Molecular characterization and antimicrobial susceptibility testing of clinical and non-clinical Brucella melitensis and Brucella abortus isolates from Egypt

Antimicrobial resistant Brucella spp. prevail in raw milk and animal feces of different livestock farms

BACKGROUND

Brucella spp. is a zoonotic pathogen that affects both livestock and humans, causing reproductive issues in animals and severe health complications in humans, including undulant fever, hepatomegaly, and arthritis. Contaminated raw milk and feces serve as potential transmission sources, despite its public health significance, limited studies have assessed the prevalence of Brucella spp. in raw milk and feces, particularly in endemic regions like Pakistan.

OBJECTIVE

This study aimed to determine the prevalence of Brucella spp. in raw milk and feces of livestock in Punjab and Islamabad Capital Territory, Pakistan, and evaluate the antibiotic resistance profiles of the isolated strains.

METHODS

The raw milk and fecal samples were collected randomly from the different livestock farms of Punjab, Pakistan. The areas were selected based on the different sociodemographic attributes like climate, land usage, number of animals, husbandry practices and operational convenience, which may influence the spatial and temporal distribution of livestock diseases. Brucella spp. was isolated using Brucella agar, a highly specific medium, and confirmed at the molecular level through IS711 gene analysis. Antibiotic susceptibility testing was performed to determine the multiple antibiotic resistance (MAR) index and identify multidrug-resistant (MDR) strains.

RESULTS

A total of 100 samples, including 60 raw milk samples (cows = 25, buffalo = 25, goats = 10) and 40 fecal samples (cows = 16, buffalo = 15, goats = 9), were collected from various livestock farms. The incidence of Brucella spp. was found higher (7.5%) in raw milk than in the animal´s feca (15%). All the strains showed multiple antibiotic resistance (MAR) index (0.3-0.5) which was higher than the critical value (> 0.2). Additionally, 75% of the strains were classified as multidrug-resistant (MDR), highlighting their resistance to multiple antibiotics.

CONCLUSION

These findings indicate the antimicrobial resistance and prevalence of Brucella spp. in the dairy industry which could be a serious threat to public health.

CLINICAL TRIAL NUMBER

Not applicable.

Genomic analysis of Brucella melitensis isolates recovered from humans in south Tunisia over 35 years between 1988 and 2022

Brucella melitensis is a zoonotic pathogen that poses a worldwide public health challenge. In recent years, whole-genome sequencing has become a widely accepted molecular typing method for the genomic epidemiology of brucellosis. This study reports the genomic characteristics of 24 B. melitensis strains isolated from human infections in southern Tunisia over 35 years (1988-2022). We utilized WGS to analyze the clonal relationships of these strains, their relatedness to international sequences, their antimicrobial resistance determinants, and their virulence factors. Our findings revealed a high genetic stability over three decades. All isolates were identified as B. melitensis biovar 3 and were assigned to the same sequence type, ST11, using the MLST-9 scheme. Using the MLST-21, Tunisian sequences shared 20 out of 21 alleles and were assigned to 2 closely related STs (ST89 and ST114). Phylogenetic analysis indicated that all Tunisian sequences were grouped into a single subcluster within lineage I, the West Mediterranean clade, and were highly related to other strains from the Maghreb region (Morocco and Algeria). Antimicrobial resistance analysis revealed no classical resistance determinants. However, mprF, bepCDEFG genes, and missense mutations in rpoB, gyrA, gyrB, and parC genes were identified. Virulence analysis identified 67 genes, predominantly involved in lipopolysaccharide biosynthesis and the type IV secretion system. To our knowledge, this study represents the first genomic investigation of B. melitensis strains circulating in Tunisia. Our findings underscore the importance of genomic surveillance in understanding the epidemiology and evolution of brucellosis in North Africa.

Seroprevalence of brucellosis in camels and humans in the Al-Qassim region of Saudi Arabia and its implications for public health

Brucellosis is a significant zoonotic disease caused by intracellular, gram-negative bacteria from the genus Brucella. Although camels are classified as secondary hosts for Brucella species, they are among the most susceptible and vulnerable animals to brucellosis, particularly Brucella abortus (B. abortus) and Brucella melitensis (B. melitensis). The present study aimed to investigate the epidemiology of camel brucellosis as a zoonotic disease by determining the seroprevalence of brucellosis in both camels and humans, assessing potential risk factors (e.g., age, size, and location), and conducting molecular characterization of Brucella spp. associated with abortion in camels. The Rose Bengal Test (RBT), Antigen Rapid Brucella Antibody Test (ARBT), indirect enzyme-linked immunosorbent assay (I-ELISA), and complement fixation test (CFT) were used to detect brucellosis in both camels and humans. Additionally, a molecular method using polymerase chain reaction was used as a confirmatory technique. A total of 625 camel serum samples and 100 human serum samples were collected in sterile vacuum tubes from various camel farms and individuals across different localities in the Al Qassim region. Additionally, samples from 10 confirmed Brucella-infected camels (including the uterus and supramammary lymph nodes) were analyzed. The results indicated that the overall prevalence of brucellosis in camel sera was 9.72%, as determined by RBT, and 8.16%, as determined by ARBT. In contrast, the overall prevalence of brucellosis in human sera from febrile patients was found to be 17% via RBT. Notably, 57.98% of camel sera that tested positive for Brucella antibodies via RBT were also positive according to I-ELISA and CFT. Furthermore, 42.1%, 70.58%, and 47.05% of human sera that were positive for Brucella antibodies as determined by RBT were also positive according to I-ELISA and CFT, respectively. The highest seropositivity for camel brucellosis was observed in female camels, particularly in the Unaizah area of the Qassim region and among the Homr breed. The prevalence of human brucellosis was highest among females and individuals who consumed raw milk. At the molecular level, B. melitensis biovar 3 was detected in the examined tissues. In conclusion, intervention measures are vital for reducing brucellosis in humans and camels. Public awareness campaigns should highlight the importance of protective clothing when handling aborted she-camels and the need to boil or pasteurize milk. Additionally, studies should differentiate between vaccinated and nonvaccinated camels, and standardizing serological tests for diagnosing brucellosis should be prioritized.

