Soroprevalência de brucelose em suínos de granjas comerciais e em criatórios de subsistência / Seroprevalence of brucellosis in farm animals and in subsistence breeders

A suinocultura industrial compreende o conjunto de produtores que incorporam os avanços tecnológicos em genética, nutrição, sanidade e demais aspectos produtivos, enquanto a suinocultura de subsistência desempenha um papel importante para a alimentação humana, sendo a criação de suínos em criatórios amplamente difundida entre os pequenos proprietários de terra ou em assentamentos. Este trabalho teve como objetivo avaliar a pesquisa de anticorpos contra Brucella sp. nos suínos de granjas comerciais, criatórios de subsistência e javalis asselvajados. Foram visitados 32 criatórios de suínos domésticos localizados na região sul de Mato Grosso do Sul. Considerando-se os fenótipos, verificou-se que os sinais indicativos de contato têm influência do município onde está situada a propriedade (χ2=8.8594, p=0,0029), sendo que o município de Deodápolis tem uma chance de ocorrência mais elevada (OR=13,00;IC95%:2,12-79,59). Através da detecção fenotípicaobserva-sea presença de animais híbridos nas propriedades analisadas, e evidencia-se assim que os animais da propriedade em algum momento entraram em contato com suínos asselvajados, os quais podem ser responsáveis pela disseminação de diversas patologias. A ausência da detecção de anticorpos anti-Brucella sp. em suínos de criatórios sugere que a bactéria não é circulante nas populações de javalis nas áreas de estudo.

Industrial pig farming comprises the group of producers that incorporate technological advances in genetics, nutrition, health and other productive aspects, while subsistence pig farming plays an important role for human nutrition, with the creation of pigs in farms being widely spread among small farms. landowners or settlements. This study aimed to evaluate the search for antibodies against Brucella sp. pigs on commercial farms, livestock farms and wild boars. Were visited 32 domestic swine farms located in the southern region of Mato Grosso do Sul. Considering the phenotypes, it was found that the indicative signs of contact have influence from the municipality where the property is located (χ2=8.8594, p=0.0029) , and the municipality of Deodápolis has a higher chance of occurrence (OR=13,00;IC95%:2,12-79,59). Through the phenotypic detection, the presence of hybrid animals in the analyzed properties is clearly observed, and it is evident that the animals of the property at some point came into contact with pigs, which may be responsible for the spread of several pathogens. The absence of detection of anti-Brucella sp. in breeding pigs it suggests that the bacteria is not circulating in wild boar populations in the study areas.

Inmunopatología de la brucelosis osteoarticular / Immunopathology of osteoarticular brucelosis

La brucelosis es una de las enfermedades zoonóticas más importantes a nivel mundial capaz de producir enfermedad crónica en los seres humanos. La localización osteoarticular es la presentación más común de la enfermedad activa en el hombre. Sin embargo, algunos de los mecanismos moleculares implicados en la enfermedad osteoarticular han comenzado a dilucidarse recientemente. Brucella abortus induce daño óseo a través de diversos mecanismos en los cuales están implicados TNF-α y RANKL. En estos procesos participan células inflamatorias que incluyen monocitos/macrófagos, neutrófilos, linfocitos T del tipo Th17 y linfocitos B. Además, B. abortus puede afectar directamente las células osteoarticulares. La bacteria inhibe la deposición de la matriz ósea por los osteoblastos y modifica el fenotipo de estas células para producir metaloproteinasas de matriz (MMPs) y la secreción de citoquinas que contribuyen a la degradación del hueso. Por otro lado, la infección por B. abortus induce un aumento en la osteoclastogénesis, lo que aumenta la resorción de la matriz ósea orgánica y mineral y contribuye al daño óseo. Dado que la patología inducida por Brucella afecta el tejido articular, se estudió el efecto de la infección sobre los sinoviocitos. Estos estudios revelaron que, además de inducir la activación de estas células para secretar quemoquinas, citoquinas proinflamatorias y MMPs, la infección inhibe la muerte por apoptosis de los sinoviocitos. Brucella es una bacteria intracelular que se replica en el retículo endoplásmico de los macrófagos. El análisis de los sinoviocitos infectados con B. abortus indicó que las bacterias también se multiplican en el retículo endoplasmático, lo que sugiere que la bacteria podría usar este tipo celular para la multiplicación intracelular durante la localización osteoarticular de la enfermedad. Los hallazgos presentados en esta revisión intentan responder a preguntas sobre los mediadores inflamatorios implicados en el daño osteoarticular causado por Brucella. (AU)

