year 17, Issue 6 (November - December 2023)                   Iran J Med Microbiol 2023, 17(6): 620-628 | Back to browse issues page

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1- Infectious Diseases and Tropical Medicine Research Center (IDTMRC), Aja university of Medical Sciences, Tehran, Iran
2- Department of Infectious Diseases and Tropical Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3- Department of General Medicine, Faculty of Medicine, Aja university of Medical Sciences, Tehran, Iran
4- Infectious Diseases and Tropical Medicine Research Center (IDTMRC), Aja university of Medical Sciences, Tehran, Iran ,
Abstract:   (608 Views)

Background and Aim: Effective brucellosis treatment necessitates antibiotics that can penetrate macrophages. This study systematic review and meta-analysis aimed at assessing the antibiotic susceptibility profile of Brucella spp. isolated from humans, addressing this critical gap in understanding Brucella infections and their treatment.
Materials and Methods: Two authors conducted a systematic search across PubMed, Web of Science, and Scopus, with no time restrictions, encompassing English studies. Data extraction employed a standardized sheet, with two independent authors, and disagreements were resolved by a third. The data sheet included study characteristics and susceptibility/resistance information for various antibiotics. Statistical analysis involved random effects models, Mantel-Haenszel methods, I2 tests, z-tests, and funnel plots using R and RStudio.
Results: Based on the pooled susceptibility ratios, among the 630 samples of Brucella spp., 98% (95% CI: 85% - 100%) were susceptible to trimethoprim. Among the 1255 samples of Brucella spp., 82% (95% CI: 54% - 95%) were susceptible to rifampicin. Among the 1344 samples of Brucella spp., 100% (95% CI: 78% - 100%) were susceptible to doxycycline. Among the 942 samples of Brucella spp., 100% (95% CI: 85% - 100%) were susceptible to tetracycline. Among the 893 samples of Brucella spp., 100% (95% CI: 82% - 100%) were susceptible to ciprofloxacin. Among the 906 samples of Brucella spp., 97% (95% CI: 96% - 98%) were susceptible to gentamicin.
Conclusion: Based on our results, trimethoprim, doxycycline, tetracycline, ciprofloxacin, and gentamicin were effective, but rifampicin had lower susceptibility. This informs antibiotic selection for Brucella infections, underscoring its importance in managing the disease.

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Type of Study: Meta-analysis Article | Subject: Antibiotic Resistance
Received: 2023/10/7 | Accepted: 2024/01/9 | ePublished: 2024/01/29

1. Yang XW, Wang YZ, Li JQ, Chen JJ, Liu JY, Tian GZ, et al. Genetic characteristics of an amikacin-resistant Brucella abortus strain first isolated from Marmota himalayana. Microb Pathog. 2022;164:105402. [DOI:10.1016/j.micpath.2022.105402] [PMID]