Animal Brucellosis in Egypt: Review on Evolution, Epidemiological Situation, Prevalent Brucella Strains, Genetic Diversity, and Assessment of Implemented National Control Measures

Brucellosis is a neglected zoonotic disease that has a significant economic and public health impact, especially in endemic countries. This review delves deeply into brucellosis's current epidemiological situation and potential sources of livestock infection in Egypt during the last two decades. MLVA-16 and Whole Genome Sequencing based on core-genome SNP analyses confirm the presence of different B. abortus and B. melitensis outbreak strains, both older widely disseminated Brucella strains and newly introduced ones. Despite implementing the test-and-slaughter control strategy over forty years, the disease is still endemic, and different Brucella species circulate among several animal species. The raising of mixed animal species in the same households or farms, exposure to aborted animals, and lack of public awareness about brucellosis transmission are among the main risk factors for increasing livestock brucellosis prevalence in Egypt. Young animals' voluntary vaccination, lack of a nationwide animal identification system, and uncontrolled animal movement stand beyond the ineffectively applied control strategy and may be subdued by applying mass vaccination to decrease disease prevalence dramatically and target imported camels, domestic pigs, and dogs (housed and stray) in the national control surveillance. Increasing awareness through educational campaigns is compulsory to reduce brucellosis transmission risk to livestock/humans.

In silico MLVA Analysis of Brucella melitensis from Human and Livestock in Iran

Brucellosis, a zoonotic disease caused by Brucella spp. globally, is of great significance not only to livestock but also to public health. The most significant of the twelve species is Brucella melitensis. This article is devoted to the endemic region of Iran and aims to uncover the molecular epidemiology of B. melitensis. Biotyping, AMOS-PCR, Bruce-ladder PCR, and the in silico method of MLVA were employed to test 40 B. melitensis isolates from humans, cows, sheep, goats, camels, and horses which are found in thirteen Iranian provinces throughout the years 2015 to 2022. The data from the MLVA-8 analysis showed that there were seven genotypes that could be identified, and the most commonly identified genotype was genotype 63. The data from the MLVA-10 analysis showed that there were seven genotypes, with genotype 213 being the most prevalent in Iran. The data from the MLVA-11 analysis showed that there were eight genotypes, with genotype 111 being the most prevalent in Iran. The MLVA and SNP analysis results showed that the bacteria were grouped into two main groups, known as the Eastern Mediterranean and American groups. Moreover, the outcomes from these analyses have added considerably to our understanding of the genetic/historical relationships among the isolates. Our study indicates a high prevalence of B. melitensis biovar 1 in Iran, accounting for 82.5% of the isolates. The study provides insight into such matters as the complex epidemiology of B. melitensis in Iran, suggesting different ways of transmission and sources of infection. This research points out the vital significance of the continuation of the surveillance and curation of B. melitensis in the diverse species of animals and humans. The simplicity and efficiency of MLVA-based molecular epidemiology offer information on the geographic distribution and genetic diversity of B. melitensis and, therefore, help in the devising of targeted strategies for the prevention of disease in animals.

Comprehensive epidemiological evaluation of ruminant brucellosis and associated risk factors in some Egyptian Governorates

Background and Aim

Brucellosis contributes to significant economic losses due to abortion, weak newborns, infertility, and up to 20% reductions in milk yield in carrier animals. This study aimed to estimate the prevalence of ruminant brucellosis in six Egyptian governorates. This study aimed to estimate the prevalence of ruminant brucellosis and evaluate the risk factors regarding the epidemiological status, highlighting the importance of early carrier detection for the success of control programs.

Materials and Methods

A total of 3000 ruminants were investigated. Blood and serum samples were collected for routine hemato-biochemical analysis (complete blood picture and metabolic panel). In addition, genotoxicity analysis was performed, whereas tissue samples were collected for histopathological analysis. The buffered acidified plate antigen test (BAPAT), Rose Bengal plate test (RBPT), and complement fixation test (CFT) were used for serological diagnosis of brucellosis. The obtained bacterial colonies were typed using Brucella abortus-, melitensis-, ovis-, and suis-polymerase chain reaction (AMOS-PCR), depending on the variability of the IS711 fragment among Brucella spp. Serum trace elements, oxidative stress, and acute phase proteins were compared according to body condition score (BCS) and clinical condition images within the study population.

Results

Mastitis and abortion were the key recorded symptoms (9.966%, 299/3000 and 6%, 180/3000, respectively); however, symptomless individuals were predominant (82.9%, 2487/3000). Blood lymphocytosis was prominent even in asymptomatic animals. Nutritional and food conversion conditions were defined as low, moderate, or high BCS. Brucella overall seropositivity by BAPAT, RBPT, and CFT was 6.1% (182/3000), 5.6% (168/3000), and 5.1% (154/3000) in ruminant species within the included governorates, respectively. Upon diagnosis, 154 seropositive cases developed 93 bacterial isolates and a 731-bp PCR fragment whose sequences confirmed Brucella melitensis biovar 3. Serum metabolic and biochemical profiles, acute phase proteins, trace elements, and oxidative stress concentrations were indicative of loss of functionality in the liver and kidneys, malnutrition and malabsorption syndrome, and DNA damage, particularly in the low-BCS groups (p < 0.0001). Granulomatous lesions were most prominent in the lymph nodes, spleen, uterus, and udder of the dams, while placental multifocal necrosis with thrombosis was recorded in aborted fetuses. There were 8 types of chromosomal aberrations detected in peripheral white blood cells. The highest frequency was for dicentric aberrations 0.025% (25/1000), whereas the lowest 0.009% (9/1000) was for acentric, ring, fusion, and polyploidy. The difference between species was significant for BCS; 14.2% in low-BCS cattle and camels and 8.4% in high-BCS buffaloes.

