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Objective:To analyze the clinical data of adult patients with brucellosis and provide scientific basis for treatment of brucellosis.Methods:The medical records of 1 279 adult brucellosis patients treated in the Brucellosis Department of Hulunbuir People's Hospital from January 2013 to December 2020 were selected. Epidemiological characteristics, clinical characteristics, laboratory examination, complications and curative effect were analyzed retrospectively.Results:Among the 1 279 cases of brucellosis, there were 797 males and 482 females, with an average age of (39 ± 15) years. There were 464 cases in acute stage, 815 cases in chronic stage, and 1 221 cases contacted with animal fur such as cattle, sheep and sheep skin. The main clinical manifestations were fatigue (974), fever (819), hyperhidrosis (674) and joint and muscle pain (752). Spleen enlargement was the most common sign, with 151 cases in sequence. There were 623 complications in 1 279 patients with brucellosis. Bone and joint damage, blood system damage and liver damage were more common, with 563, 298 and 264 cases, respectively. Some patients even had multiple system damage. The titer range of in vitro agglutination test (SAT) in 1 279 patients with brucellosis was 1 ∶ 50++ to 1 ∶ 1 600++; 198 cases were positive for Brucella in blood culture; SAT was positive in 8 cases of cerebrospinal fluid and 4 cases of pleural effusion. There were 114 cases of leucopenia, 51 cases of leucopenia, 158 cases of thrombocytopenia, 93 cases of decreased hemoglobin, 205 cases of elevated alanine aminotransferase, 198 cases of elevated aspartate aminotransferase and 143 cases of elevated creatinine in 1 279 patients with brucellosis. Erythrocyte sedimentation rate increased in 587 cases and C-reactive protein increased in 563 cases. After treatment with two or three antibiotics for at least 12 weeks, the total effective rate was 98.3% (1 257/1 279). Conclusions:The clinical manifestations of brucellosis are varied. Clinicians should highly suspect brucellosis if the patient has a history of epidemiological exposure to brucellosis and has symptoms such as fever, sweating, joint muscle pain and fatigue. Early diagnosis and standardized treatment should be carried out to prevent the disease from becoming chronic and affecting the quality of life. The occupational population should strengthen physical examination and education for brucellosis.
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Objective:To study the epidemic characteristics of human brucellosis in Shandan County, Zhangye City, Gansu Province, and provide reference basis for formulating effective prevention and control measures.Methods:The surveillance data of brucellosis were collected from the China Disease Prevention and Control Information System and Shandan Center for Disease Control and Prevention to describe the three-compartment distribution (population, time, region distribution), and were analyzed by SPSS 19.0.Results:A total of 482 cases of brucellosis were reported with an average annual incidence of 48.99/100 000 from 2016 to 2021 in Shandan County, and farmers were the mainly occupation (84.85%, 409/482). The sex ratio of men and women was 3.16 ∶ 1.00 (366/116). The onset time was mainly concentrated in summer and autumn. Breeding cattle and sheep (feeding, cleaning pens, etc.) resulted in 107 cases of direct contact infection, accounting for 22.20% of the total cases (107/482). Incidence rate of different years was quite different (χ 2 = 121.09, P < 0.001). The average annual incidence rate of brucellosis in Laojun Township (95.72/100 000) was statistically different from that in other towns (χ 2 = 20.49, P < 0.001). Conclusions:The overall high prevalence of human brucellosis in Shandan County from 2016 to 2021. The animal husbandry department should strengthen the control of infectious sources, and the health department should increase publicity and education to curb the spread of the epidemic as soon as possible.