Brucellosis is one of the most important zoonotic diseases that can produce chronic disease in humans worldwide. Osteoarticular involvement is the most common presentation of human active disease. The molecular mechanisms implicated in bone damage have started to be elucidated. B. abortus induces bone damage through diverse mechanisms in which TNF-α and RANKL are implicated. These processes are driven by inflammatory cells, including monocytes/macrophages, neutrophils, Th17 lymphocytes and B cells. Also, Brucella abortus (B. abortus) can directly affect osteoarticular cells. The bacterium inhibits bone matrix deposition by osteoblast and modifies the phenotype of these cells to produce matrix methalloproteinases (MMPs) and cytokine secretion that contribute to bone matrix degradation. B. abortus also affects osteoclast increasing mineral and organic bone matrix resorption and contributing to bone damage. Since the pathology induced by Brucella species involves joint tissue, experiments conducted in sinoviocytes revealed that besides inducing the activation of these cells to secrete chemokines, proinflammatory cytokines and MMPS, the infection also inhibits sinoviocyte apoptosis. Brucella is an intracellular bacterium that replicate in the endoplasmic reticulum of macrophages. The analysis of B. abortus infected sinoviocytes indicated that bacteria also replicate in their reticulum suggesting that the bacterium could use this cell type for intracellular replication during the osteoarticular localization of the disease. The findings presented in this review try to answer key questions about the inflammatory mediators involved in osteoarticular damage caused by Brucella. (AU)

Sinal de Faget como manifestação clínica de brucelose. Relato de caso / Faget's sign as a clinical manifestation of brucellosis: Case report

Relata-se o caso de uma paciente do sexo feminino, 32 anos, comerciante, com manifestações sistêmicas de brucelose, como febre diária contínua, sinal de Faget, lombalgia, cervicalgia, náuseas e cefaleia. Quando questionada, a paciente referiu consumo de leite e queijo não pasteurizados de origem bovina. Nos exames laboratoriais, foram evidenciados leucocitose, linfopenia, proteína C-reativa dentro dos parâmetros da normalidade e ausência de transaminasemia, contrapondo achados clássicos da doença. Os exames de imagem mostraram sinais característicos de sacroileíte. O tratamento foi realizado com doxiciclina 100mg via oral a cada 12 horas e estreptomicina 1g via intramuscular diária. O resultado da titulação para brucelose foi positivo. A paciente teve boa resposta ao tratamento, mantendo-se afebril e em bom estado geral até a alta hospitalar, que ocorreu após 14 dias do início da medicação, tendo sido mantido o tratamento ambulatorialmente. (AU)

A case of a 32-year-old female retailer with systemic manifestations of brucellosis, such as prolonged daily fever, Faget's sign, low back and neck pain, nausea and headache. When questioned, the patient reported consumption of unpasteurized milk and cheese of bovine origin. Laboratory tests revealed leukocytosis, lymphopenia, normal levels of C-reactive protein, and absence of transaminasemia, contrasting classic findings of the disease Imaging evaluation showed characteristic signs of sacroiliitis. The treatment was performed with doxycycline 100mg orally every 12 hours, and streptomycin 1g intramuscularly once daily. The serology for brucellosis was positive. The patient showed good response to the treatment, remaining afebrile and in good general condition until hospital discharge, which took place 14 days after starting the medication; she remained on treatment in an outpatient setting. (AU)

Occurrence of anti-Brucella antibodies in intensive pig farming and in non-technified pig herds / Ocorrência de anticorpos anti-Brucella em suínos de granjas comercias e de criações de subsistência

