RESUMEN
INTRODUCTION: Aminoglycosides are vital antibiotics for treating Brucella infections, because they interfere with bacterial protein production and are often combined with other antibiotics. They are cost-effective, have fewer side effects, and can penetrate biofilms. The prevalence of brucellosis has increased in recent years, increasing the need for effective treatments. In addition, the emergence of multidrug-resistant Brucella strains has highlighted the need for an updated and comprehensive understanding of aminoglycoside resistance. This systematic review aimed to provide a comprehensive overview of the global prevalence of aminoglycoside resistance in B. melitensis and B. abortus. METHODS: A systematic search of online databases was conducted and eligible studies met certain criteria and were published in English. Quality assessment was performed using the JBI Checklist. A random-effects model was fitted to the data, and meta-regression, subgroup, and outlier/influential analyses were performed. The analysis was performed using R and the metafor package. RESULTS: The results of this systematic review and meta-analysis suggested that the average prevalence rates of streptomycin, gentamicin, and amikacin resistance were 0.027 (95% confidence interval [CI], 0.015-0.049), 0.023 (95% CI, 0.017-0.032), and 0.008 (95% CI, 0.002-0.039), respectively. The prevalence of streptomycin resistance was higher in the unidentified Brucella group than in the B. abortus and B. melitensis groups (0.234, 0.046, and 0.017, respectively; p < 0.02). The prevalence of gentamicin resistance increased over time (r = 0.064; 95% CI, 0.018 to 0.111; p = 0.007). The prevalence of resistance did not correlate with the quality score for any antibiotic. Funnel plots showed a potential asymmetry for streptomycin and gentamicin. These results suggest a low prevalence of antibiotic resistance in the studied populations. CONCLUSION: The prevalence of aminoglycoside resistance in B. melitensis and B. abortus was low. However, gentamicin resistance has increased in recent years. This review provides a comprehensive and updated understanding of aminoglycoside resistance in B. melitensis and B. abortus.
Asunto(s)
Aminoglicósidos , Antibacterianos , Brucella abortus , Brucella melitensis , Brucelosis , Aminoglicósidos/farmacología , Brucella abortus/efectos de los fármacos , Brucella abortus/genética , Brucella abortus/aislamiento & purificación , Antibacterianos/farmacología , Brucelosis/microbiología , Brucelosis/epidemiología , Brucella melitensis/efectos de los fármacos , Brucella melitensis/aislamiento & purificación , Brucella melitensis/genética , Humanos , Prevalencia , Farmacorresistencia Bacteriana , Pruebas de Sensibilidad Microbiana , AnimalesRESUMEN
Brucellosis is a zoonotic disease widespread almost all over the world, representing a significant economic and public health problem. Brucella melitensis, B. suis and B. abortus are considered the most pathogenic species for humans. The most virulent species, B. melitensis is endemic in many parts of the world, particularly the biovar 3 in the Mediterranean and Eastern Europe. Some Latin American countries are seriously affected by biovar 1, especially Mexico, Peru and northern Argentina. Furthermore, while Brazil is considered free of this etiologic agent, one recurrent question is whether this infection really does not occur in Brazil or there is a lack of research/data on the subject. To answer this question, this study aims to investigate the occurrence of antibodies against smooth Brucella in goats and sheep in the states of Sergipe, Paraíba, Ceará and Paraíba. All samples were screened by the Rose Bengal test (RBT). The complement fixation (CFT) and the fluorescence polarization (FPT) tests were used as confirmatory tests. There were no positive samples in the confirmatory tests (both CFT and FPT). We, therefore, conclude that this result reinforces the previous knowledge regarding the exotic status of B. melitensis infection in Brazil.
A brucelose é uma das doenças de caráter zoonótico mais difundidas no mundo, representando um grande problema econômico e de saúde pública. A Brucella melitensis, a B. suis e a B. abortus são consideradas as mais patogênicas espécies para humanos. A espécie apontada como a mais virulenta é a B. melitensis, endêmica em várias partes do mundo, particularmente o biovar 3 na região do Mediterrâneo e na Europa Oriental. Alguns países da América Latina são seriamente afetados pelo biovar 1, especialmente México, Peru e norte da Argentina. O Brasil é considerado livre desse agente etiológico, porém sempre há o questionamento se a infecção não ocorre ou se falta pesquisa. Diante dessa questão, o objetivo deste trabalho foi investigar a ocorrência de anticorpos contra amostras lisas de Brucella em caprinos e ovinos dos estados de Sergipe, Bahia, Ceará e Paraíba. Todas as amostras foram submetidas triagem pelo teste do antígeno acidificado tamponado (AAT). Como testes confirmatórios, utilizou-se a reação de fixação de complemento (RFC) e também o teste de polarização fluorescente (TPF). Nenhuma amostra foi positiva nos testes confirmatórios (RFC e TPF). Esse resultado comprova que a infecção por B. melitensis é exótica no Brasil.
