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Microbiological Laboratory Diagnosis of Human Brucellosis: An Overview. Pathogens 2021; 10:pathogens10121623. [PMID: 34959578 PMCID: PMC8709366 DOI: 10.3390/pathogens10121623] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022] Open
Abstract
Brucella spp. are Gram-negative, non-motile, non-spore-forming, slow-growing, facultative intracellular bacteria causing brucellosis. Brucellosis is an endemic of specific geographic areas and, although underreported, represents the most common zoonotic infection, with an annual global incidence of 500,000 cases among humans. Humans represent an occasional host where the infection is mainly caused by B. melitensis, which is the most virulent; B. abortus; B. suis; and B. canis. A microbiological analysis is crucial to identifying human cases because clinical symptoms of human brucellosis are variable and aspecific. The laboratory diagnosis is based on three different microbiological approaches: (i) direct diagnosis by culture, (ii) indirect diagnosis by serological tests, and (iii) direct rapid diagnosis by molecular PCR-based methods. Despite the established experience with serological tests and highly sensitive nucleic acid amplification tests (NAATs), a culture is still considered the “gold standard” in the laboratory diagnosis of brucellosis due to its clinical and epidemiological relevance. Moreover, the automated BC systems now available have increased the sensitivity of BCs and shortened the time to detection of Brucella species. The main limitations of serological tests are the lack of common interpretative criteria, the suboptimal specificity due to interspecies cross-reactivity, and the low sensitivity during the early stage of disease. Despite that, serological tests remain the main diagnostic tool, especially in endemic areas because they are inexpensive, user friendly, and have high negative predictive value. Promising serological tests based on new synthetic antigens have been recently developed together with novel point-of-care tests without the need for dedicated equipment and expertise. NAATs are rapid tests that can help diagnose brucellosis in a few hours with high sensitivity and specificity. Nevertheless, the interpretation of NAAT-positive results requires attention because it may not necessarily indicate an active infection but rather a low bacterial inoculum, DNA from dead bacteria, or a patient that has recovered. Refined NAATs should be developed, and their performances should be compared with those of commercial and home-made molecular tests before being commercialized for the diagnosis of brucellosis. Here, we review and report the most common and updated microbiological diagnostic methods currently available for the laboratory diagnosis of brucellosis.
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Gaifer Z, Ali MEM, AlJehani BH, Shaikh HA, Hussein SB. Risk factors, outcomes and time to detect positive blood culture among cases with acute brucellosis. Trans R Soc Trop Med Hyg 2021; 116:133-138. [PMID: 34214996 DOI: 10.1093/trstmh/trab093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 05/09/2021] [Accepted: 06/09/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Brucellosis causes a disabling human disease and loss of animals' lives. The clinical significance of Brucella bacteremia is still unclear and Brucella identification in blood culture is suboptimal. METHODS This was a retrospective study conducted in Medina in Saudi Arabia from August 2016 to May 2019. We included cases with brucellosis symptoms and a positive culture or serological evidence for brucellosis, comparing bacteremic with non-bacteremic brucellosis cases for the rates of complications, infection relapses and brucellosis development. Also, we estimated blood culture positivity rates and the time to detect Brucella in an automatic blood culture instrument. RESULTS Of the total number of 147 cases, 62 (42%) had a positive blood culture for Brucella, and the blood culture instrument (BACT/ALERT 3D) detected all positive blood cultures within 3 d of incubation. We found higher rates of chronic brucellosis in bacteremia than non-bacteremia cases (OR 7.25, 95% CI 1.41 to 37.23; p=0.018). Patients aged <15 y developed a higher rate of bacteremia than those aged ≥15 yr (OR 11.93 95% CI 1.37 to 103.75; p=0.025). CONCLUSION Brucella bacteremia is an independent predictor for the development of chronic infection. Brucella bacteremia cases may need long follow-up periods and a more thorough evaluation to exclude deep-seated infection.
