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Tscherne A, Mantel E, Boskani T, Budniak S, Elschner M, Fasanella A, Feruglio SL, Galante D, Giske CG, Grunow R, Henczko J, Hinz C, Iwaniak W, Jacob D, Kedrak-Jablonska A, Jensen VK, Johansen TB, Kahlmeter G, Manzulli V, Matuschek E, Melzer F, Nuncio MS, Papaparaskevas J, Pelerito A, Solheim M, Thomann S, Tsakris A, Wahab T, Weiner M, Zoeller L, Zange S. Adaptation of Brucella melitensis Antimicrobial Susceptibility Testing to the ISO 20776 Standard and Validation of the Method. Microorganisms 2022; 10:1470. [PMID: 35889189 PMCID: PMC9316112 DOI: 10.3390/microorganisms10071470] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/08/2022] [Accepted: 07/18/2022] [Indexed: 12/10/2022] Open
Abstract
Brucellosis, mainly caused by Brucella (B.) melitensis, is associated with a risk of chronification and relapses. Antimicrobial susceptibility testing (AST) standards for B. melitensis are not available, and the agent is not yet listed in the EUCAST breakpoint tables. CLSI recommendations for B. melitensis exist, but they do not fulfill the requirements of the ISO 20776 standard regarding the culture medium and the incubation conditions. Under the third EU Health Programme, laboratories specializing in the diagnostics of highly pathogenic bacteria in their respective countries formed a working group within a Joint Action aiming to develop a suitable method for the AST of B. melitensis. Under the supervision of EUCAST representatives, this working group adapted the CLSI M45 document to the ISO 20776 standard after testing and validation. These adaptations included the comparison of various culture media, culture conditions and AST methods. A Standard Operation Procedure was derived and an interlaboratory validation was performed in order to evaluate the method. The results showed pros and cons for both of the two methods but also indicate that it is not necessary to abandon Mueller-Hinton without additives for the AST of B. melitensis.
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Affiliation(s)
- Alina Tscherne
- Bundeswehr Institute of Microbiology, Neuherbergstrasse 11, 80937 Munich, Germany; (A.T.); (E.M.); (C.H.); (L.Z.)
- Division of Virology, Department of Veterinary Sciences, LMU Munich, Veterinärstrasse 13, 80539 Munich, Germany
| | - Enrico Mantel
- Bundeswehr Institute of Microbiology, Neuherbergstrasse 11, 80937 Munich, Germany; (A.T.); (E.M.); (C.H.); (L.Z.)
| | - Talar Boskani
- Public Health Agency of Sweden, Nobels väg 18, 171 82 Solna, Sweden; (T.B.); (T.W.)
| | - Sylwia Budniak
- National Veterinary Research Institute, 57 Partyzantów Avenue, 24-100 Pulawy, Poland; (S.B.); (A.K.-J.); (M.W.)
| | - Mandy Elschner
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Bacterial Infections and Zoonoses, Naumburger Strasse 96a, 07743 Jena, Germany; (M.E.); (F.M.)
| | - Antonio Fasanella
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 20 Manfredonia Street, 72121 Foggia, Italy; (A.F.); (D.G.); (V.M.)
| | - Siri L. Feruglio
- Norwegian Institute of Public Health, Lovisenberggata 8, 0456 Oslo, Norway; (S.L.F.); (V.K.J.); (T.B.J.); (M.S.)
| | - Domenico Galante
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 20 Manfredonia Street, 72121 Foggia, Italy; (A.F.); (D.G.); (V.M.)
| | - Christian G. Giske
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Alfred Nobels Allé 8, Huddinge, 141 52 Stockholm, Sweden;
| | - Roland Grunow
- Highly Pathogenic Microorganisms, Centre for Biological Threats and Special Pathogens, Division 2 (ZBS 2), Robert Koch Institute, Seestrasse 10, 13353 Berlin, Germany; (R.G.); (D.J.)
| | - Judit Henczko
- National Public Health Center, Albert Flórián út 2-6, 1097 Budapest, Hungary;
| | - Christin Hinz
- Bundeswehr Institute of Microbiology, Neuherbergstrasse 11, 80937 Munich, Germany; (A.T.); (E.M.); (C.H.); (L.Z.)
| | | | - Daniela Jacob
- Highly Pathogenic Microorganisms, Centre for Biological Threats and Special Pathogens, Division 2 (ZBS 2), Robert Koch Institute, Seestrasse 10, 13353 Berlin, Germany; (R.G.); (D.J.)
| | - Agnieszka Kedrak-Jablonska
- National Veterinary Research Institute, 57 Partyzantów Avenue, 24-100 Pulawy, Poland; (S.B.); (A.K.-J.); (M.W.)
