Epidemiología de la brucelosis caprina y ovina en la provincia de Formosa, Argentina / Epidemiology of caprine and ovine brucellosis in Formosa province, Argentina

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.

Brucella melitensis es un agente de la artritis pediatrica: Serie de casos / Brucella melitensis is an agent in pediatric arthritis: Case series

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

Molecular detection of Brucella species in patients suspicious of Brucellosis from Zanjan, Iran

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.

Brucella melitensis: a rarely suspected cause of infections of genitalia and the lower urinary tract

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.

In vitro synergistic activity of antibiotic combinations against Brucella melitensis using E-test methodology / Atividade sinergística in vitro de combinações de antibióticos contra Brucella melitensis através da metodologia E-test

The treatment of brucellosis is still problematic, because of high rates of treatment failure or relapses. As the microorganism is an intracellular pathogen, treatment requires combined regimens. However, limited existing data on in vitro combinations are avaliable for Brucellae. The aim of this study was to investigate the in vitro efficacy of various traditional and new antibiotic combinations against 16 Brucella melitensis strains. The combination effect of antimicrobial agents was evaluated by E-test synergy method to obtain a fractional inhibitory concentration (FIC) index. Co-Trimoxazole (SXT) and moxifloxocin (MXF) exhibited the lowest MIC, while Rifampin (RIF) had the highest MIC in the study. Combinations with RIF showed the best synergistic activity (100 percent of RIF-tetracycline (TET), and 87.5 percent of RIF-SXT). Synergistic activity was also detected at seven (43.7 percent) of ciprofloxocin (CIP)-SXT, four (25 percent) of TET-MXF, and two (12.5 percent) of TET-SXT combinations. The combinations that demonstrated additivity were TET-SXT, CIP-SXT and TET-MXF. Antagonism was observed only with the TET-Streptomycin (STR) combination in three strains (18.8 percent). Further work including randomized controlled clinical trials is required to fully evaluate the usefulness of these data.

O tratamento da brucelose é problemático devido à alta freqüência de tratamentos mal sucedidos e recidivas. Por tratar-se de um patógeno intracelular, o tratamento requer procedimentos combinados. Entretanto, existem poucos dados sobre combinações in vitro para Brucellae. O objetivo deste trabalho foi investigar a eficiência de vários tratamentos tradicionais e novas combinações de antibióticos contra 16 isolados de Brucella melitensis. O efeito combinado foi avaliado através do método do E-test para obtenção do FIC (índice de concentração inibitória fracional). Co-trimoxazol (SXT) e moxifloxocina (MXF) apresentaram o MIC mais baixo, enquanto rifampicina (RIF) apresentou o MIC mais alto. Combinações com RIF mostraram a melhor atividade sinergística (100 por cento para RIF-tetraciclina e 87,5 por cento para RIF-SXT). Atividade sinergística foi também detectada para sete (43,7 por cento) combinações de ciprofloxacina (CIP-STX), quatro (25 por cento) de TET-MXF e duas (12,5 por cento) de TET-SXT. As combinações que apresentaram efeito aditivo foram TET-SXT, CIP-SXT e TET-MXF. Antagonismo foi observado somente para a combinação TET-estreptomicina (STR) em três isolados (18,8 por cento). Mais pesquisas utilizando ensaios clínicos randomizados controlados são necessárias para avaliar a utilidade desses dados.

Brucella peritonitis and leucocytoclastic vasculitis due to Brucella melitensis

Brucellosis is a multisystemic disease that rarely leads to a fatal outcome. While reticuloendothelial system organs are mostly affected, peritonitis and posthepatitic cirrhosis are also complications of brucellosis, though they are very rare. Brucella spp. can also trigger immunological reactions. We report a case of brucellosis with peritonitis, renal failure and leucocytoclastic vasculitis caused by Brucella melitensis, which led to a fatal outcome. Brucellosis should be considered in the differential diagnosis of vasculitic diseases, especially in endemic areas.

Brucellosis: the first case of King Chulalongkorn Memorial Hospital and review of the literature.

Brucellosis remains a major zoonotic disease worldwide. It has never been reported at King Chulalongkorn Memorial Hospital (KCMH). The authors describe the first case of brucellosis in KCMH, and also review all previous reports in Thailand. The presented case was a 52-year-old Thai man, living in Phetchabun Province, who was diagnosed with idiopathic pulmonary fibrosis two years prior to admission. He presented with prolonged fever, dry cough, weight loss of eight kg over three months, hepatosplenomegaly, and pancytopenia. Blood and bone marrow cultures grew Brucella melitensis at 72 hours of incubation. A slide agglutination (Rose Bengal) test was also positive for Brucella antibody. He had been exposed to contaminated placenta of his goats that had spontaneous abortion in the past few months before his illness. The patient was successfully treated with gentamicin, doxycycline, and rifampicin. Clinicians should have a high index of suspicion when evaluating patients presenting with prolonged fever and having an exposure risk of brucellosis.