2. Tscherne A, Mantel E, Boskani T, Budniak S, Fasanella A, Feruglio SL, et al. Adaptation of Brucella melitensis Antimicrobial Susceptibility Testing to the ISO 20776 Standard and Validation of the Method. Microorganisms. 2022;10(7):1470. [DOI:10.3390/microorganisms10071470] [PMID] [PMCID]
3. Sheng X, Lu W, Li A, Lu J, Song C, Xu J, et al. ANT(9)-Ic, a Novel Chromosomally Encoded Aminoglycoside Nucleotidyltransferase from Brucella intermedia. Microbiol Spectr. 2023;11(3):e00620-23. [DOI:10.1128/spectrum.00620-23] [PMID] [PMCID]
4. Ma HR, Xu HJ, Wang X, Bu ZY, Yao T, Zheng ZR, et al. Molecular characterization and antimicrobial susceptibility of human Brucella in Northeast China. Front Microbiol. 2023;14:1137932. [DOI:10.3389/fmicb.2023.1137932] [PMID] [PMCID]
5. Dadar M, Alamian S, Brangsch H, Elbadawy M, Elkharsawi AR, Neubauer H, Wareth G. Determination of Virulence-Associated Genes and Antimicrobial Resistance Profiles in Brucella Isolates Recovered from Humans and Animals in Iran Using NGS Technology. Pathogens. 2023;12(1):82. [DOI:10.3390/pathogens12010082] [PMID] [PMCID]
6. Celik E, Kayman T, Buyuk F, Saglam AG, Abay S, Akar M, et al. The canonical Brucella species-host dependency is changing, however, the antibiotic susceptibility profiles remain unchanged. Microbial Pathogenesis. 2023;182:106261. [DOI:10.1016/j.micpath.2023.106261] [PMID]
7. Manafe RP, Bhembe-Magadaza NL, Green E. Antibiogram Screening and Detection of Virulence-Associated Genes in Brucella Species Acquired from Cattle in South Africa's Eastern Cape Province. Int J Environ Res Public Health. 2022;19(5):2813. [DOI:10.3390/ijerph19052813] [PMID] [PMCID]
8. Elbehiry A, Aldubaib M, Al Rugaie O, Marzouk E, Abaalkhail M, Moussa I, et al. Proteomics-based screening and antibiotic resistance assessment of clinical and sub-clinical Brucella species: An evolution of brucellosis infection control. PLoS One. 2022;17(1):e0262551. [DOI:10.1371/journal.pone.0262551] [PMID] [PMCID]
9. Arapović J, Kompes G, Dedić K, Teskeredžić S, Ostojić M, Travar M, et al. Antimicrobial resistance profiles of human Brucella melitensis isolates in three different microdilution broths: the first multicentre study in Bosnia and Herzegovina. J Glob Antimicrob Resist. 2022;29:99-104. [DOI:10.1016/j.jgar.2022.02.005] [PMID]
10. Wareth G, El-Diasty M, Abdel-Hamid NH, Holzer K, Hamdy MER, Moustafa S, et al. Molecular characterization and antimicrobial susceptibility testing of clinical and non-clinical Brucella melitensis and Brucella abortus isolates from Egypt. One Health. 2021;13:100255. [DOI:10.1016/j.onehlt.2021.100255] [PMID] [PMCID]
11. Gültekin E, Uyanık MH, Albayrak A, Kılıç S. Investigation of antibiotic susceptibilities of Brucella Strains isolated from various clinical samples in eastern Turkey. Eur J Med Res. 2021;26(1):57. [DOI:10.1186/s40001-021-00527-5] [PMID] [PMCID]
12. Yuan HT, Wang CL, Liu LN, Wang D, Li D, Li ZJ, Liu ZG. Epidemiologically characteristics of human brucellosis and antimicrobial susceptibility pattern of Brucella melitensis in Hinggan League of the Inner Mongolia Autonomous Region, China. Infect Dis Poverty. 2020;9(1):79. [DOI:10.1186/s40249-020-00697-0] [PMID] [PMCID]
