Epidemiological aspects

Madkour, M. Monir; Gargani, G

doi:10.1016/b978-0-7236-0941-4.50009-2

Cited by 14 publications

(12 citation statements)

References 33 publications

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“…PCR using Brucella insertion sequence DNA can be made species-specific by characterization of flanking sequences (Ouaharani et al, 1996) though in the context of the Arabian Peninsula the dominant species is B. melitensis (Madkour, 2001) as our culture results have shown. Culture of the organism will remain important for monitoring the species present and antimicrobial sensitivities although thus far resistance to the commonly used agents has not been an important consideration, perhaps because multi-drug therapy has been the rule.…”

Section: Resultsmentioning

confidence: 71%

“…Brucellosis remains an important cause of persisting febrile illness in many countries in the world, particularly those of the Arabian peninsula (Madkour, 2001). Diagnosis should ideally be based on demonstrating the organism, but reports from a range of endemic areas draw attention to the relatively low frequency of isolation of the causative organism (Mousa et al, 1988).…”

Section: Introductionmentioning

confidence: 99%

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Large-scale evaluation of a single-tube nested PCR for the laboratory diagnosis of human brucellosis in Kuwait

Al-Nakkas

Mustafa

Wright

2005

Journal of Medical Microbiology

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A single-tube nested PCR assay identifying a 52 bp fragment from the genus-specific Brucella IS711 gene was used prospectively in clinical practice for the diagnosis of human brucellosis in Kuwait. Patients with suspected brucellosis and with other infections were investigated as clinically indicated but in all of them culture, serology and PCR for Brucella were carried out. Out of 263 suspected cases of brucellosis, diagnostic tests were positive in 199, serology was positive in 199 and culture in 89, while the Brucella PCR was positive in 193 (sensitivity 96 . 98 %, 95 % confidence interval 94 . 5-99 . 5 %). Chronic brucellosis, involving symptoms for more than 1 year, was diagnosed in 49 out of these 193 patients. Diagnoses in four out of the six patients with positive serology but negative PCR and culture were non-Brucella bacterial meningitis and viral meningitis. False-negative PCR results were possible in the remaining two; both had been on long-term antibiotics for previously diagnosed brucellosis but their adherence may have been questionable, allowing a relapse. The PCR was negative in 244 patients with other infections (specificity 100 %) and in 180 control subjects with negative Brucella culture and serology. PCR results were available within 24 h of sample receipt, providing diagnostic information rapidly. The PCR is expensive and technically demanding and may not be appropriate for all cases. Future studies will help define how it may best be used. For example Brucella and tuberculous meningitides can be very similar, Brucella PCR may allow prompt distinction between the two, avoiding the need for prolonged empirical treatment for both.

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Section: Resultsmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Large-scale evaluation of a single-tube nested PCR for the laboratory diagnosis of human brucellosis in Kuwait

Al-Nakkas

Mustafa

Wright

2005

Journal of Medical Microbiology

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“…The major route of human infection in endemic areas is ingestion of unpasteurized milk or its products. In non-endemic areas, occupational exposure through direct contact with infected livestock, or brucella culture represents the major route of transmission, via the respiratory tract, conjunctiva, skin abrasion and transfusion of blood [4,6,12]. * Correspondence and requests for reprints.…”

Section: Introductionmentioning

confidence: 99%

“…Many countries have reported a high incidence of adult and childhood brucellosis with serious economic and public health sequelae [1][2][3][4][5]. To date, human infection by brucella organisms has been caused by four species: Brucella melitensis, B. abortus, B. suis, and B. canis [3,6].…”

Section: Introductionmentioning

confidence: 99%

Seroprevalence of brucella antibodies among persons in high-risk occupation in Lebanon

Araj

Azzam

1996

Epidemiol. Infect.

