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BMC Infectious Diseases May 2024It is challenging to diagnose brucellosis in nonendemic regions because it is a nonspecific febrile disease. The accurate identification of Brucella spp. in clinical...
BACKGROUND
It is challenging to diagnose brucellosis in nonendemic regions because it is a nonspecific febrile disease. The accurate identification of Brucella spp. in clinical microbiology laboratories (CMLs) continues to pose difficulties. Most reports of misidentification are for B. melitensis, and we report a rare case of misidentified B. abortus.
CASE PRESENTATION
A 67-year-old man visited an outpatient clinic complaining of fatigue, fever, and weight loss. The patient had a history of slaughtering cows with brucellosis one year prior, and his Brucella antibody tests were negative twice. After blood culture, the administration of doxycycline and rifampin was initiated. The patient was hospitalized due to a positive blood culture. Gram-negative coccobacilli were detected in aerobic blood culture bottles, but the CML's lack of experience with Brucella prevented appropriate further testing. Inaccurate identification results were obtained for a GN ID card of VITEK 2 (bioMérieux, USA) and matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) using a MALDI Biotyper (Bruker, Germany). The strain showed 100.0% identity with Brucella spp. according to 16S rRNA sequencing. MALDI-TOF MS peaks were reanalyzed using the CDC MicrobeNet database to determine Brucella spp. (score value: 2.023). The patient was discharged after nine days of hospitalization and improved after maintaining only doxycycline for six weeks. The isolate was also identified as Brucella abortus by genomic evidence.
CONCLUSION
Automated identification instruments and MALDI-TOF MS are widely used to identify bacteria in CMLs, but there are limitations in accurately identifying Brucella spp. It is important for CMLs to be aware of the possibility of brucellosis through communication with clinicians. Performing an analysis with an additional well-curated MALDI-TOF MS database such as Bruker security-relevant (SR) database or CDC MicrobeNet database is helpful for quickly identifying the genus Brucella.
Topics: Aged; Humans; Male; Brucellosis; Brucella abortus; Bacteremia; Delayed Diagnosis; Anti-Bacterial Agents; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; Animals
PubMed: 38741035
DOI: 10.1186/s12879-024-09377-y -
Frontiers in Microbiology 2024Some spp. are important pathogens. According to the latest prokaryotic taxonomy, the genus consists of facultative intracellular parasitic species and extracellular...
Some spp. are important pathogens. According to the latest prokaryotic taxonomy, the genus consists of facultative intracellular parasitic species and extracellular opportunistic or environmental species. Intracellular species include classical and nonclassical types, with different species generally exhibiting host preferences. Some classical intracellular species can cause zoonotic brucellosis, including , , , and . Extracellular species comprise opportunistic or environmental species which belonged formerly to the genus and thus nowadays renamed as for example or , which are the most frequent opportunistic human pathogens within the recently expanded genus . The cause of the diverse phenotypic characteristics of different species is still unclear. To further investigate the genetic evolutionary characteristics of the genus and elucidate the relationship between its genomic composition and prediction of phenotypic traits, we collected the genomic data of from the NCBI Genome database and conducted a comparative genomics study. We found that classical and nonclassical intracellular species and extracellular species exhibited differences in phylogenetic relationships, horizontal gene transfer and distribution patterns of mobile genetic elements, virulence factor genes, and antibiotic resistance genes, showing the close relationship between the genetic variations and prediction of phenotypic traits of different species. Furthermore, we found significant differences in horizontal gene transfer and the distribution patterns of mobile genetic elements, virulence factor genes, and antibiotic resistance genes between the two chromosomes of , indicating that the two chromosomes had distinct dynamics and plasticity and played different roles in the survival and evolution of . These findings provide new directions for exploring the genetic evolutionary characteristics of the genus and could offer new clues to elucidate the factors influencing the phenotypic diversity of the genus.
PubMed: 38721599
DOI: 10.3389/fmicb.2024.1389859 -
Frontiers in Medicine 2024Brucellosis, a significant zoonotic disease, not only impacts animal health but also profoundly influences the host immune responses through gut microbiome. Our research...
OBJECTIVE
Brucellosis, a significant zoonotic disease, not only impacts animal health but also profoundly influences the host immune responses through gut microbiome. Our research focuses on whole genome sequencing and comparative genomic analysis of these strains to understand the mechanisms of their virulence changes that may deepen our comprehension of the host immune dysregulation.
