Diagnosis Of Brucellosis Research Articles

Brusellozlu Hastalarda Bakteriyeminin Makine Öğrenmesi Yöntemleri Kullanılarak Tahmin Edilmesi

Purpose: The correct and early diagnosis of brucellosis is very crucial to decelerate its spread and providing fast treatment to patients. This study aims to develop a predictive model for diagnosing bacteremia in brucellosis patients based on some hematological and biochemical markers without the need for blood culture and bone marrow and to investigate the importance of these markers in predicting bacteremia.
 Materials/Methods: 162 patients with diagnosing brucellosis, 54.9% of whom are non-bacteremic, 45.1% bacteremia were retrospectively collected. The 20 demographic, hematological and biochemical laboratory parameters and 30 classifiers are used to predict bacteremia in brucellosis. Classifiers were developed by using Python programming language. Accuracy (ACC), Area under the receiver operating characteristic curve (AROC), and F measure were employed to find the best fit classification method. Feature importance method was used to determine most diagnostic markers to predict the bacteremia. Results: Extratree classifier with criterion “entropy” (ETC1) showed the best predictive performance with Acc values ranging between 0.5 and 1.00, F values between 0.53 and 1, and AROC values between 0.62 and 1. The neutrophil%, lymphocyte%, eosinophil%, alanine aminotransferase, and C-reactive protein were determined as the most distinguishing features with the scores 0.723, 1.000, 0.920, 0.869, and 0.769, respectively.
 Conclusions: This study showed that the ETC1 classifier may be helpful in determining bacteremia in brucellosis patients and that elevated lymphocytes, alanine aminotransferase, and C-reactive protein and low neutrophils and eosinophils may indicate bacteremic brucellosis.

Diagnostic utility of LAMP PCR targeting bcsp-31 gene for human brucellosis infection

PurposeHuman brucellosis is a neglected zoonotic disease of significant public health concern. Molecular diagnosis of brucella remains challenging in low resource settings, due to the high infrastructure and cost involved. Loop-mediated isothermal amplification (LAMP) is a rapid point of care polymerase chain reaction (PCR) with the utility of on-field molecular diagnosis and offers a convenient alternative to conventional PCR. In the present study, we developed and evaluated the diagnostic utility of in house LAMP PCR targeting the Brucella genus-specific bcsp-31 gene in patients having febrile illness. Materials and methodsThe analytical sensitivity and specificity of bcsp-31 LAMP PCR was first evaluated using brucella (n ​= ​8) and non-brucella cultures (n ​= ​5), along with spiked clinical samples. The overall diagnostic utility of developed LAMP PCR was then further evaluated in 393 human samples suspected of brucellosis. ResultsThe developed LAMP PCR could detect as low as 8 ​fg of DNA by visual detection within 35min. We report sensitivity and specificity of the developed LAMP PCR as 90.91% and 99.37%.The accuracy of the developed test assay was found to be 98.60%. In clinical samples, LAMP gave positivity of 20% with the concordance of 89% with conventional PCR. ConclusionTo conclude, a rapid, efficacious, sensitive LAMP PCR targeting the bcsp 31 gene was developed. The existing LAMP PCR can be used as a point of care screening test in various low resource endemic setting in lieu of conventional PCR for estimation of prevalence data, diagnosis and treatment of brucellosis.

Comparison of the Polymerase Chain Reaction Method with Serological Tests in the Diagnosis of Human Brucellosis

Background: Brucellosis is a zoonotic disease with different clinical symptoms. Its early diagnosis is essential to prevent severe complications. Due to the limitations of serological diagnostic methods, the polymerase chain reaction (PCR) method has become important in the diagnosis of the disease. Objectives: Our study aimed to evaluate the PCR method in patients with suspected brucellosis and compare it with serological tests. Methods: This cross-sectional study was performed on 90 febrile patients with clinical features of brucellosis who were examined by an infectious disease specialist. A total of 90 serum samples were collected from the suspected brucellosis patients admitted to the hospital and were analyzed by serological (Rose Bengal) and PCR tests. Then, each method's results were recorded and compared with each other. Results: According to serological test results, 45 samples were negative, and 45 were positive. Then, among the serology-positive patients, all had positive PCR results. However, 40 out of 45 patients had a positive PCR test in serology-negative patients. According to this study, the sensitivity of PCR in diagnosing human brucellosis with the serology-positive test is 100%, and with the negative serology test is 88.9%. Therefore, the sensitivity of PCR is higher than that of serology tests in patients, which was 50% in this study. Conclusions: The PCR test can be a valuable diagnostic method for patients with negative serologic test results.