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Objective:To analyze the epidemiological characteristics and spatiotemporal characteristics of human brucellosis in Henan Province.Methods:Data of human brucellosis in Henan Province from 2005 to 2021 were collected through the China Disease Prevention and Control Information System, and a descriptive epidemiological method was used to analyze the epidemic profile of brucellosis in Henan Province and the three distribution characteristics. Global and local spatial autocorrelation were used to analyze the spatial distribution and the hot spots of brucellosis in Henan Province, respectively, and spatiotemporal scanning was used to analyze the spatiotemporal clustering regions of brucellosis in Henan Province.Results:A total of 39 862 brucellosis cases were reported in Henan Province from 2005 to 2021, with an average annual incidence of 2.44/100 000, and the number of cases showed an overall increasing trend each year (χ 2trend = 11 127.85, P = 0.001). The onset months were mainly concentrated from March to July, accounting for 59.00% (23 517/39 862), with May as the peak (5 478 cases). Cases of brucellosis were reported in 157 counties (cities, districts) of the province. The ratio of male to female was 2.52∶1.00 (28 542/11 320). Farmers were the main occupation, with 32 985 cases (82.75%). The age of onset was mainly 45 to 65 years old, with 20 226 cases (50.74%). The global spatial autocorrelation analysis showed that the global Moran's I was > 0, Z > 1.96, and P < 0.05 in all years except 2006 - 2008, showing spatial clustering. Further local spatial autocorrelation analysis was performed, and high-high and low-low clustering areas existed in 2012 - 2021 ( P < 0.01). Spatiotemporal scanning analysis showed that there was one spatiotemporal cluster in the high incidence area and two spatiotemporal clusters in the low incidence area. The high incidence cluster was centered in Neixiang County, covering 48 counties (cities, districts) including Song County and Ruzhou City, and the aggregation time was from 2014 to 2021. The two low incidence clusters were centered in Yongcheng City and Boai County, covering 58 and 18 counties (cities, districts), respectively, and the aggregation time was 2016 - 2021 and 2005 - 2012, respectively. Conclusion:The overall incidence of brucellosis in Henan Province is on the rise from 2005 to 2021, with middle-aged and elderly male farmers as the main affected population, and there are spatiotemporal clusters of brucellosis in Henan Province.
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Objective:To compare the efficacy of different antibacterial drugs combined in the treatment of adult brucellosis patients.Methods:Using a prospective design, 60 adult brucellosis patients admitted to the Affiliated Hospital of Jining Medical University from January 2018 to December 2021 were selected as the study subjects. They were randomly divided into an observation group ( n = 30) and a control group ( n = 30) using a random number table method. The observation group was treated with rifampicin combined with minocycline, and the control group was given rifampicin combined with doxycycline. The course of treatment in both groups was 6 weeks. The efficacy and clinical symptom disappearance time between the two groups, as well as the blood white blood cell count (WBC), alanine aminotransferase (ALT) levels, and serum interferon-γ (IFN-γ), interleukin-4 (IL-4) and interleukin-10 (IL-10) levels before and after treatment, and the occurrence of adverse reactions were compared. Results:The total effective rate of the observation group (96.67%, 29/30) was higher than that of the control group (73.33%, 22/30), with a statistically significant difference (χ 2 = 4.71, P = 0.030). The disappearance time of joint pain, hyperhidrosis, gastrointestinal reactions, and fever in the observation group were shorter than those in the control group, and the differences were statistically significant ( P < 0.05). After treatment, the blood WBC and ALT levels in both groups decreased compared to before treatment ( P < 0.05). After treatment, the blood WBC and ALT levels in the observation group were lower than those in the control group ( P < 0.001). The levels of serum IFN-γ and IL-10 were both decreased after treatment compared to before treatment in two groups, while IL-4 level increased compared to before treatment ( P < 0.05). The levels of serum IFN-γ and IL-10 in the observation group were lower than those of the control group, while IL-4 level was higher than that of the control group ( P < 0.001). The incidence of adverse reactions in the observation group (13.33%, 4/30) was lower than that in the control group (36.67%, 11/30), and the difference was statistically significant (χ 2 = 4.36, P = 0.037). Conclusion:The combination of rifampicin and minocycline in the treatment of adult brucellosis patients has good efficacy and can reduce serum IFN-γ and IL-10 levels and increase IL-4 level with few adverse reactions.
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Objective:To investigate the knowledge and compliance status of prevention and control of brucellosis among high-risk populations in counties and districts with high incidence of brucellosis in Xinjiang Uygur Autonomous Region (Xinjiang for brief), and to provide scientific basis for prevention and control of brucellosis and health education for high-risk populations.Methods:Huocheng County, a high incidence county of brucellosis in Xinjiang, was selected as the survey site. Three to six townships were selected, and two to three administrative villages were selected from each township as the survey villages. People over 18 years old and engaged in livestock breeding such as cattle and sheep breeders, livestock product processors, veterinarians and medical personnel were selected as the survey subjects. Face-to-face surveys were conducted by professional trained investigators in autumn and winter (December 2019 to January 2020) and spring and summer (April to July 2020). The survey included general demographic information, awareness of brucellosis prevention and control knowledge and the use of protective equipment.Results:A total of 600 people were surveyed, and 597 people completed the questionnaire, with an effective response rate of 99.50% (597/600). The overall awareness rate of brucellosis prevention and control knowledge was 68.23% (10 184/14 925), among which the awareness rate of clinical symptoms of human infection with brucellosis was high, at 73.53% (3 073/4 179). There were statistically significant differences in the awareness rate of main source of infection, main transmission route and clinical symptoms of human infection with brucellosis among people of different gender, age, nationality, education level and occupation ( P < 0.05). Among them, the awareness rate of clinical symptoms of human infection with brucellosis among veterinarians and medical personnel was 85.38% (514/602). The utilization rate of protective equipment such as rubber shoes and work clothes was high, which was 63.48% (379/597) and 60.97% (364/597), respectively. There were statistically significant differences in the utilization rate of protective equipment among different nationality, education level and occupation ( P < 0.05). Among them, The utilization rate of work clothes was the highest among people with college education or above, veterinarians and medical personnel, which was 82.61% (57/69) and 93.02% (80/86), respectively. Conclusions:The overall awareness rate of brucellosis prevention and control knowledge in high-risk groups in Huocheng County of Xinjiang is low, especially among high-risk groups such as those who are illiterate or have little literacy, and farmers, the awareness rate is low and the awareness of prevention and control is weak. There is a risk of brucellosis infection. It is necessary to further strengthen the education of brucellosis prevention and control knowledge among these groups.