Conclusion

B. melitensis biovar 3 is prevalent in Egypt. Mixed-rearing systems are the main risk factors for interspecies transmission among ruminants. The difficulty in accurately diagnosing all infected animals, particularly carriers, is a major limitation of eradication and control programs. Different biomarkers could be indicators and/or sensors for performance and/or infectivity conditions in animal herds; however, they require further optimization. Early detection using molecular technologies, highly descriptive, quantitative, sensitive, and specific methods, as alternatives to serological diagnosis (CFT, BAPAT, and RBT), is urgently needed to enhance the efficiency of brucellosis-specific prophylaxis. Such a comprehensive procedure is the World Organization for Animal Health dependent decision.

Unravelling the challenge of cotrimoxazole and rifampin resistance in B. melitensis and B. abortus: A systematic review and meta-analysis

BACKGROUND

Brucellosis caused by Brucella (B. abortus) and Brucella melitensis (B. melitensis) poses a significant threat to human and animal populations. The World Health Organization (WHO) recommends rifampin and cotrimoxazole as first-line treatments for pediatric brucellosis. However, emerging resistance to these antibiotics raises concerns regarding their continued efficacy. This systematic review and meta-analysis aimed to quantitatively assess the prevalence of rifampin and cotrimoxazole resistance in B. abortus and B. melitensis.

METHODS

Eligible studies were identified by systematically searching various databases, such as Scopus, PubMed, Web of Science, and EMBASE databases, using specified search terms until 18 June 2024. The inclusion criteria required studies in English to report the resistance proportion with sample size details. The meta-analysis utilized a random-effects model to assess heterogeneity using the Q-test and I2 statistic. Meta-regression and subgroup analyses explored temporal, geographical, and guideline-related variations in resistance prevalence.

RESULTS

Among the 905 records, 59 studies spanning 21 countries (1976 to 2024) met the inclusion criteria. The prevalence of cotrimoxazole resistance, based on 3,756 isolates, was 0.034 (95% CI, 0.017, 0.068), with increasing trends over time, especially in B. melitensis. Rifampin resistance, involving 3,938 isolates, had a prevalence of 0.046 (95% CI, 0.027, 0.077), showing temporal and species-specific increases. Subgroup analyses revealed significant variations in resistance based on temporal, geographical, and guideline-related factors.

CONCLUSIONS

This systematic review and meta-analysis highlighted an alarming rise in cotrimoxazole and rifampin resistance in B. abortus and B. melitensis, particularly in pediatric brucellosis. Temporal, geographical, and species-specific variations underscore the dynamic nature of antibiotic resistance, emphasizing the need for targeted interventions, surveillance, and global collaboration to preserve the efficacy of essential antibiotics in brucellosis treatment. The limitations include potential biases and the retrospective nature of the included studies, emphasizing the urgent need for standardized surveillance methodologies and robust reporting mechanisms.

Whole-genome sequencing-based analysis of Brucella species isolated from ruminants in various regions of Türki̇ye

BACKGROUND

Brucellosis, a zoonotic disease in Türkiye, which has significant direct and indirect impacts on the healthcare system and livestock. This study, which aimed to investigate the differences among Brucella spp. isolates originating from different regions of Türkiye, for implications for public health and veterinary medicine.

METHOD

Twenty-one isolates from ruminants and two isolates from humans obtained from various regions of Türkiye were utilized in the study. The isolates were identified and biotyped using traditional microbiological procedures, and whole-genome sequencing (WGS) was performed. This was followed by single nucleotide polymorphism (SNP)--based phylogenetic analysis and WGS-based analysis of virulence and resistance genes. Additionally, phenotypic antimicrobial resistance and phage susceptibilities were determined. The obtained data were then compared for concordance, ensuring the validity and reliability of the results.

RESULTS

Our study, employing culture methods, polymerase chain reaction (PCR), and WGS analyses, identified 11 Brucella melitensis (bv 3 (n = 9), one each bv 1 and bv 2) and 12 B. abortus (bv 3 (n = 11), bv 9 (n = 1)) isolates All B. abortus isolates were of bovine origin, while the B. melitensis isolates were from sheep (n = 7), goat (n = 1), ram (n = 1), and humans (n = 2). In the whole-genome SNP-based phylogenetic tree, all B. melitensis strains were found to be of the IIb subtype of genotype II associated with the Eastern Mediterranean lineage. Ten different genotypes were identified in the SNP analysis of the isolates, with a maximum SNP difference of 278 and a minimum SNP difference of 4 among these genotypes. According to the WGS-SNP-based phylogenetic tree of B. abortus isolates, they were grouped in clade C1. In the SNP analysis, where ten different genotypes were identified, the SNP difference among these genotypes was a maximum of 316 and a minimum of 6. In the in silico MLST analysis performed with WGS data, B. melitensis isolates were identified as ST8 and ST102 genotypes, while B. abortus isolates were identified as ST2 and ST3 genotypes. The dominant genotypes were ST8 for B. melitensis and ST2 for B. abortus, respectively. Virulence gene analysis conducted based on WGS data of the 23 B. abortus and B. melitensis isolates revealed 43 virulence gene-associated regions in all strains, irrespective of species, host, or isolation year. Although classical resistance-related genes were not detected by WGS-based antimicrobial resistance gene analysis, phenotypic resistance analysis revealed resistance to azithromycin, rifampin, and trimethoprim/sulfamethoxazole in B. abortus and B. melitensis isolates.

