Clinical and serological approach to patients with brucellosis: A common diagnostic dilemma and a worldwide perspective

Avijgan, Majid; Rostamnezhad, Mahsa; Jahanbani-Ardakani, Hamidreza

doi:10.1016/j.micpath.2019.02.011

Cited by 28 publications

(21 citation statements)

References 20 publications

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“…Due to the above-mentioned background, concern has been increasing about the importance of the awareness level of human brucellosis in communities 11 and also the clinical manifestations, diagnosis, and treatment protocols of human brucellosis. 12,13 Considering little is known about the differences of clinical manifestations, diagnosis and the efficiency of different treatment regimens between different age groups, gender, ethnicity and areas in the existing studies, the present study aimed to describe the demographic, clinical and epidemiological characteristics as well as the treatment and prognosis of human brucellosis cases in Huludao, China, compare the differences of clinical manifestation and diagnosis in different age groups, gender, ethnicity and district, in order to help the clinicians identify human brucellosis cases more quickly and offer reliable information about effective treatment options in this study area.…”

Section: Introductionmentioning

confidence: 99%

<p>Analysis of the Epidemiological, Clinical Characteristics, Treatment and Prognosis of Human Brucellosis During 2014–2018 in Huludao, China</p>

Liu¹,

Shen²,

Wei³

et al. 2020

IDR

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Purpose: To describe the incidence trend, demographic and clinical characteristics, treatment and prognosis, epidemiological history and risk factors of human brucellosis in Huludao, China. Patients and Methods: A total of 1887 brucellosis patients were reported in Huludao, China from January, 2014 to December, 2018 and the case questionnaires from 1149 patients were collected from Huludao Municipal Center for Disease Control and Prevention. Demographic characteristics of the patients and the information relating to the patients' clinical manifestations, diagnosis, treatment and prognosis were collected and analyzed. Results: The number of annually reported brucellosis patients has dropped from 711 to 187 during the study period, with the incidence decreased from 27.31/100,000 in 2014 to 7.15/ 100,000 in 2018. A total of 1149 individual data were collected, with a mean age of 49.59±13.14 years and 75.7% were male. Patients aged more than 60 years were more likely to have arthralgia/myalgia than the other age groups, and patients who had an enlarged spleen in male were more than female (P<0.05). There were more acute brucellosis cases, less sub-acute and chronic brucellosis cases in the ethnic minority (83.6%, 5.5% and 11.0%, respectively) than that in the Han nationality (64.7%, 22.2% and 13.0%, respectively, P<0.05). For antibiotic therapy, "Doxycycline plus rifampicin or streptomycin" was the most commonly used drug combination. Sheep/goat was the main contacted animal and feeding/grazing was the most frequent transmission route; no personal protective measures were the major risk factor. Conclusion: The incidence of human brucellosis is still high in Huludao, China, and this is mostly associated with contacting with domestic animals and barely taking protective measures. The most common clinical manifestations of brucellosis patients in Huludao were fatigue, hyperhidrosis, fever, and arthralgia/myalgia, the most common route of exposure was feeding and grazing, and the major species of livestock was sheep/goat. The most commonly adopted treatment option was antibiotic therapy, and most patients responded well to treatment. The integrality and accuracy of the notifiable epidemiological case questionnaire needs to be improved in order to provide more factual and objective information for both the physicians and policy-makers.

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Section: Introductionmentioning

confidence: 99%

<p>Analysis of the Epidemiological, Clinical Characteristics, Treatment and Prognosis of Human Brucellosis During 2014–2018 in Huludao, China</p>

Liu¹,

Shen²,

Wei³

et al. 2020

IDR

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“…Serological results of SAT for patients with an antibody titer of 1:50 (n = 10) SAT Serum agglutination test, RBT Rose bengal test, ELISA Enzyme linked immunesorbent assay, FPA Fluorescence polarization immunoassay, + Positive; + + Antibody titerthan those of ELISA. Studies have shown that ELISA has a sensitivity of 83.3% for IgM and 41.7% for IgG, while the combined specificity for IgG and IgM is 92.3%[22]. Therefore, the present comparison might have been affected by the disease course of the patient.…”