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Objective:To study the therapeutic effect of bone peptide combined with rifapentin and levofloxacin on bone and joint damage caused by brucellosis.Methods:A prospective study was conducted to select 64 patients with brucellosis bone and joint damage admitted to Shanxi Provincial People's Hospital from January 2017 to June 2021. They were randomly divided into a control group (32 cases) and an observation group (32 cases) using a random number table method. The control group was treated with rifapentin and levofloxacin, while the observation group was treated with bone peptide on the basis of the control group, with a treatment period of 8 weeks, and the peripheral venous blood sample was collected before and after treatment. The visual analogue scale (VAS), activity of daily living (ADL) score, serum C-reactive protein (CRP), procalcitonin (PCT), erythrocyte sedimentation rate (ESR), and cytokines [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6)] levels were compared before and after treatment.Results:The total effective rates of treatment in the observation group and the control group were 90.62% (29/32) and 65.62% (21/32), respectively, with statistically significant differences between the groups (χ 2 = 5.85, P = 0.016). After treatment, the VAS score of the observation group was lower than that of the control group ( t = 8.29, P < 0.001), and the ADL score was higher than that of the control group ( t = 6.77, P < 0.001). Both groups had lower VAS scores after treatment than before treatment in the same group ( t = 21.72, 15.09, P < 0.001), and higher ADL scores than before treatment in the same group ( t = 22.49, 12.54, P < 0.001). After treatment, the levels of CRP, PCT, ESR, TNF-α, and IL-6 of the observation group were lower than those of the control group ( t = 8.11, 10.75, 4.64, 5.11, 4.55, P < 0.001); the levels of CRP, PCT, ESR, TNF-α, and IL-6 in the two group were lower than these before treatment in the same group ( t = 14.21, 21.47, 11.21, 15.07, 9.73, 15.50, 21.30, 7.52, 6.78, 4.93, P < 0.001). Conclusion:The bone peptide combinated with rifapentin and levofloxacin has a good therapeutic effect on bone and joint damage caused by brucellosis, which can significantly reduce pain and cellular inflammatory reactions in patients, and improve their quality of life.
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Objective:To analyze the clinical characteristics of asymptomatic infection of brucellosis, in order to provide reference for prevention and treatment of brucellosis.Methods:Retrospective analysis was used to collect the clinical data of patients with brucellosis asymptomatic infection and confirmed cases admitted to the 940th Hospital of Joint Logistics Support Force of Chinese PLA from 2017 to 2021, and the demography characteristics, clinical manifestations and laboratory test results were analyzed.Results:The results showed that a total of 18 cases of asymptomatic infection and 85 confirmed cases of brucellosis were included, and there was no statistically significant difference in age, gender, occupation and ethnicity distribution between the two groups ( F = 7.09, χ 2 = 0.74, 4.02, 0.55, P = 0.295, 0.785, 0.327, 1.000). The 18 cases of asymptomatic infection of brucellosis were found through screening in key populations, and no clinical symptoms or abnormal imaging signs were observed. The clinical symptoms of 85 confirmed cases were mainly muscle and joint pain, fever, sweating, fatigue, and low back pain; and the imaging manifestations were mainly arthritis, splenomegaly, and spondylitis. The median percentage of eosinophils (0.70%, 1.40%), percentage of basophils (3.05%, 0.40%), C-reactive protein (1.62, 4.62 mg/L), erythrocyte sedimentation rate (1.00, 11.00 mm/h), and antibody titer of serum agglutination test (1 ∶ 100, 1 ∶ 200) showed statistically significant differences between asymptomatic infection and confirmed cases of brucellosis ( Z = - 2.97, - 5.11, - 3.49, - 3.21, - 3.50, P = 0.003, 0.001, 0.001, 0.001, 0.007). Conclusions:There is a difference in the composition of granulocytes between asymptomatic infection and confirmed cases of brucellosis, and the level of inflammatory response indicators is lower than that of confirmed cases. Regular seroepidemiological surveys among key populations can help screen for asymptomatic infection of brucellosis.