Asunto(s)
Animales , Brucelosis/epidemiología , Cabras/microbiología , Ovinos/microbiología , Brucella melitensis/aislamiento & purificación , Polarización de Fluorescencia/veterinariaRESUMEN
Brucella melitensis is the main cause of human brucellosis worldwide and is considered the most virulent and neurotropic species. In Mexico, this species is considered endemic, being reported since the first decade of the 20th century. Here we present a case of subacute transverse myelitis with the isolation and identification of B. melitensis as the causative agent of Neurobrucellosis in a female patient from the coastal state of Guerrero, Mexico.
Asunto(s)
Brucella melitensis/aislamiento & purificación , Brucelosis/diagnóstico , Mielitis Transversa/diagnóstico , Adulto , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Brucelosis/complicaciones , Brucelosis/tratamiento farmacológico , Ceftriaxona/administración & dosificación , Ceftriaxona/uso terapéutico , Diagnóstico Diferencial , Femenino , Humanos , Infusiones Intravenosas , Mielitis Transversa/complicaciones , Mielitis Transversa/tratamiento farmacológicoRESUMEN
BACKGROUND: Brucellosis is one of the most widespread zoonoses worldwide. It can affect any organ system, particularly the gastrointestinal system, but there is no report of acute liver failure as a brucellosis complication. CASE PRESENTATION: We present a case of acute liver failure secondary to brucellosis infection. A 75-year-old Hispanic man presented to a University Hospital in Chía, Colombia, with a complaint of 15 days of fatigue, weakness, decreased appetite, epigastric abdominal pain, jaundice, and 10 kg weight loss. On examination in an emergency room, abdomen palpation was normal with hepatosplenomegaly and the results of a liver function test were elevated. The diagnosis of brucellosis was confirmed by epidemiological contact and positive Rose Bengal agglutination with negative enzyme-linked immunosorbent assay immunoglobulin M for Brucella. He was then treated with doxycycline plus trimethoprim/sulfamethoxazole, with a favorable clinical outcome. CONCLUSIONS: The clinical presentation of brucellosis can be very imprecise because it can affect any organ system; however, there is no report of acute liver failure as a brucellosis complication. This is the first reported case in the Colombian literature of acute liver failure due to brucellosis. We found this case to be of interest because it could be taken into account for diagnosis in future appearances and we described adequate treatment and actions to be taken at presentation.
Asunto(s)
Brucella melitensis/patogenicidad , Brucelosis/microbiología , Fallo Hepático Agudo/microbiología , Pruebas de Función Hepática , Enfermedades Profesionales/microbiología , Anciano , Crianza de Animales Domésticos , Antibacterianos/uso terapéutico , Brucella melitensis/aislamiento & purificación , Brucelosis/tratamiento farmacológico , Brucelosis/fisiopatología , Colombia , Doxiciclina/uso terapéutico , Ensayo de Inmunoadsorción Enzimática , Humanos , Fallo Hepático Agudo/tratamiento farmacológico , Fallo Hepático Agudo/fisiopatología , Masculino , Rosa Bengala/análogos & derivados , Resultado del Tratamiento , Combinación Trimetoprim y Sulfametoxazol/uso terapéuticoRESUMEN
Caprine brucellosis is a chronic infectious disease caused by the gram-negative cocci-bacillus Brucella melitensis. Middle- to late-term abortion, stillbirths, and the delivery of weak offspring are the characteristic clinical signs of the disease that is associated with an extensive negative impact in a flock's productivity. B. melitensis is also the most virulent Brucella species for humans, responsible for a severely debilitating and disabling illness that results in high morbidity with intermittent fever, chills, sweats, weakness, myalgia, abortion, osteoarticular complications, endocarditis, depression, anorexia, and low mortality. Historical observations indicate that goats have been the hosts of B. melitensis for centuries; but around 1905, the Greek physician Themistokles Zammit was able to build the epidemiological link between "Malta fever" and the consumption of goat milk. While the disease has been successfully managed in most industrialized countries, it remains a significant burden on goat and human health in the Mediterranean region, the Middle East, Central and Southeast Asia (including India and China), sub-Saharan Africa, and certain areas in Latin America, where approximately 3.5 billion people live at risk. In this review, we describe a historical evolution of the disease, highlight the current worldwide distribution, and estimate (by simple formula) the approximate costs of brucellosis outbreaks to meat- and milk-producing farms and the economic losses associated with the disease in humans. Successful control leading to eradication of caprine brucellosis in the developing world will require a coordinated Global One Health approach involving active involvement of human and animal health efforts to enhance public health and improve livestock productivity.
