RESUMO
Five laboratory-acquired brucellosis (LAB) cases that occurred in the United States between 2008 and 2011 are presented. The Centers for Disease Control and Prevention (CDC) reviewed the recommendations published in 2008 and the published literature to identify strategies to further prevent LAB. The improved prevention strategies are described.
Assuntos
Brucelose/diagnóstico , Brucelose/prevenção & controle , Controle de Infecções/métodos , Exposição Ocupacional , Adulto , Criança , Feminino , Pessoal de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Estados UnidosRESUMO
We report a fatal case of Brucella suis endocarditis initially misdiagnosed by automated identification systems as Ochrobactrum anthropi infection in a patient with a history of Marfan syndrome and recreational feral swine hunting. This report emphasizes the need to consider brucellosis as a part of the differential diagnosis of acute febrile illness, particularly in patients with known risk of exposure.
Assuntos
Brucella suis/isolamento & purificação , Brucelose/diagnóstico , Erros de Diagnóstico , Endocardite Bacteriana/diagnóstico , Síndrome de Marfan/complicações , Automação/métodos , Técnicas Bacteriológicas/métodos , Brucelose/microbiologia , Brucelose/patologia , Endocardite Bacteriana/microbiologia , Endocardite Bacteriana/patologia , Evolução Fatal , Humanos , Masculino , Pessoa de Meia-Idade , Ochrobactrum anthropi/isolamento & purificaçãoRESUMO
Human Brucella canis infection incidence is unknown. Most identified cases are associated with pet dogs. Laboratory-acquired infections can occur following contact with Brucella spp. We identified a paediatric B. canis case, the source and other exposed persons. A 3-year-old New York City child with fever and dyspnoea was hospitalized for 48 h for bronchiolitis. After her admission, blood culture grew B. canis, she was prescribed anti-microbials and recovered. B. canis was also isolated from blood of the child's pet dog; these isolates were genetically similar. The dog originated from an Iowa breeding facility which was quarantined after identification of the dog's infection. Additionally, 31 laboratory workers were exposed and subsequently monitored for symptoms; 15 completed post-exposure prophylaxis. To our knowledge, this is the first report strongly suggesting B. canis zoonotic transmission to a child in the United States, and highlights the need for coordinated control policies to minimize human illness.