13. Alamian S, Dadar M, Etemadi A, Afshar D, Alamian MM. Antimicrobial susceptibility of Brucella spp. isolated from Iranian patients during 2016 to 2018. Iran J Microbiol. 2019;11(5):363-7. [DOI:10.18502/ijm.v11i5.1953] [PMID] [PMCID]
14. Mani SSR, Gunasekaran K, Iyyadurai R, Prakash JAJ, Veeraraghavan B, Mishra AK, et al. Clinical spectrum, susceptibility profile, treatment and outcome of culture-confirmed brucellosis from South India. Indian J Med Microbiol. 2018;36(2):289-92. [DOI:10.4103/ijmm.IJMM_18_236] [PMID]
15. Liu ZG, Di DD, Wang M, Liu RH, Zhao HY, Piao DR, et al. In vitro antimicrobial susceptibility testing of human Brucella melitensis isolates from Ulanqab of Inner Mongolia, China. BMC Infect Dis. 2018;18(1):43. [DOI:10.1186/s12879-018-2947-6] [PMID] [PMCID]
16. Farazi A, Hoseini SD, Ghaznavirad E, Sadekhoo S. Antibiotic Susceptibility of Brucella Melitensis in Markazi Province of Iran. Int J Infect Dis. 2018;73:124. [DOI:10.1016/j.ijid.2018.04.3697]
17. Torkaman Asadi F, Hashemi SH, Yousef Alikhani M, Moghimbeigi A, Naseri Z. Clinical and diagnostic aspects of brucellosis and antimicrobial susceptibility of brucella isolates in Hamedan, Iran. Jpn J Infect Dis. 2017;70(3):235-8. [DOI:10.7883/yoken.JJID.2016.133] [PMID]
18. Shevtsov A, Syzdykov M, Kuznetsov A, Shustov A, Shevtsova E, Berdimuratova K, et al. Antimicrobial susceptibility of Brucella melitensis in Kazakhstan. Antimicrob Resist Infect Control. 2017;6:130. [DOI:10.1186/s13756-017-0293-x] [PMID] [PMCID]
19. Reza Irajian G, Masjedian Jazi F, Mirnejad R, Piranfar V, Zahraei Salehi T, Amir Mozafari N, et al. Species-specific PCR for the diagnosis and determination of antibiotic susceptibilities of brucella strains Isolated from Tehran, Iran. Iran J Pathol. 2016;11(3):238-47.
20. Razzaghi R, Rastegar R, Momen-Heravi M, Erami M, Nazeri M. Antimicrobial susceptibility testing of Brucella melitensis isolated from patients with acute brucellosis in a centre of Iran. Indian J Med Microbiol. 2016;34(3):342-5. [DOI:10.4103/0255-0857.188336] [PMID]
21. Hashemi SH, Alikhani MY, Asadi FT, Naseri Z. Antibiotic susceptibility pattern of Brucella melitensis clinical isolates in Hamedan, West of Iran. Int J Infect Dis. 2016;45:91-2. [DOI:10.1016/j.ijid.2016.02.244]
22. Abdel-Maksoud M, House B, Wasfy M, Abdel-Rahman B, Pimentel G, Roushdy G, Dueger E. In vitro antibiotic susceptibility testing of Brucella isolates from Egypt between 1999 and 2007 and evidence of probable rifampin resistance. Ann Clin Microbiol Antimicrob. 2012;11:24. [DOI:10.1186/1476-0711-11-24] [PMID] [PMCID]
23. Al-Afifi AH, Alewy Almashhadany D, Al-Azazi ASH, Khalaf AM, Naji Ahmed Odhah M, Al-Gabri NA. Prevalence of Brucella spp. in milk from aborted and non-aborted animals in Dhamar governorate, Yemen. Ital J Food Saf. 2022;11(4):10370. [DOI:10.4081/ijfs.2022.10370] [PMID] [PMCID]