COMPARISON OF CLINICAL, LABORATORY FINDINGS AND COMPLICATIONS IN BACTERIEMIC AND NONBACTERIEMIC BRUCELLOSIS: A SINGLE CENTER EXPERIENCE

Objective: Brucellosis is a systemic zoonosis that affects various organs or body systems and can mimic many diseases. Symptoms can range from acute febrile illness to chronic clinical manifestations with severe complications. In our study, we investigated the relationship between bacteremia and clinical and laboratory findings, and complications in patients with brucellosis.
 Material and Methods: Two hundred and twenty-three patients diagnosed with brucellosis between 2005 and 2020 in the department of infectious diseases and clinical microbiology of a tertiary care university hospital were included in the study. Rose Bengal test, Brucella standard tube agglutination test and culture (blood and/or bone marrow culture) were used for the diagnosis of brucellosis. The patients were divided into two groups according to their bacteremia status. Patients with positive culture were identified as bacteremia, and patients with negative culture were identified as non-bacteriemic.
 
 Results: A total of 223 patients were included in the study, of which 142 (63.7%) were male. While weight loss, fever and hematological complications were higher in bacteremia cases (p=0.001, p

A one-health review on brucellosis in the United States.

Brucellosis is a highly infectious zoonotic disease of global significance due to its adverse impact on public health, economics, and trade. Despite being one of the most prevalent zoonoses worldwide, attention given to global brucellosis control and prevention has been inadequate. Brucella species of greatest one-health relevance in the US include those infecting dogs (Brucella canis), swine (Brucella suis), and cattle and domestic bison (Brucella abortus). Although not endemic in the US, Brucella melitensis warrants awareness as it poses a risk to international travelers. While brucellosis has been eradicated from domestic livestock in the US, its detection in US companion animals (B canis) and US wildlife reservoirs (B suis and B abortus) and enzootic presence internationally pose a threat to human and animal health, warranting its spotlight on the one-health stage. The challenges of B canis diagnosis in humans and dogs is addressed in more detail in the companion Currents in One Health by Guarino et al, AJVR, April 2023. Human consumption of unpasteurized dairy products and occupational exposure of laboratory diagnosticians, veterinarians, and animal care providers are responsible for human exposures reported to the US CDC. Diagnosis and treatment of brucellosis is challenging due to the limitations of diagnostic assays and the tendency of Brucella spp to produce nonspecific, insidious clinical signs and evade antimicrobial therapy, making prevention essential. This review will focus on zoonotic considerations for Brucella spp found within the US along with their epidemiology, pathophysiology, clinical presentation, treatment, and control strategies.

Histopathologic and immunohistochemical findings in the placentas and fetuses of domestic swine naturally infected with Brucella suis biovar 2.

Porcine brucellosis, which is caused by Brucella suis biovar (bv) 2, is a re-emerging disease that causes reproductive problems in pigs in Europe. The pathogenesis and lesions of B. suis intrauterine infection are poorly characterized; characterization could facilitate the diagnosis and investigation of porcine brucellosis. We collected samples of placentas and fetuses for histologic and microbiologic studies during an outbreak of abortions on a pig-breeding farm in Spain. Brucella was cultured from the vaginal swabs obtained from sows that had aborted, some placentas, and fetal tissues (spleen, liver, lung, gastric content); molecular testing confirmed B. suis bv 2 infection. Histologically, there was necrotizing and hemorrhagic placentitis; suppurative hepatitis; lymphoid depletion and sinusoidal histiocytosis in the spleen, lymph nodes, and thymus; and bronchointerstitial pneumonia. Hemorrhages were observed in the umbilical cord, heart, kidneys, and brain. We detected Brucella by immunohistochemistry (IHC) in all of the placentas and fetal organs studied, specifically in the trophoblasts of the chorionic epithelium, in the cytoplasm of macrophages in the chorionic stroma, and extracellularly in necrotic debris. Furthermore, we assessed the lymphocyte population in the placentas through the use of IHC (anti-CD3, anti-Pax5 antibodies), revealing that the lymphocytic response was composed of T cells but not B cells.

