Brucella Total Determination of the Antibodies Associated To The Brucellosis PRINCIPLE: The Antibodies associated to the infection by Brucellas, in the presence of inactivared bacteria in the suspension, give a visible flocculation. The colour of the suspension facilitates the reading Reagent composition Bacterial Suspension Inactivated Brucella abortus and melitensis Preservatives and Stabilizers According to the present laws the kit does not contain substances classified as dangerous Storage and Stability of Reagents Store the kit at 2 - 8°C. The reagent, is stable until the stated expiration date if stored tightly closed and refrigerated Preparation and Stability of Working solution Bacterial suspension liquid and ready to use Gently mix the suspension before use Bring reagent at Room Temperature before use Samples Fresh serum Serum may be stored at 2 - 8°C for 6 days Safety Precautions For in vitro diagnostic use only Do not pipette by mouth Exercise the normal precautions required for handling laboratory reagents Reagents Tube 1 Saline Solution Sample 900 μl 100 μl Bacterial Suspension TITRE 1: 20 Tube 2 Tube 3 ........ Tube 7 500 μl 500 μl ........ 500 μl 500 μl 500 μl ........ 500 μl from Tube 1 from Tube 2 from Tube 6 discard 500 μl from the Tube 7 500 μl 500 μl 500 μl ........ 500 μl 1: 40 1: 80 ........ Suspension Control 500 μl 500 μl 1: 1280 Gently shake the tubes and incubate at 37°C for 16 /18 hours or at 22°C for 2 days Results and Interpretation After incubation and away from vibrations, it is possible execute a first reading: Presence of a definite coloured button on tube bottom indicates negative test Presence of smooth mat of flocculation on tube bottom indicates positive test A non uniform flocculation on tube - bottom and a button in the middle indicates faint positive test Then shake gently all tubes beginning from Tube 8 (Suspension Control) and in succession 7, 6, 5, 4, 3, 2, 1. Compare each suspension appearance with Tube 8 Negative: Absence of flocculation Positive: Presence of strong flocculation The serum titre will be the highest dilution still giving a flocculation *Qualitative method 1. Place one drop of Positive control (available as Brucel Positive Control) onto the reaction circle of glass slide. 2. Place ~ 80µl of saline onto the next reaction circle of the glass slide. 3. Place ~ 80µl of patient serum to be tested onto the next reaction circle. 4. Add one drop of the appropriate Brucel antigen suspensions in each of the above circle. (Containing positive control, saline, and the patient serum to be tested.) 5. Mix Contents of each circle uniformly over the entire circle with separate mixing sticks. 6. Gently rock the slide back and forth, observe for agglutination macroscopically, at one minute against white background. *Semi-quantitative method 1. Using a pipette place 80µl, 40µl, 20µl, 10µl, and 5µl of patient serum to be tested on 5 different circles on the glass slide. The corresponding titres obtained will be 1:20, 1:40, 1:80,1:160 and 1:320 respectively. 2. Place one drop of appropriate Brucel antigen suspension to each circle. 3. Mix contents of each circle uniformly over the entire circle with separate mixing sticks. 4. Gently rock the slide back and forth, observe for agglutination macroscopically at one minute against a white background. Reference values It is appropriate to consider: Negative Titres till to 1: 40 Dubious Titres from 1: 80 to 1:160 Positive Titres over 1: 320 A significant increase of the titre, in subsequent days, indicates infection Performance Characteristics A. SENSIBILITY In presence of elevated titres of antibodies, could occur a prozone effect with absence of flocculation at lowest dilutions and presence of flocculation at higher dilutions B. SPECIFICITY Comparison between this method and another commercial one, utilizing 50 samples, showed a specificity of 100 % BioScope Another Method *Procedure Prepare 7 serum dilutions as follows: Brucella abortus + Brucella melitensis + Brucella abortus and + melitensis TOTAL + 12 7 2 0 0 0 TOTAL 12 7 2 0 21 29 29 29 50 Note A final diagnosis should not be made on the basis of a single test result but should be correlated with other tests and clinical data For in vitro diagnostic use only. The following symbols are used on labels For in vitro diagnostic use Use by (last day of the month) Temperature limitation