Factors Affecting<i>Brucella</i>spp. Blood Cultures Positivity in Children

Objective To retrospectively investigate the epidemiological features, clinical manifestations and laboratory characteristics of bacteremic brucellosis. Methods Brucellosis patients admitted to our clinic from January 2015 to December 2017 were included in the study. Patient electronic medical records were reviewed for epidemiological features, clinical manifestations, and laboratory findings. Results A total of 132 brucellosis patients were analyzed (64 cases with bacteremic brucellosis and 68 cases with nonbacteremic brucellosis). The median duration from exposure to onset of symptoms was 6.9 weeks (range: 1 day to 32 weeks) and 21.9 weeks (range: 1–76 weeks) in patients with bacteremic and nonbacteremic brucellosis, respectively. More bacteremic than nonbacteremic patients presented with fever and chills. Arthritis was observed in 34 (25.8%) patients, and was more commonly observed in nonbacteremic patients. Using C-reactive protein (CRP) and procalcitonin (PCT) as serological markers, the areas under the receiving operating characteristic curves were 0.64 [95% confidence interval (CI): 0.54–0.73] and 0.61 (95% CI: 0.51–0.70), respectively, for distinguishing bacteremic from non-bacteremic brucellosis. Conclusion Fever and chills were frequently observed in bacteremic brucellosis patients, whereas arthritis was more common in nonbacteremic brucellosis patients. Serum CRP and PCT can be used as potential serological markers for diagnosing bacteremic brucellosis.

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“…Consistent with previous studies, we found that acute brucellosis was usually associated with a high rate of Brucella bacteremia. 11 , 12 …”

Section: Discussionmentioning

confidence: 99%

Epidemiological and clinical characteristics of bacteremic brucellosis

et al. 2020

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“…Anemia, leukopenia, and especially in endemic areas thrombocytopenia can be detected in the complete blood count in patients with brucellosis [19][20][21][22]. Additionally, it has been reported that increased levels of inflammatory markers such as CRP, ESR, and liver enzymes such as AST, ALT, and GTT in biochemical tests can support the diagnosis [23][24][25][26][27]. A study by Bozdemir et al reported that increased NLR values could be used as an indicator of inflammation in childhood brucellosis [22].…”

Section: Discussionmentioning

confidence: 99%

Investigation of the Sensitivity and Specificity of Laboratory Tests Used in Differential Diagnosis of Childhood Brucellosis

Kazanasmaz¹,

Geter

2020

Cureus

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Childhood brucellosis is a common public health problem in developing countries. The diagnosis of brucellosis based on nonspecific symptoms is an ongoing problem for physicians, especially in endemic areas. In this study, it is aimed to discuss the efficacy of frequently used test methods in the differential diagnosis of brucellosis. Methods The records of 332 patients admitted to pediatric clinic on suspicion of brucellosis were retrospectively analyzed. Patients with brucellosis were included in the positive group (n = 262) and those without brucellosis were included in the negative group (n = 70). Results As a result of biochemical analysis of the cases, median alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), erythrocyte sedimentation rate (ESR), and C reactive protein (CRP) values were significantly higher in the positive group than that in the negative group (p<0.05). There was no significant difference between median white blood cell, neutrophil, lymphocyte, neutrophil to lymphocyte ratio, hemoglobin, and platelet values between groups (p>0.05). Receiver operating curves were plotted to compare predictive values of CRP (area under curve (AUC): 0.635, p= 0.001), ESR(AUC:0.701, p<0.001), AST(AUC: 0.595, p=0.015), ALT(AUC:0.604, p=0.007), and GGT(AUC:0.593, p=0.016) in 332 patients with suspected brucellosis. Conclusions Increased levels of AST, ALT, GGT, CRP, and ESR may have a complementary role in the differential diagnosis of childhood brucellosis. However, all of these markers should be evaluated with clinical findings due to their low specificity and sensitivity.

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“…Brucellemic patients frequently present with higher fever than those with no demonstrable bacteremia (30). However, because brucellae are pathogens with relatively low virulence in humans, the inflammatory response may be attenuated, and the organism may be recovered from paucisymptomatic and even afebrile patients (31).…”

Section: Culture Detection Of Brucellae Blood Culturesmentioning

confidence: 99%

Laboratory Diagnosis of Human Brucellosis

2019

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SUMMARY 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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Factors AffectingBrucellaspp. Blood Cultures Positivity in Children

Cited by 20 publications

References 23 publications

Epidemiological and clinical characteristics of bacteremic brucellosis

Epidemiological and clinical characteristics of bacteremic brucellosis

Investigation of the Sensitivity and Specificity of Laboratory Tests Used in Differential Diagnosis of Childhood Brucellosis

Laboratory Diagnosis of Human Brucellosis

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