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Fundamentos: La brucelosis es una zoonosis presente en Cuba. Su prevención es posible mediante la aplicación de estrategias de intervención encaminadas a cambiar las conductas que predisponen para la adquisición de la infección. Con la finalidad de aportar información a médicos de asistencia y decisores de salud, en esta investigación se analizan aspectos clínicos y epidemiológicos de casos notificados con brucelosis humana en tres provincias cubanas que se ubican en las regiones del occidente, centro y oriente del país. Métodos: Se realizó un estudio retrospectivo y descriptivo entre enero de 2013 y junio de 2016. Se analizaron 65 encuestas clínico-epidemiológicas de casos notificados con brucelosis humana, procedentes de tres provincias cubanas. Las variables que se exploraron fueron: edad, sexo, síntomas clínicos, ocupación, contacto directo con reservorios animales, consumo de lácteos no pasteurizados e ingestión de carne semicruda; para su análisis se utilizaron medidas de estadística descriptiva como frecuencias absolutas y porcentajes. Resultados: Entre los individuos notificados con brucelosis humana sobresalió el sexo masculino (66 por ciento), las edades entre 25 y 54 años (66,1 por ciento), el contacto directo con reservorios animales de Brucella spp. (78,5 por ciento) y, como síntomas predominantes, el malestar general (58,5 por ciento), los dolores articulares (56,9 por ciento) y la fiebre (55,4 por ciento). Conclusión: Las variables clínico-epidemiológicas descritas muestran comportamientos similares a los reportados en periodos anteriores en Cuba y en otros países donde la enfermedad es endémica, lo que sugiere la necesidad de incrementar las estrategias para la prevención, vigilancia y control de la brucelosis humana en Cuba(AU)
Introduction: Brucellosis is a zoonosis in Cuba. Preventing this disease is possible through intervention strategies aimed at changing predisposing behaviors to the infection. This research analyzes clinical and epidemiological aspects of reported cases of human brucellosis in three Cuban provinces located in the western, central, and eastern regions of the country to provide information to medical doctors and health decision-makers. Methods: A retrospective, descriptive study was conducted between January 2013 and June 2016. The clinical-epidemiological surveys of 65 reported cases of human brucellosis from three Cuban provinces were analyzed. The variables studied were: age, sex, symptoms, occupation, direct contact with animal reservoirs, and consumption of unpasteurized dairy products or half-cooked meat. Descriptive statistical measures such as absolute frequency and percentage were used for the analysis. Results: Male sex (66 percent), age between 25 and 54 years (66.1 percent), and direct contact with animal reservoirs of Brucella spp. (78.5 percent) prevailed among the individuals reported with human brucellosis. General malaise (58.5 percent), joint pain (56.9 percent), and fever (55.4 percent) were the prevailing symptoms. Conclusion: The outcomes of the clinical-epidemiological variables described were similar to those previously reported in Cuba and in other countries where the disease is endemic. It suggests the need to increase the strategies for the prevention, surveillance and control of human brucellosis in Cuba(AU)
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INTRODUCCIÓN: La brucelosis humana es un problema zoo-sanitario global. México es uno de los principales países que se ven afectados, el diagnóstico oportuno y las pruebas serológicas confirmatorias son la base para la detección. OBJETIVO: Conocer la frecuencia de casos confirmados de brucelosis en diferentes Unidades de Medicina Familiar del Instituto Mexicano del Seguro Social en el estado de Puebla, México. PACIENTES Y MÉTODOS: Estudio transversal en pacientes de ambos sexos, adultos y pediátricos, con manifestaciones clínicas sugestivas de brucelosis; se realizaron pruebas serológicas para el diagnóstico confirmatorio. RESULTADOS: De un total de 77 pacientes, se obtuvieron 39 (50,6%) casos positivos, 21 (27,3%) casos saliendo de la infección, 9 (11,7%) negativos y 8 (10,4%) con memoria inmunológica; de los casos positivos, 32 (82,1%) eran adultos y 30 (76,9%) fueron del género femenino. CONCLUSIÓN: Del total de muestras, la mitad tuvo diagnóstico de brucelosis, las manifestaciones clínicas de los pacientes estudiados fueron inespecíficas, lo cual resalta la importancia del diagnóstico de laboratorio.