Brusellozda Kas İskelet Tutulumunda Manyetik Rezonans Görüntüleme ve İnflamatuar Belirteçlerin Tanıya Katkısı

Objective: Musculoskeletal involvement in brucellosis is very important. This study aimed to evaluate the magnetic resonance imaging (MRI) findings and hematological parameters as a predictive value for the diagnosis of musculoskeletal brucellosis. Methods: This prospective case-control study was conducted between June 2011 and November 2019 in a university hospital. Ninety-nine patients with the confirmed diagnosis of brucellosis without musculoskeletal involvement and forty-three brucellosis patients with musculoskeletal involvement were examined. The hematological, biochemical parameters, and radiological imaging findings of both groups were recorded. These parameters were statistically compared between the two groups. Results: The mean age of the patients (non-involvement group) and musculoskeletal involvement groups was 44.04 ± 23.11 and 37.92 ± 24.80 years, respectively (P = 0.062). C-reactive protein (CRP) and alkaline phosphatase (ALP) levels were significantly higher in the musculoskeletal involvement group (P < 0.05). The lower lymphocyte level was statistically significant in this group. Based on the receiver operating characteristic (ROC) analysis, the sensitivity and specificity were 70% and 65% for ALP, 77% and 58% for CRP, 83% and 45% for lymphopenia, respectively. There was no statistically significant difference between the two groups in terms of the other hematological and biochemical parameters. Spondylodiscitis (34.8%) was the most common MRI finding in patients with musculoskeletal involvement. Conclusions: Our study results show that CRP, ALP, and lymphopenia can be used as valuable markers in the preliminary diagnosis of musculoskeletal brucellosis.

The Development of Diagnostic and Vaccine Strategies for Early Detection and Control of Human Brucellosis, Particularly in Endemic Areas.

Brucellosis is considered one of the most serious zoonotic diseases worldwide. This disease affects both human and animal health, in addition to being one of the most widespread zoonotic illnesses in the Middle East and Northern Africa. Human brucellosis generally presents in a diverse and non-specific manner, making laboratory confirmation of the diagnosis critical to the patient's recovery. A coordinated strategy for diagnosing and controlling brucellosis throughout the Middle East is required, as this disease cannot be known to occur without reliable microbiological, molecular, and epidemiological evidence. Consequently, the current review focuses on the current and emerging microbiological diagnostic tools for the early detection and control of human brucellosis. Laboratory assays such as culturing, serology, and molecular analysis can frequently be used to diagnose brucellosis. Although serological markers and nucleic acid amplification techniques are extremely sensitive, and extensive experience has been gained with these techniques in the laboratory diagnosis of brucellosis, a culture is still considered to be the "gold standard" due to the importance of this aspect of public health and clinical care. In endemic regions, however, serological tests remain the primary method of diagnosis due to their low cost, user-friendliness, and strong ability to provide a negative prediction, so they are commonly used. A nucleic acid amplification assay, which is highly sensitive, specific, and safe, is capable of enabling rapid disease diagnosis. Patients who have reportedly fully healed may continue to have positive molecular test results for a long time. Therefore, cultures and serological methods will continue to be the main tools for diagnosing and following up on human brucellosis for as long as no commercial tests or studies demonstrate adequate interlaboratory reproducibility. As there is no approved vaccine that prevents human brucellosis, vaccination-based control of animal brucellosis has become an important part of the management of human brucellosis. Over the past few decades, several studies have been conducted to develop Brucella vaccines, but the problem of controlling brucellosis in both humans and animals remains challenging. Therefore, this review also aims to present an updated overview of the different types of brucellosis vaccines that are currently available.

Evaluation of an in-house IgM/IgG lateral flow assay for serodiagnosis of human brucellosis.

This study aimed to evaluate the diagnostic efficacy of an in-house lateral flow assay (LFA) for the detection of IgM/IgG anti-Brucella antibodies for rapid serodiagnosis of human brucellosis. Three groups of sera samples including 476 from high-risk individuals, 27 from culture-confirmed patients, and 43 from healthy blood donors were used for evaluation of LFA. In comparison with iELISA, the sensitivity, specificity, and accuracy of LFA were >95%, >99%, and 99% respectively. Considering the very good agreement, accuracy, simplicity, and rapidity, LFAs might be useful as a point of care test for the diagnosis of human brucellosis in resource-limited laboratories.