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Affiliation(s)
- Zied Gaifer
- Department of Medicine, Prince Mohamed Bin Abdul-Aziz hospital, National Guard Hospital, Medina 41511, Kingdom of Saudi Arabia
| | - Mohammed E Mohammed Ali
- Department of Pathology and Laboratory Medicine, Prince Mohamed Bin Abdul-Aziz hospital National Guard Hospital, Medina 41511, Kingdom of Saudi Arabia
| | - Basmah H AlJehani
- Department of Infection Prevention and Control, Prince Mohamed Bin Abdul-Aziz hospital National Guard Hospital, Medina 41511, Kingdom of Saudi Arabia
| | - Hawazin A Shaikh
- Department of Infection Prevention and Control, Prince Mohamed Bin Abdul-Aziz hospital National Guard Hospital, Medina 41511, Kingdom of Saudi Arabia
| | - Sheikheldin B Hussein
- Intensive Care Medicine Department, Prince Mohamed Bin Abdul-Aziz hospital National Guard Hospital, Medina 41511, Kingdom of Saudi Arabia
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Abstract
The clinical presentation of brucellosis in humans is variable and unspecific, and thus, laboratory corroboration of the diagnosis is essential for the patient's proper treatment. The diagnosis of brucellar infections can be made by culture, serological tests, and nucleic acid amplification assays. Modern automated blood culture systems enable detection of acute cases of brucellosis within the routine 5- to 7-day incubation protocol employed in clinical microbiology laboratories, although a longer incubation and performance of blind subcultures may be needed for protracted cases. Serological tests, though they lack specificity and provide results that may be difficult to interpret in individuals repeatedly exposed to Brucella organisms, nevertheless remain a diagnostic cornerstone in resource-poor countries. Nucleic acid amplification assays combine exquisite sensitivity, specificity, and safety and enable rapid diagnosis of the disease. However, long-term persistence of positive molecular test results in patients that have apparently fully recovered is common and has unclear clinical significance and therapeutic implications. Therefore, as long as there are no sufficiently validated commercial tests or studies that demonstrate an adequate interlaboratory reproducibility of the different homemade PCR assays, cultures and serological methods will remain the primary tools for the diagnosis and posttherapeutic follow-up of human brucellosis.
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Affiliation(s)
- Pablo Yagupsky
- Clinical Microbiology Laboratory, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Pilar Morata
- Biochemistry and Molecular Biology Department, Faculty of Medicine, University of Málaga, Málaga, Spain
- IBIMA, Málaga, Spain
| | - Juan D Colmenero
- Infectious Diseases Service, University Regional Hospital, Málaga, Spain
- IBIMA, Málaga, Spain
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Dash N, Al-Zarouni M, Rattan A, Panigrahi D. Misidentification of Brucella melitensis as Bergeyella zoohelcum by MicroScan WalkAway®: a case report. Med Princ Pract 2012; 21:495-7. [PMID: 22614245 DOI: 10.1159/000338391] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Accepted: 03/18/2012] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To describe the misidentification of Brucella melitensis as Bergeyella zoohelcum by MicroScan WalkAway®, a commonly used bacterial identification system. CLINICAL PRESENTATION AND INTERVENTION A 35-year-old man was admitted to the Intensive Care Unit with sepsis syndrome. Three sets of aerobic blood culture samples were positive after 48 h of incubation. The isolated organism was identified as B. zoohelcum using the MicroScan WalkAway (Siemens Healthcare Diagnostics Inc., West Sacramento, Calif., USA). However, due to the rareness of the pathogen, the isolate was reidentified as B. melitensis with Vitek® 2 system and later 16S ribosomal sequence analysis confirmed the isolate as B. melitensis having 100% match. CONCLUSION This case showed that Brucella can be misidentified using MicroScan WalkAway. Countries where brucellosis is endemic need to be careful while using such automated identification systems in order not to miss the diagnosis of Brucella.
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Affiliation(s)
- Nihar Dash
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.
