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Objective:To identify the biotypes of blood culture positive Brucella in patients with acute brucellosis in Xinjiang Uygur Autonomous Region (hereinafter referred to as Xinjiang), and to learn about the clinical characteristics of these patients. Methods:Among the 30 patients diagnosed with acute brucellosis in First Affiliated Hospital, School of Medicine, Shihezi University from January 2019 to July 2021, the positive strains of blood culture Brucella of 12 patients with acute brucellosis were used to identify the biotype by AMOS-PCR. Then the general and clinical data of the 12 patients were collected, including demographic characteristics, epidemiological characteristics, clinical characteristics, laboratory tests, treatment and prognosis. Results:AMOS-PCR results showed that all 12 strains were Brucella melitensis. Among the 12 patients, 9 were males and 3 were females, all of whom had a clear history of livestock contact, and the onset time was concentrated in April to September. All 12 patients showed fever, followed by headache and dizziness (9/12), weakness (8/12), digestive symptoms (8/12), hyperhidrosis (7/12), lumbago and backache (6/12), and arthralgia (6/12). One patient was complicated with pleural effusion and pericardial effusion. One patient was complicated with pleural effusion, pelvic effusion and ascites. Only ascites occurred in 2 patients. Liver function was abnormal in 3 patients, lactate dehydrogenase increased in 6 patients, and blood creatinine decreased in 9 patients. Among the 12 patients, 10 patients were treated with rifampicin combined with doxycycline. The other 2 patients were treated with levofloxacin and doxycycline, supplemented by symptomatic treatment with hepatoprotective drugs due to impaired liver function. After discharge, the patients received out-of-hospital oral anti-infectious drugs for 1-2 courses (6 weeks each course), and all indicators returned to normal at 6 months and 12 months after discharge. Conclusions:All the 12 patients with acute brucellosis in Xinjiang are infected with Brucella melitensis. In addition to the common clinical features, patients are characterized by decreased creatinine and increased lactate dehydrogenase. The standardized anti- Brucella treatment is still the main treatment strategy.
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Objective:To investigate the immune response characteristics of helper T cells Th1, Th2, Th17 and their related cytokines in acute, chronic and recovery phases after Brucella infection. Methods:Using prospective study, a total of 130 patients with brucellosis in the First Affiliated Hospital of Medical College of Shihezi University from January 2017 to December 2018 were selected as the research subjects, including acute phase group (49 cases), chronic phase group (44 cases), recovery phase group (37 cases), and 30 cases of healthy physical examination during the same period were included in the control group. The peripheral blood samples of all subjects were collected, and flow cytometry was used to detect Th1, Th2 and Th17 cells in the peripheral blood; the cytometry bead array (CBA) was used to detect the serum cytokines interferon-γ (IFN-γ), interleukin (IL)-4 and IL-17A expression levels.Results:In the control, acute phase, chronic phase and recovery phase groups, the differences of the expression ratios of Th1 [(1.03 ± 0.85)%, (5.46 ± 3.54)%, (4.48 ± 2.26)%, (2.29 ± 2.25)%], Th2 [(4.72 ± 2.36)%, (7.00 ± 3.14)%, (13.99 ± 9.14)%, (5.89 ± 4.69)%], and Th17 cells [(2.09 ± 0.48)%, (3.04 ± 2.17)%, (3.61 ± 2.67)%, (2.74 ± 2.58)%] were statistically significant ( F = 20.95, 21.15, 2.90, P < 0.05). Compared with the control group, the expressions ratio of Th1, Th2, Th17 cells in acute and chronic phase groups and Th1 cells in recovery phase group were significantly higher ( P < 0.05); compared with the recovery phase group, the expressions ratio of Th1, Th2 and Th17 cells in acute and chronic phase groups were significantly higher, but the expression ratio of Th2 cells in acute phase group was lower than that in chronic phase group ( P < 0.05). The expression levels of IFN-γ, IL-4, and IL-17A in serum of control group, acute phase, chronic phase and recovery phase groups were significantly different ( F = 7.79, 15.85, 7.55, P < 0.05); compared with the control group, the expression levels of IFN-γ, IL-4, IL-17A in acute and chronic phase groups and IFN-γ, IL-4 in recovery phase group were significantly higher ( P < 0.05); compared with the recovery phase group, the expression levels of IFN-γ, IL-4, IL-17A in acute phase group and IFN-γ, IL-17A in chronic phase group were significantly higher ( P < 0.05). The expression ratio of Th1 cells in recovery phase patients who finished treatment for less than 12 months was significantly higher than that of recovery phase patients who finished treatment for ≥12 months ( t = 2.26, P < 0.05). Conclusions:After patients are infected with Brucella, Th1 cell immunity is dominant in acute phase, Th2 cell immunity is dominant in chronic phase, and there is no significant difference in the response of Th17 cell immunity between acute and chronic phases. The immune function of patients in the recovery phase may still be abnormal when the treatment time is less than 12 months. Some clinically cured patients in the recovery phase still have a relatively high proportion of Th1 cells, suggesting that the patient's immune function has not fully recovered.