The aim of this study was to determine the occurrence of antibodies anti-Brucella in 1,940 swine blood samples. Out of the 1,940 sera samples, 1,594 were from 30 intensive pig farming from seven different states, collected during the slaughtering of animals, and 346 samples from 56 non-technified (subsistence) pig herds from Jaboticabal region, São Paulo State, Brazil. All samples were tested by Buffered Plate Acidified Antigen (BPAA) and considered positive in case of agglutination. If positive, the samples were tested by Complement Fixation Reaction (CFR) as a confirmatory test. Out of the 1,594, two were positive for BPAA but negative for CFR, so the occurrence was 0%. Among the 346 samples, two were positive for BPAA but only one was positive in the confirmatory test, whith a titer of 1:8. Thus, the occurrence was 0.29%, an important result to demonstrate the improvement of the sanitary status of Brazilian non-technified pig herds, despite the low conditions of production.(AU)

O presente estudo foi realizado com o objetivo de se determinar a ocorrência de anticorpos anti-Brucella spp. em 1.940 amostras de sangue de suínos, das quais 1.594 amostras eram de 30 granjas comerciais, de sete diferentes Estados, coletadas durante o abate dos animais, e 346 amostras de 56 criações de subsistência da região de Jaboticabal, Estado de São Paulo, Brasil. Todas as amostras foram submetidas ao teste do Antígeno Acidificado Tamponado (AAT) e consideradas positivas caso ocorresse aglutinação. Quando positivas, as amostras eram submetidas ao teste de Reação de Fixação de Complemento (RFC) como teste confirmatório. Dentre as 1.594 amostras de suínos de granjas comerciais, duas se mostraram sensíveis ao AAT, porém, quando foram submetidas à RFC, ambas apresentaram reação negativa, levando a uma porcentagem de ocorrência de 0%. Já entre as 346 amostras de criações de subsistência, duas foram positivas ao AAT, sendo que apenas uma apresentou reação positiva no teste confirmatório, cujo título foi de 1:8. Desta forma, a ocorrência foi de 0,29%, resultado importante para demonstrar a melhoria do status sanitário dos rebanhos de subsistência brasileiros, apesar das condições precárias em que vivem.(AU)

Serum Levels of Interferon Gamma in Patients with Brucellosis in a Saudi Hospital.

Background: Brucellosis is a major zoonotic disease that is endemic in Saudi Arabia and it remains a major health problem that has not been eradicated in the country yet. Place and Duration of Study: This retrospective study was conducted in a Saudi Hospital at Al Madinah city during the period of 1 November, 2010 to 31 October, 2011. Methodology: All sera of patients suspected to have brucellosis (n= 65) and 18 healthy subjects were tested for brucella antibody using slide latex agglutination (SAT) and ELISA. Quantitation of IFN-ɣ was also done using ELISA. Results: Brucellosis was detected in all age groups but the incidence was higher and reached 33.3% in age group (40- <50) years with average of 43.9±2.53 years. Male to female ratio in infected patients was 2:1 by using SAT. The incidence of seropositive cases was high (80.1%) in the three months (April, May and June), with the highest peak in May (46.7%). Drinking raw milk was the most encountered risk factor with a prevalence of 66.1% followed by consumption of milk products (11.9%). The most prevalent species among the examined cases was B. melitensis (93.3%). Among the studied cases, 60 cases (92.3%) were serologically positive for brucellosis by SAT. Among the 60 cases yielding significant titers against brucella, 14 sera (23.3%) had agglutinin levels of 1:80, 34 sera (56.7%) had titers of 1:160 and 12 sera (20%) had titers of 1:320. By estimating IgM and IgG levels in the sera of examined cases using ELISA, 52 cases (80%) had brucellaIgM while 42 cases (64.6%) had brucella IgG. Sensitivities of SAT, IgM ELISA and IgG ELISA were 91.5%, 88.1% and 71.2%, respectively compared with combined ELISA. Mean IFN-ɣ levels ± SD in the subacute phase was 136.7±70.07pg/ml, 120.2±54.25pg/ml in the acute phase, and 121.3±51.09 pg/ml in the chronic phase of brucellosis. Conclusion: The sensitivity and specificity of ELISA to diagnose human brucellosis was higher when combined ELISA (IgM/IgG or both) was used. Mean IFN-ɣ levels were lower, but not significantly, in the chronic phase of the disease than in the sub acute phase and healthy subjects.