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Yingst SL, Huzella LM, Chuvala L, Wolcott M. A rhesus macaque (Macaca mulatta) model of aerosol-exposure brucellosis (Brucella suis): pathology and diagnostic implications. J Med Microbiol 2010; 59:724-730. [PMID: 20223898 PMCID: PMC3052509 DOI: 10.1099/jmm.0.017285-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The US Centers for Disease Control and Prevention lists Brucella as a potential bioterrorism threat requiring enhanced diagnostic capacity and surveillance (http://emergency.cdc.gov/bioterrorism/). Successful treatment and management of patients after exposure to biological threat agents depends on accurate and timely diagnosis, but many biothreat agents present with similar, vague clinical signs – commonly referred to as ‘flu-like illness’. Diagnosis of brucellosis is notoriously challenging, especially early in infection, and definitive diagnosis may require invasive methods, e.g. bone marrow biopsy. We studied the pathogenesis of Brucella suis aerosol infection in rhesus macaques in an effort to guide the diagnostic algorithm in case of possible intentional exposure of humans. Rhesus proved to be an excellent model for human brucellosis; the data showed that PCR DNA amplification testing of non-invasive diagnostic samples has the potential to definitively detect a point-source outbreak immediately and for several days after exposure.
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Affiliation(s)
- Samuel L Yingst
- US Army Medical Research Institute of Infectious Diseases, 1425 Porter Street, Fort Detrick, MD 21702, USA
| | - Louis M Huzella
- US Army Medical Research Institute of Infectious Diseases, 1425 Porter Street, Fort Detrick, MD 21702, USA
| | - Lara Chuvala
- Akimeka Technologies LLC, 1425 Porter Street, Fort Detrick, MD 21702, USA.,US Army Medical Research Institute of Infectious Diseases, 1425 Porter Street, Fort Detrick, MD 21702, USA
| | - Mark Wolcott
- US Army Medical Research Institute of Infectious Diseases, 1425 Porter Street, Fort Detrick, MD 21702, USA
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Gallien S, Fournier S, Porcher R, Bottero J, Ribaud P, Sulahian A, Socié G, Molina JM. Therapeutic Outcome and Prognostic Factors of Invasive Aspergillosis in an Infectious Disease Department: A Review of 34 Cases. Infection 2008; 36:533-8. [DOI: 10.1007/s15010-008-7375-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2007] [Accepted: 02/14/2008] [Indexed: 10/21/2022]
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Abdoel TH, Smits HL. Rapid latex agglutination test for the serodiagnosis of human brucellosis. Diagn Microbiol Infect Dis 2007; 57:123-8. [PMID: 17258083 DOI: 10.1016/j.diagmicrobio.2006.08.017] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2006] [Revised: 08/22/2006] [Accepted: 08/23/2006] [Indexed: 11/22/2022]
Abstract
We developed and evaluated a user-friendly latex agglutination assay for the serodiagnosis of human brucellosis. The assay was obtained by coating colored latex beads with Brucella lipopolysaccharides and drying of the activated beads onto white agglutination cards. Individual cards were sealed in a protective foil to secure stability of the dried reagent and to obtain a test in a single assay format. The latex agglutination assay is simply performed by suspending the dried latex reagent in a drop of serum and looking for macroscopic agglutination of the latex beads by visual inspection. Results are obtained within 30 s after mixing the sample with the test reagent. The sensitivity of the assay was determined to be 89.1% (95% confidence interval [CI], 76-96) for the initial serum samples collected from patients with culture-confirmed brucellosis and the specificity is 98.2% (95% CI, 96-99). The assay is ideal for use as a field test in remote areas and as point-of-care test in hospitals and health care centers that lack the expertise and facilities to perform the more demanding classic serologic tests.