BACKGROUND: Human brucellosis is a global health problem. Mexico is one of the main countries affected; timely diagnosis and serological tests are the basis for detection. AIM: To know the frequency of confirmed cases of brucellosis in different of Family Medicine Units of the Mexican Social Security Institute in the state of Puebla, Mexico. METHODS: Cross-sectional study in patients of both genders, adults and pediatrics, with clinical manifestations suggestive of brucellosis; serological tests were performed for the confirmatory diagnosis. RESULTS: Out of a total of 77 patients, 39 (50.6%) were positive, 21 (27.3%) cases coming out of infection, 9 (11.7%) were negative and 8 (10.4%) were defined with immunological memory; of positive cases, 32 (82.1%) were found in the adult group and 30 (76.9%) were female. CONCLUSION: Around half of samples were confirmed as brucellosis, the clinical manifestations of the patients studied were non-specific, which highlights the importance of laboratory diagnosis.
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Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Brucella , Brucelose/diagnóstico , Brucelose/epidemiologia , Testes Sorológicos , Estudos Transversais , México/epidemiologiaRESUMO
Resumen En este trabajo reportamos un caso de brucelosis humana ocasionada por Brucella suis en una persona que trabajaba en un establecimiento de producción porcina en pequeña escala. La granja no tenía antecedentes de la enfermedad y los animales no registraban signos clínicos al ser examinados. Se obtuvieron muestras de suero de todos los padrillos (n=3), de 16/22 chanchas y 9/25 cachorras y se analizaron mediante las técnicas de aglutinación rápida en placa con antígeno tamponado (BPA) y Rosa de Bengala (RB) y Polarización de la Fluorescencia (FPA). Muestras de tejido de un padrillo y de una hembra serológicamente positivos fueron analizadas por cultivo bacteriológico y por la técnica de Inmunofluorescencia Directa (IFD). Se detectaron anticuerpos específicos en el 53% de los cerdos adultos (10/19), mientras que todas las cachorras fueron seronegativas. Se aisló B. suis biovar 1 de un padrillo. En contraste, la bacteria no fue aislada en ninguno de los tejidos de la cerda seropositiva aunque sí se detectó la bacteria mediante IFD. A partir de los datos bacteriológicos y serológicos se evidencia la presencia de una infección endémica por B. suis. Asimismo, teniendo en cuenta la falta de medidas de prevención y de bioseguridad se concluye que la persona probablemente adquirió la enfermedad por contacto directo con los animales infectados o con el ambiente contaminado con la bacteria.
Abstract Here we report a case of human brucellosis due to Brucella suis in a person who worked in a small-scale pig farm. The farm had no history of clinical brucellosis, and signs of the disease were not observed upon clinical examination of the animals. Serum from all the 3 boars, 16/22 sows and 9/25 gilts was obtained for serological examination by Buffered Plate Agglutination Test (BPAT), Rose Bengal Test (RBT) and Fluorescent Polarization Assay (FPA). Bacteriological culture and Direct Fluorescence Antibody Test (DFAT) were performed in tissue samples from a seropositive boar and a sow. Specific antibodies were detected in 53 % (10/19) adult pigs, while all sampled gilts were seronegative. B. suis biovar 1 was isolated from one boar. In contrast, while the bacterium was not isolated from any tissue from a seropositive sow, it was detected by DFAT. From the bacteriological and serological evidence of B. suis endemic infection in the pig farm and the lack of preventive measures and biosecurity practices, it is concluded that the person most likely acquired the disease from the infected animals or by contact with contaminated environment in the farm.
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Resumen La brucelosis, principal zoonosis a nivel mundial tiene alta prevalencia en varios países de Latinoamérica. Se asocia con la exposición a ganado infectado por distintas especies del género Brucella. B. melitensis la más virulenta para el humano, causa con frecuencia complicaciones de predominio osteoarticular. En Colombia se cree que la infección por B. melitensis es una entidad ausente, a pesar de su plausibilidad biológica en nuestro contexto; sin embargo, son escasos los estudios sobre su ocurrencia y mínimo el índice de sospecha de la enfermedad, por lo cual creemos está subdiagnosticada. Presentamos el primer caso confirmado de brucelosis por B. melitensis en Colombia en una joven embarazada, con diagnóstico incidental, en quien el análisis retrospectivo de su cuadro clínico alertó sobre puntos clave que pueden impactar en el diagnóstico y tratamiento oportuno de la enfermedad. Se plantean preguntas de prevalencia real de esta entidad en Colombia.
Summary Brucellosis, the principal zoonoses globally is highly prevalent in different countries of Latin America. It is associated with the exposition of livestock infected with different Brucella species, being B. melitensis the most virulent for humans, and frequently causing osteoarticular complications. In Colombia it is believed that B. melitensis infection is an absent entity, despite its biological plausibility in our context; however, there are few studies on its occurrence and a minimum index of suspicion of the disease, which is why we believe it is underdiagnosed. We present the first confirmed case of brucellosis by B. melitensis in Colombia diagnosed in a young pregnant patient, with an incidental diagnosis, in whom a retrospective analysis of her clinical outcome warned of key points that may impact on the diagnosis and timely treatment of the disease. We present several questions surrounding the real prevalence of this entity in Colombia.
