Presence Of anti-Brucella Antibodies Research Articles

Seronegative brucella meningitis diagnosed by CSF PCR: report on seven cases

IntroductionNeurobrucellosis (NB) can be associated with meningitis and present as a headache with or without meningeal signs. Pseudotumor presentation of NB has been reported to be accompanied by lymphocytic predominant cerebrospinal fluid(CSF) pleocytosis. NB is diagnosed by means of isolation of Brucella from blood or CSF and/or the presence of anti-Brucella antibodies in the CSF. Molecular techniques have been used in chronic or challenging cases of NB.Clinical findingsWe report on seven cases of NB presenting with different types of headache and signs of meningeal involvement. In five cases, signs of intracranial hypertension were evident in the form of papilledema, sixth nerve palsy and blurred vision.DiagnosisMRIs of the brain revealed signs of intracranial hypertension in three patients, basal meningeal enhancement in one patient and white matter lesions in one patient. Brucella serology in the blood and CSF was negative in all patients. It was interesting that four patients had normocellular CSF analysis with normal glucose and protein results. The diagnosis was made by Brucella PCR in all patients.ConclusionNB should be considered in the differential diagnoses of pseudotumor cerebri syndrome in endemic areas. It is important to employ molecular techniques using sterile CSF samples in the investigation of Brucella.

Evaluation of clinical, diagnostic features and therapeutic outcome of neurobrucellosis: a case series and review of literature

Aim In this study, we aimed to discuss the clinical features, laboratory findings, treatment and outcome of seven cases of neurobrucellosis from a tertiary care center and review the available global literature. Materials and methods The diagnosis of neurobrucellosis was established using the following criteria in our setting: (1) signs and symptoms of neurological infection with examination of cerebrospinal fluid (CSF) revealing signs of meningitis, (2) isolation of Brucella spp. from blood and/or CSF and/or antibody titer ≥1:160 in serum using standard agglutination test (SAT) and/or the presence of anti-Brucella antibodies in CSF and/or detection of Brucella spp.-specific DNA from CSF using PCR. A literature search was performed to review previous cases of neurobrucellosis published worldwide during the last 30 years. Results The proportion of neurobrucellosis was 2.8% in our setting. Fever with headache and altered sensorium were the major presenting complaints. Brucella melitensis was isolated from blood culture in 6 patients. From the literature search, a total of 221 cases of neurobrucellosis were reviewed and analyzed. Meningitis (32.6%), loss of hearing (25.8%) and encephalitis (14.9%) were the most common clinical features. Involvement of cranial nerves, polyradiculopathy and paraplegia were the major complications found in patients with neurobrucellosis. Conclusions Neurobrucellosis should always be considered in the differential diagnosis of befitting neurological, rheumatological, and neuropsychiatric presentations in endemic regions for brucellosis. To prevent morbidity and mortality associated with neurobrucellosis, a multimodal diagnostic approach is essential for early and accurate diagnosis and effective treatment.

A Cluster of Neurobrucellosis at King Hussein Medical Center, Jordan - A Comprehensive Analysis And Review.

In this retrospective review, we describe the neurological clinical manifestations in five cases diagnosed with neurobrucellosis over two years between 2018 and 2020, and the application of different proposed criteria for establishing the diagnosis and treatment of neurobrucellosis. All cases were confirmed to have brucellosis with laboratory tests, and all were living in Jordan, which is considered part of a highly endemic area within the Middle East. The neurobrucellosis proposed criteria was applied, which requires signs and symptoms consistent with neurobrucellosis, presence of anti-Brucella antibodies in cerebrospinal fluid and serum with or without isolation of Brucella species in CSF and serum, cerebrospinal fluid analysis shows: lymphocytosis, high protein level, and low glucose level and radiological findings on MRI or CT. In all five cases, we have confirmed direct contact with animals or animal products either as a consumer or as a farmworker. Their signs and symptoms were consistent with brucellosis. In all cases, haematological and CSF results, in addition to imaging findings using magnetic resonance and computed tomography, were highly coherent with neurobrucellosis. Neurobrucellosis can present with different clinical manifestations, either as a sole site of infection like acute or subacute meningitis or myelitis, or in context of a multi variable systemic disease. In patients with unusual neurological clinical presentations, and those with persistent chronic symptoms like headache, malaise, or depression, neurobrucellosis should be highly suspected, especially in endemic areas. Such patients must have a prolonged course of antibiotics between 6 to 18 months with close monitoring of their serum and CSF examination

Zoonotic brucellosis: Seroprevalence and different serological tests comparison in ovine and caprine population in district Quetta, Balochistan

