Laboratory-Acquired Brucellosis: A Case Report

Öz

Brucellosis, caused by intracellular bacteria of the Brucella genus, is one of the most neglected zoonotic infections globally. Transmission primarily occurs through the are consumption of contaminated milk and dairy products and occupational exposure to infected animals or their biological products. Therefore, livestock breeders, veterinarians and laboratory personnel working with clinical materials containing highly contagious pathogens are among the most risky occupational groups in terms of brucellosis. Despite ranking among the most common laboratory-acquired infections due to its low infectious dose, high potential for aerosolization, and insufficient awareness among laboratory personnel, the number of reported laboratory-acquired brucellosis cases remains notably low in our country, where the disease is endemic. In this study, a case of brucellosis acquired in the laboratory setting by a laboratory technician, exhibiting a clear occupational origin was presented.

Anahtar Kelimeler

• Laboratory-Acquired infection
• Brucellosis
• Brucella spp.
• Occupational exposure

Laboratuvar Kaynaklı Bruselloz: Bir Olgu Sunumu

Öz

Brucella cinsi intrasellülar bakterilerin neden olduğu Bruselloz, küresel düzeyde yaygın görülen ihmal edilmiş zoonotik enfeksiyonlardandır. Başlıca bulaş yolları olarak; kontamine süt ve süt ürünlerinin tüketilmesi, enfekte hayvanlarla veya onların biyolojik ürünleriyle mesleki maruziyet sonucu meydana gelebilmektedir. Bu nedenle hayvancılıkla uğraşanlar, veteriner hekimler ve klinik laboratuvarlarda bulaşıcılığı yüksek patojeler içeren klinik materyallerle çalışan laboratuvar personeli bruselloz açısından en riskli meslek gruplarındandır. Düşük enfektif doz, kolayca aerosolize olması ve laboratauvar personelinin bu patojen hakkında yeterli bilgiye sahip olmaması gibi bulaş riskini arttıran nedenlerle laboratuvar kaynaklı en yaygın enfeksiyonlar arasında ilk sırada yer almasına rağmen, brusellozun endemik olarak görüldüğü ülkemizde bildirilen laboratuvar kaynaklı olguların sayısı oldukça azdır. Bu çalışmada bir laboratuvar teknikerinde güçlü bir mesleki karakter sergileyen ve laboratuvar ortamında kazanılmış bir bruselloz olgusu sunulmuştur.

Anahtar Kelimeler

• Laboratuvar kaynaklı enfeksiyon
• Bruselloz
• Brucella spp.
• Mesleki maruziyet

Kaynakça

1. 1. Pereira CR, Cotrim de Almeida JVF, Cardoso de Oliveira IR, Faria de Oliveira L, Pereira LJ, Zangerônimo MG, et al. Occupational exposure to Brucella spp: a systematic review and metaanalysis. PLoS Negl Trop Dis. 2020 May 11;14(5):e0008164.
2. 2. Kurmanov B, Zincke D, Su W, Hadfield TL, Aikimbayev A, Karibayev T, et al. Assays for identification and differentiation of Brucella species: a review. Microorganisms. 2022 Aug 6;10(8):1584.
3. 3. Gultekin E, Uyanik MH, Albayrak A, Kilic S. Investigation of antibiotic susceptibilities of Brucella strains isolated from various clinical samples in eastern Turkiye. Eur J Med Res. 2021 Dec 16;26(1):57.
4. 4. El-Sayed A, Awad W. Brucellosis: evolution and expected comeback. Int J Vet Sci Med. 2018;6(Suppl 1):S31–5.
5. 5. Yagupsky P, Morata P, Colmenero JD. Laboratory diagnosis of human brucellosis. Clin Microbiol Rev. 2019 Dec 18;33(1):e00039-19.
6. 6. Yagupsky P, Baron EJ. Laboratory exposures to brucellae and implications for bioterrorism. Emerg Infect Dis. 2005 Aug;11(8):1180–5.
7. 7. Sewell DL. Laboratory-associated infections and biosafety. Clin Microbiol Rev. 1995 Jul;8(3):389–405.
8. 8. Centers for Disease Control and Prevention. Assessing laboratory risk level and PEP 2025.

