Misidentification of Brucella melitensis as Octrobactrum deajoenense with MALDI-TOF MS: A report of three cases

İnal, Neşe; Hazırolan, Gülşen­

doi:10.1016/j.eimc.2021.03.004

Cited by 2 publications

(1 citation statement)

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“…Laboratories lacking experience in Brucella diagnosis may encounter misidentification, particularly with automated identification instruments. While human brucellosis is predominantly caused by Brucella melitensis , Brucella abortus , and Brucella suis [ 1 ], most misidentification reports are limited to B. melitensis and B. suis [ 3 – 11 ]. We present a case involving the delayed diagnosis of B. abortus bacteremia, which was initially misidentified, and a review of the relevant literature on the misidentification of brucellosis, laboratory safety, and nomenclature issues.…”

Section: Introductionmentioning

confidence: 99%

Delay in the diagnosis of Brucella abortus bacteremia in a nonendemic country: a case report

Park,

Kim,

Park

et al. 2024

BMC Infect Dis

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Background It is challenging to diagnose brucellosis in nonendemic regions because it is a nonspecific febrile disease. The accurate identification of Brucella spp. in clinical microbiology laboratories (CMLs) continues to pose difficulties. Most reports of misidentification are for B. melitensis, and we report a rare case of misidentified B. abortus. Case presentation A 67-year-old man visited an outpatient clinic complaining of fatigue, fever, and weight loss. The patient had a history of slaughtering cows with brucellosis one year prior, and his Brucella antibody tests were negative twice. After blood culture, the administration of doxycycline and rifampin was initiated. The patient was hospitalized due to a positive blood culture. Gram-negative coccobacilli were detected in aerobic blood culture bottles, but the CML's lack of experience with Brucella prevented appropriate further testing. Inaccurate identification results were obtained for a GN ID card of VITEK 2 (bioMérieux, USA) and matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI–TOF MS) using a MALDI Biotyper (Bruker, Germany). The strain showed 100.0% identity with Brucella spp. according to 16S rRNA sequencing. MALDI–TOF MS peaks were reanalyzed using the CDC MicrobeNet database to determine Brucella spp. (score value: 2.023). The patient was discharged after nine days of hospitalization and improved after maintaining only doxycycline for six weeks. The isolate was also identified as Brucella abortus by genomic evidence. Conclusion Automated identification instruments and MALDI–TOF MS are widely used to identify bacteria in CMLs, but there are limitations in accurately identifying Brucella spp. It is important for CMLs to be aware of the possibility of brucellosis through communication with clinicians. Performing an analysis with an additional well-curated MALDI–TOF MS database such as Bruker security-relevant (SR) database or CDC MicrobeNet database is helpful for quickly identifying the genus Brucella.

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Section: Introductionmentioning

confidence: 99%