Brucella Infections: Assessment And Management

Abstract

The causative agent of brucellosis was discovered in 1887 by David Bruce, who was a physician in British military corps in Malta. Vehicles for animal to human transmission are unpasteurized milk, milk products, and raw meat; whereas human to human transmission occurs by means of blood, exudate, genital secretions (during sexual intercourse or birth), and human milk. Brucella escapes the lysosomal enzyme killing of macrophages by altering the intracellular environment. Brucella causes protean clinical manifestations ranging from fever to behavioral changes. Any organ may be involved. Diagnosis is made in a patient with clinical findings consistent with brucellosis and a definitive test, such as bacterial culture or serum agglutination test. Therapy is a combination of tetracyclines, co-trimoxasole, aminoglycosides, and rifampin. For laboratory workers who have inadvertently been exposed to Brucella, chemoprophylaxis is recommended. As of today, no human vaccine, that is sufficiently effective and safe, exists for Brucella - a potential bioweapon.

Keywords

• Brusella vaccine,Brucella canis,Brucella melitensis,Brucella suis,brucellosis

Brusella Enfeksiyonları: Değerlendirme Ve Yönetim

Abstract

Brusella enfeksiyonunun etkeni, 1887'de Malta'daki Britanya askeri birliklerinde bir hekim olarak çalışan David Bruce tarafından saptanmıştır. Bruselloz, dünyadaki en yaygın zoonoz olup her yıl 500 000 vaka bildirilmektedir. Türkiye'deki insidansı 12-50/100 000'dir. Brusella bütünlüğü bozulmuş ciltten, mukozadan, plasentadan geçerek ve solunum yoluyla bulaşabilir. Bulaşma araçları hayvanlardan insana, pastörize edilmemiş çiğ süt ve ürünleri ile az pişmiş et; insandan insana ise kan, eksuda, genital salgılar (cinsel ilişki, doğum kanalından geçiş sırasında) ve anne sütüdür. Brusella, makrofajların lizozomal enzimlerinden hücre içi ortamını değiştirerek korunur ve yüksek ateşten davranış değişikliklerine uzanan geniş bir yelpazede klinik bulgulara neden olur. Bütün organlar tutulabilir. Brusellozun tanısı, brusellozla uyumlu bulguları olan bir hastada bakteri kültürü veya serum aglütinasyon testi gibi doğrulayıcı testlerle konur. Tedavide tetrasiklinler, kotrimoksazol, aminoglikozitler ve rifampinin çeşitli kombinasyonları kullanılmaktadır. Laboratuar çalışanlarının brusellaya yanlışlıkla maruz kalmaları durumunda kemoprofilaksi önerilmektedir. Potansiyel bir biyosilah olan brusellanın şu an için yeterince etkili ve güvenli bir aşısı yoktur.

Keywords

• Brusella aşısı,Brucella canis,Brucella melitensis,Brucella suis,bruselloz

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