| | - Veronica K. Jensen
- Norwegian Institute of Public Health, Lovisenberggata 8, 0456 Oslo, Norway; (S.L.F.); (V.K.J.); (T.B.J.); (M.S.)
| | - Tone B. Johansen
- Norwegian Institute of Public Health, Lovisenberggata 8, 0456 Oslo, Norway; (S.L.F.); (V.K.J.); (T.B.J.); (M.S.)
| | - Gunnar Kahlmeter
- EUCAST Development Laboratory (EDL) for Bacteria, 351 85 Växjö, Sweden; (G.K.); (E.M.)
| | - Viviana Manzulli
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 20 Manfredonia Street, 72121 Foggia, Italy; (A.F.); (D.G.); (V.M.)
| | - Erika Matuschek
- EUCAST Development Laboratory (EDL) for Bacteria, 351 85 Växjö, Sweden; (G.K.); (E.M.)
| | - Falk Melzer
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Bacterial Infections and Zoonoses, Naumburger Strasse 96a, 07743 Jena, Germany; (M.E.); (F.M.)
| | - Maria S. Nuncio
- National Institute of Health, Av. Padre Cruz, 1649-016 Lisbon, Portugal; (M.S.N.); (A.P.)
| | - Joseph Papaparaskevas
- Microbiology Department, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, 11527 Athens, Greece; (J.P.); (A.T.)
| | - Ana Pelerito
- National Institute of Health, Av. Padre Cruz, 1649-016 Lisbon, Portugal; (M.S.N.); (A.P.)
| | - Margrete Solheim
- Norwegian Institute of Public Health, Lovisenberggata 8, 0456 Oslo, Norway; (S.L.F.); (V.K.J.); (T.B.J.); (M.S.)
| | | | - Athanasios Tsakris
- Microbiology Department, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, 11527 Athens, Greece; (J.P.); (A.T.)
| | - Tara Wahab
- Public Health Agency of Sweden, Nobels väg 18, 171 82 Solna, Sweden; (T.B.); (T.W.)
| | - Marcin Weiner
- National Veterinary Research Institute, 57 Partyzantów Avenue, 24-100 Pulawy, Poland; (S.B.); (A.K.-J.); (M.W.)
| | - Lothar Zoeller
- Bundeswehr Institute of Microbiology, Neuherbergstrasse 11, 80937 Munich, Germany; (A.T.); (E.M.); (C.H.); (L.Z.)
| | - Sabine Zange
- Bundeswehr Institute of Microbiology, Neuherbergstrasse 11, 80937 Munich, Germany; (A.T.); (E.M.); (C.H.); (L.Z.)
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Arapović J, Kompes G, Dedić K, Teskeredžić S, Ostojić M, Travar M, Tihić N, Delić J, Skočibušić S, Zekiri-Sivro M, Verhaz A, Piljić D, Laura L, Duvnjak S, Zdelar-Tuk M, Arapović M, Šabotić E, Reil I, Nikolić J, Ahmetagić S, Cvetnić Ž, Habrun B, Bosilkovski M, Špičić S. Antimicrobial resistance profiles of human Brucella melitensis isolates in three different microdilution broths: First multicentre study in Bosnia and Herzegovina. J Glob Antimicrob Resist 2022; 29:99-104. [PMID: 35182775 DOI: 10.1016/j.jgar.2022.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/24/2022] [Accepted: 02/09/2022] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Brucellosis is a ubiquitous emergent bacterial zoonotic disease causing significant human morbidity in Bosnia and Herzegovina. So far, a high rate of resistant Brucella has been found worldwide. This study prospectively analysed the rates of resistance among human Brucella melitensis (B. melitensis) strains isolated in Bosnia and Herzegovina. METHODS This study included 108 B. melitensis isolates from 209 patients diagnosed at five medical centres in Bosnia and Herzegovina. The resistance profiles of the B. melitensis isolates for the 13 most commonly used antimicrobials were studied in standard Brucella broth (BB) and cation-adjusted Mueller-Hinton broth (CAMHB) supplemented with 4% lysed horse blood or 5% defibrinated sheep blood. RESULTS Of the 209 patients, B. melitensis blood cultures were positive for 111 (53.1%). Among the 108 isolates investigated, 91 (84.3%) were resistant to trimethoprim-sulfamethoxazole on BB, but not on either CAMHB. Nearly all isolates (>90%) were resistant to azithromycin on BB and both CAMHBs. CONCLUSIONS We observed a high rate of B. melitensis resistance to azithromycin. The high rate of resistance to trimethoprim-sulfamethoxazole that we observed was related to BB, so an alternative broth should be used, such as the enriched CAMHBs in this study, for evaluating resistance to trimethoprim-sulfamethoxazole. Whole-genome sequencing studies are needed to understand the development of antimicrobial resistance in B. melitensis strains isolated from humans.