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confidence: 87%

Fluorescence polarization assay improves the rapid detection of human brucellosis in China

et al. 2021

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Background Brucellosis is an infectious-allergic zoonotic disease caused by bacteria of the genus Brucella. Early diagnosis is the key to preventing, treating, and controlling brucellosis. Fluorescence polarization immunoassay (FPA) is a new immunoassay for relatively rapid and accurate detection of antibodies or antigens based on antigen–antibody interaction. However, there is no report on FPA-based detection of human brucellosis in China. Therefore, this study is to evaluate the value of FPA for the diagnosis of human brucellosis in China. Methods We recruited 320 suspected brucellosis cases who had the clinical symptoms and epidemiological risk factors between January and December, 2019. According to China Guideline for Human Brucellosis Diagnosis, the Rose Bengal test (RBT) was used for the screening test, and the serum agglutination test (SAT) was used as the confirmatory test. Brucellosis was confirmed only if the results of both tests were positive. Additionally, FPA and enzyme linked immune sorbent assay (ELISA) were compared with SAT, and their sensitivity, specificity, coincidence rate and consistency coefficient (Kappa value) as diagnostic tests were analyzed individually and in combination. The optimal cut-off value of FPA was also determined using the receiver operator characteristic (ROC) curve. Results The optimum cut-off value of FPA was determined to be 88.5 millipolarization (mP) units, with a sensitivity of 94.5% and specificity of 100.0%. Additionally, the coincidence rate with the SAT test was 96.6%, and the Kappa value (0.9) showed excellent consistency. The sensitivity and specificity of FPA and ELISA combined were higher at 98.0% and 100.0% respectively. Conclusions When the cut-off value of FPA test is set at 88.5 mP, it has high value for the diagnosis of brucellosis. Additionally, when FPA and ELISA are combined, the sensitivity of diagnosis is significantly improved. Thus, FPA may have potential in the future as a diagnostic method for human brucellosis in China. Graphic abstract

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“…Brucellosis is a chronic infectious disease of humans and animals, which is included in the list of quarantine diseases as a social threat factor. There are 10 known species of the causative agent of brucellosis which include those that pose a threat to human health -B. melitensis, B. abortus, B. suis and B. canis [1,2]. B. melitensis that causes the most severe and acute form of infection is responsible for 80-90% of human brucellosis cases [3].…”

Section: Introductionmentioning

confidence: 99%

A new candidate vaccine for human brucellosis based on influenza viral vectors: development of immunization schedule in guinea pig model

Bugybayeva¹,

Kydyrbayev²,

Zinina³

et al. 2020

Preprint

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Background: A new candidate vector vaccine against human brucellosis based on recombinant influenza viral vectors (rIVV) subtypes H5N1 expressing Brucella Omp16, L7/L12, Omp19 or Cu-Zn SOD proteins has been developed. This paper presents the results of the study of the safety and protective properties of the vaccine with various options of administering, dosing and frequency of use on guinea pigs.Methods: The safety of the vaccine was assessed based on the general condition, behavior and dynamics of a guinea pig weight-gain test. The effectiveness of the new anti-brucellosis vector vaccine was determined by studying its protective effect after conjunctival, intranasal and sublingual administration in doses 105 EID50, 106 EID50 and 107 EID50 during prime and boost vaccinations of animals, followed by challenge with a virulent strain of B. mellitensis 16M infection. For sake of comparison, the commercial B. melitensis Rev.1 vaccine was used as a control. The protective properties of vaccines were assessed by quantitation of Brucella colonization in organs and tissues of infected animals and compared to the control groups.Results: It was found that the vaccine after prime and booster immunization using conjunctival, intranasal and sublingual routes of administration, as well as after using various doses of vaccine were safe for guinea pigs. The most optimal way of using the vaccine has been established: double intranasal immunization of guinea pigs at a dose of 106 EID50, which provides 80% protection of guinea pigs from B. melitensis 16M infection (P < 0.05), which is comparable to the results of the effectiveness of the commercial B. melitensis Rev.1 vaccine.Conclusions: We developed effective vaccine candidate against brucellosis and developed its immunization protocol in guinea pig model. We believe that this study is a substantial step for using the vaccine for future pre-clinical and clinical trials in human.

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Clinical and serological approach to patients with brucellosis: A common diagnostic dilemma and a worldwide perspective

Cited by 28 publications

References 20 publications

<p>Analysis of the Epidemiological, Clinical Characteristics, Treatment and Prognosis of Human Brucellosis During 2014–2018 in Huludao, China</p>

<p>Analysis of the Epidemiological, Clinical Characteristics, Treatment and Prognosis of Human Brucellosis During 2014–2018 in Huludao, China</p>

Fluorescence polarization assay improves the rapid detection of human brucellosis in China

A new candidate vaccine for human brucellosis based on influenza viral vectors: development of immunization schedule in guinea pig model

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