EVALUATION OF BRUCELLOSIS BY PCR AND PERSISTENCE AFTER TREATMENT IN PATIENTS RETURNING TO THE HOSPITAL FOR FOLLOW-UP

KATHLÈNE S. J. S. M. MAAS KIT Biomedical Research, Amsterdam, The Netherlands; Departments of Microbiology and Pathology, Universidad Peruana Cayetano Heredia, Lima, Peru; Hospital Nacional Daniel Alcides Carrión, Callao, Peru; Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura, Lima, Peru; Department of International Health, Johns Hopkins University, Baltimore, Maryland; Clinica San Borja, Lima, Peru; United States Naval Medical Research Centre Detachment, Lima, Peru.

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MELISSA MÉNDEZ KIT Biomedical Research, Amsterdam, The Netherlands; Departments of Microbiology and Pathology, Universidad Peruana Cayetano Heredia, Lima, Peru; Hospital Nacional Daniel Alcides Carrión, Callao, Peru; Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura, Lima, Peru; Department of International Health, Johns Hopkins University, Baltimore, Maryland; Clinica San Borja, Lima, Peru; United States Naval Medical Research Centre Detachment, Lima, Peru.

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MILAGROS ZAVALETA KIT Biomedical Research, Amsterdam, The Netherlands; Departments of Microbiology and Pathology, Universidad Peruana Cayetano Heredia, Lima, Peru; Hospital Nacional Daniel Alcides Carrión, Callao, Peru; Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura, Lima, Peru; Department of International Health, Johns Hopkins University, Baltimore, Maryland; Clinica San Borja, Lima, Peru; United States Naval Medical Research Centre Detachment, Lima, Peru.

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JENNIE MANRIQUE KIT Biomedical Research, Amsterdam, The Netherlands; Departments of Microbiology and Pathology, Universidad Peruana Cayetano Heredia, Lima, Peru; Hospital Nacional Daniel Alcides Carrión, Callao, Peru; Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura, Lima, Peru; Department of International Health, Johns Hopkins University, Baltimore, Maryland; Clinica San Borja, Lima, Peru; United States Naval Medical Research Centre Detachment, Lima, Peru.

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MARÍA PÍA FRANCO KIT Biomedical Research, Amsterdam, The Netherlands; Departments of Microbiology and Pathology, Universidad Peruana Cayetano Heredia, Lima, Peru; Hospital Nacional Daniel Alcides Carrión, Callao, Peru; Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura, Lima, Peru; Department of International Health, Johns Hopkins University, Baltimore, Maryland; Clinica San Borja, Lima, Peru; United States Naval Medical Research Centre Detachment, Lima, Peru.

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MAXIMILIAN MULDER KIT Biomedical Research, Amsterdam, The Netherlands; Departments of Microbiology and Pathology, Universidad Peruana Cayetano Heredia, Lima, Peru; Hospital Nacional Daniel Alcides Carrión, Callao, Peru; Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura, Lima, Peru; Department of International Health, Johns Hopkins University, Baltimore, Maryland; Clinica San Borja, Lima, Peru; United States Naval Medical Research Centre Detachment, Lima, Peru.

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NILO BONIFACIO KIT Biomedical Research, Amsterdam, The Netherlands; Departments of Microbiology and Pathology, Universidad Peruana Cayetano Heredia, Lima, Peru; Hospital Nacional Daniel Alcides Carrión, Callao, Peru; Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura, Lima, Peru; Department of International Health, Johns Hopkins University, Baltimore, Maryland; Clinica San Borja, Lima, Peru; United States Naval Medical Research Centre Detachment, Lima, Peru.

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MARIA L. CASTAÑEDA KIT Biomedical Research, Amsterdam, The Netherlands; Departments of Microbiology and Pathology, Universidad Peruana Cayetano Heredia, Lima, Peru; Hospital Nacional Daniel Alcides Carrión, Callao, Peru; Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura, Lima, Peru; Department of International Health, Johns Hopkins University, Baltimore, Maryland; Clinica San Borja, Lima, Peru; United States Naval Medical Research Centre Detachment, Lima, Peru.