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Affiliation(s)
- Jurica Arapović
- University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina; School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina.
| | | | - Kanita Dedić
- Cantonal Hospital "Dr. Irfan Ljubijankic", Bihac, Bosnia and Herzegovina
| | | | - Maja Ostojić
- University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Maja Travar
- University Clinical Centre of the Republic of Srpska, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina; Faculty of Medicine, University of Banja Luka, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
| | - Nijaz Tihić
- Faculty of Medicine, University of Banja Luka, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
| | - Jasminka Delić
- Cantonal Hospital "Dr. Irfan Ljubijankic", Bihac, Bosnia and Herzegovina
| | - Siniša Skočibušić
- University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina; School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
| | | | - Antonija Verhaz
- University Clinical Centre of the Republic of Srpska, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina; Faculty of Medicine, University of Banja Luka, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
| | - Dilista Piljić
- University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Luka Laura
- Veterinary Institute of Herzegovina-Neretva Canton, Mostar, Bosnia and Herzegovina
| | | | | | - Maja Arapović
- School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina; Veterinary Institute of Herzegovina-Neretva Canton, Mostar, Bosnia and Herzegovina
| | - Enisa Šabotić
- Cantonal Hospital "Dr. Irfan Ljubijankic", Bihac, Bosnia and Herzegovina
| | - Irena Reil
- Croatian Veterinary Institute, Zagreb, Croatia
| | - Jadranka Nikolić
- University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina; School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
| | - Sead Ahmetagić
- University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | | | | | - Mile Bosilkovski
- Ss. Cyril and Methodius University in Skopje, Faculty of Medicine, University Clinic for Infectious Diseases, Skopje, Republic of North Macedonia
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Molecular Investigation of the Transmission Dynamics of Brucellosis Observed Among Children in the Province of South - East Anatolia, Turkey. Jundishapur J Microbiol 2018. [DOI: 10.5812/jjm.58857] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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In vitro antimicrobial susceptibility testing of human Brucella melitensis isolates from Qatar between 2014 - 2015. BMC Microbiol 2015; 15:121. [PMID: 26073177 PMCID: PMC4466872 DOI: 10.1186/s12866-015-0458-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 06/01/2015] [Indexed: 11/30/2022] Open
Abstract
Background Brucellosis is one of the most common zoonotic disease affecting humans and animals and is endemic in many parts of the world including the Gulf Cooperation Council region (GCC). The aim of this study was to identify the species and determine the antimicrobial susceptibility pattern of Brucella strains isolated from clinical specimens, from Qatar. Results We evaluated 231 Brucella isolates. All isolates were identified as B. melitensis. All the isolates were susceptible to doxycycline, tetracycline, streptomycin, gentamicin, trimethoprim / sulfamethoxazole and ciprofloxacin except rifampicin, where 48 % of the strains showed elevated MICs (>1 mg/L). The rifampicin-resistance related hotspots within the rpoB gene were amplified and sequenced using PCR and no rpoB mutations were found in strains with rifampicin MICs of >2 mg/L. Conclusion This study identified B. melitensis as the etiological agent of brucellosis in Qatar. No resistant isolates were detected among conventionally used antimicrobial agents.
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Denk A, Demirdag K, Kalkan A, Ozden M, Cetinkaya B, Kilic SS. In vitro activity of Brucella melitensis isolates to various antimicrobials in Turkey. Infect Dis (Lond) 2015; 47:364-9. [PMID: 25712728 DOI: 10.3109/00365548.2014.988748] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Brucellosis is a systemic infectious disease caused by Brucella bacteria. A successful treatment requires antibiotics that can penetrate into the cell at high concentrations. The aim of this study was to assess the biotype and in vitro activity of 80 Brucella isolates obtained from blood against various antimicrobials for human brucellosis in Turkey. METHODS Identification of the types of the species designated Brucella species was made using the polymerase chain reaction (PCR), with type-specific primers. Serotyping was performed using mono-specific A and M antisera. The minimum inhibitory concentrations (MICs) of antibiotics known to have good intracellular penetration (doxycycline, rifampicin, ofloxacin, levofloxacin, moxifloxacin, clarithromycin, and azithromycin) were determined by the agar dilution method. RESULTS All of the 80 Brucella isolates were determined to be Brucella melitensis: 75 B. melitensis biotype 3 (93.7%) and 5 B. melitensis biotype 1 (6.3%). Doxycycline was the most effective among the tested antibiotics against Brucella species (MIC(50)-MIC(90), 0.25-0.5 μg/ml), and it was followed by levofloxacin (MIC(50)-MIC(90), 0.5-1 μg/ml), moxifloxacin (MIC(50)-MIC(90), 1-1 μg/ml), ofloxacin (MIC(50)-MIC(90), 1-1 μg/ml), rifampicin (MIC(50)-MIC(90), 2-4 μg/ml), azithromycin (MIC(50)-MIC(90), 4-8 μg/ml), and clarithromycin (MIC(50)-MIC(90), 8-32 μg/ml), respectively. CONCLUSIONS The in vitro activity of doxycycline and rifampicin, which are used in the classic treatment of brucellosis, was found to be very good. Quinolones were found to have in vitro activity against Brucella isolates. Among the macrolides, azithromycin had a higher level of activity compared with clarithromycin. A combination of quinolones and azithromycin could be an alternative to doxycycline and rifampicin in the treatment of brucellosis.
