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Jaý M, Girault G, Perrot L, Taunay B, Vuilmet T, Rossignol F, Pitel PH, Picard E, Ponsart C, Mick V. Phenotypic and Molecular Characterization of Brucella microti-Like Bacteria From a Domestic Marsh Frog ( Pelophylax ridibundus). Front Vet Sci 2018; 5:283. [PMID: 30498697 PMCID: PMC6249338 DOI: 10.3389/fvets.2018.00283] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 10/24/2018] [Indexed: 11/13/2022] Open
Abstract
Several Brucella isolates have been described in wild-caught and "exotic" amphibians from various continents and identified as B. inopinata-like strains. On the basis of epidemiological investigations conducted in June 2017 in France in a farm producing domestic frogs (Pelophylax ridibundus) for human consumption of frog's legs, potentially pathogenic bacteria were isolated from adults showing lesions (joint and subcutaneous abscesses). The bacteria were initially misidentified as Ochrobactrum anthropi using a commercial identification system, prior to being identified as Brucella spp. by MALDI-TOF assay. Classical phenotypic identification confirmed the Brucella genus, but did not make it possible to conclude unequivocally on species determination. Conventional and innovative bacteriological and molecular methods concluded that the investigated strain was very close to B. microti species, and not B. inopinata-like strains, as expected. The methods included growth kinetic, antimicrobial susceptibility testing, RT-PCR, Bruce-Ladder, Suis-Ladder, RFLP-PCR, AMOS-ERY, MLVA-16, the ectoine system, 16S rRNA and recA sequence analyses, the LPS pattern, in silico MLST-21, comparative whole-genome analyses (including average nucleotide identity ANI and whole-genome SNP analysis) and HRM-PCR assays. Minor polyphasic discrepancies, especially phage lysis and A-dominant agglutination patterns, as well as, small molecular divergences suggest the investigated strain should be considered a B. microti-like strain, raising concerns about its environmental persistence and unknown animal pathogenic and zoonotic potential as for other B. microti strains described to date.
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Affiliation(s)
- Maryne Jaý
- ANSES/Paris-Est University, EU/OIE/FAO and National Reference Laboratory for Brucellosis, Animal Health Laboratory, Maisons-Alfort, France
| | - Guillaume Girault
- ANSES/Paris-Est University, EU/OIE/FAO and National Reference Laboratory for Brucellosis, Animal Health Laboratory, Maisons-Alfort, France
| | - Ludivine Perrot
- ANSES/Paris-Est University, EU/OIE/FAO and National Reference Laboratory for Brucellosis, Animal Health Laboratory, Maisons-Alfort, France
| | - Benoit Taunay
- ANSES/Paris-Est University, EU/OIE/FAO and National Reference Laboratory for Brucellosis, Animal Health Laboratory, Maisons-Alfort, France
| | - Thomas Vuilmet
- ANSES/Paris-Est University, EU/OIE/FAO and National Reference Laboratory for Brucellosis, Animal Health Laboratory, Maisons-Alfort, France
| | | | | | | | - Claire Ponsart
- ANSES/Paris-Est University, EU/OIE/FAO and National Reference Laboratory for Brucellosis, Animal Health Laboratory, Maisons-Alfort, France
| | - Virginie Mick
- ANSES/Paris-Est University, EU/OIE/FAO and National Reference Laboratory for Brucellosis, Animal Health Laboratory, Maisons-Alfort, France
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Facciolà A, Palamara MA, D’Andrea G, Marano F, Magliarditi D, Puglisi G, Picerno I, Di Pietro A, Visalli G. Brucellosis is a public health problem in southern Italy: Burden and epidemiological trend of human and animal disease. J Infect Public Health 2018; 11:861-866. [DOI: 10.1016/j.jiph.2018.07.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/06/2018] [Accepted: 07/15/2018] [Indexed: 10/28/2022] Open
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A MALDI-TOF MS database with broad genus coverage for species-level identification of Brucella. PLoS Negl Trop Dis 2018; 12:e0006874. [PMID: 30335748 PMCID: PMC6207331 DOI: 10.1371/journal.pntd.0006874] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 10/30/2018] [Accepted: 09/25/2018] [Indexed: 12/29/2022] Open
Abstract
Brucella are highly infectious bacterial pathogens responsible for a severely debilitating zoonosis called brucellosis. Half of the human population worldwide is considered to live at risk of exposure, mostly in the poorest rural areas of the world. Prompt diagnosis of brucellosis is essential to prevent complications and to control epidemiology outbreaks, but identification of Brucella isolates may be hampered by the lack of rapid and cost-effective methods. Nowadays, many clinical microbiology laboratories use Matrix-Assisted Laser Desorption Ionization–Time Of Flight mass spectrometry (MALDI-TOF MS) for routine identification. However, lack of reference spectra in the currently commercialized databases does not allow the identification of Brucella isolates. In this work, we constructed a Brucella MALDI-TOF MS reference database using VITEK MS. We generated 590 spectra from 84 different strains (including rare or atypical isolates) to cover this bacterial genus. We then applied a novel biomathematical approach to discriminate different species. This allowed accurate identification of Brucella isolates at the genus level with no misidentifications, in particular as the closely related and less pathogenic Ochrobactrum genus. The main zoonotic species (B. melitensis, B. abortus and B. suis) could also be identified at the species level with an accuracy of 100%, 92.9% and 100%, respectively. This MALDI-TOF reference database will be the first Brucella database validated for diagnostic and accessible to all VITEK MS users in routine. This will improve the diagnosis and control of brucellosis by allowing a rapid identification of these pathogens. Brucella are bacteria that mainly infect animals. They can also be transmitted to humans and cause a serious disease called brucellosis. Half the world's population is considered exposed, especially in the poorest rural areas. Experts agree that prompt identification of Brucella isolates is essential to provide appropriate treatment to patients and to control epidemiological outbreaks. Mis-identification of these highly infectious pathogens may lead to delays in diagnosis, but also to increased risks of accidental exposure for laboratory workers. MALDI-TOF mass spectrometry is now the first line of bacterial identification in many routine diagnostic laboratories. However, not all clinical mass spectrometers can identify Brucella. In this work, we updated a database with Brucella spectra to improve the performance of MALDI-TOF mass spectrometers. These instruments will now be able to identify accurately Brucella isolates. This will greatly improve the diagnosis of brucellosis.
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Agada CA, Mohammed J, Okoh AEJ, Ogugua JA. Prevalence and risk factors associated with brucellosis among high-risk individuals in Lafia, Nasarawa state, Nigeria. INTERNATIONAL JOURNAL OF ONE HEALTH 2018. [DOI: 10.14202/ijoh.2018.45-51] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Mazlina M, Khairani-Bejo S, Hazilawati H, Tiagarahan T, Shaqinah NN, Zamri-Saad M. Pathological changes and bacteriological assessments in the urinary tract of pregnant goats experimentally infected with Brucella melitensis. BMC Vet Res 2018; 14:203. [PMID: 29940976 PMCID: PMC6019509 DOI: 10.1186/s12917-018-1533-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 06/19/2018] [Indexed: 12/14/2022] Open
Abstract
Background This study was conducted to investigate the pathological changes and distribution of B. melitensis in the urinary tract of pregnant goats following acute experimental infection. Six Jamnapari crossbred does in their third trimester of pregnancy were randomly assigned into two groups; Group 1 was uninfected control and Group 2 was inoculated conjunctival with 0.1 mL of the inoculums containing 109 cfu/mL of live B. melitensis. All does were sacrificed 30 days post-inoculation before the kidney, ureter, urinary bladder, urethra and vaginal swab were collected for isolation of B. melitensis. The same tissue samples were fixed in 10% neutral buffered formalin for hematoxylin and eosin, and immunoperoxidase staining. Results None of the goats showed clinical signs or gross lesions. The most consistent histopathology finding was the infiltration of mononuclear cells, chiefly the macrophages with few lymphocytes and occasionally neutrophils in all organs along the urinary tract of the infected goats of Group 2. Other histopathology findings included mild necrosis of the epithelial cells of the renal tubules, congestion and occasional haemorrhages in the various tissues. Kidneys showed the most severe lesions. Immunoperoxidase staining revealed the presence of B. melitensis within the infiltrating macrophages and the epithelium of renal tubules, ureter, urethra and urinary bladder. Most extensive distribution was observed in the urinary bladder. Brucella melitensis was successfully isolated at low concentration (3.4 × 103 cfu/g) in the various organs of the urinary tract and at high concentration (2.4 × 108 cfu/mL) in the vaginal swabs of all infected goats. Although B. melitensis was successfully isolated from the various organs of the urinary tract, it was not isolated from the urine samples that were collected from the urinary bladder at necropsy. Conclusion This study demonstrates the presence of low concentrations of B. melitensis in the organs of urinary tract of pregnant does, resulting in mild histopathology lesions. However, B. melitensis was not isolated from the urine that was collected from the urinary bladder.
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Affiliation(s)
- M Mazlina
- Research Centre for Ruminant Diseases, Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia.,Department of Veterinary Pathology & Microbiology, Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - S Khairani-Bejo
- Department of Veterinary Pathology & Microbiology, Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - H Hazilawati
- Department of Veterinary Pathology & Microbiology, Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - T Tiagarahan
- Puncak Jalil Veterinary Clinic, Taman Puncak Jalil, 43300 Seri Kembangan, Seri Kembangan, Selangor, Malaysia
| | - N N Shaqinah
- Research Centre for Ruminant Diseases, Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - M Zamri-Saad
- Research Centre for Ruminant Diseases, Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia. .,Department of Veterinary Laboratory Diagnosis, Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400, Serdang, Malaysia.