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SUMMARYPrevalence of brucella-specific antibodies was measured in 597 persons in high-risk occupations living in 10 regions of Lebanon using the standard agglutination test (SAT), anti-human globulin (Coombs') test (AHGT) and enzyme-linked immunosorbent assay (ELISA) for measuring immunoglobulin G (IgG), IgM and IgA. The study population consisted of butchers (54%), farmers (35 %), laboratory technicians (8 %), abbatoir workers (2%) and veterinarians (1 %), with 82% males and 18% females. The overall seroprevalence based on SAT and AHGT titres of > 80 was 1b7% and 15 %, respectively, but seroprevalence varied by region from 0-5 % in SAT and from 3-434 % for AHGT. The overall seroprevalence based on ELISA IgG (OD > 0 6), IgM (OD > 0'6) and IgA (OD > 0 3) was 57, 61 and 26 %, respectively. The highest seroprevalence was noted in Biqaa (34 %), Kisrwan (24%), Shouf (21 %), Sidon (16 %) and Aley (12 %) regions. Nineteen percent of those surveyed reported symptoms that could be associated with brucellosis. We conclude that exposure to brucellosis is high among persons in high-risk occupations from all surveyed regions in Lebanon. Such findings should be used to design control measures especially now that the 17 years of civil strife is over.

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“…A large number of cases due to Brucella melitensis are reported every year in the Mediterranean littoral, the Middle East, and parts of Latin America (36). In the United States and other developed countries it is mainly an occupational disease; however, brucellosis can be acquired from ingestion of contaminated dairy products imported from other parts of the world where the disease is endemic (6,10,51).…”

mentioning

confidence: 99%

Doxycycline-rifampin versus doxycycline-streptomycin in treatment of human brucellosis due to Brucella melitensis. The GECMEI Group. Grupo de Estudio de Castilla-la Mancha de Enfermedades Infecciosas

Solera

Zapata

Geijo

et al. 1995

Antimicrob Agents Chemother

133

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Brucellosis is a common zoonosis in many parts of the world; the best regimen for the treatment of brucellosis has not been clearly determined. We have carried out a multicenter, open, controlled trial in five general hospitals in Spain to compare the efficacy and safety of doxycycline and rifampin (DR) versus doxycycline and streptomycin (DS) for the treatment of human brucellosis. The study included 194 ambulatory or hospitalized patients with acute brucellosis, without endocarditis or neurobrucellosis. The diagnostic criterion was isolation of Brucella species from blood or other tissues (n ‫؍‬ 120) or a standard tube agglutination titer of 1/160 or more for anti-Brucella antibodies with compatible clinical findings (n ‫؍‬ 74). Patients were randomly assigned to receive either 100 mg of doxycycline twice daily plus rifampin, 900 mg/day, in a single morning dose for 45 days (DR group) or the same dose of doxycycline for 45 days plus streptomycin, 1 g/day, intramuscularly for 14 days (DS group). A lack of therapeutic efficacy developed in 8 of the 100 patients in the DR group (8%) and in 2 of the 94 patients in the DS group (2%) (P ‫؍‬ 0.10). Relapses occurred in 16 of the 100 patients in the DR group (16%) but in only 5 of the 94 patients in the DS group (5.3%) (P ‫؍‬ 0.02). When relapse was considered in combination with initial lack of efficacy, 26 patients in the DR group (24%) and 7 patients in the DS group (7.45%) failed to respond to therapy (P ‫؍‬ 0.0016). In general, therapy was well tolerated, and only four patients (4%) in the DR group and two (2%) in the DS group had episodes of adverse effects necessitating discontinuation of treatment (P > 0.2). We conclude that a doxycycline-and-rifampin regimen is less effective than the doxycycline-and-streptomycin regimen in patients with acute brucellosis.

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Epidemiological aspects

Cited by 14 publications

References 33 publications

Large-scale evaluation of a single-tube nested PCR for the laboratory diagnosis of human brucellosis in Kuwait

Large-scale evaluation of a single-tube nested PCR for the laboratory diagnosis of human brucellosis in Kuwait

Seroprevalence of brucella antibodies among persons in high-risk occupation in Lebanon

Doxycycline-rifampin versus doxycycline-streptomycin in treatment of human brucellosis due to Brucella melitensis. The GECMEI Group. Grupo de Estudio de Castilla-la Mancha de Enfermedades Infecciosas

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