Current epizootological and epidemiologscal aspects of brucellosis in Ukraine

The analysis of monitoring studies for brucellosis among farm and wild animals for the period 2004–2021 in Ukraine was performed. The total number of tests on brucellosis during this period among cattle amounted to 62,917,946 animals, small ruminants – 10,898,075, pigs – 4,146,751, horses – 116,668, wild pigs – 22,306, roe deer – 11,548, hares (only the last two years were studied) – 430 animals. During the same period, camels, deer, dogs, cats, rabbits, poultry, zoo animals, wild animals including moose, foxes and badgers were examined in case of suspicion or request. During this period, seropositive animals were found among cattle – 607, small ruminants – 84, pigs – 219, horses – 4, dogs – 2, wild boars – 52, hares – 7. There were years when no positive animals were detected (2012, 2015), 1–3 animals were detected in 2008, 2010, 2013, 2014, 2016, 2017. The largest number of animals positive for brucellosis was detected in 2004 and 2006, respectively 107 and 328 animals. Some regions stand out among others with a significant number of positive results. Thus, in Sumy region, positive animals were isolated in 2004, 2005, 2007, 2009, 2010, 2011, 2013, 2019, 2020, 2021 (a total of 45 animals), in Dnipropetrovsk region in 2004, 2016, 2017, 2018 (a total of 11 animals). The results of the analysis showed that human brucellosis in Ukraine is registered sporadically (single cases). During the analyzed period, 32 cases of human brucellosis were detected, during the period 1994–2021, the diagnosis of brucellosis was confirmed in 45 people. Approximately 50% of human brucellosis cases in Ukraine are introduced from abroad. The vector role of wild animals-reservoirs in the spread of the brucellosis pathogen in the direction of farm animals and from them to humans is confirmed. Among the regions, the most disadvantaged were Chernihiv (cases in 2009, 2011, 2014, 2015), Lviv (2005, 2011, 2021) and Kyiv (2008, 2014, 2021). During the period 1994–2021, the disease was not registered in people at all in the Autonomous Republic of Crimea, Volyn, Vinnytsia, Transcarpathian, Zaporizhzhia, Kirovohrad, Rivne, Ternopil, Cherkasy regions.

Human brucellosis in Baringo County, Kenya: Evaluating the diagnostic kits used and identifying infecting Brucella species.

Human brucellosis diagnosis has been a challenge in Brucella-endemic areas. In Kenya, diagnosis is usually carried out using Febrile Brucella Antigen agglutination test (FBAT) whose performance is not well documented. This paper reports on the sensitivity and specificity of the FBAT used for brucellosis diagnosis on blood samples/serum collected in three healthcare facilities in Baringo County, Kenya, and on Brucella species present in the study area. The FBAT test results at the hospitals were used to guide patient management. Patients who visited the hospital's laboratory with a clinician's request for brucellosis testing also filled a questionnaire to assess knowledge and attitudes associated with transmission of the disease in the study area. The remaining serum samples were tested again using FBAT and Rose Bengal Plate Test (RBPT) within a month of blood collection at the University Nairobi Laboratory. The two rapid tests were then compared, with respect to brucellosis diagnostic sensitivity and specificity. To identify infecting Brucella species, a proportion 43% (71/166) of the blood clots were analyzed by multiplex polymerase chain reaction (PCR) using specific primers for B. abortus, B. melitensis, B. ovis and B. suis. Out of 166 serum samples tested, 26.5% (44/166) were positive using FBAT and 10.2% (17/166) positive using RBPT. The sensitivity and specificity of FBAT compared to RBPT was 76.47% and 71.19%, respectively while the positive and negative predictive values were 29.55% and 96.72%, respectively. The FBAT showed higher positivity then RBPT. The difference in sensitivity and specificity of FBAT and RBPTs was relatively low. The high FBAT positivity rate would be indication of misdiagnosis; this would lead to incorrect treatment. Brucella abortus was detected from 9.9% (7/71) of the blood clots tested; no other Brucella species were detected. Thus human brucellosis, in Baringo was mainly caused by B. abortus.

Osteoarticular Involvement in Childhood Brucellosis: Evaluation of Clinical, Laboratory and Radiologic Features of 185 Cases.