Asunto(s)
Brucella melitensis/aislamiento & purificación , Brucelosis/epidemiología , Brucelosis/veterinaria , Enfermedades de las Cabras/epidemiología , Enfermedades Desatendidas/epidemiología , Enfermedades Desatendidas/veterinaria , Zoonosis/epidemiología , Animales , Control de Enfermedades Transmisibles/métodos , Costo de Enfermedad , Salud Global , Enfermedades de las Cabras/transmisión , Cabras , Humanos , Prevalencia , Salud Pública , Zoonosis/transmisiónRESUMEN
Se realizó un estudio epidemiológico de brucelosis en 516 majadas caprinas o mixtas (caprinos/ovinos) de las 3 regiones agroecológicas de la provincia de Formosa, Argentina. Mediante las pruebas de aglutinación en placa con antígeno tamponado y de fijación del complemento en suero se estudiaron un total de 25.401 caprinos y 2.453 ovinos. Además, se realizaron cultivos bacteriológicos y PCR en muestras de leche de cabras de 3 majadas con brucelosis y abortos recientes. Se detectó brucelosis en 4 de los 9 departamentos de la provincia, la prevalencia global fue del 2 % y la intrapredial varió entre el 1 y el 40%. La proporción de majadas positivas fue del 3,6, el 12 y el 36 % para las regiones este, centro y oeste, respectivamente. Se aisló Brucella melitensis bv. 1 de cabras por primera vez en la provincia. La PCR amplificó fragmentos esperados de 827 pb correspondiente al gen omp2ab (Brucella spp.) y de 731 pb correspondiente al inserto IS711 (B. melitensis). La detección de anticuerpos en ovinos que cohabitan con caprinos sugiere que las infecciones habrían sido causadas por B. melitensis, lo que constituye un riesgo adicional para la salud pública. Los programas de control y erradicación de la brucelosis deberían considerar las majadas mixtas como una sola unidad epidemiológica. Los resultados indican que la brucelosis por B. melitensis bv. 1 es altamente endémica en las regiones centro y oeste de la provincia de Formosa.
An epidemiological study of brucellosis was carried out in 516 goats and mixed flocks (goat/sheep) from the three agro-ecological regions of Formosa province, Argentina. Serum samples from a total of 25401 goats and 2453 sheeps were analyzed using buffered plate agglutination test (BPAT) and complement fixation test (CFT). Bacteriological and PCR analyses on milk samples from goats in three flocks with a history of brucellosis and recent abortions were also performed. Brucellosis was detected in four of the nine departments of the province with an overall prevalence of 2 % and an intra-flock prevalence ranging between 1 % and 40 %. The proportion of infected flocks was 3.6 %, 12 % and 36 % for the eastern, central and western regions, respectively. Brucella melitensis bv. 1 was isolated efrom goats for the first time in the province. The expected fragments of 827 bp from the omp2ab gene (Brucella spp.) and 731 bp from the insert IS711 (B. melitensis) were amplified by PCR. Detection of antibodies by BPAT and FCT in sheep cohabiting with goats suggests that infections could have been caused by B. melitensis, posing an additional risk to public health. Control and eradication programs for brucellosis should consider mixed flocks as a single epidemiological unit. The results indicate that brucellosis by B. melitensis bv1 is highly endemic in the central and western regions of Formosa province.
Asunto(s)
Animales , Femenino , Masculino , Embarazo , Enfermedades de las Ovejas/epidemiología , Brucelosis/veterinaria , Enfermedades de las Cabras/epidemiología , Brucella melitensis/aislamiento & purificación , Argentina/epidemiología , Enfermedades de las Ovejas/microbiología , Enfermedades de las Ovejas/transmisión , Brucelosis/microbiología , Brucelosis/transmisión , Brucelosis/epidemiología , Cabras/microbiología , Ovinos/microbiología , Enfermedades de las Cabras/microbiología , Enfermedades de las Cabras/transmisión , Estudios Seroepidemiológicos , Prevalencia , Técnicas de Tipificación Bacteriana , Brucella melitensis/inmunología , Aborto Veterinario/etiología , Aborto Veterinario/microbiología , Leche/microbiología , Geografía Médica , Crianza de Animales Domésticos/métodos , Anticuerpos Antibacterianos/sangreRESUMEN
An epidemiological study of brucellosis was carried out in 516 goats and mixed flocks (goat/sheep) from the three agro-ecological regions of Formosa province, Argentina. Serum samples from a total of 25401 goats and 2453 sheeps were analyzed using buffered plate agglutination test (BPAT) and complement fixation test (CFT). Bacteriological and PCR analyses on milk samples from goats in three flocks with a history of brucellosis and recent abortions were also performed. Brucellosis was detected in four of the nine departments of the province with an overall prevalence of 2% and an intra-flock prevalence ranging between 1% and 40%. The proportion of infected flocks was 3.6%, 12% and 36% for the eastern, central and western regions, respectively. Brucella melitensis bv. 1 was isolated efrom goats for the first time in the province. The expected fragments of 827bp from the omp2ab gene (Brucella spp.) and 731bp from the insert IS711 (B. melitensis) were amplified by PCR. Detection of antibodies by BPAT and FCT in sheep cohabiting with goats suggests that infections could have been caused by B. melitensis, posing an additional risk to public health. Control and eradication programs for brucellosis should consider mixed flocks as a single epidemiological unit. The results indicate that brucellosis by B. melitensis bv1 is highly endemic in the central and western regions of Formosa province.