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Affiliation(s)
- Affan Denk
- From the Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Firat University , Elazig , Turkey
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Hashim R, Ahmad N, Mohamed Zahidi J, Tay BY, Mohd Noor A, Zainal S, Hamzah H, Hamzah SH, Chow TS, Wong PS, Leong KN. Identification and in vitro antimicrobial susceptibility of Brucella species isolated from human brucellosis. Int J Microbiol 2014; 2014:596245. [PMID: 25120569 PMCID: PMC4121247 DOI: 10.1155/2014/596245] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 06/15/2014] [Indexed: 11/18/2022] Open
Abstract
Brucellosis is a world-wide zoonotic disease with a major impact on the public health. Due to the high risk of laboratory acquired infection, limited laboratory investigations were performed on this organism, including detailed identification and susceptibility study. Brucella melitensis is the commonest aetiological agent for human brucellosis in this region. The in vitro susceptibility pattern against selected antimicrobial agents was assessed using E-test. All isolates were noted to be sensitive to all the antimicrobial agents tested except for rifampicin where elevated MIC > 1 μg/mL was noted in 30 out of 41 isolates tested.
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Affiliation(s)
- Rohaidah Hashim
- Bacteriology Unit, Infectious Disease Research Centre, Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - Norazah Ahmad
- Bacteriology Unit, Infectious Disease Research Centre, Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - Jama'ayah Mohamed Zahidi
- Bacteriology Unit, Infectious Disease Research Centre, Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - B. Y. Tay
- Bacteriology Unit, Infectious Disease Research Centre, Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - Azura Mohd Noor
- Bacteriology Unit, Infectious Disease Research Centre, Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - Sakina Zainal
- Bacteriology Unit, Infectious Disease Research Centre, Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - Hazwani Hamzah
- Bacteriology Unit, Infectious Disease Research Centre, Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - S. H. Hamzah
- Microbiology Unit, Department of Pathology, Hospital Pulau Pinang, Jalan Residensi, 10990 Georgetown, Pulau Pinang, Malaysia
| | - T. S. Chow
- Infectious Disease Unit, Medical Department, Jalan Residensi, 10990 Georgetown, Pulau Pinang, Malaysia
| | - P. S. Wong
- Infectious Disease Unit, Medical Department, Jalan Residensi, 10990 Georgetown, Pulau Pinang, Malaysia
| | - K. N. Leong
- Infectious Disease Unit, Medical Department, Jalan Residensi, 10990 Georgetown, Pulau Pinang, Malaysia
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Rodríguez Tarazona E, García Rodríguez JÁ, Muñoz Bellido JL. Emergence of quinolone-resistant, topoisomerase-mutant Brucella after treatment with fluoroquinolones in a macrophage experimental infection model. Enferm Infecc Microbiol Clin 2014; 33:248-52. [PMID: 24913992 DOI: 10.1016/j.eimc.2014.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 03/11/2014] [Accepted: 03/21/2014] [Indexed: 11/25/2022]
Abstract
AIM OF THE STUDY To determine the activity of fluoroquinolones (FQ) and the selection of FQ-resistant mutants in a macrophage experimental infection model (MEIM). MATERIAL AND METHODS Canine macrophages were inoculated with Brucella melitensis ATCC 23457 (WT), achieving intracellular counts of around 105 CFU/mL. Cell cultures were incubated in the presence of ciprofloxacin (CIP), levofloxacin (LEV), moxifloxacin (MOX), and doxycycline (DOX). After cell lysis, surviving microorganisms were plated for count purposes, and plated onto antibiotics-containing media for mutant selection. Topoisomerases mutations were detected by PCR and sequencing. RESULTS Bacterial counts after cell lysis were 14.3% (CIP), 65.3% (LEV), and 75% (MOX) lower compared to the control. Quinolone-resistant mutants emerged in cell cultures containing CIP and LEV with a frequency of around 0.5×10(-3). All mutants showed an Ala87Val change in GyrA. Mutants had FQs MICs around 10×WT. The ability of these mutants for infecting new macrophages and the intracellular lysis after antibiotic exposure did not change significantly. No 2nd step FQ-resistant mutants were selected from 1st step mutants. CONCLUSIONS Intracellular activity of FQs is low against WT and gyrA-mutant Brucella. FQs easily select gyrA mutants in MEIM. The ability of mutants for infecting new macrophages remains unchanged. In this MEIM, 2nd step mutants do not emerge.