METHODS
The strain CMCC55210 and its naturally attenuated variant CMCC55210a were used as models. Biochemical identification tests and experiments in mice verified the characteristics of the strain. To understand the mechanism of attenuation, we then performed sequencing of these two strains.
RESULTS
We discovered notable genomic differences between the two strains, with a key single nucleotide polymorphism (SNP) mutation in the gene potentially altering lipopolysaccharide (LPS) structure and influencing host immunity to the pathogen. This mutation might contribute to the attenuated strain's altered impact on the host's macrophage immune response, overing insights into the mechanisms of immune dysregulation linked to intracellular survival. Furthermore, we explore that manipulating the Type I restriction-modification system in can significantly impact its genome stability with the DNA damage response, consequently affecting the host's immune system.
CONCLUSION
This study not only contributes to understanding the complex relationship between pathogens, and the immune system but also opens avenues for innovative therapeutic interventions in inflammatory diseases driven by microbial and immune dysregulation.
PubMed: 38711779
DOI: 10.3389/fmed.2024.1363785 -
Cureus Apr 2024We present a case admitted for evaluation of suspected idiopathic intracranial hypertension (IIH) with an unusual but important departure from the expected algorithm. A...
We present a case admitted for evaluation of suspected idiopathic intracranial hypertension (IIH) with an unusual but important departure from the expected algorithm. A 31-year-old lady came with a two-week duration of a mild headache and one-week duration of double vision with no previously documented fever or any comorbidities. Clinically, she had papilledema and bilateral abducens palsy with no signs of meningeal irritation. MRI brain radiology was consistent with IIH. Her CSF study showed pleocytosis with elevated protein levels and normal glucose. Serology was positive for at low titers but CSF culture grew , confirming the diagnosis of neurobrucellosis. Her headache and abducens palsy improved over the first two weeks, and the papilledema resolved over two months with antibiotics. This clinical mimic is important for physicians (including neurophysicians) and Infectious Disease specialists. The radiological mimic comes from chinked (small) ventricles, unlike most meningeal diseases which can present with papilledema and abducens palsy including tuberculosis, cryptococcosis, and leptomeningeal carcinomatosis. A CSF study is mandatory in the workup of IIH despite massive improvements in imaging.
PubMed: 38707027
DOI: 10.7759/cureus.57496 -
Heliyon Apr 2024Co-infection with and has been rarely reported. To date, there are only two co-infection case reports from Croatia and China which diagnosed the infections mainly...
Co-infection with and has been rarely reported. To date, there are only two co-infection case reports from Croatia and China which diagnosed the infections mainly through the use of serological tests. In this report, we present the first case of molecularly confirmed bacteremia and spondylodiscitis co-infection in a goat dairy farmer who presented with lumbosacral spondylodiscitis and bilateral psoas abscesses. From the blood culture, was identified by using 16S rRNA gene sequencing and specific PCR. Lumbar bone tissue was found to be positive for using multiplex real-time PCR and was confirmed with a positive result from conventional PCR which detected the infection through the identification of the gene. The patient's condition improved after decompressive laminectomy was performed and administration of antibiotics regimen: intravenous gentamicin, oral rifampicin, and oral doxycycline. From our case, it is important to raise awareness of this underreported co-infection with multiple zoonotic diseases, especially Q fever and brucellosis, which share the same exposure risk. Moreover, we also emphasize the use of advanced molecular techniques to improve the diagnostic efficiency and reduce the use of time-consuming procedures among patients who are continuously exposed to such risk factors in areas with high seroprevalence of these zoonotic diseases.
PubMed: 38681594
DOI: 10.1016/j.heliyon.2024.e29685 -
Mikrobiyoloji Bulteni Apr 2024Brucellosis is a zoonotic disease endemic in many developing countries, including Türkiye. Among the species that are pathogenic for humans; Brucella melitensis is...