Brucellosis is a systemic zoonotic disease. Osteoarticular (OA) system involvement is a common complication and the predominant manifestation of brucellosis in children. We aimed to evaluate the epidemiologic, demographic, clinical characteristics, and laboratory and radiologic findings of children with brucellosis and how these related to OA involvement. This retrospective cohort study consisted of all consecutive children and adolescents diagnosed as having brucellosis who were admitted to the pediatric infectious disease department of University of Health Sciences Van Research and Training Hospital between August 1, 2017, and December 31, 2018, in Turkey. A total of 185 patients diagnosed as having brucellosis were evaluated, 50.8% had OA involvement (n = 94). Seventy-two patients (76.6%) exhibited peripheral arthritis involvement, among of them, hip arthritis (63.9%; n = 46) was the most common manifestation, followed by arthritis of knee (30.6%; n = 22), shoulder (4.2%; n = 3) and elbow (4.2%; n = 3). A total of 31 patients (33.0%) had sacroiliac joint involvement. Seven patients (7.4%) had spinal brucellosis. Erythrocyte sedimentation rate level above 20 mm/h at admission and age were independent predictor of OA involvement (respectively odds ratio [OR] = 2.82; 95% confidential interval [CI] = 1.41-5.64, OR peryear = 1.10; 95% CI: 1.01-1.19). Increasing age was associated types of OA involvement. A half of brucellosis cases had OA involvement. These results can help physicians to make early identification and diagnosis of childhood OA brucellosis who present with arthritis and arthralgia to enable the disease to be treated in time.

Prevalence and factors associated with brucellosis and tuberculosis in cattle from extensive husbandry systems in Sahel and Hauts-Bassins regions, Burkina Faso

Brucellosis and tuberculosis are important zoonotic diseases with high economic and public health importance mainly in low income countries. In Burkina Faso, studies have been implemented to assess prevalence of these diseases but data remain scare about the prevalence in extensive husbandry systems. This study aimed to determine the prevalence and factors associated with brucellosis and tuberculosis in cattle from extensive husbandry systems in two regions of Burkina Faso. Serums samples were collected on 2195 cattle from 206 herds in Hauts-Bassins and Sahel region. Intradermal skin test and Rose Bengal Plate test have been carried out for the diagnosis of tuberculosis and brucellosis respectively. The overall herd prevalence was 18.93% and 25.73% respectively for brucellosis and tuberculosis while the herd prevalence of co-infections was 6.31%. The individual prevalence was 3.64% (95% CI: 2.85% - 4.42%) and 3.51% (95% CI: 2.74% - 4.28%) for brucellosis and tuberculosis respectively. A prevalence of 0.32% (95% CI: 0.08% - 0.55%) was noted for co-infections. Brucellosis infection was associated with herd size, animal sex and age (p ˂ 0.05). The highest prevalence was found in herds of more than 60 animals (8.2%; 95% CI: 5.7%-10.6%) and in animal aged between 5 and 8 years old (5.3%; 95 CI: 3.4%–7.1%). The prevalence was significantly higher in females (3.9%; 95%CI: 3.0%–4.7%) compared with males (1.0%; 0.04% - 2%). Tuberculosis prevalence was significantly higher in Hauts-Bassins region (6.2%; 95% CI: 4.4%-8.0%) than in Sahel region (2.3%; 95% CI: 1.5%–3.0%). The highest prevalence of tuberculosis was found in herds with at most 30 animals (9.9%; 95% CI: 4.0% - 15.7%) and in animal less than 4 years old (5.4%; 95% CI: 3.4%–7.4%). Results suggest that brucellosis and tuberculosis are prevalent in cattle herds, therefore management practices are needed for better control of the zoonotic diseases.

Diagnostic challenges of brucellosis in humans and livestock in Tanzania: A thematic review