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Humanos , Feminino , Gravidez , Adolescente , Brucelose , Zoonoses , Brucella melitensis , Brucella , Etnicidade , Colômbia , Gado , InfecçõesRESUMO
La brucelosis es una zoonosis que en humanos está relacionada íntimamente con la enfermedad en animales domésticos y de interés económico. Presenta 2 patrones: urbano-alimentario (consumo de leche y quesos no pasteurizados) y el rural-laboral (exposición profesional al ganado infectado). El objetivo consistió en conocer las características epidemiológicas y las técnicas que arriban al diagnóstico de Brucelosis, en un consultorio del Instituto de Medicina Tropical, del 2017 al 2019. Se realizó un estudio de tipo descriptivo y corte transverso. Se realizó el análisis de 44 pacientes con diagnóstico de Brucelosis. El 25 % de los pacientes requirieron internación. El rango de edad estuvo entre 7 a 61 años, con una media de 29 años, y una moda de 22. Las puertas de entrada fueron: por contacto con cabras positivas en el campo de práctica, faenadores, veterinarios, vacunadores, y por ingesta de leche sin pasteurizar. Las muestras serológicas por reacción de Huddleson fueron positivas a bajas diluciones; Aglutinación en tubo: 31 muestras positivas; aglutinación con 2 mercaptoetanol: 11 muestras positivas. Se llegó a la identificación de cepas Brucella melitensis biotipo 1: en 13 pacientes. Nuestro estudio indica la presencia de brucelosis humana, fundamentalmente por contacto directo debido a razones profesionales y /o laborales. La vigencia de Brucelosis deriva de una situación endémica en el ganado, y por tanto se deberán intensificar las medidas del saneamiento del ganado (vacunación) y la educación de la población de riesgo.
Brucellosis is a zoonosis in humans that is closely related to the disease in domestic and of economic interest- animals. It presents 2 main patterns: urban-alimentary (for consumption of unpasteurized milk and cheeses) and the rural-occupational (for professional exposure to infected cattle). The objective was to know the frequency of cases and the different laboratory techniques that arrives to the diagnosis of Brucellosis, in the Tropical Medicine Institute (IMT by its acronym in Spanish) during the period of 2017 to 2019. It has been made a descriptive and cross-sectional investigation. It was based on the analysis of 44 patients diagnosed with Brucellosis. 25% of the patients (11) required hospitalization. The age range was between 7 to 61 years, with a mean of 29 years old and a mode of 22. The portals of entry were: by contact with positive goats in the field of practice, slaughterhouses, veterinarians, vaccinators, and consume of unpasteurized milk. The serological samples by Huddleson reaction were positive with low dilutions; tube agglutination: 31 positive samples; agglutination with 2 mercaptoethanol: 11 positive samples. Biotype 1 of Brucella melitensis: identified in 13 patients. Our study indicates the existence of human brucellosis, mainly through direct contact due to professional and/or occupational reasons. This incidence must derive from an endemic situation in cattle, and therefore the measures of sanitation of cattle (vaccination) and education of the population at risk should be intensified
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Brucelose/epidemiologiaRESUMO
Introducción: En el diagnóstico microbiológico de la brucelosis, los métodos serológicos son los más utilizados. Brucellacapt® ofrece la ventaja de detectar en cualquier momento de la enfermedad anticuerpos aglutinantes y no aglutinantes contra Brucellaspp. Objetivos: Evaluar y aplicar el sistema serológico comercial Brucellacapt® para la detección de anticuerpos contra Brucella spp. Métodos: Se realizó una investigación en servicios y sistemas de tipo observacional con un estudio de caso control anidado, en el periodo de enero de 2015 a junio de 2016, en el Laboratorio Nacional de Referencia de Espiroquetas y Brucelas. Se evaluaron 50 sueros de casos y 100 de controles por Brucellacapt®. Se aplicó Brucellacapt® en 695 sueros de casos con sospecha clínica o epidemiológica de la enfermedad, los cuales fueron confirmados por ELISA. Resultados: Brucellacapt® mostró 100 por ciento de sensibilidad, 83 por ciento de especificidad, 54,6 por ciento de reactividad y 16,4 por ciento de positividad en las muestras estudiadas. Se confirmó por ELISA la presencia de anticuerpos IgM (21, 2 por ciento), IgG (6,1 por ciento) e IgM + IgG (7,6 por ciento). Doscientas cuarenta y seis muestras y otras siete fueron reactivas y positivas respectivamente, solo por Brucellacapt®. Conclusiones: Brucellacapt® contribuyó a la detección de anticuerpos en los sueros de pacientes sospechosos de la enfermedad con valores aceptables de sensibilidad y especificidad diagnóstica. Este resultado sugiere su implementación en la red nacional de laboratorios cubanos para fortalecer el diagnóstico y la vigilancia de la brucelosis humana en Cuba(AU)