24. Lama M, Chanakya PP, Khamari B, Peketi ASK, Kumar P, Muddu GK, et al. Genomic analysis of a multidrug-resistant Brucella anthropi strain isolated from a 4-day-old neonatal sepsis patient. J Glob Antimicrob Resist. 2021;26:227-9. [DOI:10.1016/j.jgar.2021.06.013] [PMID]
25. Castillo-Zeledón A, Ruiz-Villalobos N, Altamirano-Silva P, Chacón-Díaz C, Barquero-Calvo E, Chaves-Olarte E, Guzmán-Verri C. A Sinorhizobium meliloti and Agrobacterium tumefaciens ExoR ortholog is not crucial for Brucella abortus virulence. PLoS ONE. 2021;16(8):e0254568. [DOI:10.1371/journal.pone.0254568] [PMID] [PMCID]
26. Yang XW, Piao DR, Mao LL, Pang B, Zhao HY, Tian GZ, et al. Whole-genome sequencing of roughBrucella melitensisin China provides insights into its genetic features. Emerg Microbes Infect. 2020;9(1):2147-56. [DOI:10.1080/22221751.2020.1824549] [PMID] [PMCID]
27. Sofi-Mahmudi A, Masinaei M, Shamsoddin E, Tovani-Palone MR, Heydari M-H, Shoaee S, et al. Global, regional, and national burden and quality of care index (QCI) of lip and oral cavity cancer: a systematic analysis of the Global Burden of Disease Study 1990-2017. BMC Oral Health. 2021;21(1):1-11. [DOI:10.1186/s12903-021-01918-0] [PMID] [PMCID]
28. Khan S, Akhtar MU, Khan S, Javed F, Khan AA. Nanoniosome-encapsulated levoflaxicin as an antibacterial agent against Brucella. J Basic Microbiol. 2020;60(3):281-90. [DOI:10.1002/jobm.201900454] [PMID]
29. del Villar-Perez VM, Barreras-Serrano A, Tamayo-Sosa AR, Tinoco-Gracia L, Melgarejo T. Evaluation of the antimicrobial activity of the K9CATH peptides of 21 and 38 amino acids against Brucella abortus and Brucella melitensis. Thai J Vet Med. 2020;50(4):593-7. [DOI:10.56808/2985-1130.3067]
30. Aslam M, Shehroz M, Shah M, Khan MA, Afridi SG, Khan A. Potential druggable proteins and chimeric vaccine construct prioritization against Brucella melitensis from species core genome data. Genomics. 2020;112(2):1734-45. [DOI:10.1016/j.ygeno.2019.10.009] [PMID]
31. Shoaee S, Masinaei M, Moghaddam SS, Sofi-Mahmudi A, Hessari H, Shamsoddin E, et al. National and Subnational Trend of Dental Caries of Permanent Teeth in Iran, 1990-2017. Int Dent J. 2023;74(1):129-37. [DOI:10.1016/j.identj.2023.07.012] [PMID] [PMCID]
32. Liu ZG, Cao XA, Wang M, Piao DR, Zhao HY, Cui BY, et al. Whole-Genome Sequencing of a Brucella melitensis Strain (BMWS93) Isolated from a Bank Clerk and Exhibiting Complete Resistance to Rifampin. Microbiol Resour Announc. 2019;8(33):e01645. [DOI:10.1128/MRA.01645-18] [PMID] [PMCID]
33. Khan AU, Shell WS, Melzer F, Sayour AE, Ramadan ES, Elschner MC, et al. Identification, Genotyping and Antimicrobial Susceptibility Testing of Brucella spp. Isolated from Livestock in Egypt. Microorganisms. 2019;7(12):603. [DOI:10.3390/microorganisms7120603] [PMID] [PMCID]
34. Cama BAV, Ceccarelli M, Rullo EV, Ferraiolo F, Paolucci IA, Maranto D, et al. Outbreak of Brucella melitensis infection in Eastern Sicily: Risk factors, clinical characteristics and complication rate. New Microbiol. 2019;42(1):43-8.