Asunto(s)
Brucella melitensis/aislamiento & purificación , Brucelosis/veterinaria , Enfermedades de las Cabras/epidemiología , Enfermedades de las Ovejas/epidemiología , Aborto Veterinario/etiología , Aborto Veterinario/microbiología , Crianza de Animales Domésticos/métodos , Animales , Anticuerpos Antibacterianos/sangre , Argentina/epidemiología , Técnicas de Tipificación Bacteriana , Brucella melitensis/inmunología , Brucelosis/epidemiología , Brucelosis/microbiología , Brucelosis/transmisión , Femenino , Geografía Médica , Enfermedades de las Cabras/microbiología , Enfermedades de las Cabras/transmisión , Cabras/microbiología , Masculino , Leche/microbiología , Embarazo , Prevalencia , Estudios Seroepidemiológicos , Ovinos/microbiología , Enfermedades de las Ovejas/microbiología , Enfermedades de las Ovejas/transmisiónRESUMEN
La brucelosis es un importante problema de salud y, en algunas regiones, es endémica. En ella, es muy frecuente observar un compromiso osteoarticular (20%-60%). En regiones donde es endémica, al analizar la etiología de la artritis, hay que pensar en esta entidad. En este artículo, se informan los casos de 12 pacientes; 11 de ellos eran varones, y la media de edad fue de 12 años (intervalo: de 2 a 17 años). Se determinó el compromiso de la cadera en 9 pacientes; de la articulación sacroilíaca, en 2; y de la rodilla, en 1. Todos los pacientes tenían artralgia; 8 pacientes tuvieron fiebre; y 1 paciente, leucocitosis. A un paciente se lo sometió a un tratamiento quirúrgico debido a artritis séptica. La infección puede derivar en complicaciones graves, especialmente en el compromiso del aparato locomotor. Debe tenerse en cuenta que, mediante el diagnóstico y tratamiento tempranos, es posible prevenir las complicaciones.
Brucellosis is a significant health problem and is endemic in some regions. Osteoarticular involvement is seen most frequently in brucellosis (20-60%). In regions where brucellosis is endemic, it should be considered in the etiology of arthritis. We report the 12 cases, were 11 males with a mean age of 12 years (range, 2-17 years). Involvement was determined in the hip in 9 cases, the sacroiliac joint in 2 and the knee in 1. All the cases had arthralgia, fever was determined in 8 cases and leukocytosis in one case. Surgical treatment was applied to one case because of septic arthritis. Serious complications of the infection may be encountered and particularly in musculoskeletal system involvement, it should be kept in mind that complications can be prevented by early diagnosis and treatment
Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Adolescente , Artritis/microbiología , Articulación Sacroiliaca/fisiopatología , Articulación Sacroiliaca/microbiología , Brucella melitensis/aislamiento & purificación , Articulación de la Cadera/fisiopatología , Articulación de la Cadera/microbiología , Articulación de la Rodilla/fisiopatología , Articulación de la Rodilla/microbiologíaRESUMEN
Brucellosis is a significant health problem and is endemic in some regions. Osteoarticular involvement is seen most frequently in brucellosis (20-60%). In regions where brucellosis is endemic, it should be considered in the etiology of arthritis. We report the 12 cases, were 11 males with a mean age of 12 years (range, 2-17 years). Involvement was determined in the hip in 9 cases, the sacroiliac joint in 2 and the knee in 1. All the cases had arthralgia, fever was determined in 8 cases and leukocytosis in one case. Surgical treatment was applied to one case because of septic arthritis. Serious complications of the infection may be encountered and particularly in musculoskeletal system involvement, it should be kept in mind that complications can be prevented by early diagnosis and treatment.