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Objective:To understand the results of serum protein electrophoresis in patients with acute brucellosis, and to provide objective indicators for clinical diagnosis and treatment of acute brucellosis patients.Methods:Thirty acute brucellosis patients diagnosed by the Center for Disease Prevention and Control of Donghe District, Baotou City from January to June 2021 were selected as the case group, and 30 local healthy persons who took physical examination during the same period were selected as the control group. Blood samples were collected from the two groups of people, serum was separated and serum protein electrophoresis was performed. Independent sample t-tests were used to compare total protein concentrations, protein fractions (albumin, α1-globulin, α2-globulin, β-globulin and γ-globulin) and albumin/globulin (A/G) ratio. Results:The age of patients in the case group was (52.35 ± 6.74) years old, with 25 males and 5 females. The course of the disease ranged from 0.3 to 2.6 months, with an average of 1.78 months. The age of people in the control group was (52.74 ± 5.47) years old, with 25 males and 5 females. There were no statistically significant difference in age and sex distuibution between the two groups ( P > 0.05). The concentrations of total protein and α2-globulin fractions were not significantly different between the two groups ( t = 0.78, 2.04, P > 0.05, respectively). Compared with the control group, the differences in the percentage of albumin, α1-globulin, β-globulin, γ-globulin in total protein and A/G ratio were statistically significant ( t = 4.78, 4.76, 2.89, 2.20, 3.65, P < 0.05). Conclusions:The percentage of serum albumin in total protein and A/G ratio decrease in patients with acute brucellosis, while the percentage of α1-globulin, β-globulin and γ-globulin in total protein increase. The percentage of albumin, α1-globulin, β-globulin, γ-globulin in total protein and A/G ratio can be uesed as objective indicators for clinical treatment of acute brucellosis.
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Objective:To analyze the epidemic dynamics and characteristics of human brucellosis in Jinzhong City, Shanxi Province, and to provide scientific basis for formulating prevention and control measures.Methods:Brucellosis epidemic data from "China Disease Prevention and Control Information System" from 2013 to 2020 and the surveillance data of brucellosis prevention and control in Jinzhong City over the years were collected, and the epidemiological characteristics, serological and pathogenic monitoring results of brucellosis in Jinzhong City were analyzed.Results:A total of 5 235 cases of brucellosis were reported in Jinzhong City from 2013 to 2020, with an average annual incidence of 19.60/100 000. There was a statistically significant difference in the annual incidence of each year (χ 2 = 561.09, P < 0.001). Pingyao County had the largest number of reported cases (903 cases), and Yushe County had the highest incidence (59.78/100 000). The incidence was observed in every month of the past years, with significant seasonal onset, the peak of the incidence was from March to July, accounting for 60.50% (3 167/5 235). The majority of the patients were male, aged 20 - 60 years, and farmers, accounting for 81.07% (4 244/5 235), 85.06% (4 453/5 235) and 81.34% (4 258/5 235), respectively. Epidemiological investigation revealed 33 522 high-risk occupational groups. Serological examination was performed in 24 544 people, with a positive rate of 4.45% (1 091/24 544). In 263 pathogenic culture samples, 52 strains of Brucella were found, with a detection rate of 19.77%, all of them were sheep type 3. Conclusions:In recent years, the epidemic of brucellosis in Jinzhong City has shown a sporadic trend, with significant regional differences in the incidence. The occupational population is still the focus of prevention and control. It is suggested to carry out occupational population monitoring, do a good job in health education and behavioral intervention, timely learn about the epidemic dynamics, and effectively control the brucellosis epidemic.