Isolation of brucella melitensis and brucella abortus from brucellosis patients by conventional culture method and polymerase chain reaction technique

Isolation of B. melitensis and B. abortus from brucellosis patients by application of conventional culture and PCR methods and comparison of sensitivity of both techniques in diagnosis of human brucellosis. Infectious diseases Ward, Ahwaz University's hospitals over a period of 9 months [September 2003 to May 2004]. A total of 30 peripheral blood samples were collected from patients with brucellosis referred to infectious Diseases Unit of Ahwaz University's hospitals. The samples were inoculated into Castaneda medium and after 7-30 days, the isolated colonies were identified by inoculation into brucella agar containing thionine and fuschin and by performance of biochemical tests. DNA was extracted from colonies and serum samples and examined by PCR involving specific primers for B. melitensis and B. abortus based on IS 711 in the brucella chromosome. We identified 8 isolates of B. melitensis using culture and biochemical methods. When PCR technique was applied to serum samples, 28 cases were positive for B. melitensis and we were able to isolate more cases compared to culture method and the difference was significant [P<0.05]. The sensitivities of culture and PCR in this study were determined as 26.6% and 93.3% respectively. Neither of examined cultures or sera subjected to PCR were positive for B. abortus. The results of present study showed that PCR assay is a rapid and sensitive technique for diagnosis of brucellosis compared to culture method. However it is more valuable when coupled with conventional methods

Case report: Brucellosis: a re-emerging disease in Thailand.

Brucellosis is a zoonotic disease prevalent in many countries, but it has been reported only once in Thailand, 36 years ago. We describe here two consecutive cases of brucellosis in Bangkok, Thailand. Both cases presented with prolonged fever and weight loss. Blood cultures taken from 2 patients yielded Brucella melitensis. The slide agglutination test of blood samples were also positive, with a titer of 1:64 for antibodies to Brucella. The first patient responded to a combination of doxycycline, gentamicin, and ciprofloxacin; the other responded to doxycycline and rifampicin. Brucellosis is a potential public health threat, therefore, preventive measures should be actively implemented. This clinical syndrome should be included in the differential diagnosis of patients presenting with prolonged fever, particularly those with contact to animals which could serve as reservoirs.

Brucella spondylitis: an important treatable cause of low backache.

OBJECTIVES: This study was undertaken to see if brucella spondylitis existed as a cause of backache in Mumbai and to identify the clinical setting in patients of backache where brucella serology is indicated. METHODS: In 18 months (June 1996-Dec. 1997) we performed tube agglutination test (TAT) for Brucella melitensis and abortus on 72 patients of low backache from Orthopaedics Department of a teritary health centre. All 72 patients satisfied the inclusion and exclusion criteria designed to exclude radiologically detectable congenital or degenerative cause of backache. RESULTS: Six out of 72 patients were seropositive for brucellosis. All six patients had either history of animal contact or ingestion of raw milk or milk product (cheese or paneer). The lumbosacral backache was severe, radiating to the legs and straight leg raising test was significantly positive, they had marked tenderness on spinous process of lower lumbar vertebrae. Changes of brucella spondylitis were present on plain radiogram of lumbosacral spine in three patients. Four patients had abnormalities on bone scintigraphy. CONCLUSION: Low backache of brucella spondylitis closely simulates pain of prolapsed intervertebral disc. Serologic testing for brucellosis is an important step in management of such patients, especially when history of animal contact or raw milk or milk product ingestion is present, as the disease can be eminantly treated with antibiotics.

serological survey of brucella abortus and melitensis in shepherd dogs around Mashhad Farms

Rose Bengal tube agglutination and 2 mercaptho ethanole tests were done on sera from 100 shepherd dogs around Mashhad. 38[38%] 37[37%] and 18[18%] cases out of these dogs showed positive reaction in rose Bengal tube agglutination and 2ME tests respectively. In tube agglutination test 5[5%] 11[11%] and 21[21%] dogs had a titer of 1/10, 1/20 and 1/40 respectively. In 2ME test 8[8%] 5[5%] and 5[5%] dogs with titers of 1/10, 1/20 and 1/40 were detected respectively. In this survey the hazard of infected shepherd dogs in spreading and transmission of the infection to other animals and human population are discussed

Detection of immunoglobulins on bacterial surface by laser flow cytometry: analysis between Haemoplhilus influenzae type b and Vibrio cholerae 01 of healthy mother-full term newborn sera

The identification of human IgG immunoglobulins on the surface of Vibrio cholerae O1, and Haemophilus influenzae type b microorganisms was assessed via a flow cytometric technique. A group of 31 healthy mother-full term nerwborn duo sera from a non-endemic cholera area was assayed. The sera of mothers and full-term newborns against both microorganisms were compared. The mean fluorescent intensity of the samples was not different at the 0.05 significance level by paired t-test. On the other hand, the immunoglobulins of newborn and mothers for V. cholerae O1 was notably lower when compared with H. influenzae type b microorganisms (p<0.05 by paried t-test, t=-5.570 for mother' sera, and t=-7.496 for the sera of the newborns). These data provide circumstantial evidence that LFC techique would be useful on bacteria-related serology

In vitro activity of conventional and newer antimicrobial agents against brucella melitensis clinical isolates from Kuwait

The in vitro activity of 15 antimicrobial agents was tested against 21 clinical isolates of Brucella melitensis from Kuwait. The minimum inhibitory concentration for 90% of strains [MIC 90] was determined. Tetracycline and doxycycline showed similar activity [MIC 90 0.5-4]. Antagonism [> 4] was seen in only one strain for the combination of ciprofloxacin plus rifampin and trimethoprim-sulfamethoxazole plus cefotaxime. Time-kill studies showed that doxycycline or gentamicin alone decreased the viable counts below 2 log 10 after 24 h. Combinations of doxycycline plus gentamicin or ciprofloxacin plus gentamicin decreased the viable counts below 2 log 10 within 6 h