La brucelosis es un importante problema de salud y, en algunas regiones, es endémica. En ella, es muy frecuente observar un compromiso osteoarticular (20%-60%). En regiones donde es endémica, al analizar la etiología de la artritis, hay que pensar en esta entidad. En este artículo, se informan los casos de 12pacientes; 11 de ellos eran varones, y la media de edad fue de 12 años (intervalo: de 2 a 17 años). Se determinó el compromiso de la cadera en 9 pacientes; de la articulación sacroilíaca, en 2; y de la rodilla, en 1. Todos los pacientes tenían artralgia; 8 pacientes tuvieron fiebre; y 1 paciente, leucocitosis. A un paciente se lo sometió a un tratamiento quirúrgico debido a artritis séptica. La infección puede derivar en complicaciones graves, especialmente en el compromiso del aparato locomotor. Debe tenerse en cuenta que, mediante el diagnóstico y tratamiento tempranos, es posible prevenir las complicaciones
Asunto(s)
Artritis/microbiología , Brucella melitensis/aislamiento & purificación , Adolescente , Niño , Preescolar , Femenino , Articulación de la Cadera/microbiología , Articulación de la Cadera/fisiopatología , Humanos , Articulación de la Rodilla/microbiología , Articulación de la Rodilla/fisiopatología , Masculino , Articulación Sacroiliaca/microbiología , Articulación Sacroiliaca/fisiopatologíaRESUMEN
Brucella is an intracellular pathogen capable of infecting animals and humans. The aim of this study was to identify Brucella spp in sera of high risk individuals by a polymerase chain reaction (PCR)-based method. A total of 180 patients suspected to have Brucellosis were examined by serological tests. To establish a PCR protocol for diagnosis of active brucellosis, DNA was extracted from the serum samples by using a commercial kit. PCR amplification was done for detection of Brocella DNA using BCSP31 target gene and IS711 locus. The PCR assay showed that an amplicon of 223 bp was obtained in 73.8% (133/180) of the tested sera using primers (B4/B5) derived from a gene encoding the 31-kDa Brucella abortus antigen. In another PCR, an amplicon of 498 bp was obtained in 63.8% (115/180) of the samples using Brucella abortus-specific primers derived from a locus adjacent to the 3'-end of IS711, and also an amplicon of 731 bp was produced in 4.4% (8/180) of the tested samples using Brucella melitensis-specific primers. When the Wright method was used as a gold standard, the sensitivity and specificity of the PCR technique for genus identification were found to be 96 and 80.7%, respectively. However, the sensitivity value obtained with the species-specific PCR method was 82%, and specificity was similar to that previous reported. This is the first report of a high frequency of Brucella abortus in patients suspicious of Brucellosis from the Zanjan province.
Asunto(s)
Brucella abortus/aislamiento & purificación , Brucella melitensis/aislamiento & purificación , Brucelosis/diagnóstico , Técnicas de Diagnóstico Molecular/métodos , Reacción en Cadena de la Polimerasa/métodos , Suero/microbiología , Adolescente , Adulto , Anciano , Animales , Antígenos Bacterianos/genética , Proteínas Bacterianas/genética , Brucella abortus/genética , Brucella melitensis/genética , Elementos Transponibles de ADN , ADN Bacteriano/genética , ADN Bacteriano/aislamiento & purificación , Femenino , Humanos , Irán , Masculino , Persona de Mediana Edad , Sensibilidad y Especificidad , Adulto JovenRESUMEN
Brucella is an intracellular pathogen capable of infecting animals and humans. The aim of this study was to identify Brucella spp in sera of high risk individuals by a polymerase chain reaction (PCR)-based method. A total of 180 patients suspected to have Brucellosis were examined by serological tests. To establish a PCR protocol for diagnosis of active brucellosis, DNA was extracted from the serum samples by using a commercial kit. PCR amplification was done for detection of Brocella DNA using BCSP31 target gene and IS711 locus. The PCR assay showed that an amplicon of 223 bp was obtained in 73.8% (133/180) of the tested sera using primers (B4/B5) derived from a gene encoding the 31-kDa Brucella abortus antigen. In another PCR, an amplicon of 498 bp was obtained in 63.8% (115/180) of the samples using Brucella abortus-specific primers derived from a locus adjacent to the 3'-end of IS711, and also an amplicon of 731 bp was produced in 4.4% (8/180) of the tested samples using Brucella melitensis-specific primers. When the Wright method was used as a gold standard, the sensitivity and specificity of the PCR technique for genus identification were found to be 96 and 80.7%, respectively. However, the sensitivity value obtained with the species-specific PCR method was 82%, and specificity was similar to that previous reported. This is the first report of a high frequency of Brucella abortus in patients suspicious of Brucellosis from the Zanjan province.
