Journal of Arak University Medical Sciences
Year:2012 | Volume:14 | Issue:6 (SUPPL 3)|Papers Count:20

Background: Brucella is a gram-negative intracellular bacterium. Since Brucella brings about health and socio-economic problems, its control is of primary importance. The common method of vaccination includes using live attenuated strains of this bacterium. This study was done to evaluate the immunogenicity of Brucella aburtus P39 gene in Balb/c mice.Materials and Methods: In this experimental study, P39 gene was amplified by polymerase chain reaction (PCR) method and after extraction, it was sub-cloned to eukaryotic expression vector pcDNA3. The intramuscular injection of the obtained plasmid to the Balb/c mice was done in three stages. After the last vaccination, immunologic tests, such as proliferative response in lymphocytes, IFN-g assessment, IL-5, and determination of IgG2a and IgG1, were run.Results: The level of activation in splenic lymphocytes response was 3.6 and the measured IFN-g was 3 ng/ml, whereas IL-5 was insignificant. IgG2a and IgG1 titers were 1.640 and 1.40, respectively.Conclusion: The findings of the immunological analysis show the appropriate immune response in Balb/c mice model after the injection of P39 gene containing plasmid. The immune system response was in Th1 form which decreased the number of bacteria in spleen. Therefore, P39 gene is of appropriate immunogenicity and DNA vaccination is efficient in the activation of cell immune response against this bacterium.

Background: Brucellosis, especially if caused by Brucella melitensis, remains one of the most common zoonotic diseases worldwide with more than 500,000 human cases reported annually. In Iran, brucellosis was first recognized in 1932 and control of small ruminant brucellosis began in 1963. The aim of this study is to give an overview of the National Sheep and Goat Brucellosis Control Program in Iran.Materials and Methods: In this cross-sectional study, data were collected from Iran Veterinary Organization over a period of 45 years. The national control program was based on kid and lamb vaccination and testing and slaughtering infected animals.Results: B. melitensis biotype I in sheep, goat, and man was the predominant local infective biotype. This disease was reported in sheep, goat, cattle, horse, camel, and human. In addition, the prevalence of small ruminant brucellosis was estimated around 2.1%.Conclusion: Prevention of brucellosis is dependent upon increasing public awareness of ranchers through health education programs and more active co-operation between health and veterinary medicine organizations as well as animal movement control in the borders.

Background: Prevention, control, or eradication of brucellosis in a country or region needs policy-making, decision-making, and possessing accurate epidemiological data and information. Therefore, this study was done to review the epidemiology and some factors affecting the interval between the onset and diagnosis of brucellosis in Markazi Province, Iran.Materials and Methods: In this cross-sectional study, data on patients diagnosed with brucellosis during 2010-2011 in Markazi Province were studied. Data were analyzed by descriptive statistics as well as chi-square test, Fisher's exact test, t-test, and Kolmogorov-Smirnov test using SPSS software.Results: Out of all cases (907), the interval between the onset of symptoms and diagnosis was more than a month in 363 cases (41.7%). The interval between the onset and diagnosis was significantly associated with location (urban or rural) (P=0.001), city of residence (P=0.001), career (P=0.002), and type of disease (new or failure case) (P=0.008).Conclusion: Since the interval time between the onset and diagnosis of brucellosis among rural residents, ranchers, housewives, and farmers is more, greater attention should be paid to this new class.

Background: Brucellosis is one of the most common zoonotic diseases in the world which imposes a great financial burden on the endemic regions. Diagnosis of the human brucellosis is mainly based on blood culture and serological tests. PCR, however, is recommended for diagnosis at greater specificities and sensitivities. This study aims to compare the diagnosis of human brucellosis by PCR method using l7/l12 and 16srRNA genes and serological tests.Materials and Methods: In a cross-sectional study, a total of 700 blood samples were collected from patients suspected to brucellosis who had referred to the hospitals and laboratories of Ilam, Iran. The samples were selected through Rose Bengal test. Then 50 positive samples diagnosed by Rose Bengal test were assayed by Wright, Coombs Wright, and PCR using l7/l12 and 16srRNA genes and 50 negative samples diagnosed by PCR using these two genes were tested.Results: Of the total 700 samples assayed by Rose Bengal test, 125 were positive and the rest 575 were negative. The 50 positive Rose Bengal samples in PCR were shown to be positive by both genes and 50 negative Rose Bengal samples were shown negative by both samples. 47 samples in Wright test and 49 samples in Coombs test had titration levels above 1:60.Conclusion: PCR method has a higher sensitivity and specificity in diagnosis of human brucellosis in comparison with serological tests. Sensitivity of PCR by l7/l12 gene is similar to16srRNA and can be used for diagnosis of human brucellosis.