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Olsen SC, Boggiatto P, White DM, McNunn T. Biosafety Concerns Related toBrucellaand Its Potential Use as a Bioweapon. APPLIED BIOSAFETY 2018. [DOI: 10.1177/1535676018771983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Misidentification of Risk Group 3/Security Sensitive Biological Agents by MALDI-TOF MS in Canada: November 2015-October 2017. ACTA ACUST UNITED AC 2018; 44:110-115. [PMID: 31007621 DOI: 10.14745/ccdr.v44i05a04] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Background Matrix-Assisted Laser Desorption/Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) is a technology increasingly used in diagnostic identification of microorganisms. However, anecdotal evidence suggests that this technology is associated with misidentification of Risk Group 3 (RG3)/Security Sensitive Biological Agents (SSBA) resulting in exposure risks to laboratory personnel. Objective To investigate and characterize incidents related to the use of MALDI-TOF MS in Canada between November 6, 2015, and October 10, 2017. Methods Cases were identified from laboratory incident reports in the national Laboratory Incident Notification Canada (LINC) surveillance system. Eligible cases referred directly to MALDI-TOF MS or one of three RG3/SSBA organisms, Brucella species, Francisella tularensis and Burkholderia pseudomallei. A questionnaire was developed to identify potential risk factors leading to the exposure. Reporters from organizations with selected incidents were interviewed using the questionnaire. Data were entered into an Excel spreadsheet and standard descriptive statistical analysis performed to assess common characteristics and identify possible risk factors. Results There were eight eligible incidents and a total of 39 laboratory workers were exposed to RG3/SSBA organisms. In five (out of eight) of the incidents, the reporters indicated that their device was equipped with both clinical and research reference libraries. For six incidents where reporters knew the type of library used, only the clinical library was employed at the time of the incident even though both libraries were available in five of these incidents. In all eight cases, the exposure occurred during the sample preparation stage with analyses performed on an open bench and directly from the specimen. And in all eight cases, patient specimens were received without information regarding potential risk. Conclusion This first national study characterizing the nature and extent of laboratory incidents involving RG3/SSBA that are related to the use of MALDI-TOF MS identifies risk factors and provides baseline data that can inform mitigation strategies.
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Alyousef M, Aldoghaither R. First case of cervical epidural abscess caused by brucellosis in Saudi Arabia: A case report and literature review. IDCases 2018; 12:107-111. [PMID: 29682450 PMCID: PMC5909065 DOI: 10.1016/j.idcr.2018.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Spinal epidural abscess (SEA) is an extremely rare and disastrous musculoskeletal complication of spondylodiscitis and sacroilitis secondary to brucellosis infection. Few case reports and retrospective studies have been published reporting patients with epidural abscesses mainly lumbar, and thoracic while cervical abscess are rare. Management of spinal epidural abscess due to Brucella species is not standard and remains controversial. To the best of our knowledge this is the first case of brucellar cervical epidural abscess reported in Saudi Arabia. In this paper, we review the literature and report a case of a 67-year-old Saudi gentleman, who presented with fever and back pain. Further evaluation revealed cervical epidural abscess and a positive serology for brucellosis. Following 6 months of antibiotic therapy alone against brucellosis, he showed significant clinical and radiological improvement. Spinal epidural abscess caused by brucellosis is a rare condition, difficult to diagnose, and can be complicated by disastrous neurological or vascular complication if left untreated. Brucellosis must be considered as a possible cause of spinal epidural abscess in patients from endemic area. Hence, early detection and initiation of appropriate medical treatment alone is crucial in preventing permanent neurological complication, and possibly avoid surgical intervention.
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Affiliation(s)
- Meshal Alyousef
- Department of adult infectious diseases, King Fahad Medical City, P.O. Box 59046, Riyadh, Saudi Arabia
| | - Rabia Aldoghaither
- Department of adult infectious diseases, Sheikh Khalifa Medical City, P.O. Box 51900, Abu Dhabi, United Arab Emirates
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Becker SL, Zange S, Brockmeyer M, Grün U, Halfmann A. Rapid MALDI-TOF-based identification of Brucella melitensis from positive blood culture vials may prevent laboratory-acquired infections. J Hosp Infect 2018; 100:117-119. [PMID: 29653133 DOI: 10.1016/j.jhin.2018.04.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Accepted: 04/04/2018] [Indexed: 10/17/2022]
Affiliation(s)
- S L Becker
- Institute of Medical Microbiology and Hygiene, Saarland University, Homburg/Saar, Germany; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
| | - S Zange
- Bundeswehr Institute of Microbiology, Munich, Germany
| | - M Brockmeyer
- Department of Orthopaedics, Saarland University, Homburg/Saar, Germany
| | - U Grün
- Department of Orthopaedics, Saarland University, Homburg/Saar, Germany
| | - A Halfmann
- Institute of Medical Microbiology and Hygiene, Saarland University, Homburg/Saar, Germany
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Siengsanan-Lamont J, Blacksell SD. A Review of Laboratory-Acquired Infections in the Asia-Pacific: Understanding Risk and the Need for Improved Biosafety for Veterinary and Zoonotic Diseases. Trop Med Infect Dis 2018; 3:E36. [PMID: 30274433 PMCID: PMC6073996 DOI: 10.3390/tropicalmed3020036] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 03/17/2018] [Accepted: 03/19/2018] [Indexed: 01/30/2023] Open
Abstract
A rapid review was performed to determine (1) the number and causes of reported laboratory-acquired infections (LAI) in the Asia-Pacific region; (2) their significance and threat to the community; (3) the primary risk factors associated with LAIs; (4) the consequences in the event of a LAI or pathogen escape; and (5) to make general recommendations regarding biosafety practices for diagnosis and research in the Asia-Pacific region. A search for LAI and zoonoses in the Asia-Pacific region using online search engines revealed a relatively low number of reports. Only 27 LAI reports were published between 1982 and 2016. The most common pathogens associated with LAIs were dengue virus, Arthroderma spp., Brucella spp., Mycobacterium spp., Rickettsia spp., and Shigella spp. Seventy-eight percent (21 out of 27 LAI reports) occurred in high-income countries (i.e., Australia, Japan, South Korea, Singapore, and Taiwan) where laboratories were likely to comply with international biosafety standards. Two upper-middle income countries (China (2), and Malaysia (2)) and one lower-middle income country (India (2)) reported LAI incidents. The majority of the reports (fifty-two percent (14/27)) of LAIs occurred in research laboratories. Five LAI reports were from clinical or diagnostic laboratories that are considered at the frontier for zoonotic disease detection. Governments and laboratories in the Asia-Pacific region should be encouraged to report LAI cases as it provides a useful tool to monitor unintended release of zoonotic pathogens and to further improve laboratory biosafety. Non-reporting of LAI events could pose a risk of disease transmission from infected laboratory staff to communities and the environment. The international community has an important and continuing role to play in supporting laboratories in the Asia-Pacific region to ensure that they maintain the safe working environment for the staff and their families, and the wider community.
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Affiliation(s)
| | - Stuart D Blacksell
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand.
- Centre for Tropical Medicine & Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Old Road Campus, Oxford OX3 7FZ, UK.
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Liu ZG, Di DD, Wang M, Liu RH, Zhao HY, Piao DR, Zhao ZZ, Hao YQ, Du YN, Jiang H, Cui BY, Xia XZ. In vitro antimicrobial susceptibility testing of human Brucella melitensis isolates from Ulanqab of Inner Mongolia, China. BMC Infect Dis 2018; 18:43. [PMID: 29338693 PMCID: PMC5771123 DOI: 10.1186/s12879-018-2947-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 01/04/2018] [Indexed: 11/10/2022] Open
Abstract
Background Brucellosis is an endemic disease in the Inner Mongolia Autonomous Region of China and Ulanqab exhibits the highest prevalence of brucellosis in this region. Due to the complex nature of Brucellosis, a cure for this disease has proven to be elusive. Furthermore, the reduced susceptibility of Brucella spp. to antimicrobial agents has been reported as a potential cause of therapeutic failure. However, detailed in vitro antimicrobial susceptibility patterns pertaining to Brucella isolates from this region have not yet been published. The aim of this study was to evaluate the antibiotic susceptibility profile of Brucella melitensis clinical isolates from Ulanqab, Inner Mongolia, China. Methods A total of 85 B. melitesis isolates were obtained from humans in Ulanqab of Inner Mongolia, China; the antimicrobial susceptibility of 85 clinical isolates to nine antibiotics was assessed using the E-test method according to the CLSI (Clinical and Laboratory Standards Institute) guidelines. Results All of the tested isolates were susceptible to minocycline, sparfloxacin, doxycycline, tetracycline, ciprofloxacin, gentamicin and levofloxacin. Resistance to rifampin and cotrimoxazole was observed in 1.0% (1/85) and 7.0% (6/85) of the isolates, respectively. However, rpoB gene mutations were not observed in single isolates exhibiting resistance to rifampin. Conclusions We observed that B. melitensis isolates are susceptible to the majority of the tested antibiotics. Furthermore, minocycline and sparfloxacin exhibited extremely high bactericidal effects in relation to the B. melitensis isolates. The sensitivity of commonly used drugs for the treatment of brucellosis should be regularly monitored. To the best of our knowledge, this is the first report of rifampin and cotrimoxazole resistant isolates of B. melitensis in China. In summary, based on the findings from this study, we suggest that antibiotic administration and use should be rationalized to prevent future drug resistance.