Asunto(s)
Adolescente , Adulto , Anciano , Animales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Brucella abortus/aislamiento & purificación , Brucella melitensis/aislamiento & purificación , Brucelosis/diagnóstico , Técnicas de Diagnóstico Molecular/métodos , Reacción en Cadena de la Polimerasa/métodos , Suero/microbiología , Antígenos Bacterianos/genética , Proteínas Bacterianas/genética , Brucella abortus/genética , Brucella melitensis/genética , Elementos Transponibles de ADN , ADN Bacteriano/genética , ADN Bacteriano/aislamiento & purificación , Irán , Sensibilidad y EspecificidadRESUMEN
Brucella is an intracellular pathogen capable of infecting animals and humans. The aim of this study was to identify Brucella spp in sera of high risk individuals by a polymerase chain reaction (PCR)-based method. A total of 180 patients suspected to have Brucellosis were examined by serological tests. To establish a PCR protocol for diagnosis of active brucellosis, DNA was extracted from the serum samples by using a commercial kit. PCR amplification was done for detection of Brocella DNA using BCSP31 target gene and IS711 locus. The PCR assay showed that an amplicon of 223 bp was obtained in 73.8% (133/180) of the tested sera using primers (B4/B5) derived from a gene encoding the 31-kDa Brucella abortus antigen. In another PCR, an amplicon of 498 bp was obtained in 63.8% (115/180) of the samples using Brucella abortus-specific primers derived from a locus adjacent to the 3'-end of IS711, and also an amplicon of 731 bp was produced in 4.4% (8/180) of the tested samples using Brucella melitensis-specific primers. When the Wright method was used as a gold standard, the sensitivity and specificity of the PCR technique for genus identification were found to be 96 and 80.7%, respectively. However, the sensitivity value obtained with the species-specific PCR method was 82%, and specificity was similar to that previous reported. This is the first report of a high frequency of Brucella abortus in patients suspicious of Brucellosis from the Zanjan province.
Asunto(s)
Humanos , Animales , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Anciano , Persona de Mediana Edad , Brucella abortus/aislamiento & purificación , Brucella melitensis/aislamiento & purificación , Brucelosis/diagnóstico , Técnicas de Diagnóstico Molecular/métodos , Reacción en Cadena de la Polimerasa/métodos , Suero/microbiología , Antígenos Bacterianos/genética , Proteínas Bacterianas/genética , Brucella abortus/genética , Brucella melitensis/genética , Elementos Transponibles de ADN , ADN Bacteriano/genética , ADN Bacteriano/aislamiento & purificación , Irán , Sensibilidad y EspecificidadRESUMEN
Brucellosis has been reported mainly among pregnant women, and it may lead to spontaneous abortion, intrauterine fetal death, or delivery of an infected neonate. Transmission through breast milk has also been described, but congenital cases are not commonly reported. We present the clinical findings, laboratory studies, treatment, and final outcome of a late prenatal transmission from a mother to her term infant of Brucella melitensis biovar 1. Because the maternal disease was undetected due to lack of clinical suspicion, diagnosis was made possible only by the results of infant blood cultures. Differential diagnosis of fever of unknown origin (FUO) misdiagnosed could result, as in our case, in the administration of inappropriate antimicrobial therapy. Primary health care physicians should be alerted to the clinical and laboratory findings of this infection, and pregnant women should routinely be tested serologically in areas where brucellosis is still a problem.
Asunto(s)
Brucella melitensis/aislamiento & purificación , Brucelosis/transmisión , Transmisión Vertical de Enfermedad Infecciosa , Brucella melitensis/genética , Brucelosis/diagnóstico , Brucelosis/tratamiento farmacológico , Diagnóstico Diferencial , Femenino , Humanos , Recién Nacido , Embarazo , Adulto JovenRESUMEN
Brucella melitensis is highly infectious for humans and can be transmitted to humans in a number of epidemiological contexts. Within the context of an ongoing brucellosis surveillance project, an outbreak at a Peruvian police officer cafeteria was discovered, which led to active surveillance (serology, blood culture) for additional cases among 49 police officers who had also eaten there. The cohort was followed up to 18 months regardless of treatment or symptoms. Active surveillance estimated the attack rate at 26.5% (13 of 49). Blood cultures from four cases were positive; these isolates were indistinguishable using multiple locus variable number tandem repeat analysis. This investigation indicates the importance of case tracking and active surveillance for brucellosis in the context of potential common source exposure. These results provide rationale for public health investigations of brucellosis index cases including the bioterrorism-related dissemination of Brucella.