9. 9. Turkiye Cumhuriyeti Saglik Bakanligi, Hayvan Sagligi Genel Mudurlugu, Zoonotik ve Vektorel Hastaliklar Dairesi Baskanligi. Current situation report of brucellosis in Turkiye. Ankara: T.C. Saglik Bakanligi; 2024.
10. 10. Martin-Mazuelos E, Nogales MC, Florez C, Gómez-Mateos JM, Lozano F, Sanchez A. Outbreak of Brucella melitensis among microbiology laboratory workers. J Clin Microbiol. 1994 Aug;32(8):2035–6.
11. 11. Sayin-Kutlu S, Kutlu M, Ergonul O, Akalin S, Guven T, Demiroglu YZ, et al. Laboratoryacquired brucellosis in Turkiye. J Hosp Infect. 2012 Apr;80(4):326–30.
12. 12. Fiori PL, Mastrandrea S, Rappelli P, Cappuccinelli P. Brucella abortus infection acquired in microbiology laboratories. J Clin Microbiol. 2000 May;38(5):2005–6.
13. 13. Gruner E, Bernasconi E, Galeazzi RL, Buhl D, Heinzle R, Nadal D. Brucellosis: an occupational hazard for medical laboratory personnel. Report of five cases. Infection. 1994 Jan;22(1):33–6.
14. 14. Bouza E, Sanchezcarrillo C, Hernangomez S, Josegonzalez M. Laboratory-acquired brucellosis: a Spanish national survey. J Hosp Infect. 2005 Sep;61(1):80–3.
15. 15. Ollé-Goig JE, Canela-Soler J. An outbreak of Brucella melitensis infection by airborne transmission among laboratory workers. Am J Public Health. 1987 Mar;77(3):335–8.
16. 16. Staszkiewicz J, Lewis CM, Colville J, Zervos M, Band J. Outbreak of Brucella melitensis among microbiology laboratory workers in a community hospital. J Clin Microbiol. 1991 Feb;29(2):287–90.
17. 17. Memish ZA, Mah MW. Brucellosis in laboratory workers at a Saudi Arabian hospital. Am J Infect Control. 2001 Feb;29(1):48–52.
18. 18. Traxler RM, Lehman MW, Bosserman EA, Guerra MA, Smith TL. A literature review of laboratory-acquired brucellosis. J Clin Microbiol. 2013 Sep;51(9):3055–62.
19. 19. Liu Z. Laboratory-acquired Brucella infection and S2 vaccine infection events in China. Authorea Preprints. 2020.
20. 20. Zavaleta-Monestel E, Rojas-Chinchilla C, Anchía-Alfaro A, Quesada-Loría D, GarcíaMontero J, Arguedas-Chacón S, et al. Tracking the threat, 50 years of laboratory-acquired infections: a systematic review. Acta Microbiol Hell. 2025;70(2):11.
21. 21. Ozaras R, Celik AD, Demirel A. Acute hepatitis due to brucellosis in a laboratory technician. Eur J Intern Med. 2004 Jul;15(4):264.
22. 22. Demirdal T, Demirturk N. Laboratory-acquired brucellosis. Ann Acad Med Singap. 2008 Jan;37(1):86–7.
23. 23. Ergonul O, Celikbas A, Tezeren D, Guvener E, Dokuzoguz B. Analysis of risk factors for laboratory-acquired brucella infections. J Hosp Infect. 2004 Mar;56(3):223–7.
24. 24. Toplu SA, Yilmaz F. Laboratuvar kaynakli bruselloz: bir olgu sunumu. J Turgut Ozal Med Cent. 2014;21(3):235–6.
25. 25. Gonen I, Kaya O, Sozen H. Laboratory acquired brucellosis: a report of two cases. Turk Bull Hyg Exp Biol. 2014;71(3):141–6.
26. 26. Sayar MS, Bulut D, Haykir Solay A. Two cases of laboratory acquired brucellosis. Mediterr J Infect Microbes Antimicrob. 2018 Jan;7(1):32-32.
27. 27. Sahin IH, Koruk ST. Laboratuvar kaynakli bruselloz olgusu. In: XVII. Turk Klinik Mikrobiyoloji ve Enfeksiyon Hastaliklari Kongresi (Klimik 2015); 2015 Mar; Antalya, Turkiye.