University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina; School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina.
Croatian Veterinary Institute, Zagreb, Croatia.
J Glob Antimicrob Resist. 2022 Jun;29:99-104. doi: 10.1016/j.jgar.2022.02.005. Epub 2022 Feb 16.
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 strains isolated in Bosnia and Herzegovina.
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.
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.
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.
布鲁氏菌病是一种普遍存在的新发细菌性人畜共患病，在波斯尼亚和黑塞哥维那造成了大量人类发病。迄今为止，全世界已经发现了很高比例的耐药布鲁氏菌。本研究前瞻性分析了在波斯尼亚和黑塞哥维那分离的人类马耳他布鲁氏菌菌株的耐药率。
本研究纳入了来自波斯尼亚和黑塞哥维那的五家医疗中心诊断的 209 例患者的 108 株 B. melitensis 分离株。在标准布鲁氏菌肉汤（BB）和添加了 4%裂解马血或 5%去纤维绵羊血的阳离子调整 Mueller-Hinton 肉汤（CAMHB）中，研究了 B. melitensis 分离株对 13 种最常用抗菌药物的耐药谱。
在 209 例患者中，111 例（53.1%） B. melitensis 血培养阳性。在所研究的 108 株分离株中，91 株（84.3%）在 BB 中对甲氧苄啶-磺胺甲噁唑耐药，但在任何一种 CAMHB 中均不耐药。几乎所有的分离株（>90%）在 BB 和两种 CAMHB 中均对阿奇霉素耐药。
我们观察到 B. melitensis 对阿奇霉素的耐药率很高。我们观察到的对甲氧苄啶-磺胺甲噁唑的高耐药率与 BB 有关，因此应使用替代肉汤，如本研究中的富集 CAMHB，来评估对甲氧苄啶-磺胺甲噁唑的耐药性。需要进行全基因组测序研究，以了解从人类分离的 B. melitensis 菌株中抗菌药物耐药性的发展。