Asunto(s)
Brucelosis/epidemiología , Brotes de Enfermedades , Enfermedades Transmitidas por los Alimentos/epidemiología , Adulto , Animales , Brucella melitensis/genética , Brucella melitensis/aislamiento & purificación , Brucelosis/microbiología , Queso/microbiología , Trazado de Contacto , Femenino , Microbiología de Alimentos , Cabras/microbiología , Humanos , Masculino , Persona de Mediana Edad , Exposición Profesional , Pasteurización , Perú/epidemiología , Policia , Factores de Tiempo , Adulto JovenRESUMEN
The purpose of this study is to determine the etiology of abortions presented in a goat herd declared as free of brucellosis and vaccinated with RB51 located in Mexico. The serological diagnosis of brucellosis in 33 animals was performed. The study included three goats that aborted in the last third of gestation and 15 goats that gave birth normally; samples of milk and vaginal exudate were subjected to bacteriological study. All animals were negative for serological diagnosis, and isolation of Brucella melitensis was achieved in a single goat from vaginal exudate. However, the particularity is that this goat was negative to the card, indirect ELISA, and radial immunodiffusion tests. Isolation of a field strain was confirmed by biochemical test resistance to rifampicin and PCR. It is concluded that a goat which aborted in the last third of gestation was found spreading B. melitensis through vaginal discharge despite being vaccinated with RB51 and seronegative for brucellosis.
Asunto(s)
Aborto Veterinario/microbiología , Brucelosis/veterinaria , Enfermedades de las Cabras/microbiología , Leche/microbiología , Excreción Vaginal/microbiología , Aborto Veterinario/diagnóstico , Aborto Veterinario/etiología , Aborto Veterinario/inmunología , Animales , Vacuna contra la Brucelosis/inmunología , Brucella melitensis/aislamiento & purificación , Brucelosis/diagnóstico , Brucelosis/etiología , Brucelosis/inmunología , Femenino , Enfermedades de las Cabras/diagnóstico , Enfermedades de las Cabras/etiología , Enfermedades de las Cabras/inmunología , Cabras , México , Reacción en Cadena de la Polimerasa , Polimorfismo de Longitud del Fragmento de Restricción , Pruebas SerológicasAsunto(s)
Brucella melitensis/aislamiento & purificación , Brucelosis/diagnóstico por imagen , Fiebre/etiología , Dolor de la Región Lumbar/etiología , Osteomielitis/diagnóstico por imagen , Absceso del Psoas/diagnóstico por imagen , Antibacterianos/uso terapéutico , Brucelosis/complicaciones , Brucelosis/tratamiento farmacológico , Brucelosis/patología , Femenino , Humanos , Vértebras Lumbares/patología , Persona de Mediana Edad , Osteomielitis/tratamiento farmacológico , Osteomielitis/microbiología , Osteomielitis/patología , Absceso del Psoas/tratamiento farmacológico , Absceso del Psoas/microbiología , Absceso del Psoas/patología , RadiografíaRESUMEN
Consumption of inadequately pasteurized dairy products is the most common means of transmission of brucellosis. This report describes two foodborne outbreaks that occurred in families infected after consumption of fresh home-made cheese bought in different Argentine provinces. High resolution variable number of tandem repeats (VNTR)-based analysis revealed two well-defined groups comprising essentially identical profiles and corresponding to the two different outbreaks. Similar clinical findings in members of the same family could indicate that the differential virulence of different bacterial clones, as indicated by VNTR data, could have influenced the course of the disease. We observed the importance of adequate treatment in early stages of the disease; combination therapy and extended treatment for 6 weeks or longer yielded significantly better results. The risk of the foodborne transmission of this zoonotic disease and disease prevention should be considered.
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Técnicas de Tipificación Bacteriana , Brucella melitensis/genética , Brucelosis/epidemiología , Dermatoglifia del ADN , Brotes de Enfermedades , Salud de la Familia , Repeticiones de Minisatélite , Adolescente , Adulto , Anciano , Animales , Argentina/epidemiología , Brucella melitensis/clasificación , Brucella melitensis/aislamiento & purificación , Brucelosis/microbiología , Brucelosis/patología , Niño , Análisis por Conglomerados , Femenino , Enfermedades Transmitidas por los Alimentos/epidemiología , Genotipo , Humanos , Masculino , Adulto JovenRESUMEN
The multiple-locus variable-number repeat analysis of 90 human Brucella melitensis isolates from a large urban area in central Peru revealed variations at 4 (Bruce07, Bruce09, Bruce18, and Bruce42) out of 16 loci investigated, of which 1 (Bruce42) also is used for species identification. Ten genotypes were identified, separated by the number of Bruce42 repeats into two groups that may have distinct phenotypic characteristics. Whereas genotypes with five or six Bruce42 repeats were cultured mainly from adult patients, genotypes with three Bruce42 repeats were isolated from children and young adolescents as well as from adults. In addition, the isolates with three Bruce42 repeats were obtained more often from patients with splenomegaly (P = 0.02) or hepatomegaly (P = 0.006). An annual variation in the diversity of genotypes was observed, possibly reflecting changes in sources of fresh dairy products, supply routes to city shops and markets, and the movement of infected dairy goat herds.