Introduction: Serological methods are the most commonly used for the microbiological diagnosis of brucellosis. Brucellacapt® has the advantage of detecting agglutinating and non-agglutinating antibodies against Brucella spp. at any point in the evolution of the disease. Objectives: Evaluate and apply the commercially available serological system Brucellacapt® for detection of antibodies against Brucella spp. Methods: A nested case-control observational study was conducted of services and systems from January 2015 to June 2016 at the Spirochaete and Brucella National Reference Laboratory. Evaluation was performed of 50 serum samples from cases and 100 from controls using Brucellacapt®. The system was also used in 695 serum samples from clinically or epidemiologically suspected cases, which were confirmed by ELISA. Results: Brucellacapt® showed 100 percent sensitivity, 83 percent specificity, 54.6 percent reactivity and 16.4 percent positivity in the samples studied. Presence of the following antibodies was confirmed by ELISA: IgM (21.2 percent), IgG (6.1 percent) and IgM + IgG (7.6 percent). Two hundred forty-six samples and another seven were reactive and positive, respectively, only by Brucellacapt®. Conclusions: Brucellacapt® contributed to antibody detection in serum samples from suspected cases, with acceptable diagnostic sensitivity and specificity values. This result suggests its implementation in the Cuban national network of laboratories to strengthen the diagnosis and surveillance of human brucellosis in Cuba(AU)
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Humanos , Brucelose/diagnóstico , Testes Sorológicos/métodos , Ensaio de Imunoadsorção Enzimática/métodos , CubaRESUMO
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.
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Brucella abortus/isolamento & purificação , Brucella melitensis/isolamento & purificação , Brucelose/diagnóstico , Técnicas de Diagnóstico Molecular/métodos , Reação em Cadeia da Polimerase/métodos , Soro/microbiologia , Adolescente , Adulto , Idoso , Animais , Antígenos de Bactérias/genética , Proteínas de Bactérias/genética , Brucella abortus/genética , Brucella melitensis/genética , Elementos de DNA Transponíveis , DNA Bacteriano/genética , DNA Bacteriano/isolamento & purificação , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Adulto JovemRESUMO
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.
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Humanos , Animais , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Idoso , Pessoa de Meia-Idade , Brucella abortus/isolamento & purificação , Brucella melitensis/isolamento & purificação , Brucelose/diagnóstico , Técnicas de Diagnóstico Molecular/métodos , Reação em Cadeia da Polimerase/métodos , Soro/microbiologia , Antígenos de Bactérias/genética , Proteínas de Bactérias/genética , Brucella abortus/genética , Brucella melitensis/genética , Elementos de DNA Transponíveis , DNA Bacteriano/genética , DNA Bacteriano/isolamento & purificação , Irã (Geográfico) , Sensibilidade e EspecificidadeRESUMO
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.
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Adolescente , Adulto , Idoso , Animais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Brucella abortus/isolamento & purificação , Brucella melitensis/isolamento & purificação , Brucelose/diagnóstico , Técnicas de Diagnóstico Molecular/métodos , Reação em Cadeia da Polimerase/métodos , Soro/microbiologia , Antígenos de Bactérias/genética , Proteínas de Bactérias/genética , Brucella abortus/genética , Brucella melitensis/genética , Elementos de DNA Transponíveis , DNA Bacteriano/genética , DNA Bacteriano/isolamento & purificação , Irã (Geográfico) , Sensibilidade e EspecificidadeRESUMO
Background: Brucellosis is a zoonosis whose economical impact in endemic countries is significant. Its magnitude for humans has been scarcely measured in Chile, therefore brucellosis was declared a reportable disease since 2004. Objective: To characterize the epidemiology of human brucellosis in Chile.Material: Data sources were the Obligatory Disease Notification System (ODNS), the National Reference Laboratory for brucellosis, hospital discharges and deaths statistics. Results: The average incidence, according to the ODNS was 0.55 cases per 100.000 inhabitants (men 67.8%, median age 44 years). Hospital discharges rate of brucellosis during this period were 0.43 per 100.000 inhabitants. The major diagnosis (84.3%) was A23.9 (Brucellosis unspecified). Two patients died (mortality rate for the period 0.01 deaths per 100 000 inhabitants), their education level was basic. Conclusions: The incidence rates of cases reported, hospital discharges and mortality tend to decrease. The discrepancy between reported cases and clinical/laboratory diagnosis suggests underreporting. It is necessary to improve the notification system and to optimize laboratory confirmation by the National Reference Laboratory.
