Human brucellosis: Six years retrospective study on seropositivity in Malaysia.

INTRODUCTION: Human brucellosis is a zoonotic disease in Malaysia. This study analysed six-year retrospective seropositivity trends of human brucellosis cases from 2014 to 2019. METHODS AND MATERIALS: A total of 1,281 serum samples were obtained from suspected brucellosis patients were included. The sera were tested using an enzyme-linked immunosorbent assay for IgM and IgG antibodies for Brucella spp. Samples with equivocal or positive antibody index were confirmed with an immunocapture agglutination. RESULTS: During the study period, 5.8% (n=74) of suspected cases showed seropositivity for human brucellosis. The central region has the highest seropositivity cases of human brucellosis. Consumption of unpasteurised milk was significantly associated with human brucellosis in this study with adjusted odds ratio ((AOR) = 4.56, 95% CI = 2.6, 8.02, p-value < 0.001). The age group of less than 15 years old was more likely to contract brucellosis ((AOR) = 2.81, 95% CI = 1.01, 7.84 p-value < 0.048). CONCLUSION: Serological tests have been widely used for the diagnosis of human brucellosis. However, diagnosis using serology is often challenging without the presence of a convalescent sample. In conclusion, even though human brucellosis has a low prevalence rate, the disease has serious public health implications. The usage of effective diagnostic tools as well as implementation of 'One Health' approach are the way forward to prevent and control of brucellosis in the country.

A case of mycotic aneurysm due to Burkholderia pseudomallei.

Burkholderia pseudomallei is an free-living gram-negative bacterium causing melioidosis and is endemic in Southeast Asia. A 56-year-old diabetic construction worker with a 1-month history of abdominal pain and 1-day history of high-grade fever was found to have a left non-dissecting infrarenal mycotic aortic aneurysm by abdominal computerized tomography scan. Bacteriological examination of his blood yielded Burkholderia pseudomallei. The patient was treated with right axillo-bifemoral bypass with excision of aneurysm and high-dose intravenous ceftazidime for two weeks, followed by oral trimethoprim/sulfamethoxazole and oral doxycycline for a minimum of five months.

Trend and pattern of melioidosis seropositivity among suspected patients in Malaysia 2015 - 2019.

Melioidosis is a disease of public health importance associated with high case-fatality rates in animals and humans caused by Burkholderia pseudomallei (B. pseudomallei ), a gram- negative bacterium that lives in tropical soil environments. This study determined the seropositivity for melioidosis among patients admitted to healthcare centres in Malaysia, from 2015 to 2019 and identified factors related to it. A total of 26,665 serum samples of suspected melioidosis patients from Malaysia hospitals were tested for IgM against B. pseudomallei. About 16.4% of total samples were seropositive and majority of them were 55 years old and above. However, younger people aged less than 15 years old were the most susceptible to the infection (AOR 3.04, p <0.001, 95% CI: 2.73, 3.39). Melioidosis infection was the highest in Sarawak (15.1%) while Perlis was the least exposed to the infection (0.9%). Further analyses showed that patients with chronic lung disease (adjusted OR: 4.03, p < 0.001, 95% CI: 2.77, 5.86) were more susceptible to melioidosis infection. In conclusion, although serology testing is not a gold standard test in diagnosing melioidosis, it has been used as a tool in treatment monitoring and disease surveillance among patients and at-risk community in the endemic hot-spots regions.