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Objective:To learn about the epidemic situation and trend of human brucellosis in Menyuan Hui Autonomous County (referred to as Menyuan County) of Qinghai Province, and to provide reference for formulating brucellosis prevention and control measures in Menyuan County.Methods:Data on human brucellosis in Menyuan County reported by the Infectious Disease Reporting Information Management System of China Disease Control and Prevention Information System from 2013 to 2020 were collected and analyzed by descriptive epidemiological analysis (three distribution).Results:A total of 186 cases of brucellosis were confirmed from 2013 to 2020, with an average annual incidence of 14.553/100 000. The annual incidence rate was increasing year by year(χ 2trend = 22.08, P = 0.002). The cases were distributed in 67 villages of 12 towns; cases were more common in the age group of 15-< 65 years old (96.24%, 179/186), and there were more men than women cases (sex ratio was 3.89∶1.00, 148/38). Conclusions:The incidence rate of brucellosis cases in Menyuan County is increasing year by year, and the scope of its impact is constantly expanding. A multi-sectoral joint prevention and control mechanism should be established to strengthen management, increase the prevention and control of brucellosis, and stop the spread of the epidemic to surrounding counties and cities.
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Objective:To construct a follow-up evaluation index system for "Diagnosis of Brucellosis" (WS 269-2019), and provide a reference basis for the next revision and improvement of the standard.Methods:The evaluation index system for "Diagnosis of Brucellosis" (WS 269-2019) was preliminarily established by consulting relevant references and materials. The experts in the field of diagnosis, treatment, prevention and control of brucellosis were selected, and two rounds of expert consultation were carried out in the form of questionnaires using the Delphi method. The necessity and availability of evaluation indicators were scored, and suggestions for modifying and adding indicators were put forward. Based on this, a standard follow-up evaluation index system was established. At the same time, a judgment matrix was constructed combined with the Saaty scale, and the analytic hierarchy process was used to calculate the weight of each index in the system.Results:After 2 rounds of expert ( n = 10) consultation, a standard follow-up evaluation index system for "Diagnosis of Brucellosis" (WS 269-2019) was constructed with 3 first-level indexes, 8 second-level indexes and 21 third-level indexes. The positive coefficients of experts in 2 rounds of questionnaires were both 100%; the coefficient of authority of experts was 0.82; the Kendall's coefficients of concordance of first-level, second-level and third-level indexes were 0.722, 0.260, and 0.181, respectively, with P < 0.05. Among the first-level indexes, the weight of standard quality evaluation was the highest (0.364), and the weight of standard implementation status was the lowest (0.278); among the second-level indexes, the combined weight of social benefits was the highest (0.186), and the combined weight of advanced nature was the lowest (0.043); among the third-level indexes, the combined weight of timely diagnosis rate was the highest (0.096), and the combined weight of consistency with technical data was the lowest (0.009). Conclusions:The constructed follow-up evaluation index system for "Diagnosis of Brucellosis" (WS 269-2019) is scientific and reliable, which evaluated qualitatively and quantitatively, reduces the defects of a single evaluation, and provides a basis for subsequent revision and improvement of the standard.
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Objective:To investigate the diagnostic value of 99mTc-methylenediphosphonate(MDP) whole body bone scintigraphy in early brucellosis patients with bone and joint injuries. Methods:According to the Diagnosis for Brucellosis (WS 269-2019), combined with epidemiological history, clinical manifestations and serological tests, from November 2020 to April 2021, 15 early brucellosis patients (the course of disease was within 6 months) who had not received any drug treatment diagnosed at the Department for Brucellosis Prevention and Control, Qinghai Institute for Endemic Disease Prevention and Control were selected as the research subjects, and 99mTc-MDP whole body bone scintigraphy was performed on the patients to evaluate the images and analyze the pathological changes. Results:The 99mTc-MDP whole body bone scintigraphy of 15 patients with early brucellosis showed abnormalities, and the abnormal concentration of radionuclides mainly occurred in the 8th to 12th thoracic vertebrae (T8-12), the 1st to 2nd lumbar vertebrae (L1-2) and L4-5. Among them, the thoracic vertebrae abnormalities were T8, T9, T10, T11 and T12 in 1 case each; lumbar vertebrae abnormalities were 1 case of L1, 1 case of L2, 4 cases of L4, and 5 cases of L5. Conclusions:The 99mTc-MDP whole body bone scintigraphy is abnormal in patients with early brucellosis. Bone scintigraphy has certain value in the diagnosis of bone and joint injuries in patients with early brucellosis.
