treatment still had signs and symptoms of brucellosis and required further treatment. The 2ME test is superior to the standard tube test in determining the adequacy of antibiotic therapy and a negative 2ME test is strong evidence against a diagnosis of chronic brucellosis.