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JESÚS CHACALTANA KIT Biomedical Research, Amsterdam, The Netherlands; Departments of Microbiology and Pathology, Universidad Peruana Cayetano Heredia, Lima, Peru; Hospital Nacional Daniel Alcides Carrión, Callao, Peru; Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura, Lima, Peru; Department of International Health, Johns Hopkins University, Baltimore, Maryland; Clinica San Borja, Lima, Peru; United States Naval Medical Research Centre Detachment, Lima, Peru.

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ELENA YAGUI KIT Biomedical Research, Amsterdam, The Netherlands; Departments of Microbiology and Pathology, Universidad Peruana Cayetano Heredia, Lima, Peru; Hospital Nacional Daniel Alcides Carrión, Callao, Peru; Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura, Lima, Peru; Department of International Health, Johns Hopkins University, Baltimore, Maryland; Clinica San Borja, Lima, Peru; United States Naval Medical Research Centre Detachment, Lima, Peru.

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ROBERT H. GILMAN KIT Biomedical Research, Amsterdam, The Netherlands; Departments of Microbiology and Pathology, Universidad Peruana Cayetano Heredia, Lima, Peru; Hospital Nacional Daniel Alcides Carrión, Callao, Peru; Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura, Lima, Peru; Department of International Health, Johns Hopkins University, Baltimore, Maryland; Clinica San Borja, Lima, Peru; United States Naval Medical Research Centre Detachment, Lima, Peru.

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ALFREDO GUILLEN KIT Biomedical Research, Amsterdam, The Netherlands; Departments of Microbiology and Pathology, Universidad Peruana Cayetano Heredia, Lima, Peru; Hospital Nacional Daniel Alcides Carrión, Callao, Peru; Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura, Lima, Peru; Department of International Health, Johns Hopkins University, Baltimore, Maryland; Clinica San Borja, Lima, Peru; United States Naval Medical Research Centre Detachment, Lima, Peru.

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DAVID L. BLAZES KIT Biomedical Research, Amsterdam, The Netherlands; Departments of Microbiology and Pathology, Universidad Peruana Cayetano Heredia, Lima, Peru; Hospital Nacional Daniel Alcides Carrión, Callao, Peru; Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura, Lima, Peru; Department of International Health, Johns Hopkins University, Baltimore, Maryland; Clinica San Borja, Lima, Peru; United States Naval Medical Research Centre Detachment, Lima, Peru.

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BENJAMIN ESPINOSA KIT Biomedical Research, Amsterdam, The Netherlands; Departments of Microbiology and Pathology, Universidad Peruana Cayetano Heredia, Lima, Peru; Hospital Nacional Daniel Alcides Carrión, Callao, Peru; Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura, Lima, Peru; Department of International Health, Johns Hopkins University, Baltimore, Maryland; Clinica San Borja, Lima, Peru; United States Naval Medical Research Centre Detachment, Lima, Peru.

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ERIC HALL KIT Biomedical Research, Amsterdam, The Netherlands; Departments of Microbiology and Pathology, Universidad Peruana Cayetano Heredia, Lima, Peru; Hospital Nacional Daniel Alcides Carrión, Callao, Peru; Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura, Lima, Peru; Department of International Health, Johns Hopkins University, Baltimore, Maryland; Clinica San Borja, Lima, Peru; United States Naval Medical Research Centre Detachment, Lima, Peru.

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THERESIA H. ABDOEL KIT Biomedical Research, Amsterdam, The Netherlands; Departments of Microbiology and Pathology, Universidad Peruana Cayetano Heredia, Lima, Peru; Hospital Nacional Daniel Alcides Carrión, Callao, Peru; Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura, Lima, Peru; Department of International Health, Johns Hopkins University, Baltimore, Maryland; Clinica San Borja, Lima, Peru; United States Naval Medical Research Centre Detachment, Lima, Peru.

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HENK L. SMITS KIT Biomedical Research, Amsterdam, The Netherlands; Departments of Microbiology and Pathology, Universidad Peruana Cayetano Heredia, Lima, Peru; Hospital Nacional Daniel Alcides Carrión, Callao, Peru; Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura, Lima, Peru; Department of International Health, Johns Hopkins University, Baltimore, Maryland; Clinica San Borja, Lima, Peru; United States Naval Medical Research Centre Detachment, Lima, Peru.