Background: Brucellosis is one of the zoonotic diseases that has always been considered a health problem in Iran. Since this disease is endemic in Arak and Markazi Province, this study was done to investigate its epidemiology during 2001-2010.Materials and Methods: In this epidemiological study, data on patients with brucellosis were obtained from the medical records in Arak Health Center during 2001-2010. The collected data were analyzed by SPSS software version 16.Results: During this period, 3880 new cases were reported. The mean incidence rate of brucellosis was 60 per 100000 people during 2001-2010. The greatest incidence was in 2004 (111.5 per 100000 people), whereas the lowest incidence was in 2006 (40.5 per 100000 people). Overall, 72% of the patients lived in villages, and 60% of them were male. The majority of the patients were in the second decade of their lives (10-19 years old). The majority of the patients had Wright test titer=1:320 and 2ME titer=1:80 in serology titration.Conclusion: Arak is one of the regions with high incidence of brucellosis. In this region, the patients are mostly male, live in villages, and age 10-19.

Background: Human brucellosis is a significant public health concern in many countries, including Iran. Therefore, the development of new diagnostic techniques, with high sensitivity and minimum risk of laboratory infection are of great importance. PCR is one of the procedures which has these advantages. However, PCR efficiency is largely dependent on DNA extraction methods. In this study, we studied the efficiency of three different extraction methods of brucella DNA in serum samples.Materials and Methods: In this experimental study, microbial suspensions were initially prepared in saline that its turbidity was equivalent to 0.5 McFarland. Human serum samples were spiked with certain concentrations of Brucella melitensis in vitro. DNA was extracted by three methods and tested by a genus-specific PCR method.Results: Our results showed that the cinneagen kit protocol detected brucella DNA in lower serum concentrations compared with the other protocols. Cinnagen kit could detect brucella DNA in ten-fold dilution in comparison with the other two methods.Conclusion: According to the findings of this study, cinnagen kit was the preferred assay method that yields a better sensitivity for isolation of brucella DNA in serum samples.

Background: Brucellosis is caused by brucella which is a facultative intracellular pathogen invading both professional and nonprofessional phagosytic cells. Eucalyptus globulus is one of the most widely used medicinal plants in folk medicine throughout the world. The aim of this study was to evaluate the antibacterial effects of Eucalyptus globulus extracts on intramacrophage Brucella melitensis 16M.Materials and Methods: In this experimental study, after preparing aquatic, ethanolic, and acetonic extracts of Eucalyptus globules, the effect of the extracts on intramacrophge survival of B. melitensis 16M obtained from cell culture of Balb/c mice peritoneal macrophages was studied. In order to do this, after lysis of macrophages, through preparation of serial dilutions and culture on Mueller Hinton agar medium, the number of colonies grown was counted.Results: The maximum antimicrobial activity of Eucalyptus globulus extracts on intramacrophage B. melitensis 16 M were in 1:40 dilution (21.62 mg/ml) of the aquatic extract, 1:640 dilution (1.26 mg/ml) of the ethanolic extract, and 1:320 dilution (2.59 mg/ml) of the acetonic extract after 24h.Conclusion: Aquatic, acetonic, and ethanolic extracts of Eucalyptus globulus possess antimicrobial properties against intramacrophage B. melitensis 16M and ethanolic extract has the most effective antimicrobial activity on intramacrophage Brucella melitensis; therefore, these extracts can be useful in treatment of brucellosis.