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Affiliation(s)
| | | | - Juan Luis Muñoz Bellido
- Departamento de Microbiología, Complejo Asistencial Universitario de Salamanca, Spain; Departamento de Medicina Preventiva, Salud Pública y Microbiología Médica, Universidad de Salamanca, Spain; Grupo de Investigación Reconocido MICRAPE, Universidad de Salamanca, Spain; Instituto de Investigación Biomédica (IBSAL), Salamanca, Spain.
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Kilic S, Dizbay M, Cabadak H. In VitroActivity of Tigecycline, Tetracycline and Fluoroquinolones againstBrucella melitensis. J Chemother 2013; 20:33-7. [DOI: 10.1179/joc.2008.20.1.33] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Sayan M, Kılıc S, Uyanık MH. Epidemiological survey of rifampicin resistance in clinic isolates of Brucella melitensis obtained from all regions of Turkey. J Infect Chemother 2012; 18:41-6. [DOI: 10.1007/s10156-011-0281-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Accepted: 06/26/2011] [Indexed: 11/29/2022]
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Bayram Y, Korkoca H, Aypak C, Parlak M, Cikman A, Kilic S, Berktas M. Antimicrobial susceptibilities of Brucella isolates from various clinical specimens. Int J Med Sci 2011; 8:198-202. [PMID: 21448305 PMCID: PMC3053491 DOI: 10.7150/ijms.8.198] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Accepted: 02/23/2011] [Indexed: 11/19/2022] Open
Abstract
PURPOSE Brucellosis is a worldwide zoonotic disease and still constitutes a major public health problem. In the study we claimed to identify Brucella species from clinical samples of patients with active brucellosis from Van region of Eastern Anatolia and to determine in vitro antimicrobial susceptibilities of these strains to commonly used anti-Brucella agents and a possible new alternative tigecycline. MATERIALS AND METHODS A total of 56 Brucella isolates were enrolled the study and the identification of the isolates were based on conventional methods. In vitro activities of antimicrobials were evaluated by the E test method. RESULTS All isolates were identified as B. melitensis. MIC(90) values of doxycycline, streptomycin, rifampin, trimethoprim-sulfamethoxazole and tigecycline were 0.064 mg/L, 1 mg/L, 2 mg/L, 0.125 mg/L and 0.094 mg/L, respectively. Tigecycline had low MIC(50) and MIC(90) values against all B. melitensis strains; the highest MIC observed was 0.25 μg/mL. CONCLUSION Our data suggest that tigecycline can be a therapeutic alternative option for the treatment of brucellosis.
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Affiliation(s)
- Yasemin Bayram
- 1. Van Education and Research Hospital, Department of Microbiology, 65100 Van, Turkey
| | - Hanifi Korkoca
- 2. Muş Alparslan University, School of Health, Department of Nursing, 49100 Muş, Turkey
| | - Cenk Aypak
- 3. Van Gevaş Hospital, Department of Family Medicine, 65110 Van, Turkey
| | - Mehmet Parlak
- 4. Van 100. Yil University, Department of Microbiology, 65100 Van, Turkey
| | - Aytekin Cikman
- 4. Van 100. Yil University, Department of Microbiology, 65100 Van, Turkey
| | - Selcuk Kilic
- 5. Refik Saydam National Hygiene Center, Department of Communicable Diseases Research, 06100 Ankara, Turkey
| | - Mustafa Berktas
- 4. Van 100. Yil University, Department of Microbiology, 65100 Van, Turkey
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Effect of carbon dioxide on broth microdilution susceptibility testing of Brucella spp. J Clin Microbiol 2009; 48:952-6. [PMID: 20032255 DOI: 10.1128/jcm.01860-09] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Since some strains of Brucella species may require carbon dioxide for growth, a multilaboratory study was conducted to compare broth microdilution susceptibility results using ambient air (AA) and 5% CO2 incubation conditions. Six antimicrobial agents were tested against 39 Brucella isolates. Aminoglycoside MICs tended to be 1 log2 dilution higher in CO2 than in AA; tetracycline-class MICs to be 1 log2 dilution lower in CO2.