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DOI:
https://doi.org/10.4269/ajtmh.2007.76.698
Volume/Issue:
Volume 76: Issue 4
Page(s):
698–702
Restricted access
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Polymerase chain reaction (PCR) was applied to confirm the diagnosis of brucellosis and to study its clearance in response to the standard treatment regimen with doxycycline and rifampin at hospitals in Callao and Lima, Peru. The PCR confirmed the diagnosis in 23 (91.7%) patients with brucellosis including 12 culture-confirmed cases. For patients treated at the hospital in Callao, PCR was positive for all samples collected during and at the conclusion of treatment and for 76.9% of follow-up samples collected on average 15.9 weeks after completion of treatment. For patients treated at the hospital in Lima, PCR tests were positive for 81.8% of samples collected during treatment, for 33.3% of samples collected at the conclusion of treatment, and for ≥ 50% of samples collected at first, second, and third post-treatment follow-up. Thus, Brucella DNA may persist in the serum weeks to months after completion of the standard treatment regimen.

Copyright:
Copyright 2007 The American Society of Tropical Medicine 2007
Received:
29 Aug 2006
|
Accepted:
01 Nov 2006
|
Published Online:
Apr 2007
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
  • 1

    Refai M, 2002. Incidence and control of brucellosis in the Near East region. Vet Microbiol 20 :81–110.

  • 2

    Young EJ, 1995a. An overview of human brucellosis. Clin Infect Dis 21 :283–289.

  • 3

    Morgan WTB, McDiarmid A, 1960. The excretion of Brucella abortus in the milk of experimentally infected cattle. Res Vet Sci 1 :53–56.

  • 4

    Nicoletti P, 1980. The epidemiology of bovine brucellosis. Adv Vet Sci Comp Med 24 :69–84.

  • 5

    Guillen A, Navarro AM, Acosta M, Arrelucé M, 1989. Brucellosis epidemiology. In: Annals of the National Seminary of Zoonosis and Diseases of Nourishing Transmission. Lima: Ministry of Health; 48–65.

  • 6

    Young EJ, 1995b. Brucellosis: Current epidemiology, diagnosis, and management. Curr Clin Top Infect Dis 15 :115–128.

  • 7

    Solera J, Rodriguez-Zapata M, Geijo P, Largo J, Paulino J, Saez L, Martinez-Alfaro E, Sanchez L, Sepulveda MA, Ruiz-Ribo MD, 1995. Doxycycline-rifampin versus doxycyclin-streptomycin in treatment of human brucellosis due to Brucella melitensis. Antimicrob Agents Chemother 39 :2061–2067.

    • Search Google Scholar
    • Export Citation
  • 8

    Ariza J, Gudiol F, Pallares R, Viladrich PF, Rufi G, Corredoira J, Miravitlles MR, 1992. Treatment of human brucellosis with doxycycline plus rifampin or doxycycline plus streptomycin. Ann Intern Med 117 :25–30.

    • Search Google Scholar
    • Export Citation
  • 9

    Ersoy Y, Sonmez E, Tevfik MR, But AD, 2005. Comparison of three different combination therapies in the treatment of human brucellosis. Trop Doct 35 :210–212.

    • Search Google Scholar
    • Export Citation
  • 10

    Pappas G, Solera J, Akritidis N, Tsianos E, 2005. New approaches to the antibiotic treatment of brucellosis. Int J Antimicrob Agents 26 :101–105.

    • Search Google Scholar
    • Export Citation
  • 11

    Yagupsky P, 1999. Detection of Brucellae in blood cultures. J Clin Microbiol 37 :3437–3442.

  • 12

    Al Dahouk S, Tomaso H, Nockler K, Neubauer H, Franoulidis D, 2003. Laboratory- based diagnosis of brucellosis—a review of the literature. Part II: Serological tests for brucellosis. Clin Lab 49 :577–589.

    • Search Google Scholar
    • Export Citation
  • 13

    Navarro E, Segura JC, Castano MJ, Solera J, 2006. Use of real-time quantitative polymerase chian reaction to monitor the evoluation of Brucella melitentis DNA load during therapy and post-treatment follow-up in patients with brucellosis. Clin Inf Dis. 42 :1266–1273.

    • Search Google Scholar
    • Export Citation
  • 14

    Baily GG, Krahn JB, Drasar BS, Stoker NG, 1992. Detection of Brucella melitensis and Brucella abortus by DNA amplification. J Trop Med Hyg 95 :271–275.