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Affiliation(s)
- Zhi-Guo Liu
- College of Veterinary Medical Inner Mongolia Agriculture University, Hohhot, 010018, China.,Ulanqab Centre for Endemic Disease Prevention and Control, Health and Family Planning Commission of Ulanqab, Ulanqab west Road, Jining, 012000 Inner, Mongolia.,State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention/Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping, Beijing, 102206, People's Republic of China
| | - Dong-Dong Di
- Laboratory of Zoonoses, China Animal Health and Epidemiology Center, MOA, Qingdao, China
| | - Miao Wang
- Ulanqab Centre for Endemic Disease Prevention and Control, Health and Family Planning Commission of Ulanqab, Ulanqab west Road, Jining, 012000 Inner, Mongolia
| | - Ri-Hong Liu
- Ulanqab Centre for Endemic Disease Prevention and Control, Health and Family Planning Commission of Ulanqab, Ulanqab west Road, Jining, 012000 Inner, Mongolia
| | - Hong-Yan Zhao
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention/Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping, Beijing, 102206, People's Republic of China
| | - Dong-Ri Piao
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention/Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping, Beijing, 102206, People's Republic of China
| | - Zhong-Zhi Zhao
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention/Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping, Beijing, 102206, People's Republic of China
| | - Yong-Qing Hao
- College of Veterinary Medical Inner Mongolia Agriculture University, Hohhot, 010018, China
| | - Ya-Nan Du
- College of Veterinary Medical Inner Mongolia Agriculture University, Hohhot, 010018, China
| | - Hai Jiang
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention/Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping, Beijing, 102206, People's Republic of China.
| | - Bu-Yun Cui
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention/Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping, Beijing, 102206, People's Republic of China.
| | - Xian-Zhu Xia
- College of Veterinary Medical Inner Mongolia Agriculture University, Hohhot, 010018, China. .,Institute of Military Veterinary AMMS, Changchun, 130062, China.
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Arif S, Heller J, Hernandez-Jover M, McGill DM, Thomson PC. Evaluation of three serological tests for diagnosis of bovine brucellosis in smallholder farms in Pakistan by estimating sensitivity and specificity using Bayesian latent class analysis. Prev Vet Med 2017; 149:21-28. [PMID: 29290297 DOI: 10.1016/j.prevetmed.2017.11.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 11/02/2017] [Accepted: 11/02/2017] [Indexed: 11/27/2022]
Abstract
The present study aimed to estimate the herd-level sensitivity (Se) and specificity (Sp) of three commonly used serological tests in naturally-infected cattle and buffalo in smallholder farms in Pakistan. Between February and June 2015, a cross-sectional study was carried out in five districts of Punjab (Kasur, Okara, Pakpattan, Jhelum, and Bhakkar) and two districts of Sindh (Badin and Thatta). Serum samples from mixed farms of cattle (n=441) and buffalo (n=621) were collected and tested using the Rose Bengal test (RBT), indirect ELISA (I-ELISA) and competitive ELISA (C-ELISA). A Bayesian latent class analysis (LCA) approach was used to estimate the Se and Sp of these three serological tests and the true herd-level prevalence in each district. The model was fitted under the assumption of conditional independence between three tests and also conditional dependence by including covariances between the two ELISAs. In addition, the model was fitted using three different shapes of beta distributions to incorporate prior information in the model. The test with the highest Se was the C-ELISA, with a range from 76.3% (95% PCI (Posterior Credibility Interval), 62.6-88.2%) to 81.4% (95% PCI, 68.2-92.8%). The RBT was found to have the highest Sp (99.1-99.4%) of the tests. The highest estimated herd-level prevalence, 45% (95% PCI, 32-59%), was found in Jhelum district and the lowest in Thatta district, 1.1% (95% PCI 0.04-6.0%). The results of this study identified some discrepancy between the published literature on the level of Se of these tests, especially for RBT. It appears that RBT has lower Se and higher Sp when used in the field conditions of the present study. Consequently, it is recommended that none of the evaluated tests should be performed in isolation for the diagnosis of bovine brucellosis in the field conditions of Pakistan, but the use of tests in combination, with RBT and C-ELISA used in parallel returning optimal Se and Sp, is warranted.
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Affiliation(s)
- Shumaila Arif
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia; Graham Centre for Agricultural Innovation, Charles Sturt University, Wagga Wagga, New South Wales, Australia.
| | - Jane Heller
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia; Graham Centre for Agricultural Innovation, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Marta Hernandez-Jover
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia; Graham Centre for Agricultural Innovation, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - David M McGill
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Victoria, Australia
| | - Peter C Thomson
- Graham Centre for Agricultural Innovation, Charles Sturt University, Wagga Wagga, New South Wales, Australia; School of Life and Environmental Sciences, The University of Sydney, Camden, New South Wales, Australia
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Surveillance of laboratory exposures to human pathogens and toxins: Canada 2016. ACTA ACUST UNITED AC 2017; 43:228-235. [PMID: 29770052 DOI: 10.14745/ccdr.v43i11a04] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Background Canada recently enacted legislation to authorize the collection of data on laboratory incidents involving a biological agent. This is done by the Public Health Agency of Canada (PHAC) as part of a comprehensive national program that protects Canadians from the health and safety risks posed by human and terrestrial animal pathogens and toxins. Objective To describe the first year of data on laboratory exposure incidents and/or laboratory-acquired infections in Canada since the Human Pathogens and Toxins Regulations came into effect. Methods Incidents that occurred between January 1 and December 31, 2016 were self-reported by federally-regulated parties across Canada using a standardized form from the Laboratory Incident Notification Canada (LINC) surveillance system. Exposure incidents were described by sector, frequency of occurrence, timeliness of reporting, number of affected persons, human pathogens and toxins involved, causes and corrective actions taken. Microsoft Excel 2010 was used for basic descriptive analyses. Results In 2016, 46 exposure incidents were reported by holders of 835 active licences in Canada representing 1,352 physical areas approved for work involving a biological agent, for an overall incidence of 3.4%. The number of incidents was highest in the academic (n=16; 34.8%) and hospital (n=12; 26.1%) sectors, while the number of reported incidents was relatively low in the private industry sector. An average of four to five incidents occurred each month; the month of September presented as an outlier with 10 incidents.: A total of 100 people were exposed, with no reports of secondary exposure. Four incidents led to suspected (n=3) or confirmed (n=1) cases of laboratory-acquired infection. Most incidents involved pathogens classified at a risk group 2 level that were manipulated in a containment level 2 laboratory (91.3%). Over 22 different species of human pathogens and toxins were implicated, with bacteria the most frequent (34.8%), followed by viruses (26.1%). Eleven (23.9%) incidents involved a security sensitive biologic agent. Procedure breaches (n=15) and sharps-related incidents (n=14) were the most common antecedents to an exposure. In 10 (21.7%) cases, inadvertent possession (i.e., isolation of an unexpected biological agent during routine work) played a role. Possible improvements to standard operating procedures were cited in 71.7% of incidents. Improvements were also indicated for communication (26.1%) and management (23.9%). Conclusions The Laboratory Incident Notification Canada is one of the first surveillance systems in the world to gather comprehensive data on laboratory incidents involving human pathogens and toxins. Exposure incidents reported in the first year were relatively rare, occurring in less than 4% of containment zones within laboratory settings.
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Adams DA, Thomas KR, Jajosky RA, Foster L, Baroi G, Sharp P, Onweh DH, Schley AW, Anderson WJ. Summary of Notifiable Infectious Diseases and Conditions - United States, 2015. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2017; 64:1-143. [PMID: 28796757 DOI: 10.15585/mmwr.mm6453a1] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The Summary of Notifiable Infectious Diseases and Conditions - United States, 2015 (hereafter referred to as the summary) contains the official statistics, in tabular and graphical form, for the reported occurrence of nationally notifiable infectious diseases and conditions in the United States for 2015. Unless otherwise noted, data are final totals for 2015 reported as of June 30, 2016. These statistics are collected and compiled from reports sent by U.S. state and territories, New York City, and District of Columbia health departments to the National Notifiable Diseases Surveillance System (NNDSS), which is operated by CDC in collaboration with the Council of State and Territorial Epidemiologists (CSTE). This summary is available at https://www.cdc.gov/MMWR/MMWR_nd/index.html. This site also includes summary publications from previous years.