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Affiliation(s)
- Theresia H Abdoel
- KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), 1105 AZ Amsterdam, The Netherlands
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Mitka S, Anetakis C, Souliou E, Diza E, Kansouzidou A. Evaluation of different PCR assays for early detection of acute and relapsing brucellosis in humans in comparison with conventional methods. J Clin Microbiol 2007; 45:1211-8. [PMID: 17267626 PMCID: PMC1865811 DOI: 10.1128/jcm.00010-06] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Human brucellosis is a significant public health problem in many Mediterranean countries including Greece. The conventional serological methods, as well as blood cultures, have serious limitations, especially in chronic, relapsing, and focal forms of the disease. Four different PCR assays were applied in 4,926 buffy coat, whole-blood, and serum samples received from 200 patients admitted with brucellosis to the Infectious Diseases Hospital, Thessaloniki, Greece, for the rapid diagnosis of acute infection and relapses and compared to blood culture and serological tests (i.e., Wright's seroagglutination test, Coombs' antibrucella test, and the complement fixation test). The four PCR assays had excellent sensitivity and specificity and were able to detect all of the cases of acute disease. Buffy coat and whole blood were the optimal specimens. All four PCR assays were negative in all follow-up samples from 183 patients who had completed a successful treatment and were positive in all follow-up samples from 17 patients who had relapses in the first year after therapy, including the times of the relapses. In conclusion, PCR is a very useful tool for the rapid diagnosis of acute brucellosis and a good marker for the posttreatment follow-up and the early detection of relapses.
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Affiliation(s)
- Stella Mitka
- Laboratory of Clinical Microbiology, Infectious Diseases Hospital, 13 G. Lambraki St., 54638 Thessaloniki, Greece.
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Marculescu CE, Berbari EF, Cockerill FR, Osmon DR. Fungi, mycobacteria, zoonotic and other organisms in prosthetic joint infection. Clin Orthop Relat Res 2006; 451:64-72. [PMID: 16906078 DOI: 10.1097/01.blo.0000229337.21653.f2] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
A systematic review of the presentation and management of prosthetic joint infection (PJI) due to zoonotic microorganisms, fungi, mycobacteria and other unusual microorganisms is not available. We therefore sought to provide a resource for the practicing orthopaedic surgeon which will serve as a guide for making appropriate decisions in managing such rare, but potentially problematic conditions. We conducted a Medline search of all case reports of PJI due to these unusual microorganisms. Our review of the current literature showed the diagnosis of PJI due to zoonotic microorganisms, fungi, mycobacteria and other unusual microorganisms typically necessitates specialized diagnostic tests. Maintaining a high index of suspicion in diagnosis of such unusual microorganisms and requesting the appropriate laboratory tests at the time of surgical débridement is crucial for determining the microbiologic etiology of these infections. The appropriate medical and surgical management of such infections is complex and often requires the use of special antimicrobials with which the orthopaedist may not be familiar. Collaboration with an infectious disease specialist is advisable when treating these infections.
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Troy SB, Rickman LS, Davis CE. Brucellosis in San Diego: epidemiology and species-related differences in acute clinical presentations. Medicine (Baltimore) 2005; 84:174-187. [PMID: 15879907 DOI: 10.1097/01.md.0000165659.20988.25] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Although aggressive public health measures have greatly reduced the number of brucellosis cases in the United States, there is a resurgence of interest in this worldwide zoonosis because of its potential as a bioweapon and its 8-fold higher incidence in California, Texas, and the other borderlands between the United States and Mexico compared with the national rate. Accordingly, we reviewed the clinical records of 28 patients diagnosed at a university hospital in San Diego, CA, between 1979 and 2002 to look for new epidemiologic trends and to test the hypothesis that there are species-specific differences in clinical presentations. In contrast to the latest California-wide study completed in 1992, Brucella abortus infections were more common (73%) than Brucella melitensis after 1992, and women were more commonly infected (77% compared with 39%) than men. Major risk factors remained Hispanic ethnicity, travel to Mexico, and ingestion of nonpasteurized dairy products. Analysis of diagnostic procedures suggested that the traditional practice of prolonged incubation of blood cultures increased their sensitivity for Brucella, even in automated radiometric systems. Direct comparison of the clinical manifestations of infections with B. abortus and B. melitensis strongly supported differences in acute presentations. B. melitensis presented more acutely as fevers of unknown origin with statistically significant higher rates of abdominal tenderness, hepatomegaly, splenomegaly, thrombocytopenia, pancytopenia, and hepatic dysfunction. These results suggest that the epidemiology of brucellosis in California may be evolving, and they show, to our knowledge for the first time in a single series, that species-specific differences in presentations may account for some of the protean manifestations of brucellosis. Familiarity with manifestations of brucellosis and the optimal laboratory techniques for its diagnosis could help physicians protect the public against this reemerging, under-recognized zoonosis.
