Antibiotic Susceptibility Testing of Brucella Species - Old and New Drugs

Abstract

Brucella species cause brucellosis in humans and animals, a zoonosis that can manifest not only as acute or chronic diseases but also as silent infections persisting throughout life with recurrences potentially occurring after several decades. In vitro and in vivo methods have been developed to evaluate the bacteriostatic and bactericidal activity of antibiotics against Brucella sp. Especially eukaryotic cells and animal models have been used to eval uate the ability of antibiotics, alone or in combination, to eradicate these bacteria from their intracellular reservoir. Although treatment recommendations have been established for common clinical forms of brucellosis, optimized therapeutic alternatives are still need ed for severe forms of the disease, and for infections occurring in young children and pregnant women. Moreover, acquired resistance to first-line treatments of brucellosis is a current concern. This chapter will summarize current knowledge on in vitro and in vivo interactions between Brucella species and antibiotics and new therapeutic strategies that have been evaluated. Keywords: Brucella, brucellosis, antibiotic susceptibility testing, antibiotic resistance, treatment . IntroductionMost Brucella species are highly infectious in humans and thus are considered class biological agents [ -] and potential biological threat agents by the CDC class B [ , ]. Because of a high risk of human infections, especially through inhalation of infectious aerosols, the Brucella cultures should be handled in a biosafety level laboratory. Also, in many countries, detention of these pathogens is now subject to strict regulations. The clinical symptoms of brucellosis are often unspecific. Therefore, the diagnosis may be delayed, especially in geographic areas where the disease is rare and thus often not evoked by physicians in febrile patients. A definite © 2015 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. diagnosis of brucellosis relies on isolation of Brucella sp. from infected patients, mainly from blood samples during the first few weeks following the onset of symptoms. Serological methods lack specificity, and only represent a stopgap for brucellosis diagnosis. PCR-based techniques are useful to detect Brucella DNA in clinical samples, especially in patients with suppurated secondary locations. A specific antibiotic therapy should be started as soon as possible to avoid severe complications including neurological and cardiac involvement , and evolution to a chronic debilitating disease. However, current treatment alternatives are still scarce in adult patients, and even more limited in young children and pregnant women. Although rarely fatal, brucellosis remains a major public health problem worldwide, and a significant economic burden in livestock because of its a...

Assessment of Haemato-Biochemical and Therapeutic Responses of Chronic Brucellosis in Crossbred Dairy Cows in Bangladesh

“…3 This is an endemic disease in developing world that can manifest not only as acute outbreak or chronic disease but also as sub-clinical or carrier infections persisting throughout the life with recurrences potentially during pregnancy associated with abortion in late pregnancy in cattle. 17 Although rarely fatal, brucellosis remains a major public health problem and a significant economic loss due to abortion with associated disorders in dairy cattle. 6,18 Brucella infection in pregnant cattle produces placentitis, followed by abortion in late pregnancy, temporary or permanent infertility and weak newborn calves and decreased milk production whereas it causes orchitis in male, and infertility and hygromas in both male and female cattle.…”