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Fluoroquinolone-resistant Brucella melitensis mutants obtained in vitro. Int J Antimicrob Agents 2009; 34:252-4. [DOI: 10.1016/j.ijantimicag.2008.12.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2008] [Accepted: 12/23/2008] [Indexed: 01/18/2023]
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Dizbay M, Kilic S, Hizel K, Arman D. Tigecycline: Its potential for treatment of brucellosis. ACTA ACUST UNITED AC 2009; 39:432-4. [PMID: 17464866 DOI: 10.1080/00365540601105756] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The in vitro efficacy and synergistic activity of tigecycline in comparison with other antimicrobials used in brucellosis, were tested for 16 Brucella melitensis strains by the E-test method. Tigecycline had the lowest minimal inhibitory concentration levels, and rifampin the highest, in the study. Tigecycline also provided the better synergistic activity compared to doxycycline according to the fractional inhibitory concentration index. The results of this in vitro study suggest tigecycline as a therapeutic alternative for brucellosis. These observations need to be supported with clinical studies.
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Affiliation(s)
- Murat Dizbay
- Department of Clinical Microbiology and Infectious Diseases, Gazi University School of Medicine, Ankara, Turkey.
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Rifampicin resistance phenotyping of Brucella melitensis by rpoB gene analysis in clinical isolates. J Chemother 2008; 20:431-5. [PMID: 18676221 DOI: 10.1179/joc.2008.20.4.431] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
R Rifampicin resistance of Brucella melitensis by rpoB gene analysis has not yet been performed in Turkey, where brucellosis is endemic. In this study, we investigated the efficacy of E-test and single nucleotide polymorphism (SNP) analysis of the B. melitensis rpoB gene, for the detection of mutations conferring rifampicin resistance, by sequencing 21 human B. melitensis strains from the Southeast and Marmara regions of Turkey. On CLSI slow-growing bacteria standards, all isolates were sensitive to rifampicin except for 6 which showed intermediate resistance to rifampicin. MIC(50) and MIC(90)values were 1 microg/ml and 1.5 microg/ml respectively (range 0.50 -1.5 microg/ml). The rifampicin-resistant phenotype was investigated at Cd 154 (GTT/TTT), Cd 526 (GAC/TAC, GAC/AAC, GAC/GGC), Cd 536 (CAC/CTC, CAC/TAC), Cd 539 (CGC/AGC), Cd 541 (TCG/TTG) and Cd 574 (CCG/CTG) of the rpoB gene in B. melitensis 16M and B115 strains, and in clinical isolates. No missense mutations were found in any of the B. melitensis isolates, which indicates that all isolates were rifampicin-susceptible. In conclusion, SNP analysis was useful as a molecular tool for rifampin resistance testing. Although resistance to rifampicin was not detected in our strains of B. melitensis; the presence of strains with intermediate resistance to rifampicin indicates that susceptibility testing should be performed periodically.
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15
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Jensen AE, Halling SM. Effect of polymyxin B and environmental conditions on isolation of Brucella species and the vaccine strain RB51. Comp Immunol Microbiol Infect Dis 2008; 33:121-31. [PMID: 18814911 DOI: 10.1016/j.cimid.2008.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2008] [Indexed: 10/21/2022]
Abstract
Brucella are resistant to polymyxin B (PB), but their relative susceptibility to PB and its derivative, colistin (COL) has not been rigorously or systematically studied. Comparative susceptibility of Brucella reference strains, vaccine strain RB51, and Brucella isolates from marine mammals to these two cationic peptides were determined by Etest. Vast differences among Brucella species were found in susceptibility to both PB and COL. Brucella demonstrated similar pattern of relative susceptibility to PB as that of COL, but they were less susceptible to COL. Both B. melitensis and B. suis were the least susceptible to polymyxins and rough strains were more susceptible to both PB and COL than the smooth except for the BvrR mutant. Strains were generally less susceptible to PB when cultured in CO(2) rather than ambient air; some became more susceptible in acidified medium. Results show that environment cultural conditions must be considered when selecting for CO(2)-independent strains of Brucella especially the vaccine strain RB51 on selective media containing PB. Our observations extend basic knowledge of the differential resistance of Brucella to polymyxins.
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Affiliation(s)
- Allen E Jensen
- National Animal Disease Center, United States Department of Agriculture, Ames, IA 50010, USA.