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Affiliation(s)
- Stephanie B Troy
- From Departments of Pathology (CED) and Medicine (SBT, LSR, CED), School of Medicine, University of California, San Diego and UCSD Medical Center, San Diego, CA
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Yagupsky P. Use of the BACTEC MYCO/F LYTIC medium for detection of Brucella melitensis bacteremia. J Clin Microbiol 2004; 42:2207-8. [PMID: 15131190 PMCID: PMC404615 DOI: 10.1128/jcm.42.5.2207-2208.2004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In a prospective volume-controlled study, the sensitivity of the BACTEC MYCO/F LYTIC medium was similar to that of the Peds Plus/F and Plus Aerobic/F vials for detecting Brucella melitensis bacteremia, but the time to detection with the MYCO/F LYTIC medium (101.4 +/- 46.7 h) was significantly longer than that with the combined comparator media (65.5 +/- 18.9 h, P = 0.004).
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Affiliation(s)
- Pablo Yagupsky
- Clinical Microbiology Laboratories, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel.
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Durmaz G, Us T, Aydinli A, Kiremitci A, Kiraz N, Akgün Y. Optimum detection times for bacteria and yeast species with the BACTEC 9120 aerobic blood culture system: evaluation for a 5-year period in a Turkish university hospital. J Clin Microbiol 2003; 41:819-21. [PMID: 12574291 PMCID: PMC149674 DOI: 10.1128/jcm.41.2.819-821.2003] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We tracked and documented the time of positivity of blood cultures by using the BACTEC 9120 (Becton Dickinson Diagnostic Instrument Systems) blood culture system over a 5-year study period. A 7-day protocol of the incubation period was selected, and a total of 11156 blood cultures were evaluated. The clinically significant microorganisms (32.95%) were isolated in 3676 specimens. Gram-positive and -negative bacterial isolation rates were found to be 41.07 and 44.88%, respectively. Yeasts were found in 14.03% of all pathogens. Both the false-positivity and -negativity rates were very low (0.1 and 0.3%, respectively). The mean detection times for all of the pathogens were determined to be 19.45 h. Yeasts, nonfermentative gram-negative bacteria, and Brucella melitensis strains were isolated within 5 days. By taking these data into account, we decided to establish a 5-day-incubation protocol in our laboratory instead of the 7 days that are commonly used.
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Affiliation(s)
- Gül Durmaz
- Department of Clinical Microbiology, Medical Faculty Hospital of Osmangazi University, 26480 Eskisehir, Turkey.
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Ozturk R, Mert A, Kocak F, Ozaras R, Koksal F, Tabak F, Bilir M, Aktuglu Y. The diagnosis of brucellosis by use of BACTEC 9240 blood culture system. Diagn Microbiol Infect Dis 2002; 44:133-5. [PMID: 12458118 DOI: 10.1016/s0732-8893(02)00428-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The diagnosis of brucellosis is generally made when a standard tube agglutination titer of 1/160 or more for anti-Brucella antibodies in the presence of compatible clinical signs and symptoms. However isolation of the organism from blood or bone marrow is the proof of the disease. In this study we aimed to describe the rate and duration of isolation of Brucella spp. from blood and bone marrow by use of automated blood culture system (BACTEC 9240). Between 1997 to 2001, 23 adults were diagnosed as brucellosis. Blood culture was obtained in all and simultaneous bone marrow culture in 18 and both specimens were cultured by BACTEC 9240. Brucella was isolated from blood and bone marrow cultures in 19 (82.6%) and 13 (81.2%) respectively. All positive blood cultures yielded within 7 days and bone marrow cultures in 4 days. We concluded that automated BACTEC culture systems can isolate Brucella spp. in a fast and efficient way.