Outbreak of laboratory-acquired Brucella abortus in Brazil: a case report

Human brucellosis is an occupational disease affecting workers in slaughterhouses, butcher shops and the milk and dairy product industry as well as individuals who work in clinical or research laboratories. We report the first outbreak of a Brucella abortus infection in a Brazilian laboratory and compare the data obtained with reports available in the literature. Exposure was a result of damage to a biological safety cabinet and failure of the unidirectional airflow ventilation system. An epidemiological investigation identified 3 seroconverted individuals, 1 of whom had clinical manifestations and laboratory results compatible with infection at the time of exposure (n=11; attack rate=9.1%).

Respuesta humoral y consecuencias reproductivas en ovejas desafiadas con Brucella ovis al final de la gestación / Immune response and reproductive consequences in experimentally infected ewes with Brucella ovis during late pregnancy

La brucelosis ovina por Brucella ovis es una enfermedad de prevalencia alta en Argentina. Para evaluar la patogenicidad de B. ovis y la respuesta serológica durante el último mes de gestación, 6 ovejas se distribuyeron en dos grupos: G1, ovejas preñadas, n = 4 y G2, ovejas no preñadas, n = 2. Tres ovejas del G1 (15 días preparto) y una del G2 fueron inoculadas con B. ovis. Se analizaron muestras de suero mediante diferentes pruebas serológicas. Se realizó aislamiento y PCR a partir de mucus cérvico-vaginal (mcv), placenta y leche. En las muestras de placenta se realizó histopatología. Las hembras del G1 parieron corderos vivos; se detectaron anticuerpos en las ovejas desafiadas del G1 a partir de los 5 días posinoculación. El mcv de las ovejas desafiadas resultó negativo al aislamiento en ambos grupos. Las muestras de leche del G1 fueron positivas por cultivo y PCR a B. ovis. La técnica de PCR resultó positiva en las placentas de las ovejas desafiadas del G1. La histopatología reveló una placentitis necrótica supurativa en una de las ovejas desafiadas. El desafío con B. ovis preparto resultó en la invasión de la placenta y de la glándula mamaria, con la consecuente excreción de la bacteria por leche. La infección con B. ovis indujo una respuesta humoral temprana en las ovejas. La colonización de la placenta por B. ovis y la excreción de la bacteria por la leche sugieren un potencial riesgo de infección activa para los corderos y la posibilidad de que estos se comporten como portadores latentes de la infección.

Ovine brucellosis by Brucella ovis is a highly prevalent disease in Argentina. This study aimed to evaluate the pathogenicity of B. ovis and the serological response in ewes during late pregnancy and in their offspring. Six adult ewes were distributed in two groupsGI (pregnant females, n = 4) and G2 (nonpregnant females, n = 2). Three pregnant ewes at 15 days prepartum and one nonpregnant eve were inoculated with B. ovis. Sera of sheep and their offspring were analyzed by different serological tests. Samples of cervicovaginal mucus, placenta and milk were studied by bacteriology. A Brucella genus-specific PCR assay was carried out in placenta and milk samples. Placenta samples were hystopathologically processed. G1 females gave birth to live lambs, but one died hours postpartum. Serological techniques employed detected antibodies in serum of inoculated pregnant animal 5 days postchallenge. Sera of female controls G1 and G2 remained negative throughout the study. Cervicovaginal mucus of infected ewes in G1 and G2 yielded negative results to bacteriology, but B. ovis was isolated from milk. The PCR assay was positive for the placenta and milk from inoculated pregnant ewes. Histopathology revealed necrotic suppurative placentitis in one placenta. However, although results demonstrated that B. ovis can invade the placenta and mammary gland, this bacterium did not cause abortion when it was inoculated intravenously at 15 days prepartum. B. ovis infection induced an early humoral response in pregnant ewes, but their lambs remained seronegative, indicating that there was no transfer of antibodies in infancy. Placenta colonization and milk excretion of B. ovis involves a potential source of infection for lambs, which could play a role as latent carriers of infection.