Introducción: La brucelosis es una zoonosis con importante impacto económico en las naciones donde es endémica. En Chile su magnitud en medicina humana es poco conocida, de allí que fuera declarada una enfermedad de notificación obligatoria en el año 2004. Objetivo: Caracterizar epidemiológicamente la brucelosis humana en Chile. Material: Se utilizaron datos del Sistema de Notificación Obligatoria, diagnóstico de laboratorio del Instituto de Salud Pública (ISP), egresos hospitalarios y defunciones. Resultados: La incidencia promedio, según las notificaciones obligatorias fue 0,55 casos por 100 mil habs., (hombres 67,8%, edad mediana 44 años). Los egresos hospitalarios presentaron una tasa promedio de 0,43 egresos por 100 mil habts. El diagnóstico mayormente anotado (84,3%) fue A23.9 (brucelosis, no especificada). La tasa de mortalidad para el período fue de 0,01 defunciones por 100 mil habts., (dos casos). El nivel de instrucción de los fallecidos fue básico. Conclusiones: Las tasas de incidencia de casos notificados, egresos hospitalarios y mortalidad tienden a disminuir. Llama la atención la inconsistencia entre los casos notificados y los aislamientos reportados por el ISP, laboratorio nacional de referencia en esta materia, lo cual sugiere sub-notificación. Es necesario potenciar el sistema de vigilancia caso a caso y optimizar su confirmación por el laboratorio nacional de referencia.
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Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Brucelose/epidemiologia , Chile/epidemiologia , Notificação de Doenças , Incidência , Distribuição por SexoRESUMO
Seventeen workers in a pig slaughterhouse with signs and symptoms compatible with brucellosis were clinically examined at the outpatient service of different health institutions and studied by serological tests during the period 2005-2011. Eleven blood cultures were taken and six Brucella suis strains were isolated, three biovar 1 and three with atypical characteristics. In order to confirm that these cases had no common source, a variable number of tandem repeat (VNTR) analyses were performed on 5 of the 6 strains whose results showed substantial heterogeneity in the genotypes, thereby demonstrating that the immediate origin was not the same. Two hundred adult pigs admitted for slaughter at the plant were sampled by convenience and tested by buffered antigen plate test (BPAT), serum agglutination test (SAT) and 2-mercapto-ethanol test (MET). Seven of 62 males (11%) and 25/138 (18%) females tested positive. The study results contribute information on risk scenarios for packing plant workers and underscore the need to improve plant workers' education on appropriate containment measures and to actively screen animals for swine brucellosis.
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Brucella suis , Brucelose/diagnóstico , Brucelose/transmissão , Adulto , Animais , Brucella suis/classificação , Brucella suis/genética , Brucella suis/isolamento & purificação , Brucelose/microbiologia , DNA Bacteriano , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Repetições Minissatélites/genética , Tipagem Molecular , Filogenia , Suínos , Doenças dos Suínos/diagnóstico , Doenças dos Suínos/microbiologia , Adulto JovemRESUMO
A objeto de mostrar el desarrollo y alcance de un método de análisis serológico basado en la técnica de fluorescencia polarizada (FPA) a partir de una gota de sangre obtenida mediante punción capilar, se realizó la determinación de anticuerpos antibrucelosis de un conjunto de 321 personas de alto riesgo laboral. Los resultados se compararon con la data proveniente del análisis de sueros sanguíneos mediante FPA e inmunoanálisis enzimático competitivo (ELISA-c). El número de concordantes fue 318 (99,06%), los 3 discordantes (0,93%) resultaron negativos con fluorescencia polarizada en suero (FPAs) y ELISA-c, pero positivos con FPA capilar (FPAc). Los resultados comparativos de FPAc fueron: sensibilidad: 100%; especificidad: 99,05%; valor predictivo positivo: 66,67%; valor predictivo negativo: 100,0%; proporción de falsos positivos: 0,95%; proporción de falsos negativos: 0%; exactitud: 98,0%; razón de probabilidades: 203,00. La J de Youden para ambos métodos de FPA fue de 0,667. La determinación se consideró confiable y la concordancia de ambos procedimientos de FPA y ELISA-c resultó sin diferencias estadísticas (P>0,05%), lo que permite recomendar ampliamente la implementación del estudio de la brucelosis humana con sangre proveniente de punción capilar como método preliminar.