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Affiliation(s)
- Deborah A Adams
- Division of Health Informatics and Surveillance, Office of Public Health Scientific Services, CDC
| | - Kimberly R Thomas
- Division of Health Informatics and Surveillance, Office of Public Health Scientific Services, CDC
| | - Ruth Ann Jajosky
- Division of Health Informatics and Surveillance, Office of Public Health Scientific Services, CDC
| | - Loretta Foster
- Division of Health Informatics and Surveillance, Office of Public Health Scientific Services, CDC
| | - Gitangali Baroi
- Division of Health Informatics and Surveillance, Office of Public Health Scientific Services, CDC
| | - Pearl Sharp
- Division of Health Informatics and Surveillance, Office of Public Health Scientific Services, CDC
| | - Diana H Onweh
- Division of Health Informatics and Surveillance, Office of Public Health Scientific Services, CDC
| | - Alan W Schley
- Division of Health Informatics and Surveillance, Office of Public Health Scientific Services, CDC
| | - Willie J Anderson
- Division of Health Informatics and Surveillance, Office of Public Health Scientific Services, CDC
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Lytras T, Danis K, Dounias G. Incidence Patterns and Occupational Risk Factors of Human Brucellosis in Greece, 2004-2015. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2017; 7:221-6. [PMID: 27651083 PMCID: PMC6817955 DOI: 10.15171/ijoem.2016.806] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 05/25/2016] [Indexed: 11/22/2022]
Abstract
Background: Brucellosis is the most common bacterial zoonosis worldwide. Greece has the highest reported incidence among EU countries. However, occupational risk factors have not been well described. Objective: To determine the incidence patterns and exposure risk factors of brucellosis in Greece. Methods: We used national-level surveillance and occupational denominator data to estimate the incidence patterns and exposure risk factors of brucellosis in Greece, with particular emphasis on occupation. Results: Between November 2003 and December 2015 a total of 2159 human brucellosis cases was reported. The mean incidence rate was 1.62 per 100 000 population per year. A large majority of cases (77.1%) reported consumption of unpasteurized milk or contact with livestock animals. Most cases occured in farmers and livestock breeders (1079 [87.7%] of 1231 cases reporting their occupation), corresponding to an annual incidence of 7.1 per 100 000. However, there were other occupations with a similar or higher risk: butchers and abattoir workers (12.7 per 100 000), laboratory personnel (3.1 per 100 000), while the highest risk was for veterinarians (53.2 per 100 000). Conclusion: Brucellosis incidence in specific occupational groups was much higher than in the general population. These results underline the importance of collecting information on occupation, both during the diagnostic process and in the surveillance system. Besides efforts to control brucellosis in animals, organized prevention efforts are needed within an occupational health framework, especially for the most vulnerable workers.
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Affiliation(s)
- T Lytras
- Department of Epidemiological Surveillance and Intervention, Hellenic Centre for Disease Control and Prevention, Athens, Greece. .,Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - K Danis
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.,French Institute for Public Health Surveillance (Institut de Veille Sanitaire, InVS), Paris, France
| | - G Dounias
- Department of Occupational and Industrial Hygiene, National School of Public Health, Athens, Greece
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Rossetti CA, Drake KL, Lawhon SD, Nunes JS, Gull T, Khare S, Adams LG. Systems Biology Analysis of Temporal In vivo Brucella melitensis and Bovine Transcriptomes Predicts host:Pathogen Protein-Protein Interactions. Front Microbiol 2017; 8:1275. [PMID: 28798726 PMCID: PMC5529337 DOI: 10.3389/fmicb.2017.01275] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 06/26/2017] [Indexed: 01/13/2023] Open
Abstract
To date, fewer than 200 gene-products have been identified as Brucella virulence factors, and most were characterized individually without considering how they are temporally and coordinately expressed or secreted during the infection process. Here, we describe and analyze the in vivo temporal transcriptional profile of Brucella melitensis during the initial 4 h interaction with cattle. Pathway analysis revealed an activation of the "Two component system" providing evidence that the in vivo Brucella sense and actively regulate their metabolism through the transition to an intracellular lifestyle. Contrarily, other Brucella pathways involved in virulence such as "ABC transporters" and "T4SS system" were repressed suggesting a silencing strategy to avoid stimulation of the host innate immune response very early in the infection process. Also, three flagellum-encoded loci (BMEII0150-0168, BMEII1080-1089, and BMEII1105-1114), the "flagellar assembly" pathway and the cell components "bacterial-type flagellum hook" and "bacterial-type flagellum" were repressed in the tissue-associated B. melitensis, while RopE1 sigma factor, a flagellar repressor, was activated throughout the experiment. These results support the idea that Brucella employ a stealthy strategy at the onset of the infection of susceptible hosts. Further, through systems-level in silico host:pathogen protein-protein interactions simulation and correlation of pathogen gene expression with the host gene perturbations, we identified unanticipated interactions such as VirB11::MAPK8IP1; BtaE::NFKBIA, and 22 kDa OMP precursor::BAD and MAP2K3. These findings are suggestive of new virulence factors and mechanisms responsible for Brucella evasion of the host's protective immune response and the capability to maintain a dormant state. The predicted protein-protein interactions and the points of disruption provide novel insights that will stimulate advanced hypothesis-driven approaches toward revealing a clearer understanding of new virulence factors and mechanisms influencing the pathogenesis of brucellosis.
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Affiliation(s)
- Carlos A Rossetti
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Science, Texas A&M UniversityCollege Station, TX, United States
| | | | - Sara D Lawhon
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Science, Texas A&M UniversityCollege Station, TX, United States
| | - Jairo S Nunes
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Science, Texas A&M UniversityCollege Station, TX, United States
| | - Tamara Gull
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Science, Texas A&M UniversityCollege Station, TX, United States
| | - Sangeeta Khare
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Science, Texas A&M UniversityCollege Station, TX, United States
| | - Leslie G Adams
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Science, Texas A&M UniversityCollege Station, TX, United States
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Highly Sensitive Bacteriophage-Based Detection of Brucella abortus in Mixed Culture and Spiked Blood. Viruses 2017; 9:v9060144. [PMID: 28604602 PMCID: PMC5490821 DOI: 10.3390/v9060144] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 05/25/2017] [Accepted: 06/06/2017] [Indexed: 01/18/2023] Open
Abstract
For decades, bacteriophages (phages) have been used for Brucella species identification in the diagnosis and epidemiology of brucellosis. Traditional Brucella phage typing is a multi-day procedure including the isolation of a pure culture, a step that can take up to three weeks. In this study, we focused on the use of brucellaphages for sensitive detection of the pathogen in clinical and other complex samples, and developed an indirect method of Brucella detection using real-time quantitative PCR monitoring of brucellaphage DNA amplification via replication on live Brucella cells. This assay allowed the detection of single bacteria (down to 1 colony-forming unit per milliliter) within 72 h without DNA extraction and purification steps. The technique was equally efficient with Brucella abortus pure culture and with mixed cultures of B. abortus and α-proteobacterial near neighbors that can be misidentified as Brucella spp., Ochrobactrum anthropi and Afipia felis. The addition of a simple short sample preparation step enabled the indirect phage-based detection of B. abortus in spiked blood, with the same high sensitivity. This indirect phage-based detection assay enables the rapid and sensitive detection of live B. abortus in mixed cultures and in blood samples, and can potentially be applied for detection in other clinical samples and other complex sample types.
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Pastorino B, de Lamballerie X, Charrel R. Biosafety and Biosecurity in European Containment Level 3 Laboratories: Focus on French Recent Progress and Essential Requirements. Front Public Health 2017; 5:121. [PMID: 28620600 PMCID: PMC5449436 DOI: 10.3389/fpubh.2017.00121] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 05/08/2017] [Indexed: 11/18/2022] Open
Abstract
Even if European Union (EU) Member States are obliged to implement EU Directives 2000/54/EC on the protection of workers from risks related to exposure to biological agents at work, national biosafety regulations and practices varied from country to country. In fact, EU legislation on biological agents and genetically modified microorganisms is often not specific enough to ensure harmonization leading to difficulties in implementation for most laboratories. In the same way, biosecurity is a relatively new concept and a few EU Member States are known to have introduced national laboratory biosecurity legislation. In France, recent regulations have reinforced biosafety/biosecurity in containment level 3 (CL-3) laboratories but they concern a specific list of pathogens with no correlation in other European Members States. The objective of this review was to summarize European biosafety/biosecurity measures concerning CL-3 facilities focusing on French specificities. Essential requirements needed to preserve efficient biosafety measures when manipulating risk group 3 biological agents are highlighted. In addition, International, European and French standards related to containment laboratory planning, operation or biosafety equipment are described to clarify optimal biosafety and biosecurity requirements.
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Affiliation(s)
- Boris Pastorino
- UMR “Emergence des Pathologies Virales” (EPV: Aix-Marseille Univ – IRD 190 – Inserm 1207 – EHESP – IHU Méditerranée Infection), Marseille, France
- UMR 190 “Emergence des Pathologies Virales”, Virology, 19-21 bd jean moulin faculté de medecine de la timone, Institut hospitalo-universitaire Méditerranée infection, APHM Public Hospitals of Marseille, Marseille, France
| | - Xavier de Lamballerie
- UMR “Emergence des Pathologies Virales” (EPV: Aix-Marseille Univ – IRD 190 – Inserm 1207 – EHESP – IHU Méditerranée Infection), Marseille, France
- UMR 190 “Emergence des Pathologies Virales”, Virology, 19-21 bd jean moulin faculté de medecine de la timone, Institut hospitalo-universitaire Méditerranée infection, APHM Public Hospitals of Marseille, Marseille, France
| | - Rémi Charrel
- UMR “Emergence des Pathologies Virales” (EPV: Aix-Marseille Univ – IRD 190 – Inserm 1207 – EHESP – IHU Méditerranée Infection), Marseille, France
- UMR 190 “Emergence des Pathologies Virales”, Virology, 19-21 bd jean moulin faculté de medecine de la timone, Institut hospitalo-universitaire Méditerranée infection, APHM Public Hospitals of Marseille, Marseille, France
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69
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Gerada A, Beeching NJ. Brucellosis and travel. Travel Med Infect Dis 2017; 14:180-1. [PMID: 27317845 DOI: 10.1016/j.tmaid.2016.05.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 05/24/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Alessandro Gerada
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK; Tropical and Infectious Disease Unit, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, UK.
| | - Nick J Beeching
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK; Tropical and Infectious Disease Unit, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, UK.