CONCLUSION

Both B. melitensis and B. abortus were circulating species in animals and human. The dominant genotypes were ST8 for B. melitensis and ST2 for B. abortus, respectively. All B. melitensis strains were found to be of the IIb subtype of genotype II associated with the Eastern Mediterranean lineage, while B. abortus isolates, they were grouped in clade C1. Further, a comprehensive study with a sufficient number of isolates covering all regions of Türkiye would provide more accurate information about the current epidemiological situation in the country.

Exploring genetic determinants of antimicrobial resistance in Brucella melitensis strains of human and animal origin from India

Introduction

Antimicrobial resistance (AMR) in Brucella melitensis, the causative agent of brucellosis, is of growing concern, particularly in low and middle-income countries. This study aimed to explore the genetic basis of AMR in B. melitensis strains from India.

Methods

Twenty-four isolates from humans and animals were subjected to antimicrobial susceptibility testing and whole-genome sequencing.

Results

Resistance to doxycycline (20.80%), ciprofloxacin (16.67%), cotrimoxazole (4.17%), and rifampicin (16.67%) was observed. Genome analysis revealed efflux-related genes like mprF, bepG, bepF, bepC, bepE, and bepD across all isolates, however, classical AMR genes were not detected. Mutations in key AMR-associated genes such as rpoB, gyrA, and folP were identified, intriguingly present in both resistant and susceptible isolates, suggesting a complex genotype-phenotype relationship in AMR among Brucella spp. Additionally, mutations in efflux genes were noted in resistant and some susceptible isolates, indicating their potential role in resistance mechanisms. However, mutations in AMR-associated genes did not consistently align with phenotypic resistance, suggesting a multifactorial basis for resistance.

Discussion

The study underscores the complexity of AMR in B. melitensis and advocates for a holistic multi-omics approach to fully understand resistance mechanisms. These findings offer valuable insights into genetic markers associated with AMR, guiding future research and treatment strategies.

Prevalence of Brucella melitensis and Brucella abortus Fluoroquinolones Resistant Isolates: A Systematic Review and Meta-Analysis

Background: Brucellosis impact both animals and humans worldwide. However, using antibiotics for brucellosis remains controversial despite decades of research. Relapse can complicate treatment in this area. Since the mid-1980s, microbiologists, and physicians have studied fluoroquinolones' use for treating human brucellosis. The principal advantages of fluoroquinolones are their intracellular antimicrobial activity, low nephrotoxicity, good pharmacokinetics, and the lack of drug-level monitoring. Fluoroquinolones inhibit disease recurrence. In vitro and clinical data were used to study the prevalence of Brucella melitensis and Brucella abortus fluoroquinolone-resistant isolates. Methods: The PubMed, Scopus, Embase, and Web of Science databases were carefully searched until August 6, 2022, for relevant papers. The number of resistant isolates and sample size were used to estimate the proportion of resistant isolates, fitting a model with random effects, and DerSimonian-Laird estimated heterogeneity. Furthermore, meta-regression and subgroup analyses were used to assess the moderators to identify the sources of heterogeneity. Meta-analysis was performed using R software. Results: Forty-seven studies evaluated fluoroquinolone resistance in Brucella spp. Isolates. Fluoroquinolones have shown high in vitro efficacy against Brucella spp. The resistance rates to ofloxacin, sparfloxacin, fleroxacin, pefloxacin, and lomefloxacin were 2%, 1.6%, and 4.6%, respectively. Conclusion: Clinical in vitro tests demonstrated that fluoroquinolones can eradicate Brucella spp. Owing to first-line medication resistance, recurrence, and toxicity, it is essential to standardize the Brucella antimicrobial susceptibility test method for a more precise screening of resistance status. Fluoroquinolones are less resistant to fluoroquinolone-based treatments in modern clinical practice as alternatives to standard therapy for patients with brucellosis relapse after treatment with another regimen and in patients who have developed toxicity from older agents.

Micro- and nanoformulations of antibiotics against Brucella

Brucellosis, a zoonotic intracellular bacterial infection primarily transmitted through the consumption of unpasteurized milk from infected animals, remains a challenging condition to clinically control. This is mainly because of the limited effectiveness of conventional antibiotics in targeting intracellular Brucella. Micro- and nanoformulations of antibiotics, whether used as a mono- or combination therapy, have the potential to reduce the antibiotic doses required and treatment duration. Extensive research has been conducted on various organic, semiorganic, and inorganic nanomaterials with different morphologies, such as nanoparticles (NPs), nanotubes, nanowires, and nanobelts. Metal/metal oxide, lipidic, polymeric, and carbonic NPs have been widely explored to overcome the limitations of traditional formulations. In this review, we discuss the advances and challenges of these novel formulations based on recent investigations.

Detection of Virulence-Associated Genes among Brucella melitensis and Brucella abortus Clinical Isolates in Greece, 2001-2022

Brucellosis remains an important zoonotic disease in several parts of the world; in Greece, although it is declining, it is still endemic, affecting both the financial and public health sectors. The current study was undertaken to investigate the presence and distribution of virulence-associated genes among Brucella spp. clinical strains isolated during 2001-2022. Species identification was performed using conventional methodology and Bruce-ladder PCR. The presence of the virulence genes mviN, manA, wbkA, perA, omp19, ure, cbg and virB was investigated using PCR. During the study period, a total of 334 Brucella isolates were identified, of which 328 (98.2%) were detected from positive blood cultures; 315 (94.3%) of the isolates were identified as B. melitensis, whilst the remaining 16 (4.8%) and 3 (0.9%) were identified as B. abortus and B. suis, respectively. Notably, two of the B. melitensis were assigned to the REV-1 vaccine strain type. The presence of the omp19, manA, mviN and perA genes was confirmed in all 315 B. melitensis isolates, while ure, wbkA, cbg and virB genes were detected in all but 9, 2, 1 and 1 of the isolates, respectively. All eight virulence genes were amplified in all B. abortus and B. suis isolates. The detection rate of virulence genes did not differ significantly among species. In conclusion, brucellosis is still considered a prevailing zoonotic disease in Greece, with the majority of the isolates identified as B. melitensis. The eight pathogenicity-associated genes were present in almost all Brucella isolates, although the ure gene was absent from a limited number of B. melitensis isolates.