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Affiliation(s)
- Recep Ozturk
- Department of Clinical Bacteriology and Infectious Diseases, University of Istanbul 34303, Aksaray, Istanbul, Turkey
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Antonio Lepe J, Javier Guerrero F, Garrido A, Perea R. [Detection of Brucella melitensis by BACTEC 9050 system]. Enferm Infecc Microbiol Clin 2001; 19:267-9. [PMID: 11440664 DOI: 10.1016/s0213-005x(01)72633-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate BACTEC 9050 system capacity for detection of bacteremia due to Brucella spp. MATERIAL AND METHODS 16 febrile patients were studied during an epidemic infection for Brucella spp. Suspicious of brucellosis was serologically confirmed with Rose Bengal test and agglutination tube test. Only one blood culture was processed per patient. Ten millilitres of blood were inoculated in a Bactec Plus aerobic/F bottle and incubated in BACTEC 9050 automatic system. The bottles were kept in incubation during 21 days, and they were subcultured when the machine detected its growth; if not, a blind subculture was performed after 21 days. RESULTS 13 of 16 patients showed bacteriemia (81.2%): 11 patients were detected by BACTEC 9050 system and 2 patients by blind subculture after 21 days. A positive result appeared in 149.8 hours (6.2 days) as a mean. Earlier detections were seen in 83 hours (3.4 days) and the latest ones at 245 hours (10.2 days). The aetiology agent of the epidemic infection was Brucella mellitensis biotype 1. We found significative differences comparing the BACTEC 9050 with BACTEC 9120/9240 systems (p<0.03). CONCLUSIONS Incubation protocols of 5 days are not useful for BACTEC 9050 system in the case brucellosis suspicious. Protocols of 7 would detect only 69.2% of the cases.
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Affiliation(s)
- J Antonio Lepe
- Sección de Microbiología. Hospital General de Riotinto. Huelva.
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Yagupsky P, Peled N, Press J. Use of BACTEC 9240 blood culture system for detection of Brucella melitensis in synovial fluid. J Clin Microbiol 2001; 39:738-9. [PMID: 11158139 PMCID: PMC87808 DOI: 10.1128/jcm.39.2.738-739.2001] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Synovial fluid specimens aspirated from patients with arthritis were inoculated into an aerobic Peds Plus blood culture bottle and monitored by the BACTEC 9240 instrument for 4 weeks. A total of 1,072 synovial fluid cultures were processed, and 15 (0.14%) were positive for Brucella melitensis. A single culture, harboring 1.3 CFU of viable organisms per ml, was missed by the instrument. All 14 positive BACTEC cultures were detected within 3 to 7 days.
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Affiliation(s)
- P Yagupsky
- Clinical Microbiology Laboratories, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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Simarro E, Pérez J, Ruiz J, Gómez J. [Failure to detect Brucella melitensis in 3 hemoculture systems]. Enferm Infecc Microbiol Clin 2001; 19:35-6. [PMID: 11256249 DOI: 10.1016/s0213-005x(01)72549-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
The intent of this article is to describe the optimal methods for culture recovery of 7 fastidious bacteria: Legionella species, Brucella species, Francisella tularensis, Leptospira species, Borrelia burgdorferi, Bartonella species, and Bordetella species. These organisms share much in common beyond the fact that their genus names all end in the letter "a." Culture recovery of these organisms, even from adequate clinical specimens, is logistically demanding, often costly, and lacking in both timeliness and sensitivity. In addition, there is generally no need to recover culture isolates on which to perform antimicrobial susceptibility tests because these 7 bacteria are nearly uniformly susceptible to specific, clinically useful antimicrobial agents and because, for some of them, susceptibility tests of proven reliability have not yet been devised. Perhaps for these reasons, alternative, more rapid, direct diagnostic approaches have been developed that are based on either immunochemical or nucleic-acid detection methods. These methods have generally served to supplant culture as a primary diagnostic modality. Situations exist, however, in which culture may be desirable, if not necessary, to establish a definitive diagnosis of infection with these 7 organisms. This review attempts to summarize how best to proceed in those cases.
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Affiliation(s)
- G V Doern
- Medical Microbiology Division, Department of Pathology, University of Iowa College of Medicine, Iowa City, IA 52242, USA.
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Affiliation(s)
- P Yagupsky
- Clinical Microbiology Laboratories, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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