    • Search Google Scholar
    • Export Citation
  • 15

    Alton GG, Jones LM, Pietz DF, 1975. WHO Laboratory Techniques in Brucellosis. Geneva: World Health Organization.

  • 16

    Smits HL, Abdoel TH, Solera J, Clavijo E, Diaz R, 2003. Immunochromatographic Brucella-specific immunoglobulin M and G lateral flow assays for the serodiagnosis of human brucellosis. Clin Diagn Lab Immunol 10 :1141–1146.

    • Search Google Scholar
    • Export Citation
  • 17

    Navarro E, Casao MA, Solera J, 2004. Diagnosis of human brucellosis using PCR. Expert Rev Mol Diagn 4 :115–123.

  • 18

    Queipo-Ortuno MI, Morata P, Ocon P, Manchado P, Dios Colmenero J, 1997. Rapid diagnosis of human brucellosis by peripheral-blood PCR assay. J Clin Microbiol 35 :2927–2930.

    • Search Google Scholar
    • Export Citation
  • 19

    Matar GM, Khneisser IA, Abdelnoor AM, 1996. Rapid laboratory confirmation of human brucellosis by PCR analysis of a target sequence on the 31-kilodalton Brucella antigen DNA. J Clin Microbiol 34 :477–478.

    • Search Google Scholar
    • Export Citation
  • 20

    Morata P, Queipo-Ortuno MI, Reguera JM, Miralles F, Lopez-Gonzalez JJ, Colmenero JD, 2001. Diagnostic yield of a PCR assay in focal complications of brucellosis. J Clin Microbiol 39 :3743–3746.

    • Search Google Scholar
    • Export Citation
  • 21

    Zerva L, Bourantas K, Mitka S, Kansouzidou A, Legakis NJ, 2001. Serum is the preferred clinical specimen for diagnosis of human brucellosis by PCR. J Clin Microbiol 39 :1661–1664.

    • Search Google Scholar
    • Export Citation
  • 22

    Ariza J, Gudiol F, Pallares R, Rufi G, Fernandez-Viladrich P, 1985. Comparative trial of rifampin-doxycycline versus tetracycline-streptomycin in the therapy of human brucellosis. Antimicrob Agents Chemother 28 :548–551.

    • Search Google Scholar
    • Export Citation
  • 23

    Irmak H, Buzgan T, Evirgen O, Akdeniz H, Pekcan Demiroz A, Abdoel TH, Smits HL, 2004. Use of the Brucella IgM and IgG flow assays in the serodiagnosis of human brucellosis in an area endemic for brucellosis. Am J Trop Med Hyg 70 :688–694.

    • Search Google Scholar
    • Export Citation
  • 24

    Morata P, Queipo-Ortuno MI, Reguera JM, Garcia-Ordonez MA, Pichardo C, Colmenero JD, 1999. Posttreatment follow-up of brucellosis by PCR assay. J Clin Microbiol 37 :4163–4166.

    • Search Google Scholar
    • Export Citation
  • 25

    Elfaki MG, Al-Hokail AA, Nakeeb SM, Al-Rabiah FA, 2005. Evaluation of culture, tube agglutination, and PCR methods for the diagnosis of brucellosis in humans. Med Sci Monit 11 :69–74.

    • Search Google Scholar
    • Export Citation
  • 26

    Buchanan TM, Faber LC, 1980. 2-mercaptoethanol Brucella agglutination test: Usefulness for predicting recovery from brucellosis. J Clin Microbiol 11 :691–693.

    • Search Google Scholar
    • Export Citation
  • 27

    Hasanjani Roushan MR, Mohraz M, Hajiahmadi M, Ramzani A, Valayati AA, 2006. Efficacy of gentamicin plus doxycycline versus streptomycin plus doxycycline in the treatment of brucellosis in humans. Clin Infect Dis 42 :1075–1080.

    • Search Google Scholar
    • Export Citation
  • 28

    Falagas ME, Bliziotis IA, 2006. Quinolones for treatment of human brucellosis: critical review of the evidence from microbiological and clinical studies. Antimicrob Agents Chemother 50 :22–33.

    • Search Google Scholar
    • Export Citation
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