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Objective:To learn about the epidemic dynamics and spatial epidemic characteristics of human brucellosis in Gansu Province.Methods:Data on human brucellosis in Gansu Province reported by China Disease Control and Prevention Information System from January 2016 to December 2020 were collected and analyzed by descriptive epidemiology and spatial clustering analysis.Results:A total of 10 025 cases of human brucellosis were reported in Gansu Province from 2016 to 2020, with a statistically significant difference in incidence rate between years (χ 2 = 242.86, P = 0.001). The incidence was the lowest in 2018 (6.03/100 000), and the highest in 2020 (11.39/100 000). The reported cases were concentrated in 45 - 55 years old, accounting for 34.52% (3 461/10 025); the male to female ratio was 2.91 ∶ 1.00 (7 458/2 567); farmers were the main occupation, accounting for 82.11% (8 232/10 025). Among the 86 counties (cities, districts) in Gansu Province, Yongchang County had the highest number of reported cases in 2020 (339 cases), and Sunan Yugur Autonomous County had the highest incidence in 2020 (190.89/100 000). Spatial autocorrelation analysis showed that there was significant spatial positive correlation between the incidence rate of human brucellosis in Gansu Province from 2016 to 2020 (global Moran's I > 0, Z > 1.96, P < 0.05), showing a spatial clustering distribution. The high-high clustering areas were concentrated in Yongchang County and Sunan Yugur Autonomous County. Conclusion:In Gansu Province, the main population of human brucellosis is middle-aged male farmers, and the incidence of brucellosis is spatially clustered.
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Objective:To investigate the clinical characteristics of atypical neurobrucellosis.Methods:Retrospective analysis was made on the epidemiological characteristics, clinical manifestations, laboratory and imaging findings of five cases of atypical neurobrucellosis admitted to the People's Hospital of Inner Mongolia Autonomous Region from December 2020 to June 2021.Results:The age of the five cases ranged from four to sixty-nine years old, including three females and two males. Four cases had a clear history of sheep contact. Serum F1 antibody against brucellosis was positive in all five cases, serum tube agglutination test (SAT) was positive in three cases, lumbar puncture cerebrospinal fluid (CSF) examination showed increased intracranial pressure in four cases, and bacterial smear and tuberculosis culture were negative in all of the five cases. After magnetic resonance imaging (MRI), two cases were found to have abnormal intracranial high signals, of which one case was abnormal in bilateral frontal parietal lobe and right temporal occipital lobe, showing long T1 and T2 signals and increased fluid-attenuated inversion recovery sequence(FLAIR) signal; and another case was abnormal in bilateral corona radiata, posterior limbs of internal capsule and bilateral cerebral peduncles, it showed continuous T2 and FLAIR slightly high signal intensity. One case had abnormal signal in the spinal cord, showing a small patch like long T2 signal on the right side of the spinal cord at the level of C2-3 discs. Electromyography was abnormal in one case. Among the five cases, two cases presented with brucellosis encephalitis, one case with brucellosis myelitis, one case with glossopharyngeal nerve damage caused by brucellosis, and one case with brucellosis cerebrospinal neuropathy. All five patients were treated with a combination of doxycycline, rifampicin and ceftriaxone, and three patients had a good prognosis.Conclusions:The clinical manifestations of atypical neurobrucellosis are various. Clinicians should strengthen their understanding of the disease and reduce the chance of missed diagnosis and misdiagnosis.
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Objective:To study the clinical characteristics and prognosis of Brucella and other pathogens infections complicated with anti-myelin oligodendrocyte glycoprotein-IgG associated disorders (MOGAD). Methods:The clinical data of a patient with brucellosis complicated with MOGAD diagnosed in the Department of Neurology of the First Affiliated Hospital of Zhengzhou University in April 2022 were reported, and related case reports of infection coexisting with MOGAD were reviewed and summarized.Results:This case was a 44-year-old male, with recurrent fever and anorexia, followed by sudden weakness, numbness, pain in both lower limbs and dysuria, and then pain in the right neck. Magnetic resonance imaging showed lesions in the spine and spinal cord. Due to the positive myelin oligodendrocyte glycoprotein antibodies in cerebrospinal fluid and serum, and the growth of Brucella in blood culture, he was diagnosed as brucellosis complicated with MOGAD. After anti-brucellosis and glucocorticoid therapy, his symptoms improved. The literature on infection coexisting with MOGAD was reviewed and 22 cases were included. The infection sources included COVID-19, Borrelia burgdorferi, etc. No case of Brucella infection complicated with MOGAD had been reported. The main clinical manifestations of the 22 cases included myelitis (63.6%, 14/22), optic neuritis (40.9%, 9/22), acute disseminated encephalomyelitis (18.2%, 4/22), multiphasic disseminated encephalomyelitis (4.5%, 1/22) and meningoencephalitis (4.5%, 1/22). Magnetic resonance imaging was performed in 20 cases, showing spinal cord lesions in 12 cases (60.0%, 12/20), intracranial lesions in 10 cases (50.0%, 10/20) and optic nerve lesions in 6 cases (30.0%, 6/20). Cerebrospinal fluid examination was performed in 19 patients, of whom 13 (13/19) had increased cerebrospinal fluid cell count and 10 (10/18) had increased cerebrospinal fluid protein. Twenty-two patients received glucocorticoid therapy, of which 95.5% (21/22) responded well and 95.5% (21/22) had a good prognosis. Conclusions:Brucella and other pathogens infection may complicate with MOGAD, with similar clinical manifestations, and glucocorticoid therapy is effective.