Prevalence of Brucella melitensis and Brucella abortus tetracyclines resistance: A systematic review and meta-analysis

INTRODUCTION

Brucellosis is a zoonotic disease that can be transmitted from animals to humans. Brucellosis is caused by bacteria of the genus Brucella, which are typically transmitted through contact with infected animals, unpasteurized dairy products, or airborne pathogens. Tetracyclines (tetracycline and doxycycline) are antibiotics commonly used to treat brucellosis; however, antibiotic resistance has become a major concern. This study assessed the worldwide prevalence of tetracycline-resistant Brucella isolates.

METHODS

A systematic search was conducted in Scopus, PubMed, Web of Science, and EMBASE using relevant keywords and Medical Subject Headings (MeSH) terms until August 13, 2022, to identify relevant studies for meta-analysis. A random effects model was used to estimate the proportion of resistance. Meta-regression analysis, subgroup analysis, and examination of outliers and influential studies were also performed.

RESULTS

The prevalence rates of resistance to tetracycline and doxycycline were estimated to be 0.017 (95% confidence interval [CI], 0.009-0.035) and 0.017 (95%CI, 0.011-0.026), respectively, based on 51 studies conducted from 1983 to 2020. Both drugs showed increasing resistance over time (tetracycline: r = 0.077, P = 0.012; doxycycline: r = 0.059, P = 0.026).

CONCLUSION

The prevalence of tetracycline and doxycycline resistance in Brucella was low (1.7%) but increased over time. This increase in tetracycline and doxycycline resistance highlights the need for further research to understand resistance mechanisms and develop more effective treatments.

The canonical Brucella species-host dependency is changing, however, the antibiotic susceptibility profiles remain unchanged

Brucellosis is a chronic disease caused by Brucella species with a wide range of hosts, from marine mammals to terrestrial species, but with strict host preferences. With the zoonotic character, the prevalence of human brucellosis cases is a reflection of animal infections. This study aimed to identify 192 Brucella isolates obtained from various sources by Bruce-ladder PCR and to determine their antibiotic susceptibilities by gradient diffusion method (E-test). As a result of the PCR, all human isolates (n = 57) were identified as B. melitensis. While 58 (82.9%) of the cattle isolates were identified as B. abortus, 59 (90.8%) of the sheep isolates were identified as B. melitensis. In addition, 12 (17.1%) of the cattle isolates and 6 (9.2%) of the sheep isolates were determined as B. melitensis and B. abortus, respectively. The primary host change behavior of B. melitensis was 1.9 times higher than that of B. abortus. While gentamicin and ciprofloxacin susceptibilities of Brucella isolates were 100%, tetracycline, doxycycline, streptomycin, trimethoprim/sulfamethoxazole and rifampicin susceptibilities were 99%, 99%, 97.4%, 91.7% and 83.9%, respectively. The lowest sensitivity of the isolates was determined against to cefoperazone as 26%. A triple-drug resistance was detected in 1 B. abortus isolate that included simultaneous resistance to cefoperazone, rifampicin, and trimethoprim/sulfamethoxazole. The high susceptibility profiles we found against to antibiotics such as tetracycline, doxycycline gentamicin and ciprofloxacin, used widely in treatment, are encouraging. However, the change in the canonical Brucella species-primary host preference suggests the need to reconsider eradication program, including updating vaccine formulations.

Better efficacy of triple antibiotics therapy for human brucellosis: A systematic review and meta-analysis

BACKGROUND

The treatment of brucellosis suffers from a high recurrence rate and drug resistance. Our study researched the differences in efficacy and side effects between triple antibiotics therapy and dual antibiotics therapy in the treatment of brucellosis through a systematic review and meta-analysis.

METHODS

We searched 4 English electronic databases and 2 Chinese electronic databases for randomized controlled trials and cohort studies published through September 2022 on the use of triple antibiotics versus dual antibiotics in the treatment of brucellosis. Overall outcome indicators were therapeutic failure rate, relapse rate, overall therapeutic failure rate, and side effect rate. Relative risk (RR) and 95% confidence intervals (95% CIs) were used as summary statistics. A fixed-effects model was used to combine the overall effect sizes.

RESULTS

The meta-analysis included 15 studies consisting of 11 randomized controlled trials and 4 cohort studies. Triple antibiotics showed better efficacy than dual antibiotics in a comparison of 3 overall outcome indicators (therapeutic failure rate (RR 0.42; 95% CI 0.30 to 0.59 heterogeneity P = 0.29, I2 = 15%), relapse rate (RR 0.29; 95% CI 0.18 to 0.45 heterogeneity P = 0.88, I2 = 0%), and overall therapeutic failure rate (RR 0.37; 95% CI 0.28 to 0.48 heterogeneity P = 0.35, I2 = 9%)). The incidence of side effects in patients with brucellosis treated with triple antibiotics was not significantly different from that in brucellosis patients treated with dual antibiotics (RR 0.85; 95% CI 0.67 to 1.06 heterogeneity P = 0.1, I2 = 35%). Sensitivity analyses showed robust results and Peter's test showed no publication bias. The results of subgroup analyses for the research type, drugs, and type of brucellosis were largely consistent with the overall outcome indicators, indicating the reliability and robustness of the overall results.

