The Turkish Clinical Microbiology and Infectious Diseases Society (KLİMİK) Evidence-Based Guideline for the Diagnosis and Treatment of Brucellosis, 2023

Yavuz, Serap Şimşek; Özger, Selçuk; Benli, Aysun; Ateş, Can; Aydın, Mehtap; Aygün, Gökhan; Azap, Alpay; Başaran, Seniha; Demirtürk, Neşe; Ergönül, Önder; Kocagul-Celikbas, Aysel; Kuşçu, Ferit; Sarıcaoğlu, Elif Mükime; Kutlu, Selda Sayın; Türker, Nesrin; Türkoğlu, Emine; Azap, Özlem Kurt

doi:10.36519/kd.2023.4576

Cited by 3 publications

(2 citation statements)

References 8 publications

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“…growth in blood cultures. Growth rates in previous studies have been very variable, and our rate was found to be low compared to the literature [5]. The growth rate of Brucella species in blood or other tissue samples, which is the gold standard in the diagnosis of brucellosis, varies depending on the duration of the disease, the type and circulating amount of the causative agent, the length of the incubation period, and whether the patient has received antibiotic treatment before or not [6].…”

Section: Discussionmentioning

confidence: 56%

Comparison of the Characteristics of Brucella Patients Diagnosed With Blood Culture Positivity and/or Serology

Konya,

Demirturk,

Gürbüz

et al. 2023

Cureus

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Purpose: The aim of this study is to investigate and compare the clinical, laboratory, and treatment response characteristics of patients diagnosed with positive culture or serology. In this way, we wanted to assess the validity of serological diagnosis. Materials and methods: The study was designed as a retrospective cross-sectional study between January 2010 and 2020. Patients with clinical and laboratory findings of acute/subacute brucellosis, patients with positive serological tests, and patients with growth of Brucella spp. in blood culture were included in the study. The patients were divided into three groups: Group 1 - Wright agglutination test result ≥ 1/160 and Brucella spp. growth in blood culture; Group 2 - Wright agglutination test result ≥ 1/160 and no growth in blood culture; and Group 3 - Brucella spp. growth in blood culture and negative serological test. These three groups were retrospectively evaluated for clinical features, laboratory parameters, areas of involvement, treatment options, and treatment response. Results: We identified 294 patients diagnosed with brucellosis. Blood cultures were obtained from all patients, and Brucella spp. was detected in 40 patients (13.6%). There were 35 patients in Group 1, 254 patients in Group 2, and five patients in Group 3. When examining patients with symptoms, only fever showed a difference between the groups, which was significantly higher in Group 1. Laboratory investigations of the C-reactive protein (CRP), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) levels of the patients showed significant differences between the groups; these parameters were significantly higher in Group 1. Conclusion: No significant difference was found in terms of treatment response and prognosis between patients with and without blood culture growth who were clinically compatible with acute/subacute brucellosis as diagnosed by serological methods. Therefore, serological tests are reliable methods for the diagnosis of brucellosis in cases where blood culture is inconclusive.

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Section: Discussionmentioning

confidence: 56%

Comparison of the Characteristics of Brucella Patients Diagnosed With Blood Culture Positivity and/or Serology

Konya,

Demirturk,

Gürbüz

et al. 2023

Cureus

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“…However, the duration of treatment in complicated brucellosis varies. 28,29 In order to prevent the development of complications, studies can be conducted to give more aggressive and prolonged treatment to individuals with high titers and to give shorter treatment to individuals with low titers so that they are not exposed to the side effects of combined antibiotherapy for a long time.…”