Desarrollo y evaluación de un protocolo serológico de fluorescencia polarizada en el estudio de anticuerpos contra Brucella spp en humanos / Development and evaluation of a serological protocol of fluorescence polarization for the preliminary study of Brucella spp antibodies in humans

A objeto de mostrar el desarrollo y alcance de un método de análisis serológico basado en la técnica de fluorescencia polarizada (FPA) a partir de una gota de sangre obtenida mediante punción capilar, se realizó la determinación de anticuerpos antibrucelosis de un conjunto de 321 personas de alto riesgo laboral. Los resultados se compararon con la data proveniente del análisis de sueros sanguíneos mediante FPA e inmunoanálisis enzimático competitivo (ELISA-c). El número de concordantes fue 318 (99,06%), los 3 discordantes (0,93%) resultaron negativos con fluorescencia polarizada en suero (FPAs) y ELISA-c, pero positivos con FPA capilar (FPAc). Los resultados comparativos de FPAc fueron: sensibilidad: 100%; especificidad: 99,05%; valor predictivo positivo: 66,67%; valor predictivo negativo: 100,0%; proporción de falsos positivos: 0,95%; proporción de falsos negativos: 0%; exactitud: 98,0%; razón de probabilidades: 203,00. La J de Youden para ambos métodos de FPA fue de 0,667. La determinación se consideró confiable y la concordancia de ambos procedimientos de FPA y ELISA-c resultó sin diferencias estadísticas (P>0,05%), lo que permite recomendar ampliamente la implementación del estudio de la brucelosis humana con sangre proveniente de punción capilar como método preliminar.

In order to show the development and scope of a serological analysis method based on fluorescence polarization assay (FPA) from a drop of blood obtained by the capillary technique, a Brucella antibody assay was performed on a group of 321 high-risk workers. The results were compared with data from the analysis of blood serum by FPA and a competitive enzyme immunoassay (ELISA-c). The number of concordance was 318 (99.06%), and discordant 3 (0.93%), which were negative in serum by fluorescence polarization (FPAs) and ELISA-c, but positive with capillary FPA (FPAc). The comparative results FPAc were: sensitivity 100%; specificity: 99.05%; positive predictive value 66.67%; negative predictive value 100.0%; false positive rate: 0.95%; false negative rate: 0%; accuracy: 98.0%; odds ratio: 203.00. The youden J for both FPA methods was 0.667. The identification was considered reliable and the correlation of both procedures, FPA and ELISA-c, was no statistically different (P> 0.05%), which allows to highly recommend the study implementation of human brucellosis with capillary blood as a preliminary method.

Brucellosis in a high risk occupational group: seroprevalence and analysis of risk factors

To estimate Brucella seropositivity among slaughterhouse workers of Lahore district and to elucidate risk factors associated with seropositivity to Brucella. During the year 2008, a cross-sectional study was conducted in four slaughterhouses of Lahore district. A sample of 360 workers was selected from these slaughterhouses through stratified random sampling on proportional basis. Workers were interviewed using a structured questionnaire to obtain risk factor information and their blood samples were collected to be screened for the presence of anti-Brucella IgG using Enzyme Linked Immunosorbent Assay [ELISA] technique. Data management and analysis were performed using SPSS [statistical package for social sciences] version 16. Risk factors associated with seropositivity to anti-Brucella IgG were identified by constructing a logistic regression model. Of the 360 serum samples tested, 21.7% [95% Cl 17.44% - 25.96%] were positive by ELISA test. The logistic regression model identified age [OR 0.96, 95% Cl 0.94-0.99], assistance in parturition of animal [OR 0.47, 95% Cl 0.23-0.96], consuming raw milk [OR 2.25, 95% Cl 1.04-4.87] and handling sheep [OR 0.30, 95% Cl 0.09- 0.92] as risk factors for Brucella seropositivity among slaughterhouse workers of Lahore district. To reduce the burden of brucellosis, a national brucellosis control programme should be initiated with special emphasis on the high risk population of slaughterhouse workers