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Objective To understand the infected strains and prevalence of brucellosis in occupational population in Tacheng and Kashgar regions,Xinjiang Uygur Autonomous Region.Methods In September 2015,blood samples from occupational population (including herders,semi-agricultural and semi-pastoral,veterinarians) and non-occupational population (including students and cadres) were collected to detect Brucellaspecific antibody and bacterial nucleic acids by rose bengal plate test (RBPT),serological standard tube agglutination test (SAT) and PCR methods,respectively.The positive products of PCR were sent to Shanghai Sangon Biotechnology Co.,LTD.Then the sequence results were retrieved online using the basic alignment search tool (BLAST) in GenBank web page and uploaded to NCBI (National Center for Biotechnology Information).Results A total of 546 blood samples were tested,including 300 males,aged (55-± 15) years old,and 246 females,aged (54 ± 12) years old.The positive rates were 17.58％ (96/546) and 6.78％ (37/546) in 546 blood samples by serological method and genetic markers targeting omp22 and omp2,respectively.The positive rates were statistically significant (x2 =29.8,P ＜ 0.05).Additionally,based on BLAST analysis of outer membrane protein omp22 and omp2 genes,the positive products were identified as Brucella abortus,and the sequence similarity was 100.00％ (253/253,863/863 bp) to Brucella abortus strain Wisconsin genome assembly,chromosome (LT651712).Conclusions Brucellosis has a high infection rate in the occupational population of some animal husbandry-based groups in Xinjiang.The infection strain is abortive species Brucella,and health education for the occupational population and prevention of brucellosis should be strengthened to reduce the infection rate.
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Objective To investigate the clinical features of brucellosis with thrombocytopenia. Methods The clinical data of patients with brucellosis complicated with thrombocytopenia (platelet count < 100 × 109/L) diagnosed by the Department of Infection Disease, the First Affiliated Hospital of Xinjiang Medical University from January 2012 to December 2018 were collected retrospectively, and the demographic characteristics, clinical characteristics, laboratory examinations, treatment and prognosis of the patients were analyzed. Results All the 21 patients were male and their age was (47.3 ± 12.2) years old, including 3 Uygur, 14 Han and 4 Kazak. Their occupation was dominated by farmers and herdsmen, a total of 16 patients; 11 patients had a history of close contact with cattle and sheep, 5 patients were engaged in slaughter and wool processing industries, and 5 patients were infected for unknown reason. All the 21 patients had fever, hyperhidrosis in 17 patients, fatigue in 16 patients, joint and muscle pain in 7 patients, and decreased body mass in 5 patients. Sheep Brucella blood culture were positive in 12 patients; serum tube agglutination test was positive in 16 patients, titer was 1 : 200 - 1 : 800; white blood cell count was normal [(4 - 10) × 109/L] in 3 patients, white blood cell count reduced in 18 patients. Sixteen patients were treated by orally taking rifampin capsules combined with doxycycline tablets, 3 patients were treated by orally taking baifule tablets combined with doxycycline tablets, and 2 patients were treated by orally taking baifule tablets combined with rifampin capsules; three patients with platelet count < 10 × 109/L were treated with glucocorticoid, gamma globulin and platelet transfusion. After 6 months of follow-up after treatment, 19 patients returned to normal platelet levels, and 2 patients had slightly lower platelet levels. Conclusions The main clinical features of brucellosis with thrombocytopenia are fever, hyperhidrosis, fatigue, joint and muscle pain, decreased body mass, and reduced white blood cell count. Their prognosis is better after treatment.
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Objective@#To investigate the clinical features of brucellosis with thrombocytopenia.@*Methods@#The clinical data of patients with brucellosis complicated with thrombocytopenia (platelet count < 100 × 109/L) diagnosed by the Department of Infection Disease, the First Affiliated Hospital of Xinjiang Medical University from January 2012 to December 2018 were collected retrospectively, and the demographic characteristics, clinical characteristics, laboratory examinations, treatment and prognosis of the patients were analyzed.@*Results@#All the 21 patients were male and their age was (47.3 ± 12.2) years old, including 3 Uygur, 14 Han and 4 Kazak. Their occupation was dominated by farmers and herdsmen, a total of 16 patients; 11 patients had a history of close contact with cattle and sheep, 5 patients were engaged in slaughter and wool processing industries, and 5 patients were infected for unknown reason. All the 21 patients had fever, hyperhidrosis in 17 patients, fatigue in 16 patients, joint and muscle pain in 7 patients, and decreased body mass in 5 patients. Sheep Brucella blood culture were positive in 12 patients; serum tube agglutination test was positive in 16 patients, titer was 1∶200-1∶800; white blood cell count was normal [(4-10) × 109/L] in 3 patients, white blood cell count reduced in 18 patients. Sixteen patients were treated by orally taking rifampin capsules combined with doxycycline tablets, 3 patients were treated by orally taking baifule tablets combined with doxycycline tablets, and 2 patients were treated by orally taking baifule tablets combined with rifampin capsules; three patients with platelet count < 10 × 109/L were treated with glucocorticoid, gamma globulin and platelet transfusion. After 6 months of follow-up after treatment, 19 patients returned to normal platelet levels, and 2 patients had slightly lower platelet levels.@*Conclusions@#The main clinical features of brucellosis with thrombocytopenia are fever, hyperhidrosis, fatigue, joint and muscle pain, decreased body mass, and reduced white blood cell count. Their prognosis is better after treatment.