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This study aimed to evaluate methods for studying the in vitro antimicrobial activity of lactic acid bacteria (LAB) against Brucella abortus and to evaluate the antagonistic effect of LAB on the viability of this pathogen. A total of 18 LAB strains (Lactobacillus plantarum, n = 11; Pediococcus acidilactici, n = 1; Lactobacillus rhamnosus, n = 4; and Lactobacillus brevis,n = 2), isolated from Minas artisanal cheeses produced in three regions (Canastra, Campos das Vertentes, and Araxá) of Minas Gerais State, Brazil, were tested for their antimicrobial activity against B. abortus using three methods: spot-on-lawn, agar well diffusion assay, and antagonistic activity of the culture supernatants. None of the tested LAB strains could inhibit B. abortus in the spot-on-lawn and agar-well diffusion assays. The supernatants produced by LAB had an acidic pH, with intensity depending on bacterial growth and strain, and could inhibit the growth of B. abortus. In contrast, pH-neutralized (pH 7.0) LAB supernatants did not suppress the growth of B. abortus. The results showed that the best technique to study the in vitro antagonism of LAB against B. abortus was the antagonistic activity of culture supernatants. The growth of B. abortus may have been inhibited by acid production.(AU)
Este estudo teve como objetivo avaliar métodos de estudo in vitro da atividade antimicrobiana de bactérias lácticas contra Brucella abortus e avaliar o efeito antagônico das mesmas sobre a viabilidade deste patógeno. Um total de 18 amostras de bactérias lácteas (Lactobacillus plantarum, n = 11; Pediococcus acidilactici, n = 1; Lactobacillus rhamnosus, n = 4; e Lactobacillus brevis, n = 2), isoladas de exemplares de Queijo Minas Artesanal produzidos em três regiões (Canastra, Campos das Vertentes e Araxá) do estado de Minas Gerais, Brasil, foram testados quanto à sua atividade antimicrobiana contra B. abortus usando três métodos: spot-on-lawn, ensaio de difusão em poço e atividade antagonista de sobrenadante de cultura. Nenhuma das cepas testadas foi capaz de inibir B. abortus nos ensaios spot-on-lawm e de difusão em poço. Os sobrenadantes produzidos pelas bactérias lácteas apresentaram pH ácido, com intensidade dependente do crescimento bacteriano e da amostra, podendo inibir o crescimento de B. abortus. Em contraste, os sobrenadantes com pH neutralizado (pH 7,0) não inibiram o crescimento de B. abortus. Os resultados mostraram que a melhor técnica para estudar o antagonismo in vitro de bactérias lácteas contra B. abortus foi a atividade antagonista de sobrenadante de cultura. O crescimento de B. abortus pode ter sido inibido pela produção de ácido.(AU)
Subject(s)
Lactobacillaceae/isolation & purification , Cheese/microbiology , Microbiota , Brazil , Brucella abortus , Food SupplyABSTRACT
ObjectiveTo describe the serological surveillance results of human brucellosis in Ganzhou City， Jiangxi Province from 2018 to 2021， characterize the epidemic and current situation of brucellosis， and to provide scientific evidence for effective prevention and control of brucellosis. MethodsSurveillance data of human brucellosis serological testing was collected in Ganzhou City from 2018 to 2021. Spatial， temporal， and demographic distribution was further determined. ResultsFrom 2018 to 2021， a total of 42 humans serologically positive for brucellosis were reported from 18 counties （cities and districts） in Ganzhou City， including 26 males and 16 females with a gender ratio of 1.6∶1. The number of serologically positive cases showed a decreasing trend， with the positive rate decreasing from 46.43% in 2018 to 33.33% in 2021. Majority of the cases （54.00%） aged 40‒ years old. Furthermore， the number of serologically positive cases varied by month； majority of the cases （80.95%） was from April to August. Additionally， a total of 10 counties （cities and districts） reported serologically positive cases of brucellosis， among which the top 3 counties （cities and districts） by cumulative number of positive cases were Zhanggong District （18 cases）， Dayu County（5 cases）， and Longnan City（4 cases）. ConclusionSerologically positive cases of human brucellosis decrease in Ganzhou， in which the incidence of male cases is generally higher than female cases. The seasonality of human brucellosis is in spring and summer. At-risk population is 40‒ years old. Additionally， at-risk areas are southwest and central areas of Ganzhou.