Abstract Brucellosis is an endemic bacterial zoonosis in Tanzania, and is among the most prioritized zoonotic diseases in the country. Brucellosis affects public health and livestock production in developing countries. Most human and livestock cases are not detected by the existing surveillance systems resulting in significant underestimation of the disease burden, and poor management of human cases by using nonspecific antibiotics may potentially contribute to antimicrobial resistance. To quantify the factors related to underreporting and those associated with the challenges in the diagnosis of brucellosis in Tanzania, search terms including “Brucella” “diagnosis” and “challenges” were used to query in Google search engine and publisher databases such as MEDLINE, PUBMED, NCBI, Springer, Hindawi, and Elsevier. The search parameters were limited to publications between 1995 and 2020. The searches returned 319 publications and grey articles which were screened and 57 were eligible for inclusion in this study. Four main areas were identified that cause underreporting of brucellosis and hinder brucellosis diagnosis: (1) inadequate knowledge of brucellosis among stakeholders in the livestock value chain, (2) limited diagnostic capacity for brucellosis due to unawareness of diagnostic tests and lack of epidemiological background of brucellosis among human and livestock health service workers (3) challenges associated with diagnostic tests, which include unreliable availability of diagnostic tests and unskilled workers, and (4) the uneven distribution of brucellosis surveillance studies in the country. This study suggests that there is a need for (1) training on public health education and brucellosis awareness among stakeholders in the livestock value chain; (2) providing scheduled continuing professional education with regard to brucellosis and other zoonotic diseases to health and livestock workers; (3) future brucellosis surveillance studies must focus on unrepresented regions; and (4) lastly, we recommend that the rose Bengal plate test (RBPT) and competitive enzyme-linked immunosorbent assay (cELISA) should be considered in brucellosis diagnostic schemes as a complementary tool to hasten the implementation of an ongoing national strategy for the prevention and control of brucellosis in humans and livestock in Tanzania. We suggest that these recommendations be considered for inclusion in the national strategy for brucellosis control in Tanzania. One Health Impact Statement Brucellosis is a disease caused by bacteria of genus Brucella and is transmitted from animals to humans. Humans get infected through ingestion of infected animal products but also through contact with bacteria via broken skin or inhalation of aerosolized bacteria particles during culture in the laboratory. Humans working with animals or animal products and laboratory personnel are at higher risk of infection. Tanzania has recently established a One-Health desk in the Prime Minister’s Office to address all matters related to One Health. However, the desk is in the infancy stage, more studies must be done to fill knowledge gaps so that working instruments became realistic. This review provides a synthesis of information that could be used by the One Health desk and other One Health stakeholders in the country on how to improve the existing brucellosis surveillance structures for improvement of One-Health service delivery in the country.

Prediction of Brucellosis Based on Hematological Biomarkers via Ensemble Classification Methods

Aim: Some hematological changes are frequently observed in the clinical course of brucellosis. This study aimed to predict the diagnosis of brucellosis based on some hematological biomarkers with the help of ensemble classification methods. Materials and Methods: A total of 23 ensemble classification methods, including 10 bagging, 9 boosting, and 4 stacking approaches were applied to the brucellosis data set. Each subject in the brucellosis data set contains 13 features, including age, gender, and 10 hematological variables. Results: This study included a total of 257 participants [173 (67.3%) brucellosis patients and 84 (32.7%) healthy controls]. The mean values of white blood cells (WBC), hemoglobin (HGB), neutrophil (NEUT), neutrophil/lymphocytes (NEUT/LYMP), and monocytes/lymphocytes (MO/LYMP) of brucellosis patients were found to be significantly lower than those of healthy controls. Random Forest with Gini criterion (RF2) was selected to be the best fit model with a mean accuracy of 0.728. HGB (mean score = 0.1814), age (0.1311), NEUT/LYMP (0.0938), WBC (0.0817) and mean platelet volume (MPV) (0.0815) were determined as most diagnostic parameters in brucellosis. Conclusion: The lower levels of HGB, WBC, and NEUT/LYMP and higher levels of age and MPV may be important indicators for the diagnosis of brucellosis.

The Effect of Erythritol Injection in Decreasing of Abortion Rate in Local Breed Ewes.

This study designed to evaluate the effect of Erythritol injection in decreasing of abortion rate in local breed ewes. Fifty pregnant ewes from local breed aged 2-4 years with a history of abortion except G1, were fed ad libitum hay and grains with water. The study was carried out in Salah Aldein province at special farm at a period of July-November 2022. These animals were tests for brucella by using rose Bengal and ELISA at zero day for confirmation; these animals were divided into 5 groups: G1 was brucella -ve and pregnant at 60 days, G2 was brucella +ve and pregnant at 60 days, G3 brucella+ve pregnant animals and treated by antibiotics gentamicin 10%, 3 ml/animal for 3 days, G4 brucella +ve and pregnant and giving erythritol, 10 ml S/C of 10% solution (solve in water and glycerol), and G5 was brucella +ve, and all pregnant and giving Erythritol+ gentamycin 10%, 3 ml/animal for 3 days. The experiment takes 12 weeks. Blood was withdrawn at different times of experiment (0, 2 weeks and end of experiment). The seroprevalence of brucellosis was shown that all animals at G4 and G5 where seropositive after 14 days of experiment, at end of pregnancy the seropositivity were highly significantly in G4 and G5 as compared with another groups. The current results showed that percentages of abortion were higher in G2, followed by G3, while it has been reduced significantly in G4 and G1. In conclusion, Erythritol alone can decrease the rate of abortion by making the bacteria extracellular far from placenta and evading of infection by immunity and/or gentamicin injection. Also, erythritol can be used as elicit diagnosis of brucellosis in latent infected animals.