CONCLUSIONS

In the treatment of brucellosis, triple antibiotics have better efficacy than dual antibiotics and do not increase the incidence of side effects.

Co-delivery of streptomycin and hydroxychloroquine by labeled solid lipid nanoparticles to treat brucellosis: an animal study

Can brucellosis-related biochemical and immunological parameters be used as diagnostic and treatment indicators? The goal of this project was to look at biochemical parameters, trace elements, and inflammatory factors in the acute and chronic stages of brucellosis after treatment with streptomycin and hydroxychloroquine-loaded solid lipid nanoparticles (STR-HCQ-SLN). The double emulsion method was used for the synthesis of nanoparticles. Serum levels of trace elements, vitamin D, CRP, and biochemical parameters were measured in rats involved in brucellosis. The therapeutic effect of STR-HCQ-SLN was compared with that of free drugs. In both healthy and infected rats, serum concentrations of copper, zinc, iron, magnesium, potassium, and biochemical parameters of the liver were significantly different. By altering the serum levels of the aforementioned factors, treatment with STR-HCQ-SLN had a positive therapeutic effect on chronic brucellosis. Vitamin D levels declined (46.4%) and CRP levels rose (from 7.5 mg to less than 1 mg) throughout the acute and chronic stages of brucellosis. This study showed that by comparing the biochemical parameters and the levels of trace elements in the serum of healthy and diseased mice in the acute and chronic stages of brucellosis, it is possible to get help from other routine methods for diagnosis.

Whole-genome sequencing for genetic diversity analysis of Iranian Brucella spp. isolated from humans and livestock

Brucellosis is one of the most common zoonoses in the Middle East. It is causing economic losses to the livestock industry and has a great public health concern. Little is known about the genetic diversity and distribution of brucellae in Iran. Therefore, forty Brucella spp. strains (B. abortus and B. melitensis) isolated from animals and humans were analyzed by whole genome sequencing (WGS) technology using single nucleotide polymorphism (SNP) analysis and core genome multilocus sequence typing (cgMLST). Brucella isolates were obtained from lymph nodes (cows and camels), milk (cows, camels and sheep), and aborted foetus samples (sheep and goats), as well as cerebrospinal fluid and blood of humans. The isolates were originating from thirteen provinces of Iran and isolated between 2015 and 2020. According to in-silico MLST, ST8 and ST2 were the most frequent sequence types in B. melitensis and B. abortus, respectively. Based on phylogeographic reconstruction using cgSNP analysis, the investigated Iranian B. melitensis strains belonged to the American and Mediterranean lineages of the B. melitensis phylogeny. Furthermore, cgSNP analysis revealed a similarity between Iranian B. abortus isolates and strains from Iraq and Egypt. Therefore, the origin of the Iranian strains can be suggested to be strains from neighboring and Middle East countries. Moreover, cgMLST analysis showed that the Iranian B. melitensis strains were closely relative to strains recovered from sheep and humans in Iraq, Afghanistan, Syria, Turkmenistan, and Pakistan. In the current panel of strains, cgMLST and cgSNP analysis provided an appropriate and accurate tool for effective traceback analyses for Brucella spp. from Iran. The results of cgSNP and cgMLST helped to understand the geographic distribution and interspecies transmission of Iranian strains and highlight the importance of specific brucellosis control measures in Iran with regard to the One-Health approach.

Whole-genome sequencing (WGS) analysis of Brucella suis biovar 2 isolated from domestic pigs in Egypt for epidemiological and genetic diversity tracing

In the current study, 14 Brucella suis biovar 2 (B. suis bv 2) strains isolated from slaughter pigs in Cairo were sequenced using Illumina technology to investigate genetic diversity, antimicrobial resistance (AMR) genes, and virulence-associated determinants. These strains were the first B. suis bv 2 isolates from Egypt. To place them in a global context, 92 genomes of B. suis were retrieved from the NCBI database and used for comparison. The in-silico analysis of MLST showed that all isolates have ST16. No resistome but 43 virulomes have been found without differences in distribution. The cgMLST classified the Egyptian B. suis strains into a complex type (CT) encompassing four distinct cgMLST sequence types. The closest relatives were strain B. suis 94/11 of an unknown origin and a Danish strain. Whole-genome sequencing analysis proved low diversity of Egyptian B. suis isolates; thus, a single introduction event is assumed. Investigation of a large number of B. suis isolates from different governorates is required to tailor control measures to avoid further spread.

Recent advancement, immune responses, and mechanism of action of various vaccines against intracellular bacterial infections

Emerging and re-emerging bacterial infections are a serious threat to human and animal health. Extracellular bacteria are free-living, while facultative intracellular bacteria replicate inside eukaryotic host cells. Many serious human illnesses are now known to be caused by intracellular bacteria such as Salmonella enterica, Escherichia coli, Staphylococcus aureus, Rickettsia massiliae, Chlamydia species, Brucella abortus, Mycobacterium tuberculosis and Listeria monocytogenes, which result in substantial morbidity and mortality. Pathogens like Mycobacterium, Brucella, MRSA, Shigella, Listeria, and Salmonella can infiltrate and persist in mammalian host cells, particularly macrophages, where they proliferate and establish a repository, resulting in chronic and recurrent infections. The current treatment for these bacteria involves the application of narrow-spectrum antibiotics. FDA-approved vaccines against obligate intracellular bacterial infections are lacking. The development of vaccines against intracellular pathogenic bacteria are more difficult because host defense against these bacteria requires the activation of the cell-mediated pathway of the immune system, such as CD8+ T and CD4+ T. However, different types of vaccines, including live, attenuated, subunit, killed whole cell, nano-based and DNA vaccines are currently in clinical trials. Substantial development has been made in various vaccine strategies against intracellular pathogenic bacteria. This review focuses on the mechanism of intracellular bacterial infection, host immune response, and recent advancements in vaccine development strategies against various obligate intracellular bacterial infections.