In order to show the development and scope of a serological analysis method based on fluorescence polarization assay (FPA) from a drop of blood obtained by the capillary technique, a Brucella antibody assay was performed on a group of 321 high-risk workers. The results were compared with data from the analysis of blood serum by FPA and a competitive enzyme immunoassay (ELISA-c). The number of concordance was 318 (99.06%), and discordant 3 (0.93%), which were negative in serum by fluorescence polarization (FPAs) and ELISA-c, but positive with capillary FPA (FPAc). The comparative results FPAc were: sensitivity 100%; specificity: 99.05%; positive predictive value 66.67%; negative predictive value 100.0%; false positive rate: 0.95%; false negative rate: 0%; accuracy: 98.0%; odds ratio: 203.00. The youden J for both FPA methods was 0.667. The identification was considered reliable and the correlation of both procedures, FPA and ELISA-c, was no statistically different (P> 0.05%), which allows to highly recommend the study implementation of human brucellosis with capillary blood as a preliminary method.
Assuntos
Adulto , Humanos , Anticorpos Antibacterianos/sangue , Brucella/imunologia , Imunoensaio de Fluorescência por Polarização/métodos , Matadouros , Criação de Animais Domésticos , Brucelose/imunologia , Ensaio de Imunoadsorção Enzimática , Reações Falso-Negativas , Reações Falso-Positivas , Exposição Ocupacional , Valor Preditivo dos Testes , Risco , Sensibilidade e Especificidade , Medicina VeterináriaRESUMO
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.
Assuntos
Adolescente , Adulto , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Brucella melitensis/isolamento & purificação , Brucelose/diagnóstico , Epididimite/microbiologia , Orquite/microbiologia , Aminoglicosídeos/uso terapêutico , Brucelose/tratamento farmacológico , Doxiciclina/uso terapêutico , Epididimite/diagnóstico , Epididimite/tratamento farmacológico , Orquite/diagnóstico , Orquite/tratamento farmacológico , Adulto JovemRESUMO
ABSTRACT The objective of this study was to investigate the presence of anti-Brucella abortus antibodies in occupational groups involved in cattle raising in Correntes County, Pernambuco State, Brazil, evaluating the risk factors associated with the infection in humans, and estimating the prevalence in dairy cattle. In order to do so, 1089 samples from adult bovines and from 56 humans were collected and examined by the tampon acidified antigen (TAA) test. The samples were subjected to slow serum agglutination (SSA) and to 2-mercaptoethanol (2-ME) and, when positive by one or both techniques, for any titer, were examined by the complement fixation (CF) technique. Additionally, people who were subjected to blood collection were asked to answer an investigative questionnaire. The prevalence for the bovines was 6.8% (74/1.089) obtained through the SSA and 2-ME, and in humans it was 1.8% (1/56) by TAA. In the SSA, 21.4% (12/56) of the human samples were positive, with, however, no samples positive by 2-ME (0% 0/12) or by CF (0% 0/12). The studied risk factors: intake of raw milk and its byproducts, contact with secretion, meat manipulation, glove utilization and iatrogenic transmission in the handling of the B19 vaccine, were not analyzed statistically, because no individual was detected positive by the complement fixation test. The results of this study suggest that the population of the rural zone in Correntes County is exposed to infection by Brucella abortus, although it is not possible to infer the existence of intercurrence between the bovine and human infection. Nevertheless, greater vigilance by the health authorities must be implemented.
RESUMO Objetivou-se com este estudo investigar a presença de anticorpos anti-Brucella abortus em grupos ocupacionais envolvidos com a criação de bovinos no Município de Correntes, Estado de Pernambuco, avaliando-se os fatores de risco associados à infecção em humanos, e estimar a prevalência em rebanhos bovinos leiteiros. Para tanto, foram colhidas 1.089 amostras de bovinos adultos e de 56 pessoas e examinadas pelo teste do antígeno acidificado tamponado (AAT). As amostras humanas foram submetidas à soroaglutinação lenta em tubos (SAL) e ao 2-mercaptoetanol (2-ME) e, quando reagentes a uma ou ambas as técnicas, para qualquer título, foram examinadas pela técnica de fixação do complemento (FC). Adicionalmente, pessoas submetidas à colheita de sangue foram solicitadas a responder um questionário investigativo. A prevalência para bovinos foi de 6,8% (74/1.089) obtidas através da SAL e 2-ME, e em humanos de 1,8% (1/56) ao AAT. Na SAL foi observada positividade em 21,4% (12/56) das amostras humanas, não havendo, entretanto, amostras reagentes ao 2-ME (0% 0/12) e ao FC (0% 0/12). Os fatores de risco estudados: consumo de leite cru e seus derivados, contato com secreções, manipulação de carnes, uso de luvas e transmissão iatrogênica na manipulação de vacina B19 não foram analisados estatisticamente, pois não se detectou nenhum indivíduo positivo ao teste de fixação do complemento. Os resultados deste estudo sugerem que a população da zona rural do Município de Correntes, PE, encontra-se exposta à infecção por B. abortus, embora não se possa inferir a existência de intercorrência entre a infecção bovina e a humana. De qualquer forma uma vigilância maior por parte das autoridades sanitárias deve ser implementada.