Сравнительная эффективность лабораторных методов в диагностике различных клинических форм бруцеллеза

Brucellosis is a zoonotic infection characterized by variable clinical manifestations, a variety of transmission routes, chronic inflammation, and risk of disability. Brucellosis remains a problem of practical healthcare in Russia, especially in endemic regions. Laboratory tests for brucellosis diagnosis are rarely used together, which prevents objective comparison of their effectiveness for different clinical forms of the disease. In this study, we analyzed different laboratory methods for comprehensive diagnosis of various clinical forms of brucellosis. Objective. To compare different laboratory methods for the diagnosis of various clinical forms of brucellosis. Materials and methods. We tested serum from 1049 individuals collected between 2005 and 2022. Samples were analyzed using agglutination reaction in tubes (Wright reaction; WR), on slides (Huddleson reaction; HR), Coombs test (CT), enzymelinked immunosorbent assay (ELISA), and real-time polymerase chain reaction (PCR) for BCSP31. We also performed retrospective analysis of 325 patient records. Of them, 110 patients (34%) had acute brucellosis, whereas 215 patients (66%) had chronic brucellosis. The control group comprised 604 individuals (with no clinical, epidemiological signs tested negative for brucellosis). Results. We analyzed 325 brucellosis patients (including 110 with acute disease, 215 with chronic disease, and 120 with no clinical manifestations) and 604 healthy controls. The sensitivity of PCR in acute and chronic disease was 94% and 32%, respectively. The specificity of PCR was 99.7%. ELISA demonstrated 92% and 86% sensitivity in acute and chronic disease, respectively, with a specificity of 98%. The negative and positive prognostic value for ELIZA and PCR were 95% and 96%, 83% and 99% respectively, suggesting similar effectiveness and accuracy of these methods. The sensitivity of traditional serological tests in acute disease was 75%, 62%, and 56.3% for RH, WR, and CT, respectively. In patients with chronic brucellosis, their sensitivity did not exceed 60%. Specificity of WR and CT was 97% in chronic disease, while it of RH dropped to 83%. Conclusion. PCR and ELISA ensured high diagnostic effectiveness and accuracy in assessing the activity of infection and diagnosis of brucellosis clinical forms, as well as in screening among vulnerable individuals. Traditional serological tests, despite their lower sensitivity, confirm acute disease and need for comprehensive laboratory diagnostics of brucellosis patients. Key words: brucellosis, diagnostic methods, enzyme-linked immunosorbent assay, polymerase chain reaction, Wright reaction, Huddleson reaction, Coombs test

Brucelose- a propósito de um Caso Clínico

Introduction Brucellosis is a zoonosis caused by a gram-negative coccobacillus bacterium of the genus Brucella, which can be transmitted by direct contact with animals or their secretions. Is an acute or subacute systemic disease that generally starts two to four weeks after inoculation. Its symptoms are nonspecific, but typically are presented with fever, night sweats, arthralgias or asthenia. Although being endemic in underdeveloped countries, is still an underdiagnosed and underreported disease. Case Report This is a 28 year old veterinarian assistant male, with close and frequent contact with cattle, sheep and goats. He is unaware of having ever been submitted to an aptitude test for work and, as personal protective equipment, uses gloves and a rubber apron only. He was observed in the hospital emergency department, due to recurrent testicular pain and constitutional symptoms. Serology test showed a borderline IgG for brucellosis. Therefore, the case was notified in the National System of Epidemiological Vigilance. The patient was treated with doxycycline and rifampicin, and the testicle was surgically removed. The surgical piece accused Brucella spp, which confirmed the diagnosis of brucellosis with orchiepididymitis. Discussion Considering that the symptoms of brucellosis are unspecific, a detailed clinical history, including occupational exposure/background, is fundamental for the diagnosis. The incidence of cases associated with occupational exposure is relevant, being veterinarians and large animal veterinary assistants among the professional groups with higher risk. Low adherence to personal protective equipment and lack of knowledge may be factors that perpetuate the infection. It is essential to facilitate access to Occupational Health services to ensure the health surveillance of these workers. Conclusion Brucellosis is one of the most neglected zoonosis worldwide, however, it’s one of the three most common in Portugal. This case report urges the healthcare professionals to acknowledge these less known work-related diseases, in particular zoonosis, that are often underdiagnosed. The professional risk assessment and the implementation of protective measures are fundamental in reducing occupational risk, being the assessment of working conditions by a qualified safety technician required. Thus, Occupational Health teams play a leading role in preventing professional illnesses, promoting health, implementing preventive measures and reducing morbidity and mortality. KEYWORDS: Occupational Health, Work Medicine, Work Security, Brucellosis, Veterinary.