The present study was design to determine the seroprevalence of zoonotic brucellosis and different serological tests comparison in ovine and caprine population in district Quetta, Balochistan. A total of 500 blood samples, comprising of 250 each from sheep and goat were randomly collected from out skirts of District Quetta, Balochistan. Out of the 250 blood samples 125 were collected from each males and females. The serum samples were tested for the presence of anti-Brucella antibodies by Rose Bengal Plate Test (RBPT), Serum Plate Agglutination Test (SPAT) and Serum Tube Agglutination Test (STAT). The overall prevalence of brucellosis in sheep was recorded as 16.4%, 13.2% and 10.8% by RBPT, SPAT and STAT, respectively and in goat was found to be 11.6%, 8.8% and 6.8% by RBPT, SPAT and STAT, respectively. The sex-wise prevalence of brucellosis in Ram (male sheep) was recorded as 12.8%, 8.8% and 7.2% by RBPT, SPAT and STAT, respectively; while in Ewe (female sheep) it was 20.0%, 17.6% and 14.4% by RBPT, SPAT and STAT respectively. In Buck (male goat), the seroprevalence of brucellosis was recorded 8.0%, 5.6% and 3.2%, whereas in Dew (female goat) it was 15.2%, 12.0% and 10.4% by RBPT, SPAT and STAT, respectively. The prevalence of brucellosis was relatively higher in ovine (sheep) as compared to caprine (goat), irrespective of techniques used. It was also concluded that brucellosis was higher in females than in males in both sheep and goat. Among all the serological tests applied in the present study, RBPT was found to be more sensitive and showed higher prevalence of brucellosis in sheep as well as in goat population.

Serodiagnostic potential of Brucella outer membrane and periplasmic proteins

The aim of this study was to evaluate the serological diagnostic potential of the Brucella recombinant outer membrane (rOMP25, rOMP31) and periplasmic proteins (rBP26, rSOD) in a comparative way using an indirect enzyme-linked immunosorbent assay (i-ELISA). Rabbit and/or mouse antibodies to Brucella whole cell and/or soluble protein preparations recognized all recombinant proteins used, which confirms the expression of target antigens in E. coli in active form. The recombinant proteins showed different antigenicity to antibodies of cattle kept on a brucellosis-affected (endemic) farm and/or a new focus of infection. Thus, the presence of anti-Brucella antibodies was confirmed by i-ELISA/rSOD in 79% of cows from endemic conditions with positive results by conventional serological tests (RBPT and/or CFT). However, antibodies specific to this protein were detected in only 14% of seropositive animals kept in the hotbed of a new brucellosis infection. Moreover, rSOD-specific antibodies were not detected in the sera of vaccinated cattle from a brucellosis-free farm, whereas antibodies to other recombinant proteins were found in 2%-8% of animals. Using recombinant proteins in immunoassays significantly reduced the number of cows positive for brucellosis. Furthermore, there was not a single protein among the rOMPs that would show the total positive results of all proteins used. Thus, the development of reliable ELISA tests for the diagnosis of brucellosis requires further comprehensive study of the recombinant proteins in order to design a multiprotein antigen that consists of a combination of several proteins with diagnostic potential.

A cross-sectional study of the seroprevalence and flock-level factors associated with ovine and caprine brucellosis in southeastern Iran.

This cross-sectional study was conducted to estimate seroprevalence and to identify flock-level factors associated with seropositivity to brucellosis in small ruminants in Kerman province, southeastern Iran. In October-November 2011, serum samples were randomly collected from 1767 sheep and 1233 goats, older than 18 months, from 300 flocks. The sera were initially screened for the presence of anti-Brucella antibodies using the Rose-Bengal test; those found to be positive were then examined by Wright and 2-mercaptoethanol Brucella agglutination tests. A questionnaire was used to collect data on flock-level factors likely associated with the within flock seroprevalence of brucellosis. The associations were statistically evaluated for significance in multivariable logistic models. Sixty three flocks (21.00%; 95% CI: 16.80-26.60) had at least one seropositive animal. The mean within-flock seroprevalence was 3.10% (95% CI: 2.60-3.90). The presence of newly purchased animals (OR=3.42; 95% CI: 1.35-8.65) was significantly associated with seropositivity. Our findings highlight the role of animal movement among flocks in the epidemiology of brucellosis in this region. Thus, a control program for brucellosis in the region is suggested to impose appropriate restrictions on animal trade and improve knowledge of livestock owners about quarantine principles for newly purchased animals.

