Seroprevalence of Brucellosis in Human Immunodeficiency Virus Infected Patients in Hamadan, Iran

Serological and molecular investigation of human brucellosis in participants of Famenin brucellosis cohort study, Hamadan, Iran

Background and Objectives

Brucella is an intracellular pathogen that causes brucellosis in humans and animals. This study aimed to assess the results of brucellosis seroprevalence among participants of the Famenin brucellosis cohort with molecular investigation technique and determine Brucella-approved species.

Materials and Methods

Following the first phase of the Famenin brucellosis cohort in 2016 which investigated the seroprevalence of brucellosis among 2367 participants in Famenin city, a total of 575 people including all seropositive and some seronegative people were examined again by wright serological tests in 2019. The PCR assay was accomplished on all cases that have wright titers ≥ 1/20 for tracing Brucella DNA using BCSP31 target gene and IS711 locus.

Results

Out of 575 studied cases, 145 people had wright titers ≥ 1/20. The PCR reactions of these 145 blood samples were positive in 63/145 (43.44%) tested samples using primers (B4/B5) for Brucella genus detection. In the second PCR assay using specific-primers for Brucella abortus and Brucella melitensis, 18/63 (28.57%) of the samples were diagnosed as B. abortus, and 18/63 (28.57%) were diagnosed as B. melitensis.

Conclusion

In this study, using the selected specific genes for the diagnosis of Brucella in the genus and species levels, the PCR technique was evaluated as a promising method for the rapid and safe detection of brucellosis besides the serological test for more accurate detection of brucellosis especially in cases that are not definitive.

Investigation of Linc-MAF-4 expression as an effective marker in brucellosis

Brucellosis is a zoonotic disease that is one of the most common infectious diseases. Cellular immunity is the main immune response against brucella. Long non coding RNAs are a new subset of genes that could regulate cell function and may gene regulation. We aim to investigate whether the level of Linc-MAF-4 and cMAF have considerable differences in brucella infection. In this experiment 99 patients with brucellosis were divided into three groups of acute, undertreatment and relapse and 30 volunteers with negative serologic tests as control group. The expression levels were detected using quantitative polymerase chain reaction (qPCR). Statistical analysis was performed using SPSS software version 25.0. Results showed that the expression of Linc-MAF-4 was significantly increased in the acute group in comparison to control and relapse groups. Also, cMAF expression was significantly increased in the relapse group versus the control group. Our study showed these genes play important roles in the immune response include regulating naïve T cell differentiation to T helper cells in Brucella infection. We propose that Linc-MAF-4 could be a potential biomarker for the screening, diagnosis and treatment of brucellosis.

Human Brucellosis: Risks and Prevalence among Iranian Blood Donors Residing in Endemic Areas

Background

Brucellosis is a common zoonotic infection worldwide. Transmission can be occasionally observed via transfusion or transplantation. This study was designed to survey the seroprevalence of anti-Brucella antibody in blood donors in different endemic provinces.

Materials and Methods

A total of 14,706 blood donors from the 5 most prevalent provinces were studied by standard tube agglutination (STA) and any positive subjects were further confirmed by 2-mercaptoethanol agglutination test (2-ME). Significant titres were 80 for STA and 40 for 2-ME.

Result

A total of 63 (0.43%) serum samples were STA-positive. Of these, the 2-ME test was reactive in 42 samples. The 2-ME test was reactive in 31 samples with a low titre. However, concomitant STA ≥80 and the titre of ≥40 for the 2-ME test were found in 11 subjects (0.075%), mostly resident in urban areas. Exposure to manure products was identified as a significant risk factor (p = 0.0128). Conclusion : The observed data show a somewhat noticeable prevalence among Iranian blood donors, bringing attention to the importance of pre-donation screening via a questionnaire which supplies answers about occupational history, and any history of exposure or past infections. Further studies to evaluate the frequency and related risk factors in certain populations, in conjunction with implementing stricter regulations in blood donor selection in endemic areas, may be necessary.

A case of brucellosis concomitant with HIV infection in China

Background

Human brucellosis is a neglected public health issue in China and reports of HIV-infected individuals complicated with brucellosis are rare. This report describes the case of an HIV-infected patient complicated with brucellosis. We want to raise awareness of clinical diagnosis of brucellosis among clinicians. Furthermore, we should be more concerned about cases with pyrexia of unknown origin, especially in non-epidemic areas of brucellosis in China.

Case presentation

We encountered the case of a 31-year-old HIV-infected male with a CD4+ T lymphocyte count of approximately 300. On May 1, 2019, the patient had onset of non-specific caustic irregular fever with body temperature reaching 41.0 °C. He was admitted to two medical institutions in Yunnan with pyrexia of unknown origin. Finally, on day 7 of hospitalization in the Public Health Clinical Medical Center in Chengdu City, he was diagnosed as having brucellosis infection based on blood culture results.

Conclusions

This is the first reported case of brucellosis concomitant with HIV infection in China. Laboratories in infectious disease hospitals and category A level III hospitals in the southern provinces of China should be equipped with reagents for clinical diagnosis of brucellosis and to strengthen the awareness of brucellosis diagnosis in China. Secondly, in provinces with a high incidence of AIDS and brucellosis such as Xinjiang and Henan, it is recommended to implement a joint examination strategy to ensure the early detection, diagnosis, and treatment of this infection.

Prevalence and risk factors of brucellosis among febrile patients attending a community hospital in south western Uganda

Human brucellosis, a chronic disease contracted through contact with animals and consuption of unpasteurized dairy products is underreported in limited-resource countries. This cross-sectional study aimed to determine the prevalence and risk factors of brucellosis among febrile patients attending a community hospital in South western Uganda. A questionnaire that captured socio-demographic, occupational and clinical data was administered. Blood samples were tested for Brucella antibodies using Rose Bengal Plate Test (RBPT) and blood culture with standard aerobic BACTEC bottle was done. Of 235 patients enrolled, prevalence of brucellosis (RBPT or culture confirmed) was 14.9% (95% CI 10.6-20.1) with a culture confrmation in 4.3% of the participants. The factors independently associated with brucellosis were consumption of raw milk (aOR 406.15, 95% CI 47.67-3461.69); history of brucellosis in the family (aOR 9.19, 95% CI 1.98-42.54); and selling hides and skins (aOR 162.56, 95% CI 2.86-9256.31). Hepatomegaly (p < 0.001), splenomegaly (p = 0.018) and low body mass index (p = 0.032) were more common in patients with brucellosis compared to others. Our findings reveal a high prevalence of brucellosis among febrile patients and highlight a need for implementing appropiate tests, public awareness activities and vaccination of animals to control and eliminate the disease.