Brucellosis is a zoonotic disease endemic in many developing countries, including Türkiye. Among the species that are pathogenic for humans; Brucella melitensis is isolated from livestock animals like sheep and goats, Brucella abortus from cattle and Brucella suis from pigs. Laboratory diagnosis of infection caused by Brucella species with gram-negative coccobacillus morphology; can be made through characteristic culture features, serological tests and molecular methods. Brucellosis, which has a wide distribution of clinical signs and symptoms; can cause various complications by affecting many organs and systems. Among all complications, the probability of thyroid abscess is less than 1%. In this case report; an example of thyroid abscess, one of the rare complications of brucellosis that is not frequently encountered in the literature, was presented. During the physical examination of a 45-year-old female patient who admitted with the complaint of pain in the neck area, fever, neck swelling, redness and pain that increased with palpation were detected. Leukocytosis, lymphopenia, high sedimentation and CRP, low TSH and high T4 values were detected in laboratory tests and subacute thyroiditis was considered as the preliminary diagnosis. Surgical abscess drainage was planned as the patient's clinical findings progressed during follow-up and spontaneous pus discharged from the midline of the neck. The abscess aspirate sample taken during surgical intervention and the blood culture samples taken before were evaluated microbiologically. Microorganisms that did not grow on EMB agar but grew on 5% sheep blood and chocolate agar at the 72-96th hour of incubation of culture plates; were detected to have gram-negative coccobacillus morphology and positive for catalase, oxidase and urease. Although the Wright test was negative with a titer of 1/20, the Rose Bengal test was positive, Coombs test was positive with a titer of 1/160 and the Brucellacapt test was positive with a titer of >1/5120. Microorganisms growing on culture plates were identified as B.melitensis at the species level with specific antisera. As a result of antibiotic susceptibility tests evaluated according to the European Committee on Antimicrobial Susceptibility Testing version 14.0 (EUCAST v14.0), the isolate was susceptible to rifampicin, doxycycline, gentamicin and trimethoprim-sulfamethoxazole at standart dosing regimen and susceptible to ciprofloxacin and levofloxacin at increased exposure. The patient, who was started on doxycycline and rifampicin combination treatment, was discharged without any complaints. In the diagnosis of infection due to Brucella species, which is one of the pathogens that early diagnosis and initiation of treatment greatly affects the prognosis; in addition to culture, which is the gold standard method, serological tests are also very important. If diagnosis is delayed, complications may develop due to involvement in almost every part of the body, depending on the affected organs and systems. In areas where brucellosis is endemic, patients with symptoms such as neck swelling, shortness of breath and difficulty in swallowing, thyroid tissue involvement due to brucellosis should definitely be considered etiologically.
Topics: Brucella melitensis; Brucellosis; Humans; Female; Abscess; Middle Aged; Anti-Bacterial Agents; Drainage; Thyroiditis, Subacute; Thyroid Diseases
PubMed: 38676588
DOI: 10.5578/mb.20249810 -
China CDC Weekly Mar 2024Brucellosis, mainly caused by (), is regarded as a significant zoonotic disease in China. In Weihai, located at the eastern end of the Shandong Peninsula, brucellosis...
WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?
Brucellosis, mainly caused by (), is regarded as a significant zoonotic disease in China. In Weihai, located at the eastern end of the Shandong Peninsula, brucellosis has been in a low epidemic phase for the past five years.
WHAT IS ADDED BY THIS REPORT?
This was the initial report of a brucellosis outbreak in the last five years. Strains of bv. 3 from Weihai and other cities showed a close genetic relationship, suggesting a potential common ancestry.
WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?
Epidemiological investigations depend on standardized and effective molecular typing methods and analysis tools for public health laboratories to identify and trace outbreaks. Understanding the circulation patterns of livestock in free-range households in heavily affected areas is essential for controlling the spread of brucellosis.
PubMed: 38633432
DOI: 10.46234/ccdcw2024.046 -
Frontiers in Veterinary Science 2024Brucellosis is a worldwide extended zoonosis caused by pathogens of the genus . While most , , and biovars grow slowly in complex media, they multiply intensely in...
