New developments in the diagnostic procedures for zoonotic brucellosis in humans

Federal Institute for Risk Assessment, Diedersdorfer Weg 1, D-12277 Berlin, Germany.
Revue scientifique et technique (International Office of Epizootics) (Impact Factor: 0.69). 04/2013; 32(1):177-88.
Source: PubMed

ABSTRACT At present, laboratory diagnosis of human brucellosis is based on isolation of the bacteria from clinical samples followed by standard microbiological tube testing, detection of anti-Brucella antibodies using various serological tests, and the use of molecular methods for the detection of Brucella DNA. None of these diagnostic tools can be used on its own to reliably detect the causative agent. Cultures give a low yield and subsequent phenotypic characterisation is time consuming, meaning that the initiation of adequate antibiotic therapy is frequently delayed. Serological tests seem to be more effective but are not internationally standardised. Moreover, antibodies can remain detectable despite successful therapy, cross-reacting antibodies may occur, and variable cut-offs for different levels of endemicity are lacking. Molecular assays may reduce diagnostic delays in clinical laboratories, but diagnostic criteria for active infection have not yet been defined. This article reviews the latest microbiological methods for the diagnosis of human brucellosis and outlines developments for the future.

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    • "Brucellosis is a zoonotic infection with a worldwide impact, causing significant health and economic problems (Boschiroli et al., 2001). Humans may acquire the infection by direct contact with infected animals, by inhalation of infected aerosols (Taleski et al., 2002) or indirectly through the ingestion of contaminated foods of animal origin, for example unpasteurized milk or cheese (Al Dahouk et al., 2013). More than 500 000 human cases are reported worldwide each year, particularly around the Mediterranean basin. "
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    ABSTRACT: Brucellosis is an important zoonosis caused by Brucella spp., still prevalent in most areas of the world. Brucellosis control in animals is the key to protect humans. The knowledge of Brucella spp. prevailing genotypes in a territory represents an important epidemiological tool to formulate policies and strategies for disease control and to trace back the introduction of new strains previously considered as exotic. In the last years, multiple-locus variable number tandem repeat analysis (MLVA) has been proposed as complementary to classical biotyping methods. MLVA may add important information to the classical epidemiological investigation techniques, to help in tracing back sources of infection in brucellosis outbreaks. Sardinia is an Italian region officially free from sheep and goats brucellosis since 1998. In 2011, Brucella melitensis biovar 1, a biotype not reported in Italy since 1995, was isolated in one flock in the region. The genotyping MLVA-16 showed that isolates belonged to a rare American lineage, confirming it was introduced from other countries. The strain was considered as probably originating from Spain, where this lineage is endemic. BrucellaMLVA-16 has been proved to be useful to analyse the epidemiological correlation of strains enabling to trace its geographic origin by comparing their previously reported genetic patterns. © 2015 Blackwell Verlag GmbH.
    Transboundary and Emerging Diseases 07/2015; DOI:10.1111/tbed.12397 · 3.12 Impact Factor
    • "Accordingly, a limited number of antimicrobial agents are efficient against this type of bacteria. Acute Brucellosis may relapse or become chronic disease due to lack of a sufficient long-term antimicrobial treatment, [8] [20] [21]. The World Health Organization (WHO) suggested that the most excellent mixture antibiotics used for human brucellosis are doxycycline along with either rifampin or streptomycin [22]. "
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    • "Most studies have shown a 40e70% yield. Rapid diagnosis of brucella using the new third generation continuous monitoring blood culture systems , such as non-radiometric BACTEC or BACT/ALERT, has shown a better and faster recovery with all positive cultures occurring by day 5e7 of incubation; therefore, extending the blood culture incubation to 4 weeks for improving the yield of culture is rarely required [12] [13] "
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    ABSTRACT: In Saudi Arabia, brucellosis is an endemic zoonotic disease. Although it is believed that children are not commonly involved, a number of reports from endemic areas exhibited a high percentage of pediatric patients (20–30% of affected patients). Clinical manifestations of childhood brucellosis are varied and range from minimal symptoms to extreme morbidity and occasional fatality. Asymptomatic infections are also not uncommon. The fact that brucellosis is endemic in the Kingdom became clear in the early 1980s. Several reasons have been considered, but the most prominent of them is the increase in the importation of animals from areas where brucellosis is endemic, especially some African countries. Consumption of raw milk and, to a lesser extent, contact with infected animals or their products are the primary routes of infection. The consumption of fresh, unpasteurized milk from camels is a traditional practice, and people believe that boiling the milk removes nutritional value.
    09/2014; 19(1). DOI:10.1016/j.ijpam.2014.09.004
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