Human brucellosis in Khartoum state: a commonly underdiagnosed disease

Human brucellosis is a major debilitating zoonotic disease. It is caused by bacteria of the genus Brucella The serum antibody titres to Brucella melitensis and Brucella abortus of one thousand febrile patients, randomly selected from Khartoum, Khartoum North and Omdurman Teaching Hospitals, were estimated by the STAT. Eighty nine [8.9%] of the febrile patients had brucellosis. The average age of brucellosis patient was 43.9 years. Sixty three [70.8%] of the brucellosis patients were males, and 26 [29.2%] were females. Fifty four [60.7%] of them had significant titres to Brucella melitensis while 23 [25.8%] patients had significant titres to Brucella abortus. Twelve [13.5%] patients had significant titres to both Brucella melitensis and Brucella abortus. The average diagnostic delay of brucellosis in this study was 88.6 days. Brucellosis was found to be misdiagnosed as malaria or typhoid fever. Animal contact was found to be a significant risk factor

Relapsed human brucellosis and related risk factors

To determine risk factors of relapse among outpatient treated brucellosis. It is a Cohort study carried out from 2004 to 2006, in an Infectious Diseases Clinic in Ahvaz, Iran. We studied 115 patients with brucellosis. The diagnostic criteria were the finding of > 1/80 [Wright] with a 2 mercaptoethanol [2 ME] >1/40, in association with compatible clinical findings [back pain, sweating and fever]. Treatment by standard drug regimen against brucellosis was established according to National Program against Brucellosis [NPB] in Iran. The patients were evaluated at the end of treatment and after two, four and six months by clinical and serological examinations. Patients with relapse and patients without relapse were placed separately in two groups. The data in the two groups were statistically compared with SPSS, 11.5 by chi square test. Of the 115 patients, 12 were excluded because of study's exclusion criteria. Of 93 studied patients 17 [18.3%] had relapse, results in whom are as fallow: 12 [70.6%] had Longer than three months duration of the symptoms prior to diagnosis [P=0.0001]. 100% of relapses were in male [P=0.003]. Aging was associated with increased risk of relapses [P=0.04]. Eleven patients [64.6%] had lymphopenia [P<0.0001]. Increased in ESR and CRP values were observed in 16[94.1%] and 17[100%], respectively [P0.05]. The present study showed that aging, gender, chronic infection and lymphopenia are risk factors for relapsing brucellosis

Efficacy of strain RB51 vaccine in protecting infection and vertical transmission against Brucella abortus in Sprague-Dawley rats

Immunizing animals in the wild against Brucella (B.) abortus is essential to control bovine brucellosis because cattle can get the disease through close contact with infected wildlife. The aim of this experiment was to evaluate the effectiveness of the B. abortus strain RB51 vaccine in protecting infection as well as vertical transmission in Sprague-Dawley (SD) rats against B. abortus biotype 1. Virgin female SD rats (n = 48) two months of age were divided into two groups: one group (n = 24) received RB51 vaccine intraperitoneally with 3 x 10(10) colony forming units (CFU) and the other group (n = 24) was used as non-vaccinated control. Non-vaccinated and RB51-vaccinated rats were challenged with 1.5 x 10(9) CFU of virulent B. abortus biotype 1 six weeks after vaccination. Three weeks after challenge, all rats were bred. Verification of RB51-vaccine induced protection in SD rats was determined by bacteriological, serological and molecular screening of maternal and fetal tissues at necropsy. The RB51 vaccine elicited 81.25% protection in SD rats against infection with B. abortus biotype 1. Offspring from rats vaccinated with RB51 had a decreased (p < 0.05) prevalence of vertical transmission of B. abortus biotype 1 compared to the offspring from non-vaccinated rats (20.23% and 87.50%, respectively). This is the first report of RB51 vaccination efficacy against the vertical transmission of B. abortus in the SD rat model.

