Biochemical mis-identification of Brucella melitensis and subsequent laboratory-acquired infections

Batchelor, B.; Brindle, Richard; Gilks, Charles F.; Selkon, J. B.

doi:10.1016/0195-6701(92)90100-z

Cited by 58 publications

(40 citation statements)

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“…More than 48 exposure incidents were described. Four reports described secondary exposures involving the same or related isolates (12,(25)(26)(27).…”

Section: Resultsmentioning

confidence: 99%

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A Literature Review of Laboratory-Acquired Brucellosis

et al. 2013

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bBrucellosis is a bacterial zoonotic disease which has been associated with laboratory-acquired infections. No recent reviews have addressed the characteristics of laboratory-acquired brucellosis (LAB). English-language literature was reviewed to identify reports of laboratory exposures to Brucella spp. and LAB cases between 1982 and 2007. Evaluation of 28 case reports identified 167 potentially exposed laboratory workers, of whom 71 had LAB. Nine reports were identified that summarized an additional 186 cases of LAB. Only 18 (11%) exposures were due to laboratory accidents, 147 (88%) exposures were due to aerosolization of organisms during routine identification activities, and the circumstances of 2 (1%) exposures were unknown. Brucella melitensis was the causative agent in 80% (135/167) of the exposures. Workers with high-risk exposures were 9.3 times more likely to develop LAB than workers with low-risk exposures (95% confidence interval [CI], 3.0 to 38.6; P < 0.0001); they were also 0.009 times likelier to develop LAB if they took antimicrobial PEP than if they did not (95% CI, 0 to 0.042; P < 0.0001). The median incubation period in case and summary reports was 8 weeks (range 1 to 40 weeks). Antimicrobial PEP is effective in preventing LAB. The incubation period may be used to identify appropriate serological and symptom surveillance time frames for exposed laboratory workers.

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“…More than 48 exposure incidents were described. Four reports described secondary exposures involving the same or related isolates (12,(25)(26)(27).…”

Section: Resultsmentioning

confidence: 99%

“…This can lead to exposures to Brucella spp. in clinical laboratories during culturing and isolation of clinical specimens (12)(13)(14). Also, proper safety precautions (15,16) for Brucella isolates may not be observed in laboratories that rarely receive highly pathogenic organisms.…”

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confidence: 99%

A Literature Review of Laboratory-Acquired Brucellosis

et al. 2013

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“…We believe such identification ambiguity can have several undesirable consequences. First, misidentification of Brucella species could result in accidental exposure among the laboratory personnel [11], in addition to having serious health consequences for the affected person in terms of inappropriate antimicrobial therapy, a longer hospital stay, chronicity, and relapse of the disease [12]. Secondly, this case reveals the uncertainties surrounding the use of bacterial identification systems for identifying Brucella during routine laboratory testing.…”

Section: Figure Phylogenetic Tree Of Brucella Melitensismentioning

confidence: 99%

16S rRNA gene sequence analysis of a Brucella melitensis infection misidentified as Bergeyella zoohelcum

Dash

Panigrahi

Al-Zarouni

et al. 2011

J Infect Dev Ctries

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Misidentification of Brucella species from clinical specimens using commercial bacterial identification systems is a recurring problem. An isolate from a bacterimic patient was identified as Bergeyella zoohelcum by MicroScan Walk-Away (Siemens Healthcare Diagnostics Inc., West Sacramento, CA, USA) and as Brucella melitensis by Vitek 2 system (bioMérieux Inc., Durham, NC, USA). Because of this identification ambiguity by the two automated bacterial identification systems we performed 16S rRNA sequencing and serotyping of the isolate and confirmed it as a Brucella spp. Combining the sequence data with the Vitek 2 system data we conclude that the infection was caused by B. melitensis.

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“…Identification of members of the genus Brucella is based of the presence of typical small Gram-negative coccobacilli (see Figure 1); positive oxidase, catalase, and urease tests; no fermentation of sugars; CO 2 requirement; lack of motility; and confirmed by a positive agglutination reaction with specific antiserum [14] or, alternatively, the isolate'sbiochemical profile is determined by a commercial system. The main drawbacks of this traditional approach is the slow turnaround time (2 to 3 days) and the possible misidentification of brucellae as Ochrobactrum anthropi [60], Ochrobactrum intermedium [61], Bergeyella zoohelcum [62], or Moraxella phenylpyruvica by commercial kits; a serious mistake that has already lead to an outbreak of laboratory-acquired infection [63]. …”

Section: Conventional Identification Of Blood Culture Isolatesmentioning

confidence: 99%

Blood Cultures for the Diagnosis of Human Brucellosis

Yagupsky¹

2015

Updates on Brucellosis

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Brucellosis represents a serious health threat to human populations living in areas endemic for the disease. The clinical manifestations of brucellosis are protean and nonspecific, and laboratory confirmation of the diagnosis is crucial for an adequate management of the patient and implementation of infection control measures aimed to control the disease in affected herds. Although brucellosis can be confirmed by serologic tests and nucleic acid amplification assays, culture detection of circulating Brucella organisms remains a diagnostic cornerstone. Traditionally, prolonged incubation of media and performance of blind subcultures of negative blood culture vials have been recommended to maximize isolation of the organism. In recent years, modern automated blood culture systems have revolutionized the diagnosis of human brucellosis by improving sensitivity and enabling detection of brucellae within the routine one-week incubation protocol followed in most Clinical Microbiology laboratories. Development of molecular techniques and mass-spectrometry technology have also shortened the time needed to identify members of the genus, whereas use of biological safety cabinets considerably reduce the risks of contagion to laboratory personnel.

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Biochemical mis-identification of Brucella melitensis and subsequent laboratory-acquired infections

Cited by 58 publications

References 3 publications

A Literature Review of Laboratory-Acquired Brucellosis

A Literature Review of Laboratory-Acquired Brucellosis

16S rRNA gene sequence analysis of a Brucella melitensis infection misidentified as Bergeyella zoohelcum

Blood Cultures for the Diagnosis of Human Brucellosis

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