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Grunow R, Jacob D, Klee S, Schlembach D, Jackowski-Dohrmann S, Loenning-Baucke V, Eberspächer B, Swidsinski S. Brucellosis in a refugee who migrated from Syria to Germany and lessons learnt, 2016. ACTA ACUST UNITED AC 2017; 21:30311. [PMID: 27525454 PMCID: PMC4998511 DOI: 10.2807/1560-7917.es.2016.21.31.30311] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 08/03/2016] [Indexed: 11/20/2022]
Abstract
A teenage woman migrating from Syria arrived in May 2015 in Germany. She gave birth to a healthy child in early 2016, but became febrile shortly after delivery. Blood cultures revealed Brucella melitensis. In retrospect, she reported contact with sheep in Syria and recurrent pain in the hip joints over about five months before diagnosis of brucellosis. We discuss consequences for adequate treatment of mother and child as well as for clinical and laboratory management.
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Franco-Paredes C, Chastain D, Taylor P, Stocking S, Sellers B. Boar hunting and brucellosis caused by Brucella suis. Travel Med Infect Dis 2017; 16:18-22. [PMID: 28300645 DOI: 10.1016/j.tmaid.2017.03.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 03/06/2017] [Accepted: 03/09/2017] [Indexed: 11/24/2022]
Abstract
Brucellosis remains as a significant public health concern in many areas where the infection persists in domestic hosts (i.e. goats, cattle, and domestic swine) with subsequent risk of transmission to human populations. Brucellosis caused by B. suis remains an important threat to human populations in many countries exposed to domestic and feral swine. In the U.S., swine brucellosis has been under control for many years. Meanwhile, it is a widespread infection among feral swine, particularly in the Southeastern United States; and exposure to infected animals pose a growing threat to humans. We present the case of a 31-year male hunter who six weeks after a knife injury to his hand while field dressing a wild boar, developed a febrile illness associated with hematologic abnormalities and splenic abscesses caused by Brucella suis infection.
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Affiliation(s)
- Carlos Franco-Paredes
- Hospital Infantil de Mexico, Federico Gomez, Mexico City, Mexico; Phoebe Putney Memorial Hospital, Albany, GA, USA.
| | | | - Peter Taylor
- Phoebe Putney Memorial Hospital, Albany, GA, USA
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Hashemifar I, Yadegar A, Jazi FM, Amirmozafari N. Molecular prevalence of putative virulence-associated genes in Brucella melitensis and Brucella abortus isolates from human and livestock specimens in Iran. Microb Pathog 2017; 105:334-339. [PMID: 28284850 DOI: 10.1016/j.micpath.2017.03.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 03/03/2017] [Accepted: 03/06/2017] [Indexed: 01/08/2023]
Abstract
Molecular prevalence of nine putative virulence factors in two more prevalent Brucella species in Iranian patients and livestock was investigated. During five years (2010-2015), 120 human and animal specimens were collected from three geographical areas of Iran. All samples were cultured in blood culture media and subcultured into Brucella agar medium. Nine primer pairs were designed for detection of VirB2, VirB5, VceC, BtpA, BtpB, PrpA, BetB, BPE275 and BSPB virulence factors using PCR and sequence analysis. Totally, 68 Brucella isolates including 60 B. melitensis and 8 B. abortus were isolated from the human and animal specimens examined. Approximately, all B. melitensis and B. abortus strains were positive (100%) regarding btpA, btpB, virB5, vceC, bpe275, bspB, and virB2 genes except for prpA and betB that were detected in 86% and 97% of the strains, respectively. Significant relationships were found between the presence of prpA and human B. melitensis isolates (P = 0.04), and also between the presence of betB and human isolates of B. abortus (P = 0.03). In conclusion, our results revealed that Iranian Brucella strains, regardless of human or animal sources, are extremely virulent due to high prevalence of virulence attributes in almost all strains studied.
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Affiliation(s)
- Iman Hashemifar
- Microbiology Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Yadegar
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Faramarz Masjedian Jazi
- Microbiology Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Nour Amirmozafari
- Microbiology Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
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Occupational Neurobrucellosis Mimicking a Brain Tumor: A Case Report and Review of the Literature. Case Rep Infect Dis 2017; 2017:1434051. [PMID: 28299214 PMCID: PMC5337328 DOI: 10.1155/2017/1434051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 01/26/2017] [Indexed: 12/01/2022] Open
Abstract
Brucellosis is a zoonotic bacterial infection which is transmitted to humans from infected animals and is endemic in many parts of the world including Saudi Arabia. In this article, we report a case of occupational neurobrucellosis that presented with a space-occupying lesion mimicking a brain tumor. We stress on the importance of obtaining detailed social history including occupation to reach the diagnosis in several conditions including brucellosis. We also stress on taking universal precautions when handling any specimens. It may be advisable that manipulation of all unknown specimens arriving at the laboratory should occur in biological safety cabinet until a highly infectious organism is ruled out. Neurobrucellosis should be included in the differential diagnosis in patients presenting with solitary mass lesion mimicking brain tumor especially in endemic areas or high occupational risk group.
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Mailles A, Garin-Bastuji B, Lavigne J, Jay M, Sotto A, Maurin M, Pelloux I, O’Callaghan D, Mick V, Vaillant V, De Valk H. Human brucellosis in France in the 21st century: Results from national surveillance 2004–2013. Med Mal Infect 2016; 46:411-418. [DOI: 10.1016/j.medmal.2016.08.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 08/23/2016] [Indexed: 10/20/2022]
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Combination Immunosuppressive Therapy Including Rituximab for Epstein-Barr Virus-Associated Hemophagocytic Lymphohistiocytosis in Adult-Onset Still's Disease. Case Rep Rheumatol 2016; 2016:8605274. [PMID: 28018698 PMCID: PMC5149644 DOI: 10.1155/2016/8605274] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 11/07/2016] [Indexed: 01/02/2023] Open
Abstract
Hemophagocytic lymphopcytosis (HLH) is a life-threatening condition. It can occur either as primary form with genetic defects or secondary to other conditions, such as hematological or autoimmune diseases. Certain triggering factors can predispose individuals to the development of HLH. We report the case of a 25-year-old male patient who was diagnosed with HLH in the context of adult-onset Still's disease (AOSD) during a primary infection with Epstein-Barr virus (EBV). During therapy with anakinra and dexamethasone, he was still symptomatic with high-spiking fevers, arthralgia, and sore throat. His laboratory values showed high levels of ferritin and C-reactive protein. His condition improved after the addition of rituximab and cyclosporine to his immunosuppressive regimen with prednisolone and anakinra. This combination therapy led to a sustained clinical and serological remission of his condition. While rituximab has been used successfully for HLH in the context of EBV-associated lymphoma, its use in autoimmune diseases is uncommon. We hypothesize that the development of HLH was triggered by a primary EBV infection and that rituximab led to elimination of EBV-infected B-cells, while cyclosporine ameliorated the cytokine excess. We therefore propose that this combination immunosuppressive therapy might be successfully used in HLH occurring in the context of autoimmune diseases.
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Ali S, Akhter S, Neubauer H, Scherag A, Kesselmeier M, Melzer F, Khan I, El-Adawy H, Azam A, Qadeer S, Ali Q. Brucellosis in pregnant women from Pakistan: an observational study. BMC Infect Dis 2016; 16:468. [PMID: 27590009 PMCID: PMC5010707 DOI: 10.1186/s12879-016-1799-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 08/23/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Brucella species occasionally cause spontaneous human abortion. Brucella can be transmitted commonly through the ingestion of raw milk or milk products. The objective of this study was to determine the sero-prevalence of and to identify potential risk factors for brucellosis in pregnant women from Rawalpindi, Pakistan. METHODS We conducted a cross-sectional study at the Gynecology Outdoor Patient department of the Benazir Bhutto Hospital, Rawalpindi, Pakistan from March to June 2013. Data related to potential risk factors and clinical history was collected by individual interviews on the blood sampling day. The 429 serum samples collected were initially screened by Rose Bengal Plate Agglutination test for the detection of Brucella antibodies. We applied standard descriptive statistics and logistic regression analyses. RESULTS Twenty five (5.8 %; 95 % confidence interval (CI): 3.8 % -8.5 %) serum samples were found to be seropositive. Brucellosis-related clinical symptoms were recorded in various seropositive cases. Animal contact, raw milk consumption, having an abortion history and the experience of an intrauterine fetal death were associated with seropositivity for brucellosis in univariate analyses (all p <0.05). In multiple logistic regression models only the contact with animals remained as independent and robust risk factor (odds ratio 5.21; 95 % CI: 1.88-13.75; p = 0.001) for seropositivity. CONCLUSION Brucellosis is a serious threat for pregnant women and their unborn children in Pakistan. Pregnant women having brucellosis-related symptoms or previous history of abortions, miscarriages, intrauterine fetal death and other brucellosis-related manifestations should be screened for brucellosis - especially those exposed to animals given the increased risk - and medication should be administered according to state of the art.