Background: Brucellosis is one of the most common bacterial zoonotic infections in the world. The incidence of this infection is quite high and is endemic in several countries. According to WHO report, the prevalence of zoonotic and human brucellosis is on the rise in the Mediterranean region, the Middle East, and west Asian countries. The aim of this study was to investigate the usage of silver nanoparticles in treatment of brucellosis.Materials and Methods: In this experimental study, the activity of silver nanoparticles against Brucella meltensis 16M was determined by agar well diffusion method. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of silver nanoparticles were determined by macrodilution method. Also, the antibacterial effect of silver nanoparticles was studied in mouse model.Results: The results showed that silver nanoparticles in low concentrations can kill Brucella melitensis 16M in laboratory conditions. MIC and MBC of silver nanoparticles were 4 ppm and 6 ppm in macrodilution method, respectively. The anti-brucella effect of silver nanoparticles was also observed in mouse model.Conclusion: This study demonstrated that silver nanoparticles can be used against brucellosis.

Background: Brucellosis is a zoonotic disease in humans and animals that its control is dependent on the prevalence of diseases in animal populations. The purpose of this study was to compare the sensitivity and specificity of common diagnostic tests for brucellosis.Materials and Methods: In an analytical cross-sectional study, 297 serum samples from an infected herd that had a history of abortion were prepared and evaluated through standard tube agglutination, Rose Bengal, 2-Mercaptoethanol, complement fixation, and ELISA tests. In addition, microbial culture was done for positive serum samples, lymph nodes, and infected organs.Results: Based on the total 297 serum samples tested, the sensitivities for standard tube agglutination, Rose Bengal, 2-Mercaptoethanol, complement fixation, and ELISA tests were 89, 81.5, 75.3, 89.7, and 93.2%, whereas specificities were determined to be 97.4, 94, 96, 98, and 99.3%, respectively.Conclusion: The findings of this study show that the standard tube agglutination test, complement fixation test, and ELISA are more sensitive than other tests. Moreover, ELISA test was the most sensitive and specific serological test for diagnosis of brucellosis in the present study.

Background: Brucellosis is an endemic disease in Iran and its treatment is a medical problem. This study was performed to observe the influence of the administration of corticosteroid on symptomatology of subjects with acute, subacute, and chronic brucellosis.Materials and Methods: In this randomized controlled trial, 48 patients with brucellosis were randomly assigned to two groups. The first group (N=30) received the standard regimen plus dexamethasone (4 mg t.d.s for 5 days) and the second group (N=17) received only the standard regimen. The results of corticosteroid administration were evaluated according to such factors as clinical status of the patient, duration of hospital stay, duration of illness, pain score, and use of analgesics. The results were analyzed by Chi-square test, Fisher’s exact test, independent sample t-test, and Mann-Whitney test.Results: No significant differences were seen in the mean of hospital stay, duration of illness, and use of oral and injectable analgesics between the two groups (P<0.05). Also, there was not a significant difference in mean pain score reduction between groups 1 and 2 (P<0.05).Conclusion: Noticing the findings of this study, corticosteroid does not seem to alter the clinical course of brucellosis significantly. Nevertheless, further controlled clinical trials with larger sample sizes are recommended.

Background: Brucellosis is a major zoonotic disease with worldwide distribution. The prevalence of this disease has decreased in developed countries; however, in developing countries, it is still prevalent. The aim of study was to determine the effect of a health belief model (HBM) based educational program on the empowerment of rural women in Zarandieh in prevention of brucellosis.Materials and Methods: In a quasi-experimental study with a pre-test/post-test design, 141 rural women were randomly selected and assigned to experimental and control groups. The educational program was implemented for the experimental group. Data were gathered by a researcher-made questionnaire and analyzed by SPSS software version 16.Results: Demographic variables of the two groups were similar before education. In addition, there were no significant differences between the experimental and control groups with regard to mean knowledge, HBM constructs, and performance; however, the post-test revealed significant differences in terms of  the mean of variables between the two groups (P<0.001).Conclusion: The HBM based educational program is effective in women’s empowerment and also promoting women’s beliefs and performance regarding brucellosis; therefore, the findings of this study may be used as a framework in designing zoonotic diseases prevention programs.

Human Brucellosis is an infectious disease caused by Brucella bacteria. An average of 150 cases of brucellosis among 330 million people is reported in the USA each year. This bacterium is small, gram-negative rods that grow in phagocytes. They primarily cause diseases among different animals and humans become infected when is in contact with animals or their products. Brucella can cause various symptoms in humans which is similar to human influenza. Brucellosis is diagnosed in a laboratory by finding Brucella organisms in samples of blood or bone marrow or to detect antibodies against the bacteria in two blood samples, collected 2 weeks apart. Depending on severity of illness, recovery may take as long as several months. There is no vaccine available for human except live vaccines and that should be consulted to a health care provider. DNA findings for Brucella species in the index patients focused our attention on revealed human cancers. Also, granalomatous inflammation of testes and medulloblastomas has been linked to chronic Brucellosis infection which could be similar to Helicobacter pylori that is associated with gastric tumor formation. More scientific investigation is needed to properly address the connection of Brucella with other human malignancies.

Background: Brucellosis is a zoonotic disease which is endemic in Iran. Infection with brucella species during pregnancy can have negative impacts on the outcome of pregnancy; however, there is no consensus on its leading to abortion or other severe complications. The aim of the present study is to determine the role of brucellosis in pregnancy and to characterize the risk factors, clinical presentations, and immunology of brucellosis based on the existing reports.Materials and Methods: In this review article, we studied papers on Pubmed, Elsevier, Cohrane, SID, Ovid, ISC, and IranMedex through such keywords as brucellosis, abortion, intra-uterine fatal diseases, and preterm labor.Results: Among the original research papers, 51 were found to be related to the title of this study and dealt with the outcome of brucellosis on pregnant women and had discussed the complications of pregnant patients suffering from brucellosis.Conclusion: According to the investigations made in this study, brucellosis in pregnancy can manifest as normal delivery, increased incidence of spontaneous abortion, intra-uterine fatal diseases, and premature delivery. Therefore, in endemic areas, especially those with inhabitants of low socioeconomic class, educating girls and women of childbearing age about brucellosis and its dangers and risk factors and isolating pregnant women may help prevent the disease and its complications in pregnancy. Moreover, further immunological investigation on the role of immunological reactions following brucellosis infection in pregnant women is required.

Background: Brucellosis is an endemic infectious disease in Iran. The neurological involvement of the central nervous system in brucellosis patients is about 3 to 5 %.Case: The case was a 25-year old Afghan man with weakness and arthralgia for one year as well as terrible headache, vertigo, vomiting, cough, sputum, and disequilibrium. Brain CT-Scan indicated communicating hydrocephalus in four ventricles. Since hydrocephalus was idiopathic and noticing the prevalence of tuberculosis among Afghan immigrants that can also cause hydrocephalus, ventriculo-peritoneal shunt was inserted for the patient. Pressure in CSF increased and had a turbid appearance. Glucose value of CSF decreased (35 mg/dl), whereas protein value increased (724 mg/dl). Leukocyte count was 10 mm3 with 80% neutrophils and 20% lymphocytes. The presence of brucella species in CSF culture confirmed that subacute meningitis had caused hydrocephalus due to delay in diagnosis and treatment. The patient was treated for brucellosis and discharged after 10 days with oral medications.Conclusion: Noticing this case and other studies, it is recommended that patients with neurological symptoms, such as hydrocephalus, be evaluated for neuro-brucellosis in endemic areas for brucellosis.

Background: Guillain-Barré syndrome (GBS) has several variant signs and it often presents as an acute monophasic paralyzing illness provoked by a preceding infection. Campylobacter jejuni infection is the most commonly identified cause of GBS while cytomegalovirus, Epstein-Barr virus, and human immunodeficiency virus (HIV) infections have also been associated with GBS.Case: A 55-year-old villager man who was an animal keeper was admitted to Vali-Asr Hospital with symptoms of general weakness, fever, and night sweats. With positive serology of brucellosis (Wright=1:1280, 2ME =1:640), the patient was treated with rifampin, doxycyclin, and tereptomycin (1g/daily). Having received 9 injections of streptomycin, with weakness in the right extremity, the patient was hospitalized. Brain MRI and CT-Scan were reported normal. Within two days, however, the extremity weakness progressed and spread to 4 extremities (2.5 at the proximal and 3.5 in the distal). Generalized areflexia occurred and, three days later, impaired swallowing and facial weakness ensued. Streptomycin was discontinued upon admission. EMG indicated acute and severe demyelinating polyradiculoneuropathy. CSF analysis confirmed Guillain Barre Syndrome while Wright test for CSF was negative. The patient was admitted to the ICU and underwent intubation with progressed paralysis of four limbs, the patient died in 8 days after hospitalization.Conclusion: In endemic areas, brucellosis should be considered in patients with Guillain Barre syndrome.