The status of cattle brucellosis in Ethiopia: A review

Brucellosis is an infectious bacterial disease caused by member of the genus Brucella. Bovine Brucellosis is an important disease of cattle, which has zoonotic importance with substantial economic losses. Risk factors that can predispose to brucellosis include Animal factors, Pathogen factors, environmental factors, managemental factors and occupational risk factors. Hence, knowledge of brucellosis occurrence in traditional livestock husbandry practice has considerable importance in reducing the economic and public health impacts of the disease. The possible sources of infections include all infected tissues, aborted fetus, vaginal discharges, cultures and potentially contaminated materials. The pathogenesis of the diseases lies on the presence of the bacteria, in the cells and employing various methods to survive in the phagocytic cells. The disease can be transmitted from infected host to susceptible animals in direct and indirect contacts. However, the most common mode of transmission is sexual contact. Various methods are employed for the diagnosis of brucellosis including microscopic examination, culture methods, serological and molecular biology. In Ethiopia, Brucella sero prevalence with in extensive cattle rearing system is lower than that of intensive systems. The most rational approach for control of B. abortus infection is by vaccinating young female animals. To deal with diseases like brucellosis, the public in general and high-risk groups in particular should be made aware of the zoonotic and economic importance of brucellosis through veterinary extension education.

1854. Response to an Intravenous versus Oral Antibiotic Regimen in Brucellosis Bacteremia: A Single-Center Experience

Abstract Background Human brucellosis is an infectious multisystem disease that varies in severity and clinical course. Bacteremia in brucellosis is common; however, data on epidemiology and management of Brucella bacteremia are scarce. The World Health Organization recommends using doxycycline with rifampicin or an aminoglycoside for brucellosis. This study aims to compare the efficacy of the two treatment regimens (oral doxycycline/rifampicin or ciprofloxacin versus IV gentamicin plus oral doxycycline/rifampicin or ciprofloxacin) in Brucella bacteremia. Methods In this single-center, retrospective cohort study, we analyzed the outcomes of 93 adults with confirmed Brucella bacteremia from 2017 to 2020. The diagnosis of brucellosis was based on positive blood culture for Brucella species. The patients were divided into two cohorts according to the treatment regimen received (oral versus IV). Blood culture negativity after four weeks and clinical cure rate at end of therapy were the co-primary endpoints, while side effects were secondary endpoints. Fisher's exact test and Pearson's chi-square test were applied to compare the two groups. The data were analyzed using SPSS version 23. A P-value < .05 was considered significant. Results A total of 93 cases of Brucella bacteremia were enrolled, with 64 (68.8%) patients being male, and the group mean age being 44.3 ± 19.2 years. Overall, 37 (39.8%) patients received IV regimen, while 56 (60.2%) received oral treatment. Follow-up blood culture negativity after four weeks for both groups was 90.3% (n=84) with no difference between the oral and IV regimens (87.5% (n=49) versus 94.6% (n=37); P= .348, respectively). The overall clinical cure rate was 93.5% (n=87) for both groups combined, with no significant difference between the oral and IV groups (91% (n=51) versus 97.3% (n=36); P= .397, respectively). Transaminitis (7.1% vs. 5.4%), vomiting (5.4% vs. 8.1%), and acute kidney injury (0% vs. 2.7%) were all reported in the oral and IV groups, respectively, with no statistically significant difference between the two groups (P =.590). No deaths were reported over this period. Conclusion Oral and IV antimicrobial regimens have the same response rates in Brucella bacteremia patients. Disclosures All Authors: No reported disclosures.