Determination of seroprevalence of brucellosis in livestock and high-risk population in Kurdistan, Western Iran

BACKGROUND

Brucellosis is one of the most prevalent zoonotic diseases. Using serological tests are valid and rapid methods that could be used in the detection of the history of getting brucellosis. Considering that Iran is an endemic country for brucellosis, we aimed to investigate the rate of seroprevalence of brucellosis among livestock and human in Kurdistan province.

MATERIAL AND METHOD

Serum sampling was performed from 51 slaughterhouse workers, veterinarians, and husbandry workers, along with 260 livestock (80 cattle, 120 sheep, and 60 goats). Rose Bengal plate test (RBPT), and Enzyme-linked immunosorbent assay (ELISA) were used for livestock and the anti-Brucella IgG antibody was evaluated in human participants.

RESULTS

The seroprevalence (based on ELISA assay) in sheep, goats, and cows was 5.8%, 5%, and 1.2%, respectively. Also, the rate of anti-Brucella IgG was 3.9% among human participants.

DISCUSSION

the current study, provided some valuable information on the seroprevalence of brucellosis in animal and human participants from the west of Iran. Considering the effects of brucellosis on causing reproductive disorders, including abortion, placental retention, andendometritis controlling the infection could have a significant impact on terms of economy.

Determination of Virulence-Associated Genes and Antimicrobial Resistance Profiles in Brucella Isolates Recovered from Humans and Animals in Iran Using NGS Technology

Brucellosis is a common zoonotic disease in Iran. Antimicrobial-resistant (AMR) Brucella isolates have been reported from different developing countries, posing an imminent health hazard. The objective of this study was to evaluate AMR and virulence-associated factors in Brucella isolates recovered from humans and animals in different regions of Iran using classical phenotyping and next generation sequencing (NGS) technology. Our findings revealed that B. melitensis is the most common species in bovines, small ruminants and camels. B. abortus was isolated only from one human case. Probable intermediate or resistant phenotype patterns for rifampicin, trimethoprim-sulfamethoxazole, ampicillin-sulbactam and colistin were found. Whole genome sequencing (WGS) identified mprF, bepG, bepF, bepC, bepE, and bepD in all isolates but failed to determine other classical AMR genes. Forty-three genes associated with five virulence factors were identified in the genomes of all Brucella isolates, and no difference in the distribution of virulence-associated genes was found. Of them, 27 genes were associated with lipopolysaccharide (LPS), 12 genes were related to a type IV secretion system (virB1-B12), two were associated with the toll-interleukin-1 receptor (TIR) domain-containing proteins (btpA, btpB), one gene encoded the Rab2 interacting conserved protein A (ricA) and one was associated with the production of cyclic β-1,2 glucans (cgs). This is the first investigation reporting the molecular-based AMR and virulence factors in brucellae isolated from different animal hosts and humans in Iran. Iranian B. abortus and B. melitensis isolates are still in vitro susceptible to the majority of antibiotics used for the treatment of human brucellosis. WGS failed to determine classical AMR genes and no difference was found in the distribution of virulence-associated genes in all isolates. Still, the absence of classical AMR genes in genomes of resistant strains is puzzling, and investigation of phenotypic resistance mechanisms at the proteomic and transcriptomic levels is needed.

Gut Microbiome Studies in Livestock: Achievements, Challenges, and Perspectives

The variety and makeup of the gut microbiome are frequently regarded as the primary determinants of health and production performances in domestic animals. High-throughput DNA/RNA sequencing techniques (NGS) have recently gained popularity and permitted previously unheard-of advancements in the study of gut microbiota, particularly for determining the taxonomic composition of such complex communities. Here, we summarize the existing body of knowledge on livestock gut microbiome, discuss the state-of-the-art in sequencing techniques, and offer predictions for next research. We found that the enormous volumes of available data are biased toward a small number of globally distributed and carefully chosen varieties, while local breeds (or populations) are frequently overlooked despite their demonstrated resistance to harsh environmental circumstances. Furthermore, the bulk of this research has mostly focused on bacteria, whereas other microbial components such as protists, fungi, and viruses have received far less attention. The majority of these data were gathered utilizing traditional metabarcoding techniques that taxonomically identify the gut microbiota by analyzing small portions of their genome (less than 1000 base pairs). However, to extend the coverage of microbial genomes for a more precise and thorough characterization of microbial communities, a variety of increasingly practical and economical shotgun techniques are currently available.

One Health: a holistic approach for food safety in livestock

The food safety of livestock is a critical issue between animals and humans due to their complex interactions. Pathogens have the potential to spread at every stage of the animal food handling process, including breeding, processing, packaging, storage, transportation, marketing and consumption. In addition, application of the antibiotic usage in domestic animals is a controversial issue because, while they can combat food-borne zoonotic pathogens and promote animal growth and productivity, they can also lead to the transmission of antibiotic-resistant microorganisms and antibiotic-resistant genes across species and habitats. Coevolution of microbiomes may occur in humans and animals as well which may alter the structure of the human microbiome through animal food consumption. One Health is a holistic approach to systematically understand the complex relationships among humans, animals and environments which may provide effective countermeasures to solve food safety problems aforementioned. This paper depicts the main pathogen spectrum of livestock and animal products, summarizes the flow of antibiotic-resistant bacteria and genes between humans and livestock along the food-chain production, and the correlation of their microbiome is reviewed as well to advocate for deeper interdisciplinary communication and collaboration among researchers in medicine, epidemiology, veterinary medicine and ecology to promote One Health approaches to address the global food safety challenges.