Brucellosis is a worldwide extended zoonosis caused by pathogens of the genus . While most , , and biovars grow slowly in complex media, they multiply intensely in livestock genitals and placenta indicating high metabolic capacities. Mutant analyses and in infection models emphasize that erythritol (abundant in placenta and genitals) is a preferred substrate of brucellae, and suggest hexoses, pentoses, and gluconeogenic substrates use in host cells. While sugar and erythritol catabolic pathways are known, growth on 3-4 carbon substrates persists in Fbp- and GlpX-deleted mutants, the canonical gluconeogenic fructose 1,6-bisphosphate (F1,6bP) bisphosphatases. Exploiting the prototrophic and fast-growing properties of biovar 5, we show that gluconeogenesis requires fructose-bisphosphate aldolase (Fba); the existence of a novel broad substrate bisphosphatase (Bbp) active on sedoheptulose 1,7-bisphosphate (S1,7bP), F1,6bP, and other phosphorylated substrates; that Fbp unexpectedly acts on S1,7bP and F1,6bP; and that, while active in and , GlpX is disabled in biovar 5. Thus, two Fba-dependent reactions (dihydroxyacetone-phosphate + glyceraldehyde 3-phosphate ⇌ F1,6bP; and dihydroxyacetone-phosphate + erythrose 4-phosphate ⇌ S1,7bP) can, respectively, yield fructose 6-phosphate and sedoheptulose 7-phosphate for classical gluconeogenesis and the Pentose Phosphate Shunt (PPS), the latter reaction opening a new gluconeogenic route. Since erythritol generates the PPS-intermediate erythrose 4-phosphate, and the Fba/Fbp-Bbp route predicts sedoheptulose 7-phosphate generation from erythrose 4-phosphate, we re-examined the erythritol connections with PPS. Growth on erythritol required transaldolase or the Fba/Fbp-Bbp pathway, strongly suggesting that Fba/Fbp-Bbp works as a PPS entry for both erythritol and gluconeogenic substrates in . We propose that, by increasing erythritol channeling into PPS through these peculiar routes, brucellae proliferate in livestock genitals and placenta in the high numbers that cause abortion and infertility, and make brucellosis highly contagious. These findings could be the basis for developing attenuated brucellosis vaccines safer in pregnant animals.
PubMed: 38601913
DOI: 10.3389/fvets.2024.1328293 -
IDCases 2024Brucellosis (undulant fever) is a zoonotic infection caused by Brucella species. It typically presents with fever, malaise, night sweats, and arthralgia. One of its rare...
Brucellosis (undulant fever) is a zoonotic infection caused by Brucella species. It typically presents with fever, malaise, night sweats, and arthralgia. One of its rare complications is infective endocarditis, which occurs in approximately 1.3% of patients and can be further complicated by embolic stroke. This report describes a rare occurrence of Brucella endocarditis presenting as an embolic stroke. A 34-year-old male presented with sudden left-sided weakness and fever. He reported headaches, fever, and generalized weakness in the preceding week. The patient worked on a farm and hence had animal contact. A neurological exam showed left-sided facial weakness, and power of 0/5 and 1/5 in the left upper and lower extremities, respectively. CT scan of the head revealed a right middle cerebral artery (MCA) territory infarct with penumbra and a right MCA occlusion. He underwent a cerebral artery thrombectomy with successful recanalization. However, he continued to have fever and high inflammatory markers. Echocardiography showed aortic valve vegetation and blood cultures grew . A multidisciplinary meeting was held to determine the optimal management, which included a course of rifampicin and doxycycline.
PubMed: 38601430
DOI: 10.1016/j.idcr.2024.e01937 -
Veterinary World Feb 2024is responsible for brucellosis, a highly contagious, life-threatening disease that has a high impact in low- and middle-income countries. This study aimed to compare...
BACKGROUND AND AIM
is responsible for brucellosis, a highly contagious, life-threatening disease that has a high impact in low- and middle-income countries. This study aimed to compare silica nanoparticles (SiO-NPs) loaded with ciprofloxacin with silver nanoparticles (AgNPs) loaded with ciprofloxacin to evaluate the possible replacement of silver by silica to enhance biological activity and reduce cytotoxicity.
MATERIALS AND METHODS
SiO-NPs and AgNPs loaded with ciprofloxacin were characterized using ultraviolet spectroscopy, scanning electron microscopy, and dynamic light scattering microscopy for size demonstration and loading efficiency. Both nanoparticles were treated with Rev 1 to evaluate their biological activity. Nanoparticle toxicity was also evaluated using cytotoxicity and hemolysis assays.
RESULTS
SiO-NP was found to have a smaller size (80 nm) and higher loading efficiency with polydispersity index and zeta potential of 0.43 and 30.7 mV, respectively, compared to Ag-NP (180 nm and 0.62 and 28.3 mV, respectively). SiO-NP was potent with a minimum inhibitory concentration of 0.043 μg/mL compared to Ag-NP (0.049 μg/mL), with a lower cytotoxicity and hemolysis activity.
CONCLUSION
SiO-NP, as a drug delivery system for ciprofloxacin, has better antimicrobial activity against with lower cytotoxicity and hemolysis activity. These results can be attributed to the enhanced physical characterization and better loading efficiency when compared to Ag-NP.
PubMed: 38595656
DOI: 10.14202/vetworld.2024.407-412