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16
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Kilic S, Dizbay M, Hizel K, Arman D. In vitro synergistic activity of antibiotic combinations against Brucella melitensis using E-test methodology. Braz J Microbiol 2008; 39:233-7. [PMID: 24031207 PMCID: PMC3768412 DOI: 10.1590/s1517-83822008000200006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2007] [Revised: 09/22/2007] [Accepted: 01/20/2008] [Indexed: 11/22/2022] Open
Abstract
The treatment of brucellosis is still problematic, because of high rates of treatment failure or relapses. As the microorganism is an intracellular pathogen, treatment requires combined regimens. However, limited existing data on in vitro combinations are avaliable for Brucellae. The aim of this study was to investigate the in vitro efficacy of various traditional and new antibiotic combinations against 16 Brucella melitensis strains. The combination effect of antimicrobial agents was evaluated by E-test synergy method to obtain a fractional inhibitory concentration (FIC) index. Co-Trimoxazole (SXT) and moxifloxocin (MXF) exhibited the lowest MIC, while Rifampin (RIF) had the highest MIC in the study. Combinations with RIF showed the best synergistic activity (100% of RIF-tetracycline (TET), and 87.5% of RIF-SXT). Synergistic activity was also detected at seven (43.7%) of ciprofloxocin (CIP)-SXT, four (25%) of TET-MXF, and two (12.5%) of TET-SXT combinations. The combinations that demonstrated additivity were TET-SXT, CIP-SXT and TET-MXF. Antagonism was observed only with the TET-Streptomycin (STR) combination in three strains (18.8%). Further work including randomized controlled clinical trials is required to fully evaluate the usefulness of these data.
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Affiliation(s)
- Selcuk Kilic
- Refik Saydam National Hygiene Center, Department of Communicable Diseases Research
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17
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Marianelli C, Graziani C, Santangelo C, Xibilia MT, Imbriani A, Amato R, Neri D, Cuccia M, Rinnone S, Di Marco V, Ciuchini F. Molecular epidemiological and antibiotic susceptibility characterization of Brucella isolates from humans in Sicily, Italy. J Clin Microbiol 2007; 45:2923-8. [PMID: 17634297 PMCID: PMC2045243 DOI: 10.1128/jcm.00822-07] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Brucellosis is a serious problem in Sicily. Brucella melitensis was identified as the species most frequently isolated in humans in Italy. No data, however, are available about the molecular epidemiological characterization of Brucella isolates from humans. We have conducted this study to molecularly characterize clinical isolates of Brucella spp. and to evaluate their antimicrobial susceptibilities. Twenty Brucella isolates were studied. Differential growth characteristics and DNA polymorphisms such as the restriction patterns of the PCR-amplified omp2a and omp2b genes, rpoB nucleotide sequencing, and multiple-locus variable-number tandem repeat analysis of 16 loci (MLVA-16) were used to characterize the strains. In vitro antibiotic susceptibility was determined by the E-test method on two different agar media, and the results were compared. All isolates were identified as B. melitensis biovar 3. rpoB nucleotide sequence analysis allowed the identification of two different genotypes of B. melitensis biovar 3. On the other hand, the MLVA-16 typing assay recognized 17 distinct genotypes. All isolates were sensitive to all tested antibiotics (rifampin, doxycycline, ciprofloxacin, ceftriaxone, and trimethoprim-sulfamethoxazole), and the Mueller-Hinton agar plate is recommended for antibiotic susceptibility testing by the E-test method. Our findings identify B. melitensis biovar 3 as the etiological agent isolated in Sicily and encourage the use of both molecular methods, and in particular of the MLVA-16 assay, in epidemiological trace-back analysis. This study represents the first epidemiological data from molecular typing of Brucella strains circulating in Italy and, in particular, in eastern Sicily.