Identification of Pseudomonas aeruginosa From the Skin Ulcer Disease of Crocodile Lizards (Shinisaurus crocodilurus) and Probiotics as the Control Measure

The crocodile lizard (Shinisaurus crocodilurus) is an endangered ancient reptile species. Captive breeding is an important conservation measure for the potential restoration and recovery of their wild populations. However, a skin ulcer disease caused by an unknown pathogen has become a serious threat to captive breeding individuals. In the current study, based on microbial isolation, we identified Pseudomonas aeruginosa as the dominant pathogen in skin ulcer disease. Chinese skinks (Plestiodon chinensis) were used to verify the pathogenicity of P. aeruginosa in skin ulcer disease in vivo. As expected, subcutaneous inoculation of P. aeruginosa induced skin disease in healthy skinks and P. aeruginosa was re-isolated from the induced skin ulcers. Therefore, P. aeruginosa, an opportunistic and ubiquitous pathogen that causes a wide range of infections, appears to be the main pathogen of the skin disease affecting crocodile lizards. In the aquaculture industry, probiotics are widely used in the prevention and control of animal diseases caused by such pathogens. Here, we administered probiotics to the breeding crocodile lizards for 6 months. The three experiment groups treated with different kinds of probiotics showed significance at controlling case incidence. Three of the four groups treated with probiotics showed significant disease prevention (Effective Microorganisms mixed probiotics P = 0.0374; Double-dose Effective Microorganisms, P = 0.0299; Bacillus subtilis, P = 0.0140, T-test), and CFUs in the water of the breeding enclosures were also inhibited after probiotics usage (P < 0.001, T-test). Our study demonstrated the role of Pseudomonas aeruginosa in development of skin ulcer disease of crocodile lizards in a local zoo and offered the probiotic-based method for control measurements, which would be of benefit for the conservation of endangered reptiles.

The perspective of antibiotic therapeutic challenges of brucellosis in the Middle East and North African (MENA) countries: Current situation and therapeutic management

Brucellosis is among the most prevalent zoonotic infections in Middle Eastern and North African (MENA) countries, critically impacting human and animal health. A comprehensive review of studies on antibiotic susceptibility and therapeutic regimes for brucellosis in ruminants and humans in the MENA region was conducted to evaluate the current therapeutic management in this region. Different scientific databases were searched for peer-reviewed original English articles published from January 1989 to February 2021. Reports from research organizations and health authorities have been taken into consideration. Brucella melitensis and Brucella abortus have been reported from the majority of MENA countries, suggesting a massive prevalence particularly of B. melitensis across these countries. Several sporadic cases of brucellosis relapse, therapeutic failure, and antibiotic resistance of animal and human isolates have been reported from the MENA region. However, several studies proved that brucellae are still in-vitro susceptible to the majority of antibiotic compounds and combinations in current recommended WHO treatment regimens, e.g. levofloxacin, tetracyclines, doxycycline, streptomycin, ciprofloxacin, chloramphenicol, gentamicin, tigecycline, and trimethoprim/sulfamethoxazole. The current review presents an overview on resistance development of brucellae and highlights the current knowledge on effective antibiotics regimens for treating human brucellosis. This article is protected by copyright. All rights reserved.

Proteomics-based screening and antibiotic resistance assessment of clinical and sub-clinical Brucella species: An evolution of brucellosis infection control

Brucellae are intracellular sneaky bacteria and they can elude the host's defensive mechanisms, resulting in therapeutic failure. Therefore, the goal of this investigation was to rapid identification of Brucella species collected from animals and humans in Saudi Arabia, as well as to evaluate their resistance to antibiotics. On selective media, 364 animal samples as well as 70 human blood samples were cultured. Serological and biochemical approaches were initially used to identify a total of 25 probable cultured isolates. The proteomics of Brucella species were identified using the MALDI Biotyper (MBT) system, which was subsequently verified using real-time polymerase chain reaction (real-time PCR) and microfluidic electrophoresis assays. Both Brucella melitensis (B. melitensis) and Brucella abortus (B. abortus) were tested for antimicrobial susceptibility using Kirby Bauer method and the E-test. In total, 25 samples were positive for Brucella and included 11 B. melitensis and 14 B. abortus isolates. Twenty-two out of 25 (88%) and 24/25 (96%) of Brucella strains were recognized through the Vitek 2 Compact system. While MBT was magnificently identified 100% of the strains at the species level with a score value more than or equal to 2.00. Trimethoprim-sulfamethoxazole, rifampin, ampicillin-sulbactam, and ampicillin resistance in B. melitensis was 36.36%, 31.82%, 27.27%, and 22.70%, respectively. Rifampin, trimethoprim-sulfamethoxazole, ampicillin, and ampicillin-sulbactam resistance was found in 35.71%, 32.14%, 32.14%, and 28.57% of B. abortus isolates, correspondingly. MBT confirmed by microfluidic electrophoresis is a successful approach for identifying Brucella species at the species level. The resistance of B. melitensis and B. abortus to various antibiotics should be investigated in future studies.

Secretory System Components as Potential Prophylactic Targets for Bacterial Pathogens

Bacterial secretory systems are essential for virulence in human pathogens. The systems have become a target of alternative antibacterial strategies based on small molecules and antibodies. Strategies to use components of the systems to design prophylactics have been less publicized despite vaccines being the preferred solution to dealing with bacterial infections. In the current review, strategies to design vaccines against selected pathogens are presented and connected to the biology of the system. The examples are given for Y. pestis, S. enterica, B. anthracis, S. flexneri, and other human pathogens, and discussed in terms of effectiveness and long-term protection.