Utilidad de la determinación de anticuerpos IgG e IgM por ELISA e inmunocaptura en una serie clínica de brucelosis humana / Usefulness of the determination of IgG and IgM antibodies by ELISA and immunocapture in a clinical series of human brucellosis

Introducción: El diagnóstico de brucelosis continúa siendo complejo en la actualidad y se requieren nuevas pruebas de diagnóstico. Objetivo: Evaluar pruebas comerciales para la determinación serológica de anticuerpos anti Brucella sp mediante ELISA e inmunocaptura en una serie clínica de pacientes de la Red de Salud UC. Métodos: Estudio retrospectivo de pacientes cuyos sueros fueron recibidos en el laboratorio de Microbiología para estudio serológico de brucelosis. Se obtuvieron 2 grupos, aquellos que cumplían criterios diagnósticos de brucelosis [cuadro clínico compatible, y/o hemocultivo positivo y/o serología por seroaglutinación en tubo (SAT) en títulos > 1/160] y el grupo control. Todos los sueros se analizaron mediante aglutinación con inmunocaptura (Brucellacapt®), ELISA IgM y ELISA IgG. Resultados: De 10 pacientes con brucelosis, los resultados serológicos fueron: 8/10 positivos para ELISA IgG, 7/10 para Brucellacapt® y SAT y 5/10 para ELISA IgM. Discusión: ELISA IgG por si solo fue la mejor prueba para el diagnóstico de brucelosis. La combinación ELISA IgG+ Brucellacapt® alcanza un buen rendimiento de detección (9/10) y puede ser una alternativa a la SAT.

Introduction: The diagnostic difficulties of brucellosis makes the evaluation of new diagnostic tests necessary. Objectives: Evaluation of different commercial tests in the serological diagnosis of brucellosis by ELISA and immunocapture antibodies in a clinical series of patients with brucellosis of the Health Network of the Catholic University of Chile. Methods: All the serums received in the Laboratory of Microbiology for suspicion of brucellosis during five years were studied. Two groups were obtained, one that fulfilled diagnostic criteria for brucellosis [clinical evidence, and/or positive blood culture and/or seroagglutination test (SAT) in titers > 1/160] and the control group. Each serum sample was analyzed using irnmunocapture-agglutination test (Brucellacapt®), ELISA IgM and IgG. Results: Of 10 patients with brucellosis, the serologic results were: 8/10 positives for ELISA IgG, 7/10 for Brucellacapt® and SAT, and 5/10 for ELISA IgM. Discussion: ELISA IgG alone was superior than SAT. The combination ELISA IgG/ Brucellacapt® reaches the best detection performance (9/10) and can be an alternative to SAT.

Relationship between Brucella immunocomplex and glomerulopathies

Brucellosis is a zoonotic disease with a very wide spectrum of clinical findings. Brucellosis is about 10 times more prevalent in patients with renal failure [dialysis patients] compared to population background. Precipitation of immunocomplexes produced by brucellosis is important in causing glomerulonephritis. Because the hallmark of glomerular diseases is abnormal protein loss in the urine we have decided to study proteinuria in brucellosis immunocomplex. The aim of this study was to evaluate probable relationship between brucellosis and glomerulonephritis. This cross sectional study, performed on 200 patients with a history of the disease for about 1 year, diagnosed as having chronic brucellosis. The diagnosis was confirmed in 150 patients and by applying Brucella Standard Agglutination Test [SAT] and 2-mercaptoethanol test [2-ME]. Titers of IgG/IgM and IgG/IgA in two groups of "with proteinuria" and "without proteinuria" was measured. Both SAT and 2-ME tests test demonstrated that proteinuria increases with rising antibodies titers. In SAT, titer 1/160 was the most frequent, observed in 44% of the patients. In 2-ME test 1/40 titer was observed in 44% of the patients and was the most frequent. Our results clearly demonstrated that in both chronic and acute patients, proteinuria increases with rising IgG/IgA and IgM/IgG titers. Therefore brucellosis can cause nephropathy but chronic or untreated brucellosis is more important because it can permanently damage kidney

Epistaxis as the inital manifestation of brucellosis

Brucellosis is a multisystem disease with a broad spectrum of clinical manifestations. Hematologic complications in the form of mild pancytopenia are occasionally reported in the course of acute brucellosis. Rarely, thrombocytopenia is severe and can be associated with purpura and mucosal bleeding. Epistaxis as the initial manifestation of brucellosis is a rarely reported phenomenon. A case of young adult is being reported who presented with epistaxis due to brucellosis-induced thrombocytopenia

Brucellosis and dengue fever A co infection or cross reactivity?

