title: Clinical and Diagnostic Aspects of Brucellosis and Antimicrobial Susceptibility of Brucella Isolates in Hamedan, Iran.
abstract: Current drug regimens for brucellosis are associated with relatively high rates of therapeutic failure or relapse. Reduced antimicrobial susceptibility of Brucella spp. has been proposed recently as a potential cause of therapeutic failure. The aim of this study was to evaluate the antibiotic resistance pattern of Brucella melitensis clinical isolates by E-test method in Hamadan, west of Iran. In a 15-month period, all patients with suspected brucellosis were enrolled. Blood specimens were collected for diagnosis of brucellosis by BACTEC system and serological tests. Antimicrobial susceptibility of clinical isolates to 7 antibiotics was assessed by the E-test method. One hundred forty-nine patients with brucellosis were evaluated. 38.3% of cultures of clinical samples were positive for BACTEC system, of which 91.2% were associated with a positive serological test result. No significant associations were found between serology and the culture method. All Brucella isolates were susceptible to doxycycline, streptomycin, gentamicin, ciprofloxacin, and moxifloxacin. However, decreased sensitivity to rifampin and trimethoprim-sulfamethoxazole was found in 35.1% and 3.5% of isolates, respectively. Because of the high rates of intermediate sensitivity to rifampin among Brucella isolates, this drug should be prescribed with caution. We recommend restricting the use of rifampin for treatment of brucellosis except as an alternative drug for special situations.
authors: Brucellosis Research Center, Hamedan University of Medical Sciences.|Blood Transfusion Research Center, High Institute for Research; Education in Transfusion.
authors: Fatemeh
authors: F
authors: Torkaman Asadi
authors: Brucellosis Research Center, Hamedan University of Medical Sciences.|Division of Infectious Diseases, Sina Hospital.
authors: Seyyed Hamid
authors: SH
authors: Hashemi
authors: Brucellosis Research Center, Hamedan University of Medical Sciences.
authors: Mohammad Yousef
authors: MY
authors: Alikhani
authors: Brucellosis Research Center, Hamedan University of Medical Sciences.
authors: Abbas
authors: A
authors: Moghimbeigi
authors: Blood Transfusion Research Center, High Institute for Research; Education in Transfusion.
authors: Zahra
authors: Z
authors: Naseri
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D017347:Brucella melitensis / Q000187:drug effects* / Q000302:isolation & purification; D002006:Brucellosis / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology* / Q000473:pathology; D002648:Child; D052978:Disk Diffusion Antimicrobial Tests; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: E-test; brucellosis; drug resistance