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Affiliation(s)
- Shahzad Ali
- University of Veterinary and Animal Sciences, Lahore, Pakistan.
| | - Shamim Akhter
- Pir Mehr Ali Shah Arid Agriculture University, Rawalpindi, Pakistan
| | - Heinrich Neubauer
- Friedrich-Loeffler-Institut, Institute of Bacterial Infections and Zoonoses, Naumburger Str. 96a, 07743, Jena, Germany
| | - André Scherag
- Clinical Epidemiology, Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
| | - Miriam Kesselmeier
- Clinical Epidemiology, Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
| | - Falk Melzer
- Friedrich-Loeffler-Institut, Institute of Bacterial Infections and Zoonoses, Naumburger Str. 96a, 07743, Jena, Germany
| | - Iahtasham Khan
- University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Hosny El-Adawy
- Friedrich-Loeffler-Institut, Institute of Bacterial Infections and Zoonoses, Naumburger Str. 96a, 07743, Jena, Germany
| | - Asima Azam
- Pir Mehr Ali Shah Arid Agriculture University, Rawalpindi, Pakistan
| | - Saima Qadeer
- Pir Mehr Ali Shah Arid Agriculture University, Rawalpindi, Pakistan
| | - Qurban Ali
- National Veterinary Laboratories, Islamabad, Pakistan
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Lewis JM, Folb J, Kalra S, Squire SB, Taegtmeyer M, Beeching NJ. Brucella melitensis prosthetic joint infection in a traveller returning to the UK from Thailand: Case report and review of the literature. Travel Med Infect Dis 2016; 14:444-450. [PMID: 27591088 PMCID: PMC5093331 DOI: 10.1016/j.tmaid.2016.08.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 08/19/2016] [Accepted: 08/23/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND Brucella spp. prosthetic joint infections are infrequently reported in the literature, particularly in returning travellers, and optimal treatment is unknown. METHOD We describe a prosthetic joint infection (PJI) caused by Brucella melitensis in a traveller returning to the UK from Thailand, which we believe to be the first detailed report of brucellosis in a traveller returning from this area. The 23 patients with Brucella-related PJI reported in the literature are summarised, together with our case. RESULTS The diagnosis of Brucella-related PJI is difficult to make; only 30% of blood cultures and 75% of joint aspiration cultures were positive in the reported cases. Culture of intraoperative samples provides the best diagnostic yield. In the absence of radiological evidence of joint loosening, combination antimicrobial therapy alone may be appropriate treatment in the first instance; this was successful in 6/7 [86%] of patients, though small numbers of patients and the likelihood of reporting bias warrant caution in drawing any firm conclusions about optimal treatment. Aerosolisation of synovial fluid during joint aspiration procedures and nosocomial infection has been described. CONCLUSIONS Brucella-related PJI should be considered in the differential of travellers returning from endemic areas with PJI, including Thailand. Personal protective equipment including fit tested filtering face piece-3 (FFP3) mask or equivalent is recommended for personnel carrying out joint aspiration when brucellosis is suspected. Travellers can reduce the risk of brucellosis by avoiding unpasteurised dairy products and animal contact (particularly on farms and abattoirs) in endemic areas and should be counselled regarding these risks as part of their pre-travel assessment.
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Affiliation(s)
- Joseph M Lewis
- Tropical and Infectious Disease Unit, Royal Liverpool University Hospital, Liverpool, UK; Wellcome Trust Liverpool Glasgow Centre for Global Health Research, Liverpool, UK.
| | - Jonathan Folb
- Brucella Reference Unit, Liverpool Clinical Laboratories, Royal Liverpool University Hospital, Liverpool, UK
| | - Sanjay Kalra
- Department of Orthopaedics, Royal Liverpool University Hospital, Liverpool, UK
| | - S Bertel Squire
- Tropical and Infectious Disease Unit, Royal Liverpool University Hospital, Liverpool, UK; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Miriam Taegtmeyer
- Tropical and Infectious Disease Unit, Royal Liverpool University Hospital, Liverpool, UK; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Nick J Beeching
- Tropical and Infectious Disease Unit, Royal Liverpool University Hospital, Liverpool, UK; Brucella Reference Unit, Liverpool Clinical Laboratories, Royal Liverpool University Hospital, Liverpool, UK; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK; NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, L69 7BE, UK
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78
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Alfouzan W, Al-Sahali S, Sultan H, Dhar R. Classical Presentation of Acute Pyelonephritis in a Case of Brucellosis. Case Rep Nephrol Dial 2016; 6:83-88. [PMID: 28101501 PMCID: PMC5216229 DOI: 10.1159/000446393] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 04/23/2016] [Indexed: 01/07/2023] Open
Abstract
Although Brucella species is known to affect almost all organs in humans, renal involvement presenting as acute pyelonephritis remains a rare entity in brucellosis. We report the case of a female patient who presented with symptoms of fever with chills, right loin pain and dysuria in the emergency room. Blood cultures drawn at the time of admission grew Brucella spp., but no organisms were isolated from urine culture although urinalysis data was indicative of urinary tract infection. Empiric therapy with piperacillin/tazobactam plus gentamicin relieved her symptoms. However, the treatment was switched to doxycycline plus rifampicin once the blood culture result was obtained.
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Affiliation(s)
- Wadha Alfouzan
- Microbiology Unit, Department of Laboratories, Al-Farwania Hospital, Kuwait City, Kuwait; Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Sara Al-Sahali
- Microbiology Unit, Department of Laboratories, Al-Farwania Hospital, Kuwait City, Kuwait
| | - Hawra'a Sultan
- Department of Medicine, Al-Farwania Hospital, Kuwait City, Kuwait
| | - Rita Dhar
- Microbiology Unit, Department of Laboratories, Al-Farwania Hospital, Kuwait City, Kuwait
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79
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Wurtz N, Papa A, Hukic M, Di Caro A, Leparc-Goffart I, Leroy E, Landini MP, Sekeyova Z, Dumler JS, Bădescu D, Busquets N, Calistri A, Parolin C, Palù G, Christova I, Maurin M, La Scola B, Raoult D. Survey of laboratory-acquired infections around the world in biosafety level 3 and 4 laboratories. Eur J Clin Microbiol Infect Dis 2016; 35:1247-58. [PMID: 27234593 PMCID: PMC7088173 DOI: 10.1007/s10096-016-2657-1] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 04/20/2016] [Indexed: 11/27/2022]
Abstract
Laboratory-acquired infections due to a variety of bacteria, viruses, parasites, and fungi have been described over the last century, and laboratory workers are at risk of exposure to these infectious agents. However, reporting laboratory-associated infections has been largely voluntary, and there is no way to determine the real number of people involved or to know the precise risks for workers. In this study, an international survey based on volunteering was conducted in biosafety level 3 and 4 laboratories to determine the number of laboratory-acquired infections and the possible underlying causes of these contaminations. The analysis of the survey reveals that laboratory-acquired infections have been infrequent and even rare in recent years, and human errors represent a very high percentage of the cases. Today, most risks from biological hazards can be reduced through the use of appropriate procedures and techniques, containment devices and facilities, and the training of personnel.
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Affiliation(s)
- N Wurtz
- URMITE, CNRS UMR 7278, IRD 198, Inserm 1095, Aix Marseille Université, IHU Méditerranée Infection, 27 bd Jean Moulin, 13005, Marseille, France
| | - A Papa
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - M Hukic
- International Burch University of Sarajevo, Sarajevo, Bosnia and Herzegovina
- Department of Medical Science, Academy of Sciences and Arts of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
| | - A Di Caro
- National Institute for Infectious Diseases L. Spallanzani, Rome, Italy
| | - I Leparc-Goffart
- ERRIT-IRBA, HIA Laveran, Centre National de Référence des Arboviroses, 13384, Marseille, France
| | - E Leroy
- Laboratoire MiVEGEC, UMR IRD 224 CNRS 5290 UMI, 911 Av. Agropolis, 34394, Montpellier Cedex 5, France
- International Center for Medical Research of Franceville, BP769, Franceville, Gabon
| | - M P Landini
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St Orsola-Malpighi University Hospital, Bologna, Italy
| | - Z Sekeyova
- Institute of Virology, Slovak Academy of Sciences, Dúbravská cesta 9, 845 05, Bratislava, Slovak Republic
| | - J S Dumler
- Departments of Pathology and Microbiology & Immunology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - D Bădescu
- Cantacuzino National Institute of Research, Bucharest, Romania
| | - N Busquets
- IRTA, Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Campus de la Universitat Autònoma de Barcelona, 08193, Bellaterra, Spain
| | - A Calistri
- Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padova, Italy
| | - C Parolin
- Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padova, Italy
| | - G Palù
- Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padova, Italy
| | - I Christova
- Department of Microbiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - M Maurin
- Centre National de Référence des Francisella, Laboratoire de Bactériologie, Département des Agents Infectieux, Institut de Biologie et Pathologie, Centre Hospitalier Universitaire de Grenoble, Université Joseph Fourier, Grenoble, France
| | - B La Scola
- URMITE, CNRS UMR 7278, IRD 198, Inserm 1095, Aix Marseille Université, IHU Méditerranée Infection, 27 bd Jean Moulin, 13005, Marseille, France
| | - D Raoult
- URMITE, CNRS UMR 7278, IRD 198, Inserm 1095, Aix Marseille Université, IHU Méditerranée Infection, 27 bd Jean Moulin, 13005, Marseille, France.