RESUMO
Prevalence of serum antibodies for the bacterium Brucella sp. in a tropical human population. Brucellosis is a systemic bacterial disease that can last years if not treated properly. The laboratory diagnosis is made by serological tests or isolation of the agent. We studied the prevalence of antibodies against Brucella sp. in inhabitants of rural communities of Cartago, Costa Rica, who are dedicated mainly to dairy cattle activities. We analyzed 714 representative samples with the Rose Bengal plate agglutination test (RBT) and the standard agglutination test in microplate (SAT). The overall prevalence was 0.87 %. No seroconversion was demonstrated for seropositive individuals. Even though 71 % of the population mentioned consuming non-pasteurized milk, no statistically significant association was found (1.09 %, IC 0.30-2.77) between milk consumption and the presence of antibodies suggestive of infection by Brucella sp. As a brucellosis high-risk population, the absence of symptoms in the population agrees with the observed titers of antibodies, suggesting a low previous exposure to the agent. Rev. Biol. Trop. 55 (2): 385-391. Epub 2007 June, 29.
La brucelosis es una enfermedad bacteriana generalizada con tendencia a la cronicidad si no se trata adecuadamente. El diagnóstico de laboratorio se realiza por el aislamiento e identificación del agente o en la mayoría de los casos mediante pruebas serológicas. En este estudio se informa la prevalencia de anticuerpos séricos contra Brucella sp. en habitantes de comunidades rurales de Cartago dedicadas principalmente a la ganadería de leche. Se analizó un total de 714 muestras representativas de la población mediante la técnica de aglutinación Rosa de Bengala en lámina (RBT) y la prueba de aglutinación en microplaca (SAT). Se encontró una prevalencia de 0.87 %, y en ninguna persona seropositiva se demostró seroconversión. Aún, cuando el 71 % de la población refirió consumir leche no pasteurizada, no se encontró asociación estadísticamente significativa (1.09 %, IC 0.30-2.77) entre el consumo de leche no pasteurizada y la presencia de anticuerpos sugestivos de infección por Brucella sp. A pesar de ser una zona de alta prevalencia de brucelosis bovina por Brucella abortus, la ausencia de síntomas en la población y los bajos títulos de anticuerpos observados sugieren una escasa exposición previa al agente.
Assuntos
Adolescente , Adulto , Idoso , Animais , Bovinos , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Anticorpos Antibacterianos/sangue , Brucella/imunologia , Brucelose/epidemiologia , Testes de Aglutinação , Brucelose/diagnóstico , Costa Rica/epidemiologia , Métodos Epidemiológicos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , População RuralRESUMO
Introducción: la brucelosis es una zoonosis, que causa grandes pérdidas económicas en las zonas conurbanas de la Ciudad de México y es un problema importante de salud pública en los habitantes circunvecinos al Distrito Federal. El objetivo fue detectar anticuerpos anti-Brucella y según los resultados que proporcionó esta investigación, se propone como prueba de laboratorio de escrutinio en los donadores de sangre. Material y métodos: se analizaron 500 sueros sanguíneos de disponentes efectivos seleccionados y cuya muestra fue representativa de acuerdo al análisis estadístico elaborado. Las pruebas de laboratorio incluyeron Rosa de Bengala, Aglutinación Estándar en Microplaca y 2 Mercaptoetanol. Resultados: de los 500 sueros analizados 18 mostraron seropositividad con una tasa de seroprevalencia de 3.6%, predominando el sexo masculino (83.4%), por grupo de actividad las secundarias (72.2%), por grado de estudios académicos los de secundaria fueron los de mayor positividad (55.6%). Conclusión: la brucelosis posee características epidemiológicas peculiares en los bancos de sangre participantes en esta investigación, por lo que es importante incluir pruebas de escrutinio en búsqueda de anticuerpos anti-Brucella en los disponentes de sangre efectivos.
