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Laboratory Parameters and Serum Tub Agglutination as Markers for Brucellosis Treatment Response
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DOI：10.1016/j.micinf.2025.105588.png)
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Abstract
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This study aims to compare the clinical, laboratory, and therapeutic outcomes between acute and subacute/chronic phases of brucellosis and to identify independent predictors of a favorable treatment response. This retrospective observational and analytic study included 171 patients with brucellosis, categorized as acute (n=146) or subacute/chronic (n=25). A therapeutic response was defined as the complete resolution of initial symptoms with no relapse during a 12-month follow-up. A serological response was defined as a ≥4-fold decrease in the serum tube agglutination (STA) titer post-treatment. Outcomes were compared using appropriate statistical tests (p<0.05), and logistic regression was used to identify predictors of response. Compared to the subacute/chronic group, patients with acute brucellosis had a significantly higher frequency of leukopenia (21.2% vs. 0%; p<0.01), elevated C reactive protein (CRP) (76.7% vs. 52.0%; p=0.01), and elevated transaminases (43.8% vs. 20.0%; p=0.025). A significantly higher therapeutic response rate was observed in acute cases (93.2%) compared to subacute/chronic cases (76.0%) (p=0.01). Furthermore, the serological response was also found to be better in the acute group (73.1% vs. 68.8%; p=0.01). Multivariate analysis identified elevated baseline CRP (OR: 4.00; p=0.02) and a post-treatment decrease in STA titer (OR: 5.84; p=0.007) as independent predictors of a favorable therapeutic response. In conclusion, acute brucellosis presents with a more pronounced inflammatory profile than subacute/chronic forms. While patients with acute brucellosis demonstrated a significantly higher therapeutic response rate, the serological response was also more pronounced in this group. Elevated CRP at diagnosis and a significant decrease in STA titer post-treatment are strong, independent predictors of successful outcomes, highlighting their value in patient monitoring.
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