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80
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Abstract
Regular review of the management of bioterrorism is essential for maintaining readiness for these sporadically occurring events. This review provides an overview of the history of biological disasters and bioterrorism. I also discuss the recent recategorization of tier 1 agents by the U.S. Department of Health and Human Services, the Laboratory Response Network (LRN), and specific training and readiness processes and programs, such as the College of American Pathologists (CAP) Laboratory Preparedness Exercise (LPX). LPX examined the management of cultivable bacterial vaccine and attenuated strains of tier 1 agents or close mimics. In the LPX program, participating laboratories showed improvement in the level of diagnosis required and referral of isolates to an appropriate reference laboratory. Agents which proved difficult to manage in sentinel laboratories included the more fastidious Gram-negative organisms, especially Francisella tularensis and Burkholderia spp. The recent Ebola hemorrhagic fever epidemic provided a check on LRN safety processes. Specific guidelines and recommendations for laboratory safety and risk assessment in the clinical microbiology are explored so that sentinel laboratories can better prepare for the next biological disaster.
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Affiliation(s)
- Elizabeth Wagar
- University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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81
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A Simple and Safe Protocol for Preparing Brucella Samples for Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry Analysis. J Clin Microbiol 2015; 54:449-52. [PMID: 26582837 DOI: 10.1128/jcm.02730-15] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 11/11/2015] [Indexed: 12/19/2022] Open
Abstract
We describe a simple protocol to inactivate the biosafety level 3 (BSL3) pathogens Brucella prior to their analysis by matrix-assisted laser desorption ionization-time of flight mass spectrometry. This method is also effective for several other bacterial pathogens and allows storage, and eventually shipping, of inactivated samples; therefore, it might be routinely applied to unidentified bacteria, for the safety of laboratory workers.
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82
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Hielpos MS, Ferrero MC, Fernández AG, Bonetto J, Giambartolomei GH, Fossati CA, Baldi PC. CCL20 and Beta-Defensin 2 Production by Human Lung Epithelial Cells and Macrophages in Response to Brucella abortus Infection. PLoS One 2015; 10:e0140408. [PMID: 26448160 PMCID: PMC4598116 DOI: 10.1371/journal.pone.0140408] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 09/24/2015] [Indexed: 01/18/2023] Open
Abstract
Both CCL20 and human β-defensin 2 (hBD2) interact with the same membrane receptor and display chemotactic and antimicrobial activities. They are produced by airway epithelia in response to infectious agents and proinflammatory cytokines. Whereas Brucella spp. can infect humans through inhalation, their ability to induce CCL20 and hBD2 in lung cells is unknown. Here we show that B. abortus induces CCL20 expression in human alveolar (A549) or bronchial (Calu-6) epithelial cell lines, primary alveolar epithelial cells, primary human monocytes, monocyte-derived macrophages and the monocytic cell line THP-1. CCL20 expression was mainly mediated by JNK1/2 and NF-kB in both Calu-6 and THP-1 cells. CCL20 secretion was markedly induced in A549, Calu-6 and THP-1 cells by heat-killed B. abortus or a model Brucella lipoprotein (L-Omp19) but not by the B. abortus lipopolysaccharide (LPS). Accordingly, CCL20 production by B. abortus-infected cells was strongly TLR2-dependent. Whereas hBD2 expression was not induced by B. abortus infection, it was significantly induced in A549 cells by conditioned media from B. abortus-infected THP-1 monocytes (CMB). A similar inducing effect was observed on CCL20 secretion. Experiments using blocking agents revealed that IL-1β, but not TNF-α, was involved in the induction of hBD2 and CCL20 secretion by CMB. In the in vitro antimicrobial assay, the lethal dose (LD) 50 of CCL20 for B. abortus (>50 μg/ml) was markedly higher than that against E. coli (1.5 μg/ml) or a B. abortus mutant lacking the O polysaccharide in its LPS (8.7 ug/ml). hBD2 did not kill any of the B. abortus strains at the tested concentrations. These results show that human lung epithelial cells secrete CCL20 and hBD2 in response to B. abortus and/or to cytokines produced by infected monocytes. Whereas these molecules do not seem to exert antimicrobial activity against this pathogen, they could recruit immune cells to the infection site.
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Affiliation(s)
- M Soledad Hielpos
- Instituto de Estudios de la Inmunidad Humoral (IDEHU, CONICET-UBA), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Mariana C Ferrero
- Instituto de Estudios de la Inmunidad Humoral (IDEHU, CONICET-UBA), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Andrea G Fernández
- Instituto de Estudios de la Inmunidad Humoral (IDEHU, CONICET-UBA), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Josefina Bonetto
- Instituto de Estudios de la Inmunidad Humoral (IDEHU, CONICET-UBA), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Guillermo H Giambartolomei
- Instituto de Inmunología, Genética y Metabolismo (INIGEM, CONICET-UBA), Hospital de Clínicas "José de San Martín", Buenos Aires, Argentina
| | - Carlos A Fossati
- Instituto de Estudios Inmunológicos y Fisiopatológicos (IIFP, CONICET-UNLP), Facultad de Ciencias Exactas, Universidad Nacional de La Plata, La Plata, Argentina
| | - Pablo C Baldi
- Instituto de Estudios de la Inmunidad Humoral (IDEHU, CONICET-UBA), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
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83
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Castrodale LJ, Raczniak GA, Rudolph KM, Chikoyak L, Cox RS, Franklin TL, Traxler RM, Guerra M. A Case-Study of Implementation of Improved Strategies for Prevention of Laboratory-acquired Brucellosis. Saf Health Work 2015; 6:353-6. [PMID: 26929849 PMCID: PMC4682031 DOI: 10.1016/j.shaw.2015.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 07/01/2015] [Accepted: 07/21/2015] [Indexed: 11/26/2022] Open
Abstract
Background In 2012, the Alaska Section of Epidemiology investigated personnel potentially exposed to a Brucella suis isolate as it transited through three laboratories. Methods We summarize the first implementation of the United States Centers for Disease Control and Prevention 2013 revised recommendations for monitoring such exposures: (1) risk classification; (2) antimicrobial postexposure prophylaxis; (3) serologic monitoring; and (4) symptom surveillance. Results Over 30 people were assessed for exposure and subsequently monitored for development of illness. No cases of laboratory-associated brucellosis occurred. Changes were made to gaps in laboratory biosafety practices that had been identified in the investigation. Conclusion Achieving full compliance for the precise schedule of serologic monitoring was challenging and resource intensive for the laboratory performing testing. More refined exposure assessments could inform decision making for follow-up to maximize likelihood of detecting persons at risk while not overtaxing resources.
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Affiliation(s)
- Louisa J Castrodale
- Alaska Department of Health and Social Services, Division of Public Health, Anchorage, AK, USA
| | - Gregory A Raczniak
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Zoonotic and Emerging Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Anchorage, AK, USA
| | - Karen M Rudolph
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Zoonotic and Emerging Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Anchorage, AK, USA
| | - Lori Chikoyak
- Yukon-Kuskokwim Delta Regional Hospital, Bethel, AK, USA
| | - Russell S Cox
- Yukon-Kuskokwim Delta Regional Hospital, Bethel, AK, USA
| | - Tricia L Franklin
- Alaska Department of Health and Social Services, Division of Public Health, Anchorage, AK, USA
| | - Rita M Traxler
- Division of High-consequence Pathogens and Pathology, NCEZID, CDC, Atlanta, GA, USA
| | - Marta Guerra
- Division of High-consequence Pathogens and Pathology, NCEZID, CDC, Atlanta, GA, USA
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84
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Coelho AC, García Díez J. Biological Risks and Laboratory-Acquired Infections: A Reality That Cannot be Ignored in Health Biotechnology. Front Bioeng Biotechnol 2015; 3:56. [PMID: 25973418 PMCID: PMC4412124 DOI: 10.3389/fbioe.2015.00056] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 04/10/2015] [Indexed: 12/16/2022] Open
Abstract
Advances and research in biotechnology have applications over a wide range of areas, such as microbiology, medicine, the food industry, agriculture, genetically modified organisms, and nanotechnology, among others. However, research with pathogenic agents, such as virus, parasites, fungi, rickettsia, bacterial microorganisms, or genetic modified organisms, has generated concern because of their potential biological risk - not only for people, but also for the environment due to their unpredictable behavior. In addition, concern for biosafety is associated with the emergence of new diseases or re-emergence of diseases that were already under control. Biotechnology laboratories require biosafety measures designed to protect their staff, the population, and the environment, which may be exposed to hazardous organisms and materials. Laboratory staff training and education is essential, not only to acquire a good understanding about the direct handling of hazardous biological agents but also knowledge of the epidemiology, pathogenicity, and human susceptibility to the biological materials used in research. Biological risk can be reduced and controlled by the correct application of internationally recognized procedures such as proper microbiological techniques, proper containment apparatus, adequate facilities, protective barriers, and special training and education of laboratory workers. To avoid occupational infections, knowledge about standardized microbiological procedures and techniques and the use of containment devices, facilities, and protective barriers is necessary. Training and education about the epidemiology, pathogenicity, and biohazards of the microorganisms involved may prevent or decrease the risk. In this way, the scientific community may benefit from the lessons learned in the past to anticipate future problems.