35. Moscowchi A, Moradian-Lotfi S, Koohi H, Sarrafan Sadeghi T. Levels of smoking and outcome measures of root coverage procedures: a systematic review and meta-analysis. Oral Maxillofac Surg. 2023. [DOI:10.1007/s10006-023-01172-4] [PMID]
36. Trott DJ, Abraham S, Adler B. Antimicrobial Resistance in Leptospira, Brucella, and Other Rarely Investigated Veterinary and Zoonotic Pathogens. Microbiol Spectr. 2018;6(4):A11. [DOI:10.1128/microbiolspec.ARBA-0029-2017] [PMID]
37. Singh DK, Kumar B, Shrinet G, Singh RP, Das A, Mantur BG, et al. Draft genome sequence of field isolate Brucella melitensis strain 2007BM/1 from India. J Glob Antimicrob Resist. 2018;13:152-3. [DOI:10.1016/j.jgar.2018.04.008] [PMID]
38. Monti SM, Meccariello A, Ceruso M, Szafrański K, Sławiński J, Supuran CT. Inhibition studies of Brucella suis β-carbonic anhydrases with a series of 4-substituted pyridine-3-sulphonamides. J Enzyme Inhib Med Chem. 2018;33(1):255-9. [DOI:10.1080/14756366.2017.1413097] [PMID] [PMCID]
39. Shoaee S, Saeedi Moghaddam S, Masinaei M, Sofi-Mahmudi A, Hessari H, Heydari M-H, et al. Trends in dental caries of deciduous teeth in Iran: a systematic analysis of the national and sub-national data from 1990 to 2017. BMC Oral Health. 2022;22(1):634. [DOI:10.1186/s12903-022-02634-z] [PMID] [PMCID]
40. Basyony AF, Aboulwafa MM, Hafez MM, Abou-Gazia KAS. Antimicrobial susceptibility profile, Adherence and invasion to mammalian cells of Brucella melitensis isolates. Pak J Pharm Sci. 2018;31(6):2379-90.
41. Zuo SW, Ni ZL, Yao YB, Yang RS, Wang SK, Zhou YH. [Study on antimicrobial susceptibility of Brucella in a city]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2017;35(12):939-41.
42. Qian J, Bu Z, Lang X, Yan G, Yang Y, Wang X, Wang X. A safe and molecular-tagged Brucella canis ghosts confer protection against virulent challenge in mice. Vet Microbiol. 2017;204:121-8. [DOI:10.1016/j.vetmic.2017.04.027] [PMID]
43. Monti SM, Meccariello A, Ceruso M, Szafranski K, Slawinski J, Supuran CT. Inhibition studies of Brucella suis beta-carbonic anhydrases with a series of 4-substituted pyridine-3-sulphonamides. J Enzyme Inhib Med Chem. 2017;33(1):255. [DOI:10.1080/14756366.2017.1413097] [PMID] [PMCID]
44. Mortazavi H, Sadeghian A, Hazrati P, Heydari M-H, Madihi S. Oral hemorrhagic blister and its possible related factors: Analyses of reported cases in the literature. J Oral Maxillofac Surg Med Pathol. 2023;35(4):358-67. [DOI:10.1016/j.ajoms.2022.12.009]
45. Khazaei Z, Najafi A, Piranfar V, Mirnejad R. Microarray-based long oligonucleotides probe designed for Brucella Spp. detection and identification of antibiotic susceptibility pattern. Electron Physician. 2016;8(4):2297-303. [DOI:10.19082/2296] [PMID] [PMCID]
46. Wu T, Wang S, Wang Z, Peng X, Lu Y, Wu Q. A multicopper oxidase contributes to the copper tolerance of Brucella melitensis 16M. FEMS Microbiol Lett. 2015;362(12):fnv078. [DOI:10.1093/femsle/fnv078]
47. Maansi M, Upadhyay AK. Antibiotic susceptibility of smooth Brucella Abortus S99 and rough Brucella Melitensis B115 strains. Indian Vet J. 2015;92(7):80-1.
48. Deshmukh A, Hagen F, Sharabasi OA, Abraham M, Wilson G, Doiphode S, et al. In vitro antimicrobial susceptibility testing of human Brucella melitensis isolates from Qatar between 2014 - 2015. BMC Microbiol. 2015;15:121. [DOI:10.1186/s12866-015-0458-9] [PMID] [PMCID]
49. Shoaee S, Rezaie F, Payab M, Bakhtiari F, Heydari M-H. Experiences from the management of COVID-19 pandemic in a nursing home in Iran (March-April, 2020). J Diabetes Metab Disord. 2022;21(1):1195-9. [DOI:10.1007/s40200-022-01005-3] [PMID] [PMCID]

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