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Brucella melitensis/clasificación , Brucella melitensis/aislamiento & purificación , Brucelosis/epidemiología , Brucelosis/microbiología , ADN Bacteriano/genética , Polimorfismo Genético , Animales , Técnicas de Tipificación Bacteriana , Brucella melitensis/genética , Análisis por Conglomerados , Dermatoglifia del ADN , Productos Lácteos/microbiología , Genotipo , Cabras/microbiología , Hospitales , Humanos , Repeticiones de Minisatélite , Epidemiología Molecular , Perú/epidemiología , Población UrbanaRESUMEN
We examined the clinical presentation and outcome of Brucellar infections of genitalia and the lower urinary tract through a review of the medical records of 10 cases of male patients with brucellar infections of the genitalia and lower urinary tract. The mean age of the patients with brucellosis was 49.2, (median 52, range 15-77 years). Eleven out of 17 patients were rural residents, 15 reported that they might have consumed unpasteurized dairy products) and four reported occupational exposure. Symptoms onset was acute in almost all cases. Scrotal pain, epidedimal swelling and fever were the most common symptoms. The Wright test was positive in 13 patients, while Brucella sp. was isolated from blood cultures in six cases. Only two patients were found with abnormal liver ultrasonography. All patients underwent treatment with doxycycline and aminoglycoside for seven days and doxycycline alone for two months. Most of them responded to antibiotic therapy with rapid regression of symptoms. One patient failed to respond to therapy and presented necrotizing orchitis, as well as abscesses, which required orchectomy. Brucellar infections of the genitalia and lower urinary tract have no specific clinical presentation; the usual laboratory examination is not sufficient to diagnose this kind of infection, therefore it could easily be misdiagnosed. An analytical medical history (including overall dietary habits and recent consumption of non-pasteurized dairy products) could indicate Brucelosis as would the persistence of symptoms despite a one-week antibiotic treatment. In general, patients afflicted by brucellar epididymoorchitis respond to Brucellosis antibiotic therapy, except for some rare cases that present necrotizing orchitis and require surgical treatment.
Asunto(s)
Adolescente , Adulto , Anciano , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Brucella melitensis/aislamiento & purificación , Brucelosis/diagnóstico , Epididimitis/microbiología , Orquitis/microbiología , Aminoglicósidos/uso terapéutico , Brucelosis/tratamiento farmacológico , Doxiciclina/uso terapéutico , Epididimitis/diagnóstico , Epididimitis/tratamiento farmacológico , Orquitis/diagnóstico , Orquitis/tratamiento farmacológico , Adulto JovenRESUMEN
BACKGROUND: Ocular brucellosis is usually diagnosed by clinical criteria and serological tests. Little is known with regard to the ocular immunology of brucellosis and the use of intraocular diagnostic tests. We report retrospectively the laboratory findings of patients with ocular involvement associated with brucellosis. MATERIALS AND METHODS: Patients with uveitis with no evident etiologic diagnosis were evaluated at the Instituto de Medicina Tropical "Alexander von Humboldt" of the Universidad Peruana Cayetano Heredia and the Hospital Nacional Cayetano Heredia. Patients were tested for brucellosis, tuberculosis, syphilis, toxoplasmosis, toxocariasis, and human T-cell lymphotropic virus-1. Blood and intraocular fluid samples were examined. Patients with a diagnosis of brucellar uveitis were selected as cases and patients with a diagnosis of uveitis of other etiology were included as controls. The Goldmann-Witmer coefficient was determined. RESULTS: Twelve patients with clinical and laboratory findings suggestive of brucellar uveitis were considered as cases. Seven patients with uveitis of other etiology were selected as controls. Four (33.3%) patients with ocular brucellosis had negative ocular agglutinations and eight (66.7%) had positive agglutinations. No control cases had positive agglutinations for Brucella melitensis. The sensitivity of the test was 66.7% and the specificity 100%. Only one patient had a positive culture for B. melitensis in subretinal fluid. The Goldmann-Witmer coefficient was calculated in six cases of brucellosis uveitis and five uveitis controls. It was highly positive in three patients with ocular brucellosis. Tissue samples showed lymphoplasmacytic infiltrates. CONCLUSIONS: Intraocular serological tests could be used to support the diagnosis of ocular brucellosis.