Section: Discussionmentioning

confidence: 99%

Investigation of brucellosis cases in and around Yozgat Province

Felek,

Çınar

2023

JTPM

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Aims: Brucellosis causes a zoonotic infectious disease that is very common in our country as well as around the whole world. Infected individuals most frequently present with nonspecific symptoms such as fever, chills, malaise, and generalized body pain. Therefore, it is very difficult to diagnose. When diagnosis and treatment are delayed, it causes serious complications. It can cause pictures with high mortality, such as epididymoorchitis, endocarditis, hepatitis, neurobrucellosis, and pancytopenia. The first approach to treatment is rest. Antibiotics with intracellular bactericidal action should be used in combination due to resistance development. Methods: 136 individuals with serum titers who were diagnosed with brucellosis by serological tests and who applied to our hospital between 2017-2022 were included in the study. The patient files were analyzed to evaluate the complaints of these individuals, their Brucella ELISA titers, serum aspartate aminotransferase (AST), alanine aminotranspherase (ALT), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), lactate dehydrogenase (LDH) values, if any, at the time of diagnosis, the treatments they received, and the response to the treatment. Results: The first complaints of 136 patients who were diagnosed with brucellosis by serological tests were the most common; Joint pain was present in 48 (35.29%), widespread body pain in 26 (19.11%), and fever in 18 (13.23%). Sacroiliitis in 5 (3.67%), gonarthrosis in 4 (2.94%), bursitis in 4 (2.94%), discitis in 3 (2.2), and psoriasis in 1 of the patients’ abscess (0.73%) was detected. R=0.28 in the same direction between the first titers recognized by the patients and ALT; the same direction between titer and LDH R=0.30; the same ratio between titer and CRP is R=0.45; and there is a correlation coefficient of R=0.26 between titer and sediment in the same direction. It is important to take these correlation coefficients statistically (p<0.05). Accordingly, these values also change when it titrates. But it is weakened weights as a measure of relationship. Conclusion: Although fever comes to mind first in Brucellosis, it was observed that the first complaint of individuals in our study was complicated surgery, and fever ranked third. For this reason, Brucellosis should be approached with suspicion, since it is endemic in individuals presenting with non-specific complaints. It is widely present between serum titer and ESR, and C-reactive protein as markers of inflammation. In individuals with high vibration and inflammation markers, controlled caution should be exercised. Even treatment times can be changed.

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Determining Diagnostic Sensitivity: A Comparison of Rose Bengal Test, Coombs Gel Test, ELISA and Bacterial Culture in Brucellosis Diagnosis—Analyzing Clinical Effectiveness in Light of Inflammatory Markers

Barkay,

Karakeçili,

Binay

et al. 2024

Diagnostics

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Background: Brucellosis is a zoonotic infectious disease. It is estimated that the number of cases reported today is much less than the actual number. We still have difficulty in diagnosing the disease and its organ involvement. In this sense, new approaches that can be useful in clinical practice are required, and we aimed to evaluate this situation in our study. Methods: 171 of 213 patients followed in our center between January 2021 and April 2024 were included in the study. A total of 150 patients were included in the study as a control group. Rose Bengal test (RBT), Coombs gel test (CGT), enzyme-linked immunosorbent assay (ELISA), and automated blood culture were used for diagnosing brucellosis. Complete blood count, sedimentation, C-reactive protein, and biochemical parameters were obtained. Inflammation markers such as neutrophil–lymphocyte ratio, platelet–lymphocyte ratio, systemic immune-inflammation index, and systemic inflammation response index were calculated. Results: The most successful results in the diagnosis were ELISA (89.4%), RBT (88.3%), CGT (83%), and blood culture (34.8%). For diagnosing sacroiliitis and spondylodiscitis, instead of resorting to expensive methods like magnetic resonance, a combination of ELISA positivity with elevated acute phase reactants and inflammatory markers could be significantly instructive. Conclusions: Optimizing diagnostic algorithms and exploring novel diagnostic approaches, such as inflammatory markers, hold promise for improving diagnosis and management.

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The Turkish Clinical Microbiology and Infectious Diseases Society (KLİMİK) Evidence-Based Guideline for the Diagnosis and Treatment of Brucellosis, 2023

Cited by 3 publications

References 8 publications

Comparison of the Characteristics of Brucella Patients Diagnosed With Blood Culture Positivity and/or Serology

Comparison of the Characteristics of Brucella Patients Diagnosed With Blood Culture Positivity and/or Serology

Investigation of brucellosis cases in and around Yozgat Province

Determining Diagnostic Sensitivity: A Comparison of Rose Bengal Test, Coombs Gel Test, ELISA and Bacterial Culture in Brucellosis Diagnosis—Analyzing Clinical Effectiveness in Light of Inflammatory Markers

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