Brucella Antibody Panel

CERNER / EPIC MNEMONIC: MICRO REF
POE DESCRIPTION: MICROBIOLOGY REFERRAL
CPT CODE: 86622 (x2)
TEST INFORMATION: Test includes antibody titers to Brucella abortus.
DAYS PERFORMED: Monday-Friday, 0700-1400
TURNAROUND TIME: 2-5 days
SPECIAL INSTRUCTIONS: Acute and convalescent specimens should be submitted with the convalescent specimen submitted 2-3 weeks after the acute. It is the requesting physician`s responsibility to see that both acute and convalescent specimens are obtained.
CONTAINER TYPE: Red top Vacutainer® tube or SSTTM tube
SPECIMEN REQUIREMENTS: Blood (serum)
REJECTION CRITERIA: Inappropriate specimen container, insufficient specimen volume.
MINIMUM VOLUME: 5 mL blood (1 mL serum)
HANDLING INSTRUCTIONS: Specimen should be transported as soon as possible. When transportation is delayed, refrigerate.
REFERENCE RANGE: IgG <1:160; IgM <1:160
LIMITATIONS OF TEST: Cross reactions can occur with other Brucella species, Yersinia enterocolitica serotype 9, Francisella tularensis, and Vibrio cholerae. Brucella abortus antigen detects infection also caused by B. suis and B. melitensis, but not B. canis.
METHODOLOGY: Indirect fluorescent antibody (IFA)
REFERRAL LABORATORY: Commercial Laboratory
ADDITIONAL INFORMATION: Antibody titers are measured against Brucella abortus ONLY. Brucellosis antibody appears during the second week in acute cases and peaks in 3-6 weeks. Titers > 1:160 are considered positive. Acute disease is manifested by the presence of specific IgM and increasing amounts of IgG antibodies. Elevated concentrations of Brucella specific IgG are seen in patients with chronic brucellosis. IgG titers greater than IgM titers indicate late disease, localized infection, relapse, or chronic infection. Individuals occupationally exposed to the organism can have slightly elevated concentrations of IgG. Successful treatment of brucellosis is indicated by decreasing IgG titers, whereas chronic or partial treatment is indicated by stable elevated IgG titers. Brucella canis antibody testing will no longer be performed since the necessary organism-specific reagents are no longer available.