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Affiliation(s)
- Ana Cláudia Coelho
- Department of Veterinary Sciences, Veterinary and Animal Science Center (CECAV), School of Agrarian and Veterinary Sciences, University of Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Juan García Díez
- Department of Veterinary Sciences, Veterinary and Animal Science Center (CECAV), School of Agrarian and Veterinary Sciences, University of Trás-os-Montes e Alto Douro, Vila Real, Portugal
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85
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Li XZ, Plésiat P, Nikaido H. The challenge of efflux-mediated antibiotic resistance in Gram-negative bacteria. Clin Microbiol Rev 2015; 28:337-418. [PMID: 25788514 PMCID: PMC4402952 DOI: 10.1128/cmr.00117-14] [Citation(s) in RCA: 939] [Impact Index Per Article: 104.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
The global emergence of multidrug-resistant Gram-negative bacteria is a growing threat to antibiotic therapy. The chromosomally encoded drug efflux mechanisms that are ubiquitous in these bacteria greatly contribute to antibiotic resistance and present a major challenge for antibiotic development. Multidrug pumps, particularly those represented by the clinically relevant AcrAB-TolC and Mex pumps of the resistance-nodulation-division (RND) superfamily, not only mediate intrinsic and acquired multidrug resistance (MDR) but also are involved in other functions, including the bacterial stress response and pathogenicity. Additionally, efflux pumps interact synergistically with other resistance mechanisms (e.g., with the outer membrane permeability barrier) to increase resistance levels. Since the discovery of RND pumps in the early 1990s, remarkable scientific and technological advances have allowed for an in-depth understanding of the structural and biochemical basis, substrate profiles, molecular regulation, and inhibition of MDR pumps. However, the development of clinically useful efflux pump inhibitors and/or new antibiotics that can bypass pump effects continues to be a challenge. Plasmid-borne efflux pump genes (including those for RND pumps) have increasingly been identified. This article highlights the recent progress obtained for organisms of clinical significance, together with methodological considerations for the characterization of MDR pumps.
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Affiliation(s)
- Xian-Zhi Li
- Human Safety Division, Veterinary Drugs Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Patrick Plésiat
- Laboratoire de Bactériologie, Faculté de Médecine-Pharmacie, Centre Hospitalier Régional Universitaire, Université de Franche-Comté, Besançon, France
| | - Hiroshi Nikaido
- Department of Molecular and Cell Biology, University of California, Berkeley, California, USA
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86
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Total Laboratory Automation in Clinical Bacteriology. METHODS IN MICROBIOLOGY 2015. [DOI: 10.1016/bs.mim.2015.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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87
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Lowe CF, Showler AJ, Perera S, McIntyre S, Qureshi R, Patel SN, Allen V, Devlin HR, Muller MP. Hospital-associated transmission of Brucella melitensis outside the laboratory. Emerg Infect Dis 2015; 21:150-2. [PMID: 25531198 PMCID: PMC4285263 DOI: 10.3201/eid2101.141247] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Brucella melitensis was identified in an aspirate obtained from a patient's hip joint during a procedure at a hospital in Canada. We conducted an investigation into possible exposures among hospital workers; 1 worker who assisted with the procedure tested positive for B. melitensis. Aerosol-generating procedures performed outside the laboratory may facilitate transmission of this bacterium.
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88
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Solís García del Pozo J, Lorente Ortuño S, Navarro E, Solera J. Detection of IgM antibrucella antibody in the absence of IgGs: a challenge for the clinical interpretation of brucella serology. PLoS Negl Trop Dis 2014; 8:e3390. [PMID: 25474572 PMCID: PMC4256177 DOI: 10.1371/journal.pntd.0003390] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 10/31/2014] [Indexed: 11/04/2022] Open
Abstract
The use of enzyme-linked immunosorbent assay (ELISA) for the detection of IgG and IgM antibodies antibrucella has become widespread in the diagnosis of human brucellosis. IgM anti-Brucella antibodies are indicative of acute infection. Between 2009-2013, 5307 patients were evaluated for serologic diagnosis at the Microbiology Laboratory of the Albacete General Hospital. A ELISA IgM-positive, IgG-negative anti-Brucella antibody serology pattern was detected in 17 of those patients. Epidemiology data, symptoms, laboratory data, treatment and outcome from these patients were reviewed. Sixteen patients presented with musculoskeletal pain, fatigue and/or fever and 1 was asymptomatic. Five patients received treatment with doxycycline combined with rifampin, gentamycin or streptomycin during 6-12 weeks, with no improvement. None of the 17 patients were finally diagnosed with brucellosis. Our results indicate that anti-Brucella IgM positive serology, per se, is not enough to diagnose acute brucellosis and other methods should be used for confirmation. Brucella serology data should be interpreted taking into account the patient's clinical history and epidemiological context.
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Affiliation(s)
| | | | - Elena Navarro
- Research Unit, University General Hospital of Albacete, Albacete, Spain
| | - Javier Solera
- Department of Internal Medicine, University General Hospital of Albacete, Albacete, Spain
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89
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Rodrigues ALC, Silva SKLD, Pinto BLA, Silva JBD, Tupinambás U. Outbreak of laboratory-acquired Brucella abortus in Brazil: a case report. Rev Soc Bras Med Trop 2014; 46:791-4. [PMID: 24474027 DOI: 10.1590/0037-8682-0160-2013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2012] [Accepted: 11/21/2013] [Indexed: 11/22/2022] Open
Abstract
Human brucellosis is an occupational disease affecting workers in slaughterhouses, butcher shops and the milk and dairy product industry as well as individuals who work in clinical or research laboratories. We report the first outbreak of a Brucella abortus infection in a Brazilian laboratory and compare the data obtained with reports available in the literature. Exposure was a result of damage to a biological safety cabinet and failure of the unidirectional airflow ventilation system. An epidemiological investigation identified 3 seroconverted individuals, 1 of whom had clinical manifestations and laboratory results compatible with infection at the time of exposure (n=11; attack rate=9.1%).
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Affiliation(s)
| | | | | | | | - Unaí Tupinambás
- Departamento de Clínica Médica, Universidade Federal de Minas Gerais, Belo HorizonteMG
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90
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Hartady T, Saad MZ, Bejo SK, Salisi MS. Clinical human brucellosis in Malaysia: a case report. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2014. [DOI: 10.1016/s2222-1808(14)60332-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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91
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Traxler RM, Guerra MA, Morrow MG, Haupt T, Morrison J, Saah JR, Smith CG, Williams C, Fleischauer AT, Lee PA, Stanek D, Trevino-Garrison I, Franklin P, Oakes P, Hand S, Shadomy SV, Blaney DD, Lehman MW, Benoit TJ, Stoddard RA, Tiller RV, De BK, Bower W, Smith TL. Review of brucellosis cases from laboratory exposures in the United States in 2008 to 2011 and improved strategies for disease prevention. J Clin Microbiol 2013; 51:3132-6. [PMID: 23824776 PMCID: PMC3754678 DOI: 10.1128/jcm.00813-13] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 06/18/2013] [Indexed: 01/18/2023] Open
Abstract
Five laboratory-acquired brucellosis (LAB) cases that occurred in the United States between 2008 and 2011 are presented. The Centers for Disease Control and Prevention (CDC) reviewed the recommendations published in 2008 and the published literature to identify strategies to further prevent LAB. The improved prevention strategies are described.
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Affiliation(s)
- R. M. Traxler
- Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - M. A. Guerra
- Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - M. G. Morrow
- Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - T. Haupt
- Wisconsin Department of Health Services, Madison, Wisconsin, USA
| | - J. Morrison
- University of Wisconsin—Madison Environment, Health and Safety, Madison, Wisconsin, USA
| | - J. R. Saah
- North Carolina Department of Health and Human Services, Raleigh, North Carolina, USA
| | - C. G. Smith
- North Carolina Department of Health and Human Services, Raleigh, North Carolina, USA
| | - C. Williams
- North Carolina Department of Health and Human Services, Raleigh, North Carolina, USA
| | - A. T. Fleischauer
- Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- North Carolina Department of Health and Human Services, Raleigh, North Carolina, USA
| | - P. A. Lee
- Bureau of Public Health Laboratories, Florida Department of Health, Jacksonville, Florida, USA
| | - D. Stanek
- Bureau of Epidemiology, Florida Department of Health, Tallahassee, Florida, USA
| | | | - P. Franklin
- Missouri Department of Health and Senior Services, Jefferson City, Missouri, USA
| | - P. Oakes
- Mississippi State Department of Health, Jackson, Mississippi, USA
| | - S. Hand
- Mississippi State Department of Health, Jackson, Mississippi, USA
| | - S. V. Shadomy
- Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - D. D. Blaney
- Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - M. W. Lehman
- Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - T. J. Benoit
- Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - R. A. Stoddard
- Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - R. V. Tiller
- Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - B. K. De
- Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - W. Bower
- Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - T. L. Smith
- Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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