Seroprevalence of Brucellosis in Sheep and Humans in District Kohat, Pakistan

| Brucellosis is a bacterial disease and is caused by genus Brucella. It is highly prevalent zoonotic disease in developing countries including Pakistan. This study was conducted to determine the prevalence of brucellosis in sheep and humans of district Kohat, Khyber Pakhtunkhwa. For this purpose, one hundred blood samples from each humans and sheep (50 each from both sexes) were randomly collected at three different tehsils (Lachi, Seni Gumbat and Kohat) of district Kohat. The serum samples were tested for presence of anti-Brucella antibodies by Rose Bengal Plate Test (RBPT) and Serum Agglutination Test (SAT). Moreover, a total of 50 milk samples were also collected from various sheep herds for subsequent conduction of milk ring test (MRT). The estimated prevalence of ovine brucellosis was 12.12%, 09% and 08.82% in Lachi, Seni Gumbat and Kohat, respectively, with an overall prevalence of 10% in the district. Whereas, SAT and RBPT demonstrated the prevalence as 7% and 6%, respectively, in humans. The results of current study validated that brucellosis was widespread in district Kohat with a relatively higher prevalence being recorded in ewes and occupationally exposed women than their male counterparts. Furthermore, the prevalence of brucellosis was significantly higher in sheep and humans of Lachi and Seni Gumbat tehsils as compared to Kohat. Results of the current study may support the health care organizers to formulate suitable control plans against Brucellosis.

Neurobrucellosis: Clinical and Diagnostic Features

We describe the neurological involvement in brucellosis and revisited diagnostic criteria for neurobrucellosis. Patients with laboratory-confirmed brucellosis who were consequently hospitalized were observed prospectively in a brucellosis-endemic region. The neurobrucellosis was diagnosed by any one of the following criteria: (1) symptoms and signs consistent with neurobrucellosis; (2) isolation of Brucella species from cerebrospinal fluid (CSF) and/or presence of anti-Brucella antibodies in CSF; (3) the presence of lymphocytosis, increased protein, and decreased glucose levels in CSF; or (4) diagnostic findings in cranial magnetic resonance imaging or CT. Lumbar puncture was performed in 128 laboratory-confirmed brucellosis cases who had neurological symptoms and signs, and 48 (37.5%) were diagnosed as neurobrucellosis. The sensitivity of tube agglutination (TA) in CSF was 0.94, specificity 0.96, positive predictive value 0.94, and negative predictive value 0.96. Brucella bacteria were isolated from CSF in 7 of 48 patients (15%). The mean age of 48 neurobrucellosis patients was 42 years (SD, 19 years), and 16 (33%) were female. The most common neurological findings were agitation (25%), behavioral disorders (25%), muscle weakness (23%), disorientation (21%), and neck rigidity (17%). Cranial nerves were involved in 9 of 48 patients (19%). One patient was left with a sequela of peripheral facial paralysis and 2 patients with sensorineural hearing loss. Patients with severe and persistent headache and other neurologic symptoms and signs should be considered for neurobrucellosis in endemic regions and to possibly receive longer therapy than 6 weeks. Brucella TA with Coombs test in CSF is sensitive and specific by using a cutoff of ≥1:8.

Seroprevalence of human brucellosis in Erbil city

Background and objectives: Brucellosis is an acute or chronic illness manifested principally by chills and fever. Occasionally, chronic relapsing febrile episodes occur. Brucellosis is endemic in animal and humans are infected incidentally. The aim of the study was to examine the incidence of brucellosis in Erbil City, study the relation between the rate of infection and a number of predisposing factors. Methods: Blood samples were collected from (2085) patients suspected of having brucellosis attending, Erbil Teaching Hospitals and Rizgary. The sera were examined using Rose Bengal test. Results: Serum samples from patients showed (10.7%) of positive reaction indicating the presence of anti-brucella antibodies. Seropositivity of brucellosis in female (12.48%) was significantly higher than male (8.02%), and in rural area was (40.98%) and in urban area was (9.44%). The highest seropositivity of brucellosis occurred among age group (21-30) years. The infection rate with B. miletensis and Brucella abortus was (71.75%) and (28.25%) respectively. The highest seropositivity occurred among individuals who were in contact with animals (37.34%), and in occupations was the highest among the farmers and dairy workers (37.5% and 37.28%) respectively. In Monthly distribution showed the highest sero-positivity occurred in October (12.72%). Conclusion: Sero-posivity of brucellosis in Erbil City is somehow similar to the neighboring countries. There are variations in the incidence of brucellosis in relation to sex, age, area, occupation, source of infection and seasons.