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@#Abstract: Objective To investigate the clinical characteristics and incidence of Brucella encephalitis and meningitis in children. Methods We report the clinical data of a child with Brucella melitensis meningitis in children, and summarize the incidence, diagnosis methods and treatment of Brucella encephalitis or meningitis in children, taking into account the relevant domestic and foreign literature from January 2014 to December 2020. Results A 4-year-old girl was admitted to the hospital with status epilepticus on March 15, 2021 because of interrupted right limb numbness for 16 hours and convulsions for 2 hours. She had 2 non-febrile convulsions three months before admission and was diagnosed with epilepsy. This incident was acute, accompanied by low fever, with epilepsy as the main manifestation. Cerebrospinal fluid test suggested central nervous system infection, but the nature of infection could not be determined by routine and biochemistry of cerebrospinal fluid.The cerebrospinal fluid next generation sequencing confirmed that the pathogen of the infection was B. melitensis, which was further verified by the peripheral blood antibody test. After effective antibiotics combined with a full course of treatment, the patient recovered after six months of treatment. A total of 60 articles were retrieved in the database, including 29 in Chinese. During this period, a total of 7 cases of brucellosis in children with nervous system involvement were reported, one of which was a case report, and the other 6 cases were mentioned in the comprehensive analysis of children with brucellosis. Conclusions Brucella encephalitis or meningitis in children has a low incidence and various clinical features, which are easy to be misdiagnosed or missed.
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Objective To perform a visual bibliometric analysis of hot spots as well as areas of Brucella disease research by searching brucellosis related literature. Methods A thematic search was conducted in the web of science core set database using Brucella disease or brucellosis as keywords to retrieve literature between January 1985 and December 2021. CiteSpace was used to visualize the countries, institutions, authors, and keywords in the retrieved relevant literatures. Results A total of 4 495 eligible articles studies were included, with the United States being the most populous country and the University of Sao Paulo being the most influential. Jilin University and Shihezi University in Xinjiang, China were relatively influential in this field. For the key words analysis, the top 3 of high-frequency words were infection, diagnosis, abortion, and in the 12 clusters formed, the clusters formed by #1, #4 were larger and the research hotspot continued. Keywords in the last five years including human brucellosis, immunity, zoonotic disease, were highlighted. Conclusion Study analysis suggested that human brucellosis with zoonosis was a research hotspot, more scholars focused on the infectious route and other exposure risks of cattle as intermediate hosts, epidemiological studies on brucellosis or will be new trends.
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Objective@#To investigate the epidemiological characteristics of human brucellosis in Jiaxing City from 2010 to 2021, so as to provide insights into the development of the brucellosis control strategy.@*Methods@#The epidemiological and clinical data of brucellosis patients and epidemiological data of brucellosis outbreaks in Jiaxing City from 2010 to 2021 were collected from Chinese Disease Control and Prevention Information System, and the epidemiological features and outbreaks of brucellosis were analyzed descriptively.@*Results@#Totally 160 brucellosis patients were reported in Jiaxing City from 2010 to 2021, and the incidence of brucellosis appeared a tendency towards a rise (χ2trend=28.564, P=0.002), with annual mean incidence of 0.29/105. No deaths due to brucellosis occurred in Jiaxing City from 2010 to 2021. Brucellosis cases were reported each month, which were concentrated in the first and second quarters, and the greatest number was seen in May (27 cases, 16.88%). The brucellosis cases were predominantly reported in Tongxiang City (114 cases, 71.25%), and 75.00% were male (120 cases) and 70.63% were occupational populations (113 cases). The patients had a median (interquartile range) age of 57 (12) years at onset, and the median duration (interquartile range) from onset to definitive diagnosis was 18 (28) days. The clinical manifestations mainly included fever and weakness, and a total of 18 Brucella melitensis isolates and one B. bovis isolate were cultured.@*Conclusions@#The incidence of brucellosis was rising in Jiaxing City from 2010 to 2021. The brucellosis patients were predominantly reported in Tongxiang City in the first and second quarters, and young, middle-aged men and occupational populations were at a high risk of brucellosis.