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Affiliation(s)
- Cinzia Marianelli
- Dipartimento di Sanità Alimentare ed Animale, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
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18
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Turkmani A, Ioannidis A, Christidou A, Psaroulaki A, Loukaides F, Tselentis Y. In vitro susceptibilities of Brucella melitensis isolates to eleven antibiotics. Ann Clin Microbiol Antimicrob 2006; 5:24. [PMID: 17014707 PMCID: PMC1617115 DOI: 10.1186/1476-0711-5-24] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2006] [Accepted: 10/02/2006] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Brucellosis is an endemic disease present in many countries worldwide, but it is rare in Europe and North America. Nevertheless brucella is included in the bacteria potentially used for bioterrorism. The aim of this study was the investigation of the antibiotic susceptibility profile of brucella isolates from areas of the eastern Mediterranean where it has been endemic. METHODS The susceptibilities of 74 Brucella melitensis isolates derived from clinical samples (57) and animal products (17) were tested in vitro. The strains originate from Crete (59), Cyprus (10), and Syria (5). MICs of tetracycline, rifampicin, streptomycin, gentamicin, norfloxacin, ciprofloxacin, levofloxacin, trimethoprim/sulfamethoxazole, ampicillin, amoxicillin/clavulanic acid, and erythromycin were detected by E-test method. The NCCLS criteria for slow growing bacteria were considered to interpret the results. RESULTS All the isolates were susceptible to tetracycline, streptomycin, gentamicin, ciprofloxacin, norfloxacin, and levofloxacin. Two isolates presented reduced susceptibility to rifampicin (MIC value: 1.5 mg/l) and eight to SXT (MIC values: 0.75-1.5 mg/l). Erythromycin had the highest (4 mg/l) MIC90value and both norfloxacin and erythromycin the highest (1.5 mg/l) MIC50 value. CONCLUSION Brucella isolates remain susceptible in vitro to most antibiotics used for treatment of brucellosis. The establishment of a standardized antibiotic susceptibility method for Brucella spp would be useful for resistance determination in these bacteria and possible evaluation of bioterorism risks.
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Affiliation(s)
- Aun Turkmani
- Department of Clinical Bacteriology, Parasitology, Zoonoses, and Geographical Medicine, Faculty of Medicine, University of Crete, Greece
| | - Alexandros Ioannidis
- Department of Clinical Bacteriology, Parasitology, Zoonoses, and Geographical Medicine, Faculty of Medicine, University of Crete, Greece
| | - Athanasia Christidou
- Department of Clinical Bacteriology, Parasitology, Zoonoses, and Geographical Medicine, Faculty of Medicine, University of Crete, Greece
| | - Anna Psaroulaki
- Department of Clinical Bacteriology, Parasitology, Zoonoses, and Geographical Medicine, Faculty of Medicine, University of Crete, Greece
| | | | - Yiannis Tselentis
- Department of Clinical Bacteriology, Parasitology, Zoonoses, and Geographical Medicine, Faculty of Medicine, University of Crete, Greece
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Baykam N, Esener H, Ergönül O, Eren S, Celikbas AK, Dokuzoguz B. In vitro antimicrobial susceptibility of Brucella species. Int J Antimicrob Agents 2004; 23:405-7. [PMID: 15081093 DOI: 10.1016/j.ijantimicag.2003.09.024] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2003] [Accepted: 09/22/2003] [Indexed: 10/26/2022]
Abstract
MIC50 and MIC90 values of doxycycline, rifampicin, ciprofloxacin, trimethoprim-sulphamethoxazole and ceftriaxone for 42 blood isolates of Brucella species were determined using the Etest. Thirty-seven isolates were identified as B. melitensis and five as B. abortus. Doxycycline had the lowest and rifampicin the highest MIC50 values. Four strains were non-susceptible to rifampicin, and one strain was resistant to trimethoprim-sulphamethoxazole. There is no significantly important resistance problem for antibiotics targeted against Brucella species in Turkey. However, since rifampicin is commonly used for prevalent diseases such as tuberculosis, the regional susceptibility pattern of rifampicin should be assessed periodically.
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Affiliation(s)
- Nurcan Baykam
- Ankara Numune Research and Education Hospital, First Infectious Diseases and Clinical Microbiology Department, Ankara, Turkey.
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Bodur H, Balaban N, Aksaray S, Yetener V, Akinci E, Colpan A, Erbay A. Biotypes and antimicrobial susceptibilities of Brucella isolates. SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES 2003; 35:337-8. [PMID: 12875523 DOI: 10.1080/00365540310008348] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
41 Brucella strains isolated from blood and cerebrospinal fluid cultures were identified to species level and biotypes detected. All of the isolates were Brucella melitensis: 2 strains of B. melitensis biotype-1 and 39 strains of B. melitensis biotype-3. In vitro activities of these strains were detected by the E test method. According to the 90% minimal inhibitory concentration (MIC90) values, the most active agent was doxycycline (MIC90 0.064 microg/ml), followed by ciprofloxacin (MIC90 0.25 microg/ml), trimethoprim-sulfamethoxazole and ceftriaxone (MIC90 0.38 microg/ml). Rifampin exhibited the highest MIC90 value (0.75 microg/ml).
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Affiliation(s)
- Hürrem Bodur
- Infectious Diseases and Clinical Microbiology Clinic, Ankara Numune Training and Research Hospital, Ankara, Turkey.
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