Introduction: to determine seroprevalence for Brucella sp. in blood donors, a serologic study was carried out at three blood banks of the Instituto Mexicano del Seguro Social (IMSS). Methods: 500 blood samples were taken from selected blood donors. Laboratory tests were used, such as Bengal rose (BR), Standard agglutination in microplate (SAM) and in presence of 2-Mercaptoethanol agglutination in microplate (2ME), which were applied to 500 blood sera from selected effective blood donors. The sample was representative according to the statistical analysis developed. Results: 18 of 500 analyzed sera were positive, with seroprevalence of 3.6%, male sex (83.4%), predominating, as secondary activity group (72.2%). According to academic archivement, blood donors with secondary school had highest seropositivity (55.6%). Conclusion: In this study, we conclude that brucellosis has peculiar epidemiologic characteristics in blood banks that participated in this research; therefore it is highly recommended to perform screening tests such as BR, SAM, and 2ME to identified anti-Brucella antibodies in the sera of effective blood donors.
Assuntos
Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Anticorpos Antibacterianos/sangue , Doadores de Sangue , Bancos de Sangue/estatística & dados numéricos , Brucella/imunologia , Brucelose/epidemiologia , Brucelose/imunologia , Prevalência , Estudos SoroepidemiológicosRESUMO
Tube, plate and card serum agglutination tests for human brucellosis were applied to 1.662 serum samples from workers in slaughter houses and rural populations from the North of Parana and from Cearâ (Brazil). The results showed mean prevalence rates of 5% for slaugher house workers and 2,2% for rural populations of Parana, J 1,4% for in intrabitants of artificially irrigated areas and 9,1% for populations in the Ceará state. The sex distribution of agglutination tests was 7,6% in males and 3,4% in females in Parana while the incidence was practically equal in both sexes (10,6% in males and 10, 7% in females) in Ceará. The presence of positive tests in young children and in females permit us to characterize human bmcellosis as alimentary transmission disease in Ceará while presents professional disease characteristics in Parana.
A soroaglutinação para brucelose humana em tubo, em placa e o "Card-test" foi aplicada a 1662 amostras de soro procedentes de trabalhadores em frigoríficos e de populações rurais do Norte do Paraná e do Estado do Ceará. Os resultados mostraram índices de prevalência médios de 5% para trabalhadores em frigoríficos e 2,2% para populações rurais do Paraná. No Estado do Ceará, a prevalência média foi de 11,2% para habitantes de perímetros irrigados com atividade agropecuária e de 9,1% para populações rurais. A distribuição por sexo, no Paraná, indicou 7,6% de reagentes no masculino e 3,4% no feminino, enquanto no Ceará, a prevalência foi praticamente igual nos dois sexos (10,6% no masculino e 10,7% no feminino). Reações positivas em crianças de tenra idade e em mulheres permitem caracterizar a brucelose humana como doença de transmissão essencialmente alimentar nas populações analisadas no Estado do Ceará, enquanto apresenta características de doença profissional no Paraná.
RESUMO
Tube, plate and card serum agglutination tests for human brucellosis were applied to 1.662 serum samples from workers in slaughter houses and rural populations from the North of Parana and from Cearâ (Brazil). The results showed mean prevalence rates of 5% for slaugher house workers and 2,2% for rural populations of Parana, J 1,4% for in intrabitants of artificially irrigated areas and 9,1% for populations in the Ceará state. The sex distribution of agglutination tests was 7,6% in males and 3,4% in females in Parana while the incidence was practically equal in both sexes (10,6% in males and 10, 7% in females) in Ceará. The presence of positive tests in young children and in females permit us to characterize human bmcellosis as alimentary transmission disease in Ceará while presents professional disease characteristics in Parana.
A soroaglutinação para brucelose humana em tubo, em placa e o "Card-test" foi aplicada a 1662 amostras de soro procedentes de trabalhadores em frigoríficos e de populações rurais do Norte do Paraná e do Estado do Ceará. Os resultados mostraram índices de prevalência médios de 5% para trabalhadores em frigoríficos e 2,2% para populações rurais do Paraná. No Estado do Ceará, a prevalência média foi de 11,2% para habitantes de perímetros irrigados com atividade agropecuária e de 9,1% para populações rurais. A distribuição por sexo, no Paraná, indicou 7,6% de reagentes no masculino e 3,4% no feminino, enquanto no Ceará, a prevalência foi praticamente igual nos dois sexos (10,6% no masculino e 10,7% no feminino). Reações positivas em crianças de tenra idade e em mulheres permitem caracterizar a brucelose humana como doença de transmissão essencialmente alimentar nas populações analisadas no Estado do Ceará, enquanto apresenta características de doença profissional no Paraná.