Isolation of Brucella Melitensis in Azerbaijan in 2014

Abstract

Purpose: Republican Anti-Plague Station (RAPS) in Azerbaijan provides confirmatory tests for especially dangerous pathogens (e.g.Yersinia pestis, Bacillus anthracis, Brucella spp., Francisella tularensis). In Azerbaijan RAPS and its regional Anti-Plague Divisions (APDs) are responsible for testing human samples for abovementioned pathogens. RAPS receives samples for confirmatory test from patients referred by Baku, regional hospitals and APDs.The aim of this study was to isolate and identify Brucella cultures from human blood samples. Methods & Materials: In 2014, 1,137 blood samples were collected by RAPS from patients with clinical symptoms such as high temperature, perspiration, chills, myalgia, arthralgia, headache, fatigue, lack of appetite. All samples were tested using the Azerbaijan Ministry of Health (EDPs Laboratory Guidelines, 2013) algorithm via bacteriology and serology tests. Blood serum was tested for the presence of the antibodies of Brucella spp. via Huddleson reaction, Rose Bengal test and Wright's reaction. Samples positive for Brucella spp. per Huddleson and Rose-Bengal reactions further were tested by Wright's reaction. Positive blood samples by Wright's reaction with titers 1/200 and higher were then cultured. Isolated pure cultures were examined by biochemical (Urease, Oxidase, Catalase, TSI/H2S, Dye sensitivities) and serology (Trypaflavine, Agglutination with specific polyvalent serum, anti -A and anti -M monospecific sera) tests. Results: Data showed that 54.3% from total number of serum samples were positive by Huddleson reaction; 35.6% from total were positive by Rose-Bengal reaction and 38.7% from total samples were positive by Wright's reaction. Positive blood samples with titer 1/200 and higher from first diagnosed patients (n = 89) were cultured. All isolates were identified as Brucella melitensis (an overall isolation rate was 16.9%). The reports about positive results are sent to the Ministry of Health and State Veterinary Control Service (SVCS) and entered into the Electronic Integrated Disease Surveillance System (EIDSS) database of the Ministry of Health of Azerbaijan. Data from the system allows tracking the incidence of brucellosis and making operational decisions. Conclusion: Future genetic analyses of these isolates can help identify subtypes of Brucella melitensis and establish the origin of B.melitensis circulating in the Azerbaijan territory and compare the results with those of neighboring countries.