Brucellosis and Dengue fever can present with acute febrile illness with other nonspecific symptoms and share common haematological and biochemical abnormalities making their clinical differentiation a diagnostic challenge. We present two cases admitted with acute febrile illness and other nonspecific symptoms. In both patients diagnosis of brucellosis was confirmed by positive blood culture and or positive serology by tube agglutination test method, in both patients Dengue virus 1gM and or IgG was also positive. This may represent co-infection or cross-reactivity between serological tests used for the diagnosis of brucellosis and dengue fever. To the best of our knowledge this has not been previously reported. Both these cases are presented here to share our experience with others

Brucelosis: una revisión práctica / Brucellosis: a practical revision

La brucelosis es una enfermedad zoonótica causada por bacterias pertenecientes al género Brucella que ocasiona problemas de salud importantes entre los individuos que ingieren alimentos contaminados o mantienen un estrecho contacto con el ganado. En el presente trabajo se describen, brevemente, algunas características de las bacterias de este género, la patología que producen, la respuesta inmune que desencadenan y se destaca la metodología empleada en el diagnóstico de la enfermedad, tanto en el hombre como en los animales. Se profundiza además en los aspectos presentes y futuros de las vacunas preventivas. Finalmente, se considera en particular a la brucelosis humana, describiendo su cuadro clínico, los métodos directos e indirectos de diagnóstico y la interpretación de sus resultados con el objeto de contribuir a esclarecer aspectos relevantes que deben tenerse en cuenta para un correcto seguimiento de la infección.

Polymorphism in the first intron of interferon gamma gene [+874T-A] in Iranian patients with brucellosis

Brucella is a gram-negative bacterium, causing acute and chronic infection in humans and animals. Cell-mediated immunity is the main protective immune response against Brucella spp. Activation of macrophages by IFN-gamma and generation of reactive oxygen intermediates and nitric oxide are the main immunologic mechanisms responsible for control of Brucella infection. To investigate the correlation between IFN-gamma gene polymorphism and brucellosis. 195 patients with brucellosis, 186 healthy patients' family members and 82 healthy farmers who kept infected animals and consumed their contaminated dairy products were selected to take part in the study. IFN-gamma genotyping at position +874 [T to A] was carried out by allele specific polymerase chain reaction [AS-PCR] method. The frequency of AT and TT genotypes significantly increased in farmers compared to patients with rucellosis [P=0.03] while there was no significant difference in genotype distribution between patients and their healthy family members. IFN-gamma [+874] AA genotype is probably a genetic factor that contributes to the susceptibility of the individuals to brucellosis

Cytokine profile and nitric oxide levels in sera from patients with brucellosis

The aims of this study were to investigate the serum levels of some cytokines [tumor necrosis factor-alpha (TNF-alpha), interleukin 1ß (IL-1ß), IL-2R, IL-6, and IL-8] and nitric oxide (NO) levels in patients with untreated brucellosis and to test the correlation of these parameters with each other. The study was conducted on 67 subjects, 37 patients with brucellosis and 30 healthy individuals with no history of Brucella infection. Brucellosis was identified by a positive blood culture and/or increased Brucella antibodies in serological tests in addition to compatible clinical symptoms. Cytokine profile analysis was performed by the immulite chemiluminescent enzyme immunometric assay whose inter- and intra-assay coefficients of variance were 2.6-3.6 and 4.4-8.5 percent, respectively. The levels of nitrites/nitrates, which are representative of NO levels, were measured by the Griess method. Patients with brucellosis had significantly elevated serum levels of nitrites/nitrates, IL-2R, IL-6 and IL-8 (mean ± SD, 102.8 ± 23.8 æmol/l, 806.1 ± 58.5 U/ml, 21.1 ± 2.3 pg/ml, and 8.8 ± 1.6 pg/ml, respectively) compared to healthy controls, whereas TNF-alpha and IL-1ß levels were unchanged. No statistically significant correlation was detected between any of the studied cytokine levels and nitrate/nitrite concentrations according to Pearson's linear correlation test. We conclude that only IL-6, IL-8 and IL-2R are elevated in brucellosis and the extent of elevation depends on the severity and clinical pattern of the disease. Moderate elevation in serum NO was comparable to that observed in previous studies. This explains the absence or very rare occurrence of septic shock in brucellosis.