RESUMO
The lysis centrifugation technique is preferred for culturing Brucella spp. at all stages of brucellosis because it yields 25% more positive results and on average provides results 10 days earlier than the Ruiz-Castaneda method. This lysis method is inexpensive and easier to use and may be used in laboratories with limited expertise or equipment if all safety precautions are taken.
Assuntos
Técnicas Bacteriológicas/métodos , Brucella/isolamento & purificação , Brucelose/microbiologia , Brucelose/diagnóstico , Humanos , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Testes SorológicosRESUMO
During home visits and using a point-of-care test for brucellosis, we screened the household members of adult patients found to have brucellosis by investigation at the Hospital Nacional Daniel Alcides Carrión in Callao, Peru. A total of 206 household members of 43 patients were screened, and 15 (7.3%) household members in 10 (23.3%) households tested seropositive. Brucellosis was diagnosed in 14 of them, all but 4 presenting with acute or subacute uncomplicated disease. Regardless of attempts to control brucellosis in Peru, the disease continues to be reasonably common among household members of brucellosis patients. Household members presumably remain the single most important identifiable risk group in an urban setting, and screening them provides an effective means for their early diagnosis. Although contact with livestock was rare, the consumption of unpasteurized dairy products was reported by almost all patients with brucellosis, their household members, and hospitalized non-brucellosis patients.
Assuntos
Brucelose/epidemiologia , População Urbana/estatística & dados numéricos , Doença Aguda , Anticorpos Antibacterianos/sangue , Brucelose/prevenção & controle , Características da Família , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Masculino , Programas de Rastreamento , Paris/epidemiologiaRESUMO
Treatment failure and relapse are major problems in the management of brucellosis. In developing countries, treatment with the oral combination doxycycline/rifampicin is preferred because of its convenience. However, its efficacy is lower than that of the doxycycline/streptomycin regimen and is likely further reduced when compliance is poor. Alternative regimens should be investigated in well designed clinical trials to determine whether treatment can be improved. Use of DNA detection as a marker for treatment success and for the prediction of relapse requires confirmation. In the absence of simple and effective treatment regimens, patient education to promote compliance is essential.