Arapović Jurica, Špičić Silvio, Ostojić Maja, Duvnjak Sanja, Arapović Maja, Nikolić Jadranka, Cvetnić Željko
Department of Infectious Diseases, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina; Faculty of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina.
Laboratory for Bacterial Zoonosis and Molecular Diagnostics of Bacterial Diseases of Croatian Veterinary Institute, Zagreb, Croatia.
Acta Med Acad. 2018 May;47(1):50-60. doi: 10.5644/ama2006-124.214.
The aim of this study was to evaluate an ongoing outbreak of brucellosis in southern region of Bosnia and Herzegovina (BIH) on the epidemiological, clinical and molecular level.
This study included 19 patients affected by brucellosis between 2015 and 2017, in Trebiševo (BIH). Out of 19 patients, 16 were admitted to and treated at the Department of Infectious diseases of the University Clinical Hospital Mostar, while three patients were treated in ambulatory care setting. Epidemiological, clinical and microbiological parameters were investigated. The Rose Bengal test (RBT) positive sera were serologically confirmed by complement fixation test (CFT). We also analyzed blood cultures, and isolates were additionally serotyped. Molecular analyses were performed with Bruce-ladder multiplex polymerase chain reaction (PCR) and multiple locus variable number of tandem repeat analysis of 16 loci (MLVA-16) assay.
Fifteen out of 19 patients had been professionally exposed to the bacterium, while four patients acquired brucellosis without prior contact with infected animals. In seven out of eight (87.5%) patients with localized form of brucellosis, we detected significantly higher values of C-reactive protein (CRP) or erythrocyte sedimentation rate (P<0.001). B. melitensis was isolated from 13/16 (81.3%) blood culture samples, and additionally serotyped as biovar 3. Using MLVA16 assay, 11 isolates were genotyped. We observed complete genotype matches among 8/11 B. melitensis isolates, while 3/11 isolates differed in Bruce04 locus.
Overall, our study confirms the usefulness of MLVA-16 method in the epidemiological and molecular research of brucellosis during epidemic that, most likely, originated from the same source.
本研究旨在从流行病学、临床和分子水平评估波斯尼亚和黑塞哥维那（波黑）南部地区正在爆发的布鲁氏菌病疫情。
本研究纳入了2015年至2017年期间在特雷比舍沃（波黑）感染布鲁氏菌病的19例患者。19例患者中，16例被收治于莫斯塔尔大学临床医院传染病科并接受治疗，3例患者在门诊接受治疗。对流行病学、临床和微生物学参数进行了调查。采用补体结合试验（CFT）对玫瑰红试验（RBT）阳性血清进行血清学确认。我们还分析了血培养结果，并对分离株进行了额外的血清分型。采用布鲁氏菌阶梯式多重聚合酶链反应（PCR）和16个位点的多位点可变数目串联重复序列分析（MLVA-16）试验进行分子分析。
19例患者中有15例曾职业性接触该细菌，4例患者在未接触感染动物的情况下感染布鲁氏菌病。在8例（87.5%）局部型布鲁氏菌病患者中，有7例C反应蛋白（CRP）或红细胞沉降率值显著更高（P<0.001）。从13/16（81.3%）份血培养样本中分离出羊种布鲁氏菌，并额外血清分型为生物变种3。使用MLVA16试验对11株分离株进行了基因分型。我们观察到8/11株羊种布鲁氏菌分离株之间基因型完全匹配，而3/11株分离株在Bruce04位点存在差异。
总体而言，我们的研究证实了MLVA-16方法在布鲁氏菌病疫情期间的流行病学